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European Journal of Psychotraumatology logoLink to European Journal of Psychotraumatology
. 2025 Nov 17;16(1):2524901. doi: 10.1080/20008066.2025.2524901

Body and Movement-Oriented Interventions in adolescents’ trauma: a scoping review

Intervenciones Orientadas al Cuerpo y al Movimiento en el trauma adolescente: una revisión de alcance

Paulo Pelixo a, Guida Veiga b, Anabela Pereira c, Graça D Santos b,CONTACT
PMCID: PMC12624909  PMID: 41247767

ABSTRACT

Background:

In recent years, there has been a growing interest in new therapeutic approaches to treat trauma, namely through Body and/or Movement-Oriented Interventions (BMOIs), seeking to change the way the body responds to traumatic experiences. This is a recent research field, and it has focused mainly on adults. As traumatic experiences deeply affect adolescents, it is crucial to understand if BMOIs are effective approaches to reduce trauma-based symptoms in this population.

Objective:

The knowledge about the effects of BMOIs in traumatized adolescents is still limited. This paper aims to address this gap by reviewing the research on BMOIs to systematize their effects on adolescents’ trauma-based symptoms.

Methods:

A meticulous search of databases and grey literature was conducted to gather relevant information on this research topic. Studies published between 2000 and 2024 were analysed. Ninety relevant studies were identified, nine of which met the inclusion criteria. The selected studies were analysed to assess their characteristics and procedures and the effects of BMOIs.

Results:

The results suggest that BMOIs may be promising approaches to reduce PTSD symptoms and PTSD comorbidities, such as mood or anxiety disorders. They also indicate BMOIs potentiality at improving arousal regulation, contributing to normalise excitability and reactivity patterns.

Conclusion:

This study demonstrates that BMOIs may have a positive impact on adolescents’ trauma-based symptoms and on psychophysiological patterns affected by traumatic experiences. Although preliminary, these findings suggest that BMOIs are valid approaches to address trauma in this population.

KEYWORDS: Body and Movement-Oriented Interventions (BMOIs), adolescents, PTSD, trauma-based symptoms, scoping literature review

HIGHLIGHTS

  • Body and Movement Oriented Interventions appear promising to reduce PTSD symptoms in adolescents.

  • Body and Movement Oriented Interventions may be helpful to reduce trauma-based symptoms in adolescents.

  • Preliminary evidence indicates that Body and Movement Oriented Interventions may have a positive effect on the psychophysiological dysregulation associated with traumatic experiences.

1. Introduction

Trauma affects not only individual well-being but also places a significant burden on healthcare systems, communities, and society at large, thus demanding comprehensive approaches to prevention and recovery (Lovell et al., 2022). In this sense, it is considered a public health issue (Lee & Bowles, 2023) that may stem from a single incident (type I trauma) or from prolonged exposure to threats to physical and psychological integrity (type II trauma) (Ford & Courtois, 2020). Trauma often leads to chronic and debilitating effects and is associated with multiple physical and mental health comorbidities (Cardoso et al., 2020).

When experienced during adolescence trauma can profoundly affect all areas of a young person’s life immediately and/or in the long term (Ford et al., 2021). Adolescence is a critical development stage for the neurophysiological system, as well as for social and behavioural skills (Lohrasbe & Ogden, 2017; Soma et al., 2021). Consequently, adolescent trauma is linked to a broad range of mental health comorbidities (Levin & Liu, 2024; McGreevy & Boland, 2020; Van der Kolk, 2014), including sleep and/or eating disorders (Mayer, 2019; Mensinger, 2022), mood and anxiety disorders, somatoform disorders, and substance use disorders (Van de Kamp et al., 2019). In addition to these clinical conditions, adolescents who have experienced trauma often display difficulties such as impulsivity, irritability, emotional dysregulation, aggression, and risk-taking behaviours, alongside academic challenges (Mayer, 2019). Moreover, they may also present with more subtle symptoms – such as psychosomatic complaints – that are frequently overlooked and not readily associated with traumatic experience (Soma et al., 2021).

Over the last two decades, various therapeutic approaches have emerged to address the needs of traumatized adolescents (Joseph et al., 2021; Stark et al., 2020; Warner et al., 2020). Most current approaches follow a top-down approach, such as Trauma-Focused Cognitive Behavioural Therapy. These approaches address trauma through higher cortical skills and executive functions of the brain, such as verbal language, autobiographical memory, and abstraction (Warner et al., 2020).

