Healing Framework · Evidence-Based Modalities
There is no single correct therapy modality. This is one of the most important things to understand before beginning, or returning to, therapeutic work. The wound type matters more than the label. A person carrying developmental trauma stored somatically will likely find cognitive approaches frustrating not because cognitive approaches are inferior but because the wound is held in a layer of the nervous system that cognition does not directly reach. A person with a single-incident PTSD presentation will likely find somatic approaches valuable but may benefit first from the structured memory processing that EMDR provides. The modality and the wound have to match.
The therapeutic relationship matters more than any technique within it. Research across modalities consistently finds that the quality of the therapeutic alliance, the felt sense of being understood, the experience of a reliably consistent and attuned presence, predicts outcome more reliably than which treatment protocol is used. This does not mean protocols are irrelevant; it means they work best when they are delivered within a relationship the client experiences as genuinely safe. For people with attachment wounds, the relationship is not just the container for the work; it is the work.
The pages below describe ten evidence-based modalities in the depth they deserve: what each is, how it works, who developed it and where the research comes from, which wound types it addresses most effectively, and how it fits into the nervous system and attachment framework that runs across this site. These are not advertisements for particular approaches. They are maps for a person who is trying to understand what kind of help exists, and which kind might fit what they are carrying.
Which modality for which wound
Complex PTSD and developmental trauma
Worth wound and conditional self-concept
Relational patterns and repeating relationship dynamics
Freeze, collapse, and somatic shutdown
Childhood trauma (for parents and those understanding origin patterns)
All ten modalities
Developed by Peter Levine in the 1970s-1990s · Somatic Experiencing International (SEI)
Developed by Francine Shapiro in 1987-1989 · EMDR International Association (EMDRIA)
Developed by Richard Schwartz beginning in the 1980s · IFS Institute
Developed by Aaron Beck in the 1960s · Beck Institute for Cognitive Behavior Therapy
Developed by Marsha Linehan in the 1980s · Behavioral Tech (Linehan Institute)
Developed by Steven Hayes in the 1980s-1990s · Association for Contextual Behavioral Science (ACBS)
Rooted in Bowlby's attachment theory (1960s-1980s); developed as a clinical approach by multiple theorists including Diana Fosha, Daniel Hughes, and Jeremy Holmes · Multiple — Diana Fosha's AEDP Institute, Daniel Hughes's Dyadic Developmental Psychotherapy, Jeremy Holmes's attachment-informed psychodynamic
Rooted in Freud (1890s-1930s); modernized by object relations theorists (Winnicott, Klein, Kohut) through the 20th century · Multiple — American Psychoanalytic Association, British Psychoanalytical Society, Tavistock and Portman NHS Foundation Trust
Based on Stephen Porges's polyvagal theory (1994-present); applied clinically by Deb Dana and colleagues beginning in the 2010s · Polyvagal Institute; PESI (continuing education)
Developed by Anthony Mannarino, Judith Cohen, and Esther Deblinger in the 1990s · Medical College of Pennsylvania-Hahnemann University; Medical University of South Carolina (MUSC)
The Elysian Press
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