Dr. Tiffany Simpson, Kim Mulholland, TCTSY-F, and BHU staff

Hospital Implements TCTSY Pilot Program Within Inpatient Behavioral Health Unit
Written by Kim Mulholland, TCTSY-F and Dr. Tiffany Simpson

Kim: I started my healthcare career as a Speech & Language Pathologist at Haywood Regional Medical Center (HRMC). Little did I know my professional career would lead me back home to my community hospital twenty years later as a Trauma Center Trauma Sensitive Yoga Facilitator (TCTSY-F). It is a true honour to work with a hospital who’s guiding principles value quality patient care, health and well-being for each patient and the community we serve and share life with.  

In February 2018, with the support of hospital administration and Dr. Tiffany Simpson, Clinical Psychologist and Director of Behavioral Health Services, we launched a pilot TCTSY program on the inpatient behavioural health unit(BHU). There were many challenges and considerations we had to explore and navigate to make this a permanent service. Recognizing TCTSY is an empirically validated and evidenced-based treatment there was still a concern as to whether the service could provide a safe therapeutic relationship for an array of psychiatric and mental health conditions, patients experiencing psychosis, suicidality or other self-injurious behaviours. Could these patients learn to safely reconnect to their existing bodies when their body connections are often unsafe, untrustworthy, overwhelming, disorganized and distorted? There were a host of other challenges to overcome such as limited space and how to use equipment safely.

We began the program relying on the 13 years of TCTSY research and knowledge that the experience of trauma has profound effects on the bodies of people suffering from psychological trauma. Acknowledging that learning to befriend how one feels inside is a critical adjunctive component of healing and recovery while also recognizing the acuity in our patients. We met each presented challenge adhering to TCTSY core principles. Initially, we implemented TCTSY individually in patient rooms and discovered the individual sessions were beneficial and also supportive to patients that isolate. For some of these patients finding safety in the intervention seemed to foster an openness to explore the other therapeutic groups offered on the unit.

The patients and staff quickly began reporting positive and supportive experiences with TCTSY. The unit staff would often report that a patient’s anxiety level had greatly decreased after a session, sometimes to the point of not needing to take a medication they would have normally resorted to. Patients reported feeling safely connected to themselves in ways they had never experienced before and many proudly stated they could not wait to share what they had experienced and learned. Sometimes, after only one session, patients stated they felt peaceful, calm and relaxed and shared they could not remember the last time they felt this way. Many reported feeling more hopeful, present, connected, grounded and more able to manage emotions, stress, anxiety and triggers. Within a few months, TCTSY became a permanent and integral part of the behavioural health services at HRMC.

Dr. Simpson shares: “Kim and TCTSY have been able to take mind and body wellness from aspiration to practice for the patients on our inpatient psychiatric units. To say that TCTSY has had a remarkable impact on our patients is an understatement. TCTSY has allowed patients to connect with their bodies in a way that many of them never thought possible. It has also allowed patients experiencing a mental health crisis to have hope that mental health wellness is possible.”

I recall one patient’s recent comments about TCTSY. “I feel as though I have been given a new life.” There is something so beautiful when a person can, often for the first time, safely inhabit their body no longer stuck continually re-experiencing the past or feeling numb and where respite and bodily rest can be found away from racing thoughts. It is as if one’s body is saying; “welcome home” and healing begins from within. Witnessing these transformative moments is deeply moving and meaningful, even in a hospital room.

In addition to all of the benefits for the majority of our patients, there are two particularly critical things that Kim has been able to accomplish. The first is that because inpatient units are acute in nature the length of stay for a patient is on average three to five days. As such, maximizing TCTSY contact is important especially since at maximum capacity we have 33 patients and only one Kim. Kim has responded to this need by utilizing TCTSY and related concepts in a group setting when appropriate and making visual yoga cards for patients to have in their rooms to practice when Kim is not available. We are also trying to utilize technology in the form of videos and the internet to make TCTSY practices led by Kim available to patients upon discharge as part of comprehensive discharge planning.

The other amazing, and honestly, the surprising impact is the work that Kim is doing with our geriatric patients. Many of the patients on our senior behavioural health unit also have a neurocognitive disorder and are often “unreachable” in many ways. Kim’s understanding of interoception interventions (awareness of inner body sensations) has offered a path to calming and soothing the souls of these patients suffering from the devastating effects of the neurocognitive disorder.

Kim: In closing, I wholeheartedly credit the success of our Trauma Yoga BHU program to the administration’s willingness to explore a cutting edge adjunctive service. Also to Tiffany, whose passion and knowledge of our work was instrumental in the program development, and to the dedication of our multidisciplinary team of providers. The nurses, social workers, and recreational therapist that I am so honoured and privileged to work alongside. Dr. Simpson would like for everyone that is already doing or considering this work to please know that it is a vital part of healing our trauma laden world. 

*Upcoming TCTSY Workshops*

Medellin Colombia
May 10-12, 2019 20-hour workshop with Morgan Vanderpool, LICSW, E-RYT, TCTSY-F
Sydney Australia
May 10-12, 2019 20-hour workshop with Edwina Kempe, TCTSY-F 
Malmö, Sweden
May 17-19, 2019 20-hour workshop with Krystyna Kowalski, C-IAYT, TCTSY-F
Bend, OR, USA
May 17-19, 2019 20-hour workshop with Keri Sawyer, TCTSY-F
Bogotá,  Colombia
May 17-19, 2019 20-hour workshop with Morgan Vanderpool, LICSW, E-RYT, TCTSY-F
Melbourne, Australia
May 18 & 19 20-hour workshop with Kristen Pringle, TCTSY-F, IAYT, OT
Cleveland, OH, USA
May 31- June 2, 2019 20-hour workshop with Jenn Turner, LMHC, TCTSY-F 
Byron Bay, Australia
June 14-16, 2019 20-hour workshop with Edwina Kempe, TCTSY-F
Tacoma, WA, USA
June 14-16, 2019 20-hour workshop with Morgan Vanderpool, LICSW, E-RYT, TCTSY-F
Haarlem, Netherlands
June 21-23, 2019 20-hour workshop with Esther van der Sande, TCTSY-F 
London, England
June 24-26, 2019 20-hour workshop with Alex Cat, TCTSY-F
Wales, WI, USA
June 28-30, 2019 20-hour workshop with Keri Sawyer, TCTSY-F 
July 1 & 2 , 2019 for Mental Health Professionals 20-hour workshop with Kristen Pringle, TCTSY-F, IAYT, OT 
July 4 & 5, 2019 for Yoga Teachers 20-hour workshop with Kristen Pringle, TCTSY-F, IAYT, OT 

For a complete list of workshops and trainings: Visit our website

Interested in becoming certified in TCTSY? 

Enrollment is currently OPEN!

UPDATE: We are no longer accepting applications for the Boston, Massachusetts opening weekend/cohort. We have limited spaces available in Berlin, Germany and Melbourne, Australia. 
To find out if you qualify for application please visit our website HERE

TCTSY is a program of:
The Center for Trauma and Embodiment at JRI160 Gould Street, Suite 300Needham, MA 02494 USA

In partnership with: