Somatic Psychotherapy

The NeuroAffective Relational Model (NARM) is a therapeutic framework tailored to address Complex Post-Traumatic Stress Disorder (C-PTSD), seamlessly integrating both cognitive (top-down) and somatic (bottom-up) techniques. A key component of the NARM model is the reinforcement of client agency, which is one of its four foundational pillars. This Interpretative Phenomenological Analysis explored how the NARM model influences client agency through the insights of NARM Therapists. Fourteen NARM Therapists participated in a focus group to share their experiences as trained trauma therapists treating clients who have encountered C-PTSD, alongside related methods such as EMDR therapy and Somatic Experiencing. The study revealed four predominant themes that encapsulate the notion of client agency as supported by the NARM model from the perspective of these therapists. The emerging themes include Connecting to Present Moment Awareness, Reflecting and Reinforcing Client Choices, Acknowledging Client Insight, and Contracting with the Client. Social workers can enhance their support for clients experiencing C-PTSD by reinforcing client agency and employing trauma-informed therapy approaches like NARM and Integral Somatic Psychology to further the NASW standards for clinical social work practice, including standards one, two, and eleven (focused on values and ethics, specialized practice skills, and professional development). Vasquez, J. (2024). The Impact of the Neuro Affective Relational Model (NARM) on client agency. Studies in Clinical Social Work: Transforming Practice, Education and Research, 5(1), 1-20. doi: 10.1080/28376811.2024.2387677 http://dx.doi.org/10.1080/28376811.2024.2387677

This study explored professional sustainability from the perspective of NeuroAffective Relational Model (NARM)-trained trauma therapists who have faced vicarious trauma. Research indicates that trauma-informed therapy training, including NARM, EMDR therapy, and Integral Somatic Psychology, can effectively counteract the detrimental effects of vicarious trauma on therapists. The participants in this study are licensed therapists who have completed NARM training, a therapeutic model designed to aid professionals working with complex trauma. Four key themes emerged from this research: therapists feel supported in their practice, experience heightened confidence, engage in more effective work, and find their work more enjoyable. The outcomes of this study clearly demonstrate that trauma trainings, such as those based on Somatic Experiencing and the NeuroAffective Relational Model, can not only prepare therapists for the challenges they face but also promote sustainability despite the risk of exposure to vicarious trauma. 

Vasquez, J. (2024). The impact of vicarious trauma exposure on the professional sustainability of trauma therapists: A qualitative analysis of NeuroAffective Relational Model (NARM) therapists. Professional Development: The International Journal of Continuing Social Work Education, 27(2), 13. https://sites.utexas.edu/ioe/files/2024/10/272047.pdf

The NeuroAffective Relational Model (NARM) therapy is a trauma-informed therapy approach designed to address developmental trauma by focusing on attachment and interpersonal dynamics. This model draws on principles from various clinical mental health therapy modalities, including Psychodynamic Psychotherapy, Attachment Theory, Cognitive Therapy, Gestalt Therapy, and Somatic Experiencing, and it emphasizes self-regulation and awareness, aligning with relational approaches. As research on developmental trauma expands, there is a growing need for insights that inform clinical social workers about the benefits of NARM therapy. This paper argues that NARM is a promising therapeutic model that can help prevent and mitigate secondary traumatic stress and burnout among social workers, and it can also be effective in trauma work with clients. A case vignette is included to illustrate the application of the four pillars of the NARM model in practice, highlighting its relevance alongside other techniques like EMDR therapy and Integral Somatic Psychology. 

Vasquez, J., & Bowie-Viverette, A. C. (2024). Trauma and the case for utilizing NARM therapy in clinical social work: Implications for practice, compassion fatigue, and burnout. Clinical Social Work Journal. https://doi.org/10.1007/s10615-024-00973-8

The NeuroAffective Relational Model (NARM) is a therapeutic framework designed to address Complex Post Traumatic Stress Disorder (C-PTSD) by integrating both top-down cognitive methods and bottom-up somatic approaches, such as Somatic Experiencing and Integral Somatic Psychology. With the inclusion of C-PTSD in the ICD-11, there is a growing need for treatment models that specifically cater to the unique requirements of clients experiencing C-PTSD. Therapists working with clients facing complex trauma are often exposed to secondary trauma, which can result in secondary traumatic stress and burnout, contributing to compassion fatigue. Despite these challenges, trauma therapists also experience compassion satisfaction, reflecting their positive emotional response from making a meaningful impact through trauma-informed therapy. Training is recognized as an essential protective factor against the risk of compassion fatigue. This mixed-methods analysis explored both compassion fatigue and compassion satisfaction among NARM Therapists. Findings revealed that NARM Therapists (n=53) reported significantly lower levels of compassion fatigue and higher compassion satisfaction compared to other trauma workers. Utilizing the ProQOL5 measure (Stamm, 2024), it was found that 84.9% of NARM Therapists scored low for burnout, 83% scored low for secondary traumatic stress, and 67.9% reported high compassion satisfaction. The study identified four key themes that illustrate the effects of NARM on compassion satisfaction and compassion fatigue from the perspective of NARM Therapists: expending less effort, establishing improved boundaries, experiencing increased energy, and gaining enhanced confidence. This highlights how the NeuroAffective Relational Model serves as a protective factor for trauma therapists.

