PTSD: A controlled trial (Brom et al., 2017) reported in the Journal of Traumatic Stress involved 33 patients receiving 15 weekly sessions of Somatic Experiencing and 30 patients in a waitlist control group. Participants receiving Somatic Experiencing reported a significant decrease in the severity of PTSD symptoms and depression compared to the control group.

A systematic analysis of 16 studies on Somatic Experiencing (Kuhfuß et al., 2021) reported in the European Journal of Psychotraumatology found preliminary evidence supporting its effectiveness in reducing PTSD-related symptoms, as well as improvements in affective and somatic symptoms and overall well-being.

A systematic review by (de Sousa et al., 2020) reported in the Journal Estudos de Psicologia focused on somatic interventions for PTSD, including SE, brainspotting, yoga and meditation. The somatic approaches presented in this review showed a positve impact on complementary treatments producing perceptible physiological, psychological and behavioral results. The effects were better with SE and brainspotting (between 80% and 90%), which were found to have the greater potential for PTSD treatment.

Depression: A controlled trial of body psychotherapy (Röhricht et al., 2013) reported in the Journal of Affect Disorders involved 21 patients with chronic depression who had more than 2 years of symptoms and had not responded well to standard treatments, against a waiting control group of 10. Body psychotherapy was manualized and delivered in small groups for 20 sessions over a 10 weeks period. Participants receiving body psychotherapy showed significant improvements in depression symptoms compared to those receiving treatment as usual.

Low-back pain & PTSD: A controlled clinical trial (Andersen et al., 2017) reported in the European Journal of Psychotraumatology involved 91 patients with chronic low-back pain and comorbid PTSD. Half received treatment as usual involving 4–12 sessions of supervised exercises for low back pain while the other half received an additional 6-12 sessions of Somatic Experiencing. The group receiving SE experienced a significant reduction in PTSD symptoms and fear of movement and improvements in physical functioning over the control group at a one-year follow-up.

Low back pain & PTSD, full-length protocol: A second randomized controlled trial (Andersen et al., 2020) reported in the European Journal of Psychotraumatology randomized 114 patients with chronic low back pain and comorbid posttraumatic stress symptoms to a 12-session Somatic Experiencing program plus physiotherapy or physiotherapy alone. Both groups achieved a 20 to 27% reduction in pain-related disability at 6 and 12 months and a small reduction in posttraumatic symptoms, with no significant differences between groups.

Disaster survivors: A field study (Leitch, 2007) reported in Traumatology delivered one to two Somatic Experiencing-based sessions to tsunami survivors in Thailand. Immediately after treatment, 67% showed complete or partial improvement in reported symptoms, and one year later 90% of the 22 participants who could be located reported maintaining that improvement. A larger field study (Parker et al., 2008) reported in Traumatology treated 150 tsunami survivors in southern India with one or two SE sessions; at 8-month follow-up, 90% reported significant improvement or complete resolution of intrusion, arousal, and avoidance symptoms.

Frontline workers: A quasi-experimental study (Leitch et al., 2009) reported in Social Work evaluated brief Somatic Experiencing treatment for social service workers after Hurricanes Katrina and Rita. Workers who received the intervention showed reduced PTSD symptoms and improved resilience compared with a similar group that did not receive treatment, and the gains were maintained at four-month follow-up while participants continued working in post-disaster conditions.

Cancer-related trauma: A controlled pilot (Vagnini et al., 2023) reported in the International Journal of Environmental Research and Public Health assigned 35 breast cancer survivors to eight weeks of web-based group Somatic Experiencing sessions (n = 21) or a control group (n = 14). The SE group showed decreases in anxiety, depression, distress, and anxious preoccupation, and improvements in forward-focus coping and body image, while controls worsened on hopelessness/helplessness and avoidance coping.

Other body psychotherapies: A meta analysis (Rosendahl et al., 2021) reported in Frontiers of Psychiatry reviewed 18 controlled studies of body psychotherapies including functional relaxation, dance/movement therapy, concentrative movement therapy, and body psychotherapy approaches inspired by Reichian methods. It found that body psychotherapies significantly reduced symptoms of psychological distress, such as depression, anxiety, and somatization.

Case Studies: Two case studies involving a man (Payne et al., 2015), and a woman (Bonzon, 2013), showed SE to be an effective approach to help reduce dysregulation and the use of medication.

References

Andersen, T. E., Lahav, Y., Ellegaard, H., & Manniche, C. (2017). A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms. European Journal of Psychotraumatology, 8(1), 1331108. https://doi.org/10.1080/20008198.2017.1331108

Andersen, T. E., Ellegaard, H., Schiøttz-Christensen, B., Mejldal, A., & Manniche, C. (2020). Somatic Experiencing® for patients with low back pain and comorbid posttraumatic stress symptoms – a randomised controlled trial. European Journal of Psychotraumatology, 11(1), 1797306. https://doi.org/10.1080/20008198.2020.1797306

Bonzon, R. (2013). Intervenção da experiência somática em caso de TEPT complexo. In C. P. Rossi & L. Netto (Eds.), Práticas psicoterápicas e resiliência: diálogos com a experiência somática (pp. 246-261). São Paulo: Scortecci.

Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic Experiencing for Posttraumatic Stress Disorder: A Randomized Controlled Outcome Study. Journal of Traumatic Stress, 30(3), 304–312.

de Sousa, A. (2020). A systematic review of somatic intervention treatments in PTSD: Does Somatic Experiencing® (SE) have the potential to be a suitable choice? Archives of Mental Health, 21(4), 121–130.

Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing: Effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), 1929023. https://doi.org/10.1080/20008198.2021.1929023

Leitch, M. L. (2007). Somatic Experiencing treatment with tsunami survivors in Thailand: Broadening the scope of early intervention. Traumatology, 13(3), 11–20.

Leitch, M. L., Vanslyke, J., & Allen, M. (2009). Somatic Experiencing treatment with social service workers following Hurricanes Katrina and Rita. Social Work, 54(1), 9–18. https://doi.org/10.1093/sw/54.1.9

Parker, C., Doctor, R. M., & Selvam, R. (2008). Somatic therapy treatment effects with tsunami survivors. Traumatology, 14(3), 103–109.

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 1-18.

Röhricht F, Papadopoulos N, Priebe S. An exploratory randomized controlled trial of body psychotherapy for patients with chronic depression. J Affect Disord. 2013 Oct;151(1):85-91. doi: 10.1016/j.jad.2013.05.056. Epub 2013 Jun 14. PMID: 23769289.

Rosendahl, S & Sattel, H & Lahmann, C. (2021). Effectiveness of Body Psychotherapy. A Systematic Review and Meta-Analysis. Frontiers in Psychiatry. 12. 10.3389/fpsyt.2021.709798.