Despite being considered the best evidence-based practice for trauma intervention, these top-down approaches have been criticized for several limitations when applied to adolescents with trauma (Laricchiuta et al., 2023). The top cortical functions are highly affected by trauma (Van der Kolk, 2014), and traumatized adolescents often struggle to access and master those cortical functions (Finn et al., 2018; Fraser et al., 2017; Soma et al., 2021). Moreover, top-down approaches fail to address the mind–body disconnection and the psychophysiological dysregulation resulting from trauma (Kearney & Lanius, 2022; Van der Kolk, 2014).

The mind–body disconnection is critical factor in trauma intervention. Research indicates that experiences of extreme stress or trauma can dysregulate the nervous system, thereby affecting both physical and emotional states (Berman, 2019). Traumatic events are often multisensory and aversive experiences of fear, helplessness and/or horror, and can result in a profound distrust in one's own body (Kearney & Lanius, 2022). As a result, bodily manifestations of trauma are frequently observed (Laricchiuta et al., 2023).

Therefore bottom-up approaches, using corporeality as a core focus (Van de Kamp et al., 2019), have been acknowledged as fundamental for trauma intervention (Classen et al., 2021; Grabbe & Miller-Karas, 2018; Invitto & Moselli, 2024; Punkanen & Buckley, 2021; Rosendahl et al., 2021). These approaches target the subcortical brain areas affected by traumatic experiences through Body and Movement-Oriented Interventions (BMOIs) to process trauma (Warner et al., 2020) and to regulate arousal and affect (Van de Kamp et al., 2023). These approaches target subcortical areas of the brain affected by trauma, using Body and Movement-Oriented Interventions (BMOIs) to process traumatic memories (Warner et al., 2020) and to regulate arousal and affect (Van de Kamp et al., 2023). The term BMOI has been used in the literature as an umbrella concept encompassing interventions that integrate bodywork (e.g. touch, massage, body awareness and/or movement) and sensory experience as central elements of therapeutic intervention (Payne et al., 2019). These approaches are grounded in an understanding of the interconnection between mind and body, and the relationship between emotions, cognitions and sensations (Mischke-Reeds, 2018; Payne et al., 2019). BMOIs employ bodily and movement-based strategies to support self-regulation (Warner et al., 2014), affect modulation (Almeida et al., 2019) and behavioural, cognitive and emotional transformation (Vriend et al., 2024). They encompass a diverse range of modalities, including Dance Movement Therapy, relaxation techniques, and sensory-based interventions (Dias Rodrigues et al., 2022).

While a growing number of studies highlight the significant role of BMOIs within psychotraumatology, – – particularly in adult populations (Kuhfuß et al., 2021; Laricchiuta et al., 2023; Rosendahl et al., 2021; Van de Kamp et al., 2019; Van de Kamp et al., 2023), (Nicotera & Viggiano, 2021; Warner et al., 2020), emerging research has begun to explore their relevance and effectiveness for adolescents (Finn et al., 2018). However, to date, no study has systematically synthesized the existing evidence on the effects of BMOIs for traumatised adolescents.

This paper aims to address that gap. The objective of this scoping review is to analyse the current research on BMOIs and synthesize their reported effects on trauma-related symptoms in adolescents. It is guided by a central research question: how effective are BMOIs in reducing trauma-based symptoms in adolescents?

2. Methods

2.1. Literature search

The authors followed the guidelines for scoping reviews – PRISMA-ScR (Tricco et al., 2018), as it allows for identifying and mapping the types of evidence available, thereby providing a comprehensive review of the existent research (Amendoeira, 2022; Munn et al., 2018), regardless of the research designs (Arksey & O'Malley, 2005).

The authors defined and agreed on the fundamental criteria for this scoping review and conducted an exhaustive search in EBSCO Discovery Services (that includes several databases such as CINAHL Ultimate, PubMed, MEDLINE and Scopus) and Proquest between 1 July and 31 August 2024. The search terms were based on the expressions used in the literature to designate (1) BMOIs (‘body-oriented intervention’ OR ‘body-based intervention’ OR ‘body therapy’ OR ‘body psychotherapy’ OR ‘embodied intervention’ OR ‘somatic intervention’ OR ‘somatic therapy’ OR ‘somatic-based’ OR ‘somatic-oriented’ OR ‘mind-body’ OR ‘sensory-based’ OR ‘sensory therapy’ OR ‘sensory psychotherapy’ OR ‘dance movement therapy’ OR ‘DMT’ OR ‘dance’ OR ‘dance therapy’ OR ‘movement’ OR ‘movement-based’ OR ‘movement-oriented’), (2) trauma (‘trauma’ OR ‘trauma-related’ OR ‘PTSD’ OR ‘post-traumatic stress disorder’ OR ‘posttraumatic stress disorder’ OR ‘post-traumatic stress disorder’) and (3) adolescents (‘adolescent’ OR ‘teenager’ OR ‘teen’ OR ‘youth’ OR ‘young person’ OR ‘young people’ OR ‘children’ OR ‘child’).