Vasquez, J. & Bowie-Viverette, A.C (2025). Compassion fatigue and compassion satisfaction

among NeuroAffective Relational Model therapists: How NARM serves as a protective factor for trauma therapists. Social Work and Social Sciences Review. https://doi.org/10.1921/swssr22326

Research indicates that trauma therapists, including those practicing EMDR therapy and Integral Somatic Psychology, often face secondary trauma, which can result in secondary traumatic stress, compassion fatigue, and burnout. Trauma-informed therapy training, particularly in the NeuroAffective Relational Model (NARM) and Somatic Experiencing, has demonstrated potential in improving practitioners' professional quality of life, especially for those who routinely engage with trauma. To our knowledge, no prior studies have explored the training outcomes of NARM therapists regarding professional quality-of-life indicators. This cross-sectional observational study assessed the professional quality of life among NARM therapists in the United States (n = 13) utilizing the ProQOL 5 scale. Descriptive findings revealed that therapists reported moderate levels of compassion satisfaction (¯x = 36.92), burnout (¯x = 23.46), and secondary traumatic stress (¯x = 23.54). Although this study is limited by a small sample size and the inability to establish causality, it offers preliminary insights into the professional well-being of NARM therapists. These findings may assist trauma therapists and training providers in understanding typical ranges of compassion satisfaction, burnout, and secondary traumatic stress among clinicians using relational and developmental trauma models, while also identifying areas where additional support or training in trauma-informed therapy could be beneficial.

Vasquez, J. & Bowie-Viverette, A.C. (2026). A Frequency Analysis of NARM Therapists’ Professional Quality of Life After NARM Training. OBM Integrative and Complementary Medicine, http://dx.doi.org/10.21926/obm.icm.2601001  

This dissertation explores the professional quality of life of trauma therapists trained in the NeuroAffective Relational Model (NARM), emphasizing how meaning making impacts their experiences of compassion fatigue, burnout, and compassion satisfaction. Using qualitative research methods, the study investigates the specific challenges and protective factors encountered by NARM therapists, who provide trauma-informed therapy to complex trauma populations. Additionally, it examines how techniques from EMDR therapy, Integral Somatic Psychology, and Somatic Experiencing contribute to the unique resilience and emotional regulation of these therapists. Findings emphasize the importance of NARM’s somatic and relational approach in enhancing professional sustainability. This research enhances our understanding of how specialized trauma therapy training supports therapists’ well-being and informs best practices for mitigating secondary traumatic stress in clinical social work. Recommendations for future research and implications for clinical practice are also discussed. 

Vasquez, J. A. (2022). Meaning making: Understanding professional quality of life for NeuroAffective Relational Model trained trauma therapists (Order No. 29069087) [Doctoral dissertation, Our Lady of the Lake University]. ProQuest One Academic; Sociological Abstracts. https://www.proquest.com/dissertations-theses/meaning-making-understanding-professional-quality/docview/2659277203/se-2

In this episode of Transforming Trauma, our host Emily is joined by Dr. Jena Vasquez, LCSW-S, NARM Therapist, SEP, Yoga Therapist and Instructor, professor and researcher. Dr. Vasquez recently completed her doctoral dissertation, Meaning Making: Understanding Professional Quality of Life for NARM Trained Trauma Therapists, one of the first studies to explore how professional training in trauma, including modalities like EMDR therapy and Integral Somatic Psychology, impacts the quality of life for trauma therapists. Dr. Vasquez specifically chose to focus on the NeuroAffective Relational Model (NARM) in her research, and throughout the conversation, she shares her findings along with powerful quotes from those she studied. 

Having worked in the trauma field for many years, Dr. Vasquez observed that many of her colleagues and supervisees were experiencing significant burnout. She reflected on available resources and found that those who pursued further training in trauma, such as Somatic Experiencing and NARM, tended to fare better. After training in various modalities, she noticed a distinct difference in the well-being of NARM-trained therapists. In her quest to better support fellow therapists, she began to hypothesize that NARM Training offers unique benefits for trauma therapists. "The NARM Training can really help trauma therapists to reduce the impact of secondary traumatic stress, burnout, and compassion fatigue that so many therapists encounter in their work," Dr. Vasquez states. 

Dr. Vasquez shares insightful quotes from NARM Therapists including:  

"I feel more joy in my work, and in my life personally."  

"Working with trauma is a difficult choice, and using NARM has allowed me to really stay in it without being in a way that negatively impacts myself and my ability to be present for others."  

"Not only is the modality effective, but it also supports me in sustaining my work."  

She also discusses her personal journey through the NARM Therapist Training, detailing how this experience and the supportive community influenced her approach. Now, she integrates NARM into her teaching, supervision, and clinical work. Reflecting on her integration of NARM, she explains, "The four pillars of NARM provide the framework that guides my practice with complex trauma survivors." Together, Dr. Vasquez and Emily delve into the transformative nature of NARM Therapy and explore avenues for further research on NARM clients.  

We invite you to listen to the full episode to hear their complete conversation and gain insights into Dr. Vasquez’s research and her innovative work with NARM:  Professional Quality of Life for Trauma Therapists