Vagnini, D., Grassi, M. M., & Saita, E. (2023). Evaluating Somatic Experiencing® to heal cancer trauma: First evidence with breast cancer survivors. International Journal of Environmental Research and Public Health, 20(14), 6412. https://doi.org/10.3390/ijerph20146412

EMDR is well-known as one of the most scientifically-validated psychotherapies, with hundreds of published studies. The American Psychological Association (APA), the Department of Veterans Affairs (VA) and Department of Defense have each recognized EMDR as an effective treatment for PTSD. The World Health Organization (WHO) currently recommends EMDR as one of only two trauma therapies with strong empirical support, alongside Trauma-Focused CBT. EMDR is also recommended as a first-line treatment for adults with PTSD in the NICE guideline (2018), and the International Society for Traumatic Stress Studies treatment guidelines (2018)

Meta-analyses: A systematic review and meta-analysis (Lewis et al., 2020) reported in the European Journal of Psychotraumatology pooled 114 randomized trials with 8,171 participants and found that EMDR and trauma-focused CBT had the strongest evidence, with large effects compared with waitlist and significant effects compared with treatment as usual. A network meta-analysis conducted for the NICE guideline (Mavranezouli et al., 2020) reported in Psychological Medicine analyzed 90 trials with 6,560 participants and found EMDR among the most effective interventions at treatment endpoint and at one- to four-month follow-up.

A meta-analysis of 76 trials (Cuijpers et al., 2020) published in the Journal of Psychological Medicine concluded that EMDR was more effective than other therapies for PTSD, anxiety, and depression symptoms.

A meta-analysis of 70 trials involving 4,761 participants (Bisson et al., 2013) published in the Cochrane Database of Systematic Reviews found EMDR and Trauma-Focused CBT to be more effective than waitlist or usual care.

Depression: A systematic review and meta-analysis (Carletto et al., 2021) reported in the European Journal of Psychotraumatology identified 11 controlled studies in which EMDR was delivered as the primary treatment for depression, nine of which were pooled in the meta-analysis with a combined 373 participants. Across all comparisons, EMDR produced a large reduction in depressive symptoms (Hedges' g = −1.07). In the seven studies that compared EMDR with an active treatment such as CBT or treatment as usual, the advantage for EMDR was moderate (g = −0.68), and in the three studies with 3- to 6-month follow-up the effect remained significant (g = −0.62).

Chronic pain: A systematic review (Tesarz et al., 2014) reported in Pain Medicine identified 12 studies of EMDR in chronic pain, including two randomized trials, and found preliminary evidence of reductions in pain intensity and pain-related distress.

Phobias: A randomized trial (De Jongh et al., 2002) published in the Journal of Clinical Psychology involved 184 patients with travel phobia who received an average of 7.3 1-hour sessions. EMDR therapy produced significant reductions in travel anxiety and a return to driving or traveling.

Neuroimaging: An EEG study (Pagani et al., 2012) reported in PLOS ONE monitored brain activity during EMDR sessions and found that after successful treatment, activation during trauma recall shifted from limbic and prefrontal regions toward temporal, parietal, and occipital cortical areas associated with cognitive processing. A systematic review of mechanism studies (Landin-Romero et al., 2018) reported in Frontiers in Psychology summarized neuroimaging findings showing changes in prefrontal, limbic, and memory-related regions following EMDR.

EMDR versus medication: A randomized trial (van der Kolk et al., 2007) reported in the Journal of Clinical Psychiatry assigned 88 adults with PTSD to eight weeks of EMDR, fluoxetine, or pill placebo. EMDR produced greater symptom reduction than fluoxetine at six-month follow-up, and among participants with adult-onset trauma, 75% of the EMDR group were asymptomatic at follow-up compared with none of the fluoxetine group.

References

Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews, (12), CD003388.

Cuijpers, P., Veen, S. C. V., Sijbrandij, M., Yoder, W., & Cristea, I. A. (2020). Eye movement desensitization and reprocessing for mental health problems: a systematic review and meta-analysis. Psychological Medicine, 1-12.

De Jongh, A., Holmshaw, M., Carswell, W., & Van Wijk, A. J. (2002). Usefulness of a trauma-focused treatment approach for travel phobia. Journal of Clinical Psychology, 58(12), 1413–1424.

Carletto, S., Malandrone, F., Berchialla, P., Oliva, F., Colombi, N., Hase, M., Hofmann, A., & Ostacoli, L. (2021). Eye movement desensitization and reprocessing for depression: A systematic review and meta-analysis. European Journal of Psychotraumatology, 12(1), 1894736. https://doi.org/10.1080/20008198.2021.1894736

International Society for Traumatic Stress Studies. (2018). Posttraumatic stress disorder prevention and treatment guidelines: Methodology and recommendations. ISTSS.

Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, 1395. https://doi.org/10.3389/fpsyg.2018.01395

Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy and Experimental Psychiatry, 44(2), 231–239. https://doi.org/10.1016/j.jbtep.2012.11.001

Lewis, C., Roberts, N. P., Andrew, M., Starling, E., & Bisson, J. I. (2020). Psychological therapies for post-traumatic stress disorder in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), 1729633. https://doi.org/10.1080/20008198.2020.1729633

Mavranezouli, I., Megnin-Viggars, O., Daly, C., Dias, S., Welton, N. J., Stockton, S., Bhutani, G., Grey, N., Leach, J., Greenberg, N., Katona, C., El-Leithy, S., & Pilling, S. (2020). Psychological treatments for post-traumatic stress disorder in adults: A network meta-analysis. Psychological Medicine, 50(4), 542–555. https://doi.org/10.1017/S0033291720000070

National Institute for Health and Care Excellence. (2018). Post-traumatic stress disorder (NICE Guideline NG116). https://www.nice.org.uk/guidance/ng116

Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Monaco, L., Lauretti, G., Russo, R., Niolu, C., Ammaniti, M., Fernandez, I., & Siracusano, A. (2012). Neurobiological correlates of EMDR monitoring: An EEG study. PLOS ONE, 7(9), e45753. https://doi.org/10.1371/journal.pone.0045753

Tesarz, J., Leisner, S., Gerhardt, A., Janke, S., Seidler, G. H., Eich, W., & Hartmann, M. (2014). Effects of eye movement desensitization and reprocessing (EMDR) treatment in chronic pain patients: A systematic review. Pain Medicine, 15(2), 247–263. https://doi.org/10.1111/pme.12303

U.S. Department of Veterans Affairs & U.S. Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder (Version 4.0).

van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenance. Journal of Clinical Psychiatry, 68(1), 37–46. https://doi.org/10.4088/jcp.v68n0105

World Health Organization. (2013). Guidelines for the management of conditions specifically related to stress. Geneva: WHO.

Peer-reviewed studies show support for the effectiveness of IFS for depression, rheumatoid arthritis-related pain, childhood trauma, PTSD and internet addiction.

Depression: A randomized controlled trial of 37 female college students experiencing depression (Haddock et al., 2016) published in the Journal of Marriage and Family Therapy found that IFS produced significant improvement in symptoms of depression compared to the other therapy models tested (CBT and interpersonal psychotherapy).

Rheumatoid-arthritus related-pain: A randomized controlled trial (Shadick et al, 2013) published in the Journal of Rheumatology involved 39 patients receiving 36 weeks of IFS therapy versus 40 patients receiving education (control). The IFS-based intervention produced greater positive effects, reducing pain and depressive symptoms, while improving physical function and self-compassion. Results were sustained at a one year follow-up.

