An Innovative Alternative Healing Modality

Trauma-Informed Strength Training

Introduction

There is extensive research on the importance of the mind-body connection when healing from trauma. According to a 2014 study, “a 10-week weekly yoga program compared with supportive therapy can significantly reduce PTSD [Post-Traumatic Stress Disorder] symptomatology in women with chronic treatment-resistant PTSD, with effect sizes comparable to well-researched psychotherapeutic and pharmacologic approaches” (van der Kolk, Rhodes, Suvak, & Spinazzola).

In 2019, an interdisciplinary team built upon the existing research on trauma-informed yoga to create an innovative treatment modality for healing from trauma using weight lifting and strength training, called trauma-informed strength training. This interdisciplinary planning team consisted of gender-based violence Survivor Leader Carmen Guzman Lombert, gender-based violence Survivor Leader and fitness instructor Sandra Manick, Licensed Clinical Social Worker Shobana Powell, and Personal Trainer and Certified Strength and Conditioning Specialist Dianna Scotece, who created the fitness curriculum and strength training protocols for the project.

Methods

The planning team sought to create a trauma-informed strength training modality as a new approach to holistic healing and to test whether the new modality could, like trauma-informed yoga, reduce PTSD symptoms. The goal of the project was to empower survivors to steward their wellness, connect with their bodies, and reclaim power and control over their bodies.

The team piloted the approach with the Survivor Leadership Coalition, a program of Sanctuary for Families, one of the largest gender-based violence service providers in New York City. The program participants were Survivor Leaders, meaning each participant had lived experience as a survivor of gender-based violence and was an advocate in the movement to end gender-based violence. The team piloted the program with Survivor Leaders, as they were established in their ongoing healing journeys, were not in crisis, and had support systems in place should any challenges arise throughout the program.

The pilot program began with informational sessions for potential participants to learn more about the program and expectations. Six Survivor Leaders expressed interest, and four completed the program. The two who were unable to complete the program dropped out due to challenges with availability and scheduling. Each participant attended one-on-one strength training sessions, twice a week with trauma-trained fitness instructors at various gyms across New York City. Over the course of six (6) weeks, participants attended a total of twelve (12) sessions each.

The project included mandatory trauma training for all fitness instructors, led by experts on gender-based violence with both clinical and lived experience. The training included recommendations such as focusing on the participant’s power and control over their own body in their strength training work, being mindful of instructor tone and body language, acknowledging systemic power and privilege dynamics within the instructor-participant relationship, instructing without touching the participant, understanding common challenges survivors of gender-based violence may face with strength-training and fitness, understanding gender-based violence and the impact of trauma on the body and the brain, co-creating healthy boundaries in the instructor-participant relationship, clearly defining roles and expectations of instructors and participants, referring out to experts for mental health support as needed, and sharing power and control in the instructor-participant relationship by providing options for each exercise, co-creating strength training plans with participants, and establishing a plan for communicating if a participant feels uncomfortable at any time.

Upon completion of the trauma training, the fitness instructors then met individually with the participants to teach basic weightlifting and resistance training techniques and to co-design individualized programs that the participants could update, modify, and execute on their own. If there were any concerns or questions, a clinician and experts with lived experience were available for consultation and technical assistance.

At the conclusion of the program, the planning team held focus groups with participants and fitness instructors to receive feedback and recommendations.

Results

Of the three fitness instructors who participated in the pilot, 100% felt that facilitating the program taught them about their own resiliency through the resiliency of the participants. This finding suggests that facilitating trauma-informed strength training can result in increased “vicarious resilience”, when the process of witnessing resiliency of survivors of trauma has a positive effect on the advocate working with that individual, including an increase in one’s own ability to heal and adapt to adversity (Hernandez, Gangsei, & Engstrom, 2007).

Of the four Survivor Leaders who participated in the pilot, 100% felt that trauma-informed strength training improved their sense of empowerment and their overall mental health. These findings suggest that trauma-informed strength training can result in improved empowerment and mental health for survivors of gender-based violence.

Testimonials from fitness instructors*:

“We had this whole experience around learning to trust your body after the trauma.”

“We were figuring out how to share power.”

“We co-created the program, flowing in and out of leadership.”

Testimonials from Survivor Leader participants*:

“It was like reiterating your agency over your body.”

“In addition to some new muscles, I have gained incredible inspiration and motivation in my present and future.”

“In that one activity [strength training], you can engage in physical, spiritual, emotional, intellectual [healing].”

“I walked out of the first session, and I felt I could fly.”

Challenges & Recommendations

Limitations of the project include that it was developed and implemented within the same organization and the sample size was small. This modality should be tested with other organizations and populations, including survivors who are not in leadership roles and who are at varying stages in their healing journeys. As this was a pilot project and not a formal research study, there was no control group, and there were many factors that were not accounted for. For example, each instructor received the same trauma training; however, their implementation of those concepts was not measured. There was likely variation in approaches such as instructor styles, exercises used, and use of trauma-informed language and techniques. Results were measured through focus groups rather than using a formal assessment tool. Future research in this area should include the use of standardized assessment and/or screening tools.

Although the interdisciplinary planning team included expertise from perspectives of a trauma clinician, fitness instructors, and those with lived experiences, an additional limitation is that the team lacked representation of those with experience in trauma-informed yoga, yoga therapy, or somatic therapy. Future research on trauma-informed fitness programming should include leadership and input from experts in those related fields.

Another challenge is that access to affordable physical fitness resources is limited for marginalized communities, especially people of color, immigrants, LGBTQ+ folks, and people with disabilities. As gender-based violence disproportionately impacts marginalized communities, it is vital to address this intersectionality and the consequent systemic barriers to access (Granger & Sabri, 2018). As such, the interdisciplinary planning team developed resource lists of affordable and accessible gym memberships in New York City, in order to promote sustainability and access. Further studies on trauma-informed strength training should also focus on cultural and linguistic inclusion for diverse communities.

As gender-based violence is rooted in the abuse of power and control, it was imperative that this project centered on shared power, collective decision-making, and co-creation. Fitness instructors were taught how to share power, and survivors led and informed the project from its inception. Future iterations of this approach should continue to center the input and leadership of those with lived experience, especially those from marginalized communities, to ensure the program is inclusive and accessible. Additional recommendations include 1) extending the duration of the program from 6 weeks to at least 9 weeks to allow more time to develop new habits and 2) addressing availability and scheduling challenges to increase accessibility and completion rates.

Conclusion

Based on the results of this pilot program, trauma-informed strength training shows promise as a form of holistic healing from trauma. Formal research should be conducted to further assess the impact and any potential negative consequences of this approach. This approach is not recommended to replace other forms of treatment for trauma; however, further research should explore whether it could be effective as an adjunctive treatment for Post-Traumatic Stress Disorder, similar to trauma-informed yoga.

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*Participant and instructor names and identifying information are confidential, as is best practice for program evaluation.