In addition, we made another research on Google Scholar and on related literature reviews to ensure the inclusion of all qualified publications in this scoping review. Subsequently, two authors independently reviewed the titles and abstracts of the included articles before full-text assessment. In cases of disagreement between researchers regarding the inclusion or exclusion of a study, a third author was engaged to reach a final decision.

All screening processes were made using Microsoft Excel.

2.2. Inclusion and exclusion criteria

After collecting the initial data, all studies that met the following criteria were included: (1) published between 2000 and 2024, as since the late nineties, several trauma-specific treatments for children and adolescents have emerged, namely, BMOIs (Warner et al., 2020); (2) published in English; (3) empirical studies with quantitative/qualitative assessment and analysis methodologies and N ≥ 1 samples; (4) the participants are adolescents (10-21 years old); (5) BMOI is used as the main or complementary intervention approach; (6) the symptomatology presented by the target group is trauma-related; (7) analysed the effects of the intervention on the symptomatology presented by the target group.

Studies were excluded if they (1) only explained theoretical aspects of BMOIs and/or discussed theoretical differences between BMOIs and other therapeutic modalities; (2) consisted of literature reviews on the subject; (3) investigated mental health conditions other than those related to trauma.

No inclusion or exclusion criteria were defined based on the measures used or intervention details such as the number of sessions or the duration of the treatments.

Figure 1 shows the PRISMA flow diagram for selecting studies.

Figure 1.

Figure 1.

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PRISMA flow diagram.

2.3. Data extraction

All included studies were imported to Microsoft Excel for data extraction including (1) bibliographic information (first author, publication year); (2) participant information (age, gender, sample size in experimental and control groups and inclusion and exclusion criteria); (3) methodology information (study design, type of BMOI and duration of intervention, sampling methods, setting and context, variables, assessment instruments, measures), (4) effectiveness (key results, pre and post-test effects, data analysis method), (5) results analysis (limitations, future research and implications, (6) quality of included quantitative studies (RCT, statistical power, validity/fidelity, effect sizes).

2.4. Data analysis

The aim of this scoping review is to present and summarize data without quantitatively assessing the quality of evidence.

Descriptive data are used to summarize the characteristics of the studies included in this review (Table 1), as well as the implemented intervention (Table 2).

Table 1.

Study characteristics.

        Sample  
Study Research design IBCM Objectives N Inclusion criteria Sex Age Exclusion Criteria Selection method Country
Berman (2019) Case study Somatic Experiencing To explore whether SE is a valid approach to treat trauma-based OCD in adolescents as a preferred or complementary approach. 1 OCD diagnosis.
Previous trauma.
Anxiety and/or depression.
Teenagers (10-19 years old).
Fluency in English.		 M = 100% 16 No information. Convenience South Africa
Burns (2016) Quasi-experimental Dance-Movement therapy To establish the effect of dance movement therapy on self-esteem and level of hostility in an adolescent population at a children's home. 18 Sexual abuse victim.
Ages 11-18.
Resident at the Children's Home.		 M = 28%
F = 72%		 11–18 No information. Convenience South Africa
Chettiar & Mascarenhas (2024) Quasi-experimental Dance-Movement Therapy To assess the impact of a DMT intervention in reducing aggression, depression, anxiety and increasing levels of self-esteem in adolescents who experienced trauma. 60 To have experienced trauma (Child sexual abuse, domestic violence, HIV).
To be in childcare.		 F = 100% 13–18 No information. Convenience India
Davis & Aylward (2023) RCT Trauma-informed Yoga To assess the efficacy and the feasibility of a remotely delivered (via Zoom) trauma-informed yoga intervention for 15–18-year-old male and female high school students.
Evaluate the study's school-community-academic partnership at the conclusion of the program.		 45 No information. M = 56%
F = 44%		 15–18 No information Convenience USA
Ezeh et al. (2023) RCT Dance therapy To compare the effectiveness of dance therapy and art therapy in reducing symptoms of