Childhood trauma: In a clinical trial (Hodgdon et al., 2021) published in the Journal of Aggression, Maltreatment and Trauma, 17 adults with a history of multiple childhood traumas received 16 90-minute sessions of IFS therapy. Patients started the trial with a moderate-to-severe degree of PTSD and at a one month follow-up, 92% of participants no longer met criteria for PTSD. Significant gains were reported in depression, dissociation, self-compassion, affect regulation and self perception which were statistically and clinically significant.

PTSD: In a clinical trial (Comeau et al., 2024) published in the APA Journal of Psychological Trauma: Theory, Research, Practice, and Policy, 15 patients with PTSD from childhood, physical or sexual abuse, or intimate partner violence received 16 90-minute weekly groups and 8 50-minute biweekly individual sessions of IFS therapy. A clinically meaningful response in PTSD symptoms was demonstrated in 53% of participants with improvements in decentering, self-compassion, and emotion regulation.

A randomized controlled trial (Joss et al., 2026) reported in Psychological Trauma: Theory, Research, Practice, and Policy randomized 60 patients with PTSD to the 16-week online group-based PARTS program (n = 30) or an active control condition, Nature-Based Stress Reduction for Trauma Survivors (n = 30), with each arm also receiving eight biweekly individual sessions. Both arms showed statistically significant and large reductions in clinician-rated PTSD symptoms on the CAPS-5, and the PARTS group attended more sessions and reported higher group satisfaction. This is the first randomized trial of a group PTSD treatment derived from IFS.

A pilot study (Ally et al., 2025) reported in Frontiers in Psychiatry delivered an online group IFS intervention to community mental health patients with co-occurring PTSD and substance use. PTSD symptoms decreased by 1.7 points per week on the PCL-5, with 54% of participants reaching a minimally important difference; craving decreased over treatment; participants rated the program 86% on acceptability, and 70% were retained at 12 weeks.

Trauma-exposed adolescents: A mixed-methods study (Habibi et al., 2026) reported in Child Abuse & Neglect evaluated an IFS-based group intervention for trauma-exposed adolescents in out-of-home care and found significant reductions in posttraumatic cognitions and in fear of compassion for oneself and for others, with large effect sizes.

Internet Addiction: In a randomized controlled trial (Mehrad Sadr et al., 2023) published in the Journal of Psychological Science, 17 adults diagnosed with internet addiction received 10 2-hour group IFS therapy sessions over 1.5 months, compared to a control group of 18 adults that received no treatment. The IFS intervention produced a statistically and clinically significant reduction in symptoms of internet addiction.

Scoping review: A scoping review (Buys, 2025) reported in Clinical Psychologist identified 27 peer-reviewed IFS studies, including two randomized controlled trials, five quasi-experimental studies, three qualitative studies, and 17 case studies, and concluded that IFS is a promising treatment, particularly for chronic pain, depression, and PTSD, while calling for larger rigorous trials.

IFS was listed in 2015 on the SAMHSA National Registry of Evidence-based Programs and Practices, which rated it effective for improving general functioning and well-being, and promising for phobia, panic, and generalized anxiety symptoms, physical health conditions, resilience and self-concept, and depressive symptoms.

References:

Ally, D., Tobiasz-Veltz, L., Tu, K., Comeau, A., Bumpus, C., Blot, T., Rice, F. K., Orr, B., Soumerai Rea, H., Sweezy, M., & Schuman-Olivier, Z. (2025). A pilot study of an online group-based Internal Family Systems intervention for comorbid posttraumatic stress disorder and substance use. Frontiers in Psychiatry, 16, 1544435. https://doi.org/10.3389/fpsyt.2025.1544435

Buys, M. E. (2025). Exploring the evidence for Internal Family Systems therapy: A scoping review of current research, gaps, and future directions. Clinical Psychologist. Advance online publication. https://doi.org/10.1080/13284207.2025.2533127

Comeau, A., Smith, L. J., Smith, L., Soumerai Rea, H., Ward, M. C., Creedon, T. B., Sweezy, M., Rosenberg, L. G., & Schuman-Olivier, Z. (2024). Online group-based internal family systems treatment for posttraumatic stress disorder: Feasibility and acceptability of the program for alleviating and resolving trauma and stress.Psychological Trauma: Theory, Research, Practice, and Policy, 16(Suppl 3), S636–S640. https://doi.org/10.1037/tra0001688.

Habibi, N., Basharpoor, S., Atadokht, A., Narimani, M., & Hatami Varzaneh, A. (2026). A mixed-methods study of the development and evaluation of an Internal Family Systems (IFS)-based group intervention for post-traumatic cognitions and fear of compassion among trauma-exposed adolescents in out-of-home care (OOHC). Child Abuse & Neglect, 178, 108140. https://doi.org/10.1016/j.chiabu.2026.108140

Haddock SA, Weiler LM, Trump LJ, Henry KL. The Efficacy of Internal Family Systems Therapy in the Treatment of Depression Among Female College Students: A Pilot Study. J Marital Fam Ther. 2017 Jan;43(1):131-144. doi: 10.1111/jmft.12184. Epub 2016 Aug 8. PMID: 27500908.

Hodgdon, Hilary & Anderson, Frank & Southwell, Elizabeth & Hrubec, Wendy & Schwartz, Richard. (2021). Internal Family Systems (IFS) Therapy for Posttraumatic Stress Disorder (PTSD) among Survivors of Multiple Childhood Trauma: A Pilot Effectiveness Study. Journal of Aggression, Maltreatment & Trauma. 31. 1-22. 10.1080/10926771.2021.2013375.

Joss, D., Comeau, A., Chevannes, R., Parry, G., Soumerai Rea, H., Barria, J., Bumpus, C., Rector, A., Rajan, A., Rosansky, J., Rice, F. K., Ward, M. C., Tobiasz Veltz, L., Ally, D., Rosenberg, L. G., Sweezy, M., Lovas, D., & Schuman-Olivier, Z. (2026). A randomized controlled trial of an online group-based Internal Family Systems treatment for posttraumatic stress disorder: The Program for Alleviating and Resolving Trauma and Stress (PARTS) study. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0002089

Mehrad Sadr, M., Borjali, A., Eskandari, H., & Delavar, A. (2023). Design and validation of a therapy program based on the internal family systems model and its efficacy on internet addiction. Journal of Psychological Science, 22(121), 19-35.

Shadick NA, Sowell NF, Frits ML, Hoffman SM, Hartz SA, Booth FD, Sweezy M, Rogers PR, Dubin RL, Atkinson JC, Friedman AL, Augusto F, Iannaccone CK, Fossel AH, Quinn G, Cui J, Losina E, Schwartz RC. A randomized controlled trial of an internal family systems-based psychotherapeutic intervention on outcomes in rheumatoid arthritis: a proof-of-concept study. J Rheumatol. 2013 Nov;40(11):1831-41. doi: 10.3899/jrheum.121465. Epub 2013 Aug 15. PMID: 23950186.

Chronic back pain: A randomized controlled trial (Ashar et al., 2022) reported in JAMA Psychiatry involved 151 adults with primary chronic back pain (mean duration 10 years) randomized to PRT, an open-label placebo injection, or usual care. PRT consisted of one telehealth session with a physician and 8 therapy sessions over 4 weeks. At post-treatment, 33 of 50 participants (66%) in the PRT group were pain-free or nearly pain-free, compared with 10 of 51 (20%) receiving placebo and 5 of 50 (10%) receiving usual care, with gains largely maintained at one-year follow-up. Treatment effects were mediated by reduced beliefs that pain indicates tissue damage, and fMRI showed reduced prefrontal responses to evoked back pain and increased prefrontal-somatosensory connectivity in the PRT group. nih

Five-year follow-up: A follow-up of the same trial (Ashar et al., 2025) reported in JAMA Psychiatry obtained data from 113 of the original 151 participants. 55% of PRT patients were nearly or completely pain-free at 5 years vs 26% in the placebo and 36% in the usual care groups. PRT also produced significant improvements in pain interference, depression, anger, fear of movement, and attribution of pain to mind-brain processes, with no booster sessions provided. Medscape

Mechanism: A secondary analysis (Ashar et al., 2023) reported in JAMA Network Open examined participants' natural language descriptions of their pain. 51% of post-treatment attributions in the PRT condition were mind- or brain-related, compared with 8% in control conditions, and increases in mind-brain attribution mediated the effects of PRT on pain intensity at one-year follow-up. ResearchGate

Chronic back pain: A randomized trial (Donnino et al., 2021) reported in Pain Reports tested Psychophysiologic Symptom Relief Therapy, a related brain-based approach, in 35 patients with chronic back pain against mindfulness-based stress reduction and usual care. The PSRT group showed an 83% reduction in pain disability at 26 weeks versus 22% and 11% in the comparison groups, and 64% reported being pain-free at 26 weeks versus 25% and 17%.

Fibromyalgia: An open-label pilot (Sturgeon et al., 2025) reported in Regional Anesthesia & Pain Medicine tested a brief three-session telehealth version of PRT in 35 adults with fibromyalgia. Completers reported significant reductions in average pain intensity (effect sizes of d=0.56 at 1 month, d=0.80 at 2 months, and d=0.89 at 3 months) and pain interference, along with reduced pain-related fear. Blairgolson

A cluster-randomized trial on a related treatment (Lumley et al., 2017) reported in Pain assigned 230 adults with fibromyalgia to Emotional Awareness and Expression Therapy (EAET), CBT, or fibromyalgia education, each delivered in eight weekly 90-minute group sessions. At six-month follow-up, EAET outperformed education on pain and several secondary outcomes, and 22.5% of EAET participants reported at least 50% pain reduction compared with 8.3% of the CBT group.

Chronic widespread pain: A pilot randomized clinical trial (2026) reported in the Journal of Psychosomatic Research enrolled 53 participants with chronic widespread pain, randomized to PRT (n=27) or psychoeducation control (n=26) over 12 weeks. PRT was found to be feasible and acceptable, with favorable trends in pain, functional outcomes, and psychological well-being. ScienceDirect

Migraine: A case series (Fishbein et al., 2025) reported in Headache applied PRT to patients with migraine and reported improvements in headache outcomes.

Older veterans: A randomized clinical trial on a related treatment (Yarns et al., 2024) reported in JAMA Network Open compared Emotional Awareness and Expression Therapy with CBT in 126 veterans aged 60 to 95 with at least three months of musculoskeletal pain. At post-treatment, 63% of EAET participants had clinically significant pain reduction of at least 30% compared with 17% of CBT participants, and 35% versus 7% achieved at least 50% reduction. EAET was also superior on anxiety, depression, PTSD symptoms, and life satisfaction, and 41% of EAET participants maintained clinically significant pain reduction at six months versus 14% for CBT.

References

Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2022). Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23.

Ashar, Y. K., Low, E. L., Knight, K., et al. (2025). Pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: 5-year follow-up of a randomized clinical trial. JAMA Psychiatry, 82(10), 1049–1051.

Ashar, Y. K., Lumley, M. A., Perlis, R. H., Liston, C., Gunning, F. M., & Wager, T. D. (2023). Reattribution to mind-brain processes and recovery from chronic back pain: A secondary analysis of a randomized clinical trial. JAMA Network Open, 6(9), e2333846.

Donnino, M. W., Thompson, G. S., Mehta, S., Paschali, M., Howard, P., Antonsen, S. B., Balaji, L., Bertisch, S. M., Edwards, R., Ngo, L. H., & Grossestreuer, A. V. (2021). Psychophysiologic symptom relief therapy for chronic back pain: A pilot randomized controlled trial. Pain Reports, 6(3), e959.

Fishbein, J. N., Schuster, N. M., Anders, A., Portera, A. M., & Herbert, M. S. (2025). Pain reprocessing therapy for migraine: A case series. Headache, 65(9), 1660–1665.

Lumley, M. A., Schubiner, H., Lockhart, N. A., Kidwell, K. M., Harte, S. E., Clauw, D. J., & Williams, D. A. (2017). Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: A cluster-randomized controlled trial. Pain, 158(12), 2354–2363.

Sturgeon, J., Trost, Z., Ashar, Y. K., Lumley, M. A., Schubiner, H., Clauw, D., & Hassett, A. L. (2025). Brief pain reprocessing therapy for fibromyalgia: A feasibility, acceptability, and preliminary efficacy pilot. Regional Anesthesia & Pain Medicine. Advance online publication.

Sit, R. W. S., Chan, C. Y. K., Fong, H. P. Y., Fung, C. L. C., & Wong, S. Y. S. (2026). Pain reprocessing therapy in adults with chronic widespread pain: A pilot randomized clinical trial. Journal of Psychosomatic Research.

Yarns, B. C., Jackson, N. J., Alas, A., Melrose, R. J., Lumley, M. A., & Sultzer, D. L. (2024). Emotional awareness and expression therapy vs cognitive behavioral therapy for chronic pain in older veterans: A randomized clinical trial. JAMA Network Open, 7(6), e2415842.

Stress, anxiety, and depression: A meta-analysis of randomized controlled trials (Fincham et al., 2023) reported in Scientific Reports pooled 12 RCTs with 785 adult participants for the primary outcome of self-reported stress and found breathwork was associated with lower stress than control conditions (g = −0.35). Secondary analyses for anxiety (20 RCTs) and depressive symptoms (18 RCTs) showed similar effect sizes of g = −0.32 and g = −0.40.

Mood and physiological arousal: A remote randomized controlled trial (Balban et al., 2023) reported in Cell Reports Medicine assigned 114 adults to one of three daily 5-minute breathwork practices (cyclic sighing, box breathing, or cyclic hyperventilation with retention) or an equivalent period of mindfulness meditation for one month. Both breathwork and mindfulness meditation improved daily positive affect and reduced state anxiety and negative affect, but breathwork, especially cyclic sighing, was more effective than meditation at increasing positive affect over the 28-day period, and the effect increased with more days of practice. Cyclic sighing also produced a significantly greater reduction in respiratory rate than meditation.

Anxiety: A randomized waitlist-controlled trial (Blake et al., 2025) reported in the Journal of Affective Disorders delivered six weekly 90-minute online group sessions of conscious connected breathwork to adults with anxiety. Breathwork reduced anxiety symptoms by a mean of 10.56 points on the Self-Rating Anxiety Scale compared with 1.89 points in the control group, and at n = 107 it is the largest randomized trial of this method to date.

Major depressive disorder: A randomized pilot trial (Sharma et al., 2017) reported in the Journal of Clinical Psychiatry enrolled 25 patients with MDD who had not responded adequately to antidepressants and compared 8 weeks of Sudarshan Kriya Yoga breathing with a waitlist. The breathing group showed significantly greater reductions in Hamilton Depression Rating Scale scores than the waitlist group. A separate randomized dosing study (Streeter et al., 2017) reported in the Journal of Alternative and Complementary Medicine combined Iyengar yoga with coherent breathing at 5 breaths per minute over 12 weeks in adults with MDD; both dosing groups showed clinically significant reductions in Beck Depression Inventory-II scores, with larger gains in the higher-dose group.

Posttraumatic stress disorder: A randomized controlled longitudinal study (Seppälä et al., 2014) reported in the Journal of Traumatic Stress assigned 21 U.S. male veterans with PTSD to a 7-day Sudarshan Kriya breathing-based intervention or a waitlist. The breathing group showed reduced PTSD symptom scores, reduced anxiety, and reduced respiration rate, along with a lower eye-blink startle response; symptom improvements were maintained at 1-month and 1-year follow-up.

Panic disorder: A randomized trial (Meuret et al., 2008) reported in the Journal of Psychiatric Research assigned 37 patients with panic disorder to 4 weeks of capnometry-assisted respiratory training, which teaches slow, shallow breathing to raise end-tidal CO2, or a waitlist. Treatment normalized end-tidal CO2 and produced clinically significant reductions in panic symptom severity that were maintained at 12-month follow-up.

Attention, negative affect, and cortisol: A randomized controlled trial (Ma et al., 2017) reported in Frontiers in Psychology assigned 40 healthy adults to 20 sessions of diaphragmatic breathing training over 8 weeks or a control condition. The breathing group showed improved sustained attention, lower negative affect, and significantly lower salivary cortisol at post-test.

Stress and resilience in high-stress trainees: A single-blind parallel-group randomized controlled trial (Little et al., 2026) reported in Stress and Health randomized 98 paramedicine students from two Australian universities to a 12-week structured breathwork protocol or control. The intervention was twice-daily slow diaphragmatic breathing (5-second inhale, 5-second exhale, 2-second hold) with video and audio guidance; at post-intervention the breathwork group reported significantly lower stress, anxiety, and depression scores and higher resilience than controls.

Hypertension: A meta-analysis of randomized controlled trials (Chaddha et al., 2019) reported in Complementary Therapies in Medicine included 17 studies of device-guided or non-device-guided slow breathing at 10 breaths per minute or fewer, practiced at least 5 minutes on at least 3 days per week for at least 4 weeks. Slow breathing decreased systolic blood pressure by 5.62 mmHg and diastolic blood pressure by 2.97 mmHg, and the authors concluded it may be a reasonable first treatment for low-risk hypertensive and prehypertensive patients reluctant to start medication.

Asthma: A randomized controlled trial (Bruton et al., 2018) reported in The Lancet Respiratory Medicine recruited 655 adults with asthma and impaired quality of life from 34 UK general practices and assigned them to a self-guided DVD and booklet breathing retraining program (261 patients), three face-to-face physiotherapist sessions (132 patients), or usual care (262 patients). Mean Asthma Quality of Life Questionnaire scores at 12 months were significantly higher in the DVD group (5.40) and the face-to-face group (5.33) than in usual care (5.12), with the video program producing benefits equivalent to therapist-delivered training. A Cochrane review (Santino et al., 2020) pooling 22 trials and 2,880 participants similarly found breathing exercises improved asthma-related quality of life and hyperventilation symptoms.

References

Balban, M. Y., Neri, E., Kogon, M. M., Weed, L., Nouriani, B., Jo, B., Holl, G., Zeitzer, J. M., Spiegel, D., & Huberman, A. D. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895

Blake, R., et al. (2025). Efficacy of online conscious connected breathwork in reducing symptoms of anxiety: A randomized waitlist control trial. Journal of Affective Disorders. Advance online publication.

Bruton, A., Lee, A., Yardley, L., Raftery, J., Arden-Close, E., Kirby, S., Zhu, S., Thiruvothiyur, M., Webley, F., Taylor, L., Gibson, D., Yao, G., Stafford-Watson, M., Versnel, J., Moore, M., George, S., Little, P., Djukanovic, R., Price, D., ... Thomas, M. (2018). Physiotherapy breathing retraining for asthma: A randomised controlled trial. The Lancet Respiratory Medicine, 6(1), 19–28. https://doi.org/10.1016/S2213-2600(17)30474-5

Chaddha, A., Modaff, D., Hooper-Lane, C., & Feldstein, D. A. (2019). Device and non-device-guided slow breathing to reduce blood pressure: A systematic review and meta-analysis. Complementary Therapies in Medicine, 45, 179–184. https://doi.org/10.1016/j.ctim.2019.03.005

Fincham, G. W., Strauss, C., Montero-Marin, J., & Cavanagh, K. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports, 13, Article 432. https://doi.org/10.1038/s41598-022-27247-y

Goessl, V. C., Curtiss, J. E., & Hofmann, S. G. (2017). The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis. Psychological Medicine, 47(15), 2578–2586. https://doi.org/10.1017/S0033291717001003

Laborde, S., Allen, M. S., Borges, U., Dosseville, F., Hosang, T. J., Iskra, M., Mosley, E., Salvotti, C., Spolverato, L., Zammit, N., & Javelle, F. (2022). Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neuroscience & Biobehavioral Reviews, 138, 104711. https://doi.org/10.1016/j.neubiorev.2022.104711

Little, A., Stainer, M., MacQuarrie, A., Wiseman, N., & Haskins, B. (2026). Examining the effectiveness of breathwork to improve resilience and psychological wellbeing while reducing anxiety, depression, stress, and insomnia in paramedicine students: A single-blind randomised controlled trial. Stress and Health, 42(2), e70161. https://doi.org/10.1002/smi.70161

Ma, X., Yue, Z.-Q., Gong, Z.-Q., Zhang, H., Duan, N.-Y., Shi, Y.-T., Wei, G.-X., & Li, Y.-F. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology, 8, Article 874. https://doi.org/10.3389/fpsyg.2017.00874

Meuret, A. E., Wilhelm, F. H., Ritz, T., & Roth, W. T. (2008). Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder. Journal of Psychiatric Research, 42(7), 560–568. https://doi.org/10.1016/j.jpsychires.2007.06.005

Santino, T. A., Chaves, G. S. S., Freitas, D. A., Fregonezi, G. A. F., & Mendonça, K. M. P. P. (2020). Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews, 3, CD001277. https://doi.org/10.1002/14651858.CD001277.pub4

Seppälä, E. M., Nitschke, J. B., Tudorascu, D. L., Hayes, A., Goldstein, M. R., Nguyen, D. T. H., Perlman, D., & Davidson, R. J. (2014). Breathing-based meditation decreases posttraumatic stress disorder symptoms in U.S. military veterans: A randomized controlled longitudinal study. Journal of Traumatic Stress, 27(4), 397–405. https://doi.org/10.1002/jts.21936

Sharma, A., Barrett, M. S., Cucchiara, A. J., Gooneratne, N. S., & Thase, M. E. (2017). A breathing-based meditation intervention for patients with major depressive disorder following inadequate response to antidepressants: A randomized pilot study. Journal of Clinical Psychiatry, 78(1), e59–e63. https://doi.org/10.4088/JCP.16m10819

Streeter, C. C., Gerbarg, P. L., Whitfield, T. H., Owen, L., Johnston, J., Silveri, M. M., Gensler, M., Faulkner, C. L., Mann, C., Wixted, M., Hernon, A. M., Nyer, M. B., Brown, E. R. P., & Jensen, J. E. (2017). Treatment of major depressive disorder with Iyengar yoga and coherent breathing: A randomized controlled dosing study. Journal of Alternative and Complementary Medicine, 23(3), 201–207. https://doi.org/10.1089/acm.2016.0140

Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, Article 353. https://doi.org/10.3389/fnhum.2018.00353

Two notes for your own review: the Blake et al. (2025) co-author list was not available to me and should be completed from the article, and this section omits the 400-participant placebo-controlled coherent breathing trial (Fincham, Kartar, et al., 2023), which found no advantage over paced-breathing placebo, because you asked for positive results only.

Meta-analysis: A meta-analysis (Moyer, Rounds, & Hannum, 2004) reported in Psychological Bulletin pooled 37 randomized studies with 1,802 participants across nine outcome variables. Single applications of massage reduced state anxiety, blood pressure, and heart rate. Multiple sessions produced the largest effects on trait anxiety and depression, with a course of treatment yielding benefits similar in magnitude to those reported for psychotherapy.

Generalized anxiety disorder: A randomized, single-blind, proof-of-concept trial (Rapaport et al., 2016) reported in the Journal of Clinical Psychiatry assigned 47 untreated adults with DSM-IV GAD to twice-weekly 45-minute Swedish massage or a light-touch control for six weeks. Hamilton Anxiety Rating Scale scores fell 11.67 points with massage versus 8.41 with light touch, a 3.26-point difference (p = .030, effect size = 0.69), with group differences emerging by the end of week 3. The authors describe it as the first monotherapy trial of massage for an anxiety disorder.

Clinical anxiety: A randomized, double-blind, placebo-controlled trial (Gozalo-Pascual et al., 2023) reported in Complementary Therapies in Clinical Practice assigned 36 adults with clinical anxiety to four 40-minute myofascial sessions over four weeks or a sham myofascial protocol of identical duration. Trait anxiety on the STAI fell 19.98 points from baseline in the myofascial group versus 5.95 in placebo (p < .001), with a large effect size for anxiety and medium effects for central sensitization and somatization, and gains were maintained at 1-, 3-, and 6-month follow-up. Patients and evaluators were blinded, the analysis was intention-to-treat, and no adverse events occurred.

Fibromyalgia: A systematic review and meta-analysis (Li, Wang, Feng, Yang, & Sun, 2014) reported in PLoS ONE pooled nine RCTs with 404 fibromyalgia patients. Massage courses of five weeks or longer significantly improved anxiety (SMD = 0.44, 95% CI 0.09 to 0.78), pain (SMD = 0.62), and depression (SMD = 0.49) but not sleep disturbance.

Depression: A meta-analysis (Hou, Chiang, Hsu, Chiu, & Yen, 2010) reported in the Journal of Clinical Psychiatry pooled 17 RCTs with 786 participants, excluding infant and pregnancy trials. All 17 trials favored massage, with a pooled standardized mean difference of 0.76 (95% CI 0.61 to 0.91) in the fixed-effects model and 0.73 (95% CI 0.52 to 0.93) in the random-effects model.

The Li et al. (2014) meta-analysis found massage courses of five weeks or longer improved depression in fibromyalgia (SMD = 0.49, 95% CI 0.15 to 0.84).

In the Moyer et al. (2004) meta-analysis, depression reduction after a course of massage was one of the two largest effects observed, at a magnitude the authors compared to psychotherapy outcomes.

Prenatal major depression: A randomized trial (Field, Diego, Hernandez-Reif, Deeds, & Figueiredo, 2009) reported in Infant Behavior and Development assigned pregnant women diagnosed with major depression to 12 weeks of twice-weekly massage delivered by their significant other or to standard care. The massage group had lower depression at the end of treatment and lower depression and cortisol in the postpartum period, and their newborns had lower rates of prematurity and low birthweight, lower cortisol, and better Brazelton habituation, orientation, and motor scores.

Sexual abuse survivors: A controlled trial (Field et al., 1997) reported in the Journal of Bodywork and Movement Therapies gave women with a history of sexual abuse (mean age 35) a 30-minute massage twice weekly for one month, with relaxation therapy as the comparison. Immediately after sessions the massage group reported lower depression and anxiety and showed decreased salivary cortisol, and over the month depression and life-event stress decreased. The relaxation group also reported lower anxiety and depression but showed no change in stress hormones and an increasingly negative attitude toward touch.

A randomized efficacy study (Price, 2005) reported in Alternative Therapies in Health and Medicine assigned 24 women with histories of childhood sexual abuse to eight weekly sessions of body-oriented therapy, which combined massage with guided inner-body awareness, or to massage alone. Both groups improved in psychological well-being, physical well-being, and body connection, and a follow-up analysis (Price, 2007) reported in Complementary Therapies in Clinical Practice found dissociation decreased significantly over the course of treatment.

Emotion regulation in a trauma-exposed population: A three-arm randomized trial (Price, Thompson, Crowell, & Pike, 2019) reported in Drug and Alcohol Dependence assigned 187 women in intensive outpatient substance use disorder treatment at three community clinics to treatment-as-usual alone, plus eight weekly sessions of Mindful Awareness in Body-oriented Therapy (a manual, mindfulness, and psychoeducational protocol teaching interoceptive awareness), or plus a matched women's health education control. MABT significantly improved days abstinent versus treatment-as-usual at 6 and 12 months, and reductions in craving and emotion dysregulation were maintained from 3 to 12 months; neither control group showed lasting change.

Sleep: A randomized sham-controlled trial (Matarán-Peñarrocha et al., 2011) reported in Evidence-Based Complementary and Alternative Medicine assigned 84 fibromyalgia patients to 25 weeks of craniosacral therapy or sham treatment. Pittsburgh Sleep Quality Index scores were significantly better in the craniosacral group after treatment, at 6 months, and at 1 year, making sleep the only outcome that remained significant at the final follow-up.

A randomized sham-controlled trial (Castro-Sánchez et al., 2011) in the same journal assigned 74 fibromyalgia patients to 20 weeks of massage-myofascial release or sham treatment. Sleep quality improved over sham immediately after treatment and at 1 month and was the only outcome that remained significantly different at 6 months.

Perceived stress in older adults: A randomized trial (Sharpe, Williams, Granner, & Hussey, 2007) reported in Complementary Therapies in Medicine assigned 54 community-dwelling older adults to 50-minute sessions of massage combining Swedish, neuromuscular, and myofascial techniques or to guided relaxation, twice weekly for four weeks. Massage improved positive well-being and reduced stress perception relative to guided relaxation.

Advanced cancer: A randomized trial (Kutner et al., 2008) reported in the Annals of Internal Medicine assigned 380 patients with advanced cancer and moderate to severe pain to six 30-minute massage or simple-touch sessions over two weeks. Both groups improved in pain and mood over time; massage produced greater immediate reductions in pain and improvement in mood after each session.

Craniosacral therapy for chronic pain: A systematic review and meta-analysis (Haller et al., 2020) reported in BMC Musculoskeletal Disorders pooled 10 randomized trials with 681 patients and found craniosacral therapy reduced pain intensity and disability compared with treatment as usual and sham treatment at post-treatment and at six-month follow-up.

References

Castro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J. M., & Moreno-Lorenzo, C. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidence-Based Complementary and Alternative Medicine, 2011, 561753. https://doi.org/10.1155/2011/561753

Cherkin, D. C., Sherman, K. J., Kahn, J., Wellman, R., Cook, A. J., Johnson, E., Erro, J., Delaney, K., & Deyo, R. A. (2011). A comparison of the effects of 2 types of massage and usual care on chronic low back pain: A randomized, controlled trial. Annals of Internal Medicine, 155(1), 1–9. https://doi.org/10.7326/0003-4819-155-1-201107050-00002

Diego, M. A., Field, T., Sanders, C., & Hernandez-Reif, M. (2004). Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate. International Journal of Neuroscience, 114(1), 31–44. https://doi.org/10.1080/00207450490249446

Diego, M. A., & Field, T. (2009). Moderate pressure massage elicits a parasympathetic nervous system response. International Journal of Neuroscience, 119(5), 630–638. https://doi.org/10.1080/00207450802329605

Furlan, A. D., Giraldo, M., Baskwill, A., Irvin, E., & Imamura, M. (2015). Massage for low-back pain. Cochrane Database of Systematic Reviews, 2015(9), CD001929. https://doi.org/10.1002/14651858.CD001929.pub3

Field, T., Diego, M., Hernandez-Reif, M., Deeds, O., & Figueiredo, B. (2009). Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behavior and Development, 32(4), 454–460. https://doi.org/10.1016/j.infbeh.2009.07.001

Field, T., Diego, M., Hernandez-Reif, M., Schanberg, S., & Kuhn, C. (2004). Massage therapy effects on depressed pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 25(2), 115–122. https://doi.org/10.1080/01674820412331282231

Field, T., Diego, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapies, 16(2), 204–209. https://doi.org/10.1016/j.jbmt.2011.08.002

Field, T., Hernandez-Reif, M., Hart, S., Quintino, O., Drose, L. A., Field, T., Kuhn, C., & Schanberg, S. (1997). Effects of sexual abuse are lessened by massage therapy. Journal of Bodywork and Movement Therapies, 1(2), 65–69. https://doi.org/10.1016/S1360-8592(97)80002-2

Gozalo-Pascual, R., González-Ordi, H., Atín-Arratibel, M. Á., Llames-Sánchez, J., & Álvarez-Melcón, Á. C. (2023). Efficacy of the myofascial approach as a manual therapy technique in patients with clinical anxiety: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice, 51, 101753. https://doi.org/10.1016/j.ctcp.2023.101753

Haller, H., Lauche, R., Sundberg, T., Dobos, G., & Cramer, H. (2020). Craniosacral therapy for chronic pain: A systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders, 21, 1. https://doi.org/10.1186/s12891-019-3017-y

Hou, W.-H., Chiang, P.-T., Hsu, T.-Y., Chiu, S.-Y., & Yen, Y.-C. (2010). Treatment effects of massage therapy in depressed people: A meta-analysis. Journal of Clinical Psychiatry, 71(7), 894–901. https://doi.org/10.4088/JCP.09r05009blu

Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing: Effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), 1929023. https://doi.org/10.1080/20008198.2021.1929023

Kutner, J. S., Smith, M. C., Corbin, L., Hemphill, L., Benton, K., Mellis, B. K., Beaty, B., Felton, S., Yamashita, T. E., Bryant, L. L., & Fairclough, D. L. (2008). Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: A randomized trial. Annals of Internal Medicine, 149(6), 369–379. https://doi.org/10.7326/0003-4819-149-6-200809160-00003

Li, Y.-H., Wang, F.-Y., Feng, C.-Q., Yang, X.-F., & Sun, Y.-H. (2014). Massage therapy for fibromyalgia: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 9(2), e89304. https://doi.org/10.1371/journal.pone.0089304

Matarán-Peñarrocha, G. A., Castro-Sánchez, A. M., Carballo García, G., Moreno-Lorenzo, C., Parrón Carreño, T., & Onieva Zafra, M. D. (2011). Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia. Evidence-Based Complementary and Alternative Medicine, 2011, 178769. https://doi.org/10.1093/ecam/nep125

Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research. Psychological Bulletin, 130(1), 3–18. https://doi.org/10.1037/0033-2909.130.1.3

Price, C. (2005). Body-oriented therapy in recovery from child sexual abuse: An efficacy study. Alternative Therapies in Health and Medicine, 11(5), 46–57.

Price, C. (2007). Dissociation reduction in body therapy during sexual abuse recovery. Complementary Therapies in Clinical Practice, 13(2), 116–128. https://doi.org/10.1016/j.ctcp.2006.08.004

Price, C. J., Thompson, E. A., Crowell, S., & Pike, K. (2019). Longitudinal effects of interoceptive awareness training through mindful awareness in body-oriented therapy (MABT) as an adjunct to women's substance use disorder treatment: A randomized controlled trial. Drug and Alcohol Dependence, 198, 140–149. https://doi.org/10.1016/j.drugalcdep.2019.02.012

Rapaport, M. H., Schettler, P., & Bresee, C. (2010). A preliminary study of the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals. Journal of Alternative and Complementary Medicine, 16(10), 1079–1088. https://doi.org/10.1089/acm.2009.0634

Rapaport, M. H., Schettler, P., & Bresee, C. (2012). A preliminary study of the effects of repeated massage on hypothalamic-pituitary-adrenal and immune function in healthy individuals: A study of mechanisms of action and dosage. Journal of Alternative and Complementary Medicine, 18(8), 789–797. https://doi.org/10.1089/acm.2011.0071

Rapaport, M. H., Schettler, P., Larson, E. R., Edwards, S. A., Dunlop, B. W., Rakofsky, J. J., & Kinkead, B. (2016). Acute Swedish massage monotherapy successfully remediates symptoms of generalized anxiety disorder: A proof-of-concept, randomized controlled study. Journal of Clinical Psychiatry, 77(7), e883–e891. https://doi.org/10.4088/JCP.15m10151

Sharpe, P. A., Williams, H. G., Granner, M. L., & Hussey, J. R. (2007). A randomised study of the effects of massage therapy compared to guided relaxation on well-being and stress perception among older adults. Complementary Therapies in Medicine, 15(3), 157–163. https://doi.org/10.1016/j.ctim.2007.01.004

Stub, T., Kiil, M. A., Lie, B., Kristoffersen, A. E., Weiss, T., Hervik, J. A., & Musial, F. (2020). Combining psychotherapy with craniosacral therapy for severe traumatized patients: A qualitative study from an outpatient clinic in Norway. Complementary Therapies in Medicine, 49, 102320. https://doi.org/10.1016/j.ctim.2020.102320

Meta-analysis: A meta-analysis (Roddy et al., 2020) reported in the Journal of Consulting and Clinical Psychology synthesized data from 58 studies encompassing over 2,000 couples. Couples therapy was found to produce a large effect on relationship satisfaction and significant improvements in communication, emotional intimacy, and partner behaviors. These gains were generally maintained over both short- and long-term follow-ups. Notably, couples on waitlists showed minimal improvement.

Emotionally focused therapy: A meta-analysis (Johnson et al., 1999) reported in Clinical Psychology: Science and Practice pooled the controlled trials of EFT then available and found a large effect on relationship satisfaction (effect size 1.3), with 70 to 73% of couples recovering from relationship distress and 86% showing significant improvement. A later meta-analysis (Rathgeber et al., 2019) reported in the Journal of Marital and Family Therapy examined EFT and behavioral couple therapy trials and found both produced significant improvements in relationship satisfaction that were maintained at follow-up. A two-year follow-up study (Wiebe et al., 2017) in the same journal followed 32 couples after EFT and found relationship satisfaction gains were maintained and attachment avoidance continued to decrease across the follow-up period.

Neural effects of couples therapy: An fMRI study (Johnson et al., 2013) reported in PLOS ONE scanned women in distressed relationships while they faced the threat of electric shock, alone or holding their partner's hand, before and after a course of EFT. Before therapy, holding a partner's hand did not reduce neural threat responses; after therapy it did, particularly in prefrontal regions, and the change tracked improvements in relationship satisfaction.

Long-term outcomes: A five-year follow-up of a randomized trial (Christensen et al., 2010) reported in the Journal of Consulting and Clinical Psychology tracked 134 chronically and seriously distressed married couples treated with traditional or integrative behavioral couple therapy. Five years after treatment, about half of couples in each condition showed clinically significant improvement in relationship satisfaction (50% integrative, 46% traditional).

Online couples program: A randomized controlled trial (Doss et al., 2016) reported in the Journal of Consulting and Clinical Psychology assigned 300 couples to the web-based OurRelationship program or a waitlist. The program produced a medium to large improvement in relationship satisfaction (d = 0.69) along with gains in relationship confidence and reductions in depressive and anxious symptoms.

References:

Christensen, A., Atkins, D. C., Baucom, B., & Yi, J. (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 78(2), 225–235. https://doi.org/10.1037/a0018132

Doss, B. D., Cicila, L. N., Georgia, E. J., Roddy, M. K., Nowlan, K. M., Benson, L. A., & Christensen, A. (2016). A randomized controlled trial of the web-based OurRelationship program: Effects on relationship and individual functioning. Journal of Consulting and Clinical Psychology, 84(4), 285–296. https://doi.org/10.1037/ccp0000063

Johnson, S. M., Burgess Moser, M., Beckes, L., Smith, A., Dalgleish, T., Halchuk, R., Hasselmo, K., Greenman, P. S., Merali, Z., & Coan, J. A. (2013). Soothing the threatened brain: Leveraging contact comfort with emotionally focused therapy. PLOS ONE, 8(11), e79314. https://doi.org/10.1371/journal.pone.0079314

Johnson, S. M., Hunsley, J., Greenberg, L., & Schindler, D. (1999). Emotionally focused couples therapy: Status and challenges. Clinical Psychology: Science and Practice, 6(1), 67–79. https://doi.org/10.1093/clipsy.6.1.67

Rathgeber, M., Bürkner, P.-C., Schiller, E.-M., & Holling, H. (2019). The efficacy of emotionally focused couples therapy and behavioral couples therapy: A meta-analysis. Journal of Marital and Family Therapy, 45(3), 447–463. https://doi.org/10.1111/jmft.12336

Roddy, M. K., Walsh, L. M., Rothman, K., Hatch, S. G., & Doss, B. D. (2020). Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators. Journal of Consulting and Clinical Psychology, 88(7), 583–596.

Wiebe, S. A., Johnson, S. M., Lafontaine, M.-F., Burgess Moser, M., Dalgleish, T. L., & Tasca, G. A. (2017). Two-year follow-up outcomes in emotionally focused couple therapy: An investigation of relationship satisfaction and attachment trajectories. Journal of Marital and Family Therapy, 43(2), 227–244. https://doi.org/10.1111/jmft.12206

Meta-analysis: A meta-analysis (Batastini et al., 2021) reported in the Journal of Clinical Psychology and Psychotherapy evaluated the efficacy of live video-delivered psychotherapy compared to traditional in-person sessions. Analyzing data from 57 studies encompassing over 9,000 participants, the study found that video-based therapy is as effective as face-to-face therapy, particularly for treatments targeting anxiety, depression, and PTSD. Findings support the clinical viability of video-based psychotherapy as an effective alternative to in-person therapy.

A meta-analysis (Fernandez et al., 2021) reported in Clinical Psychology & Psychotherapy pooled studies directly comparing live video psychotherapy with in-person treatment and found no significant difference in outcomes, with equivalence holding across treatment types and clinical targets. A systematic review and noninferiority meta-analysis (Norwood et al., 2018) in the same journal found that although clients rated the working alliance slightly lower by video, symptom outcomes were not inferior to in-person therapy. A meta-analysis of randomized trials (Greenwood et al., 2022) reported in JMIR Mental Health found no significant differences between telehealth and face-to-face psychotherapy for less common conditions including PTSD and eating disorders.

COVID-19: A meta-analysis (Liu et al., 2022) reported in Frontiers in Psychology focused on online psychological interventions during the COVID-19 pandemic. The study concluded that online interventions effectively reduced depression, anxiety, and stress levels. Therapist-guided interventions were found to be more effective than self-help formats.

Children and adolescents: A systematic review (Ebert et al., 2023) reported in the Journal JMIR Mental Health examined the effectiveness of online and remote interventions for mental health in children and adolescents. The findings indicated significant effects in reducing depressive symptoms and moderate effects on anxiety and social functioning.

Veterans with PTSD: A noninferiority trial (Acierno et al., 2017) reported in Behaviour Research and Therapy randomized 132 veterans with PTSD to prolonged exposure therapy delivered in person or by home-based video and found home-based delivery was not inferior on PTSD symptom outcomes. A larger comparison (Morland et al., 2020) reported in Depression and Anxiety assigned 175 veterans to prolonged exposure delivered by home-based video, in-home in person, or in the clinic; all three formats produced clinically significant reductions in PTSD symptoms with no significant differences between modalities.

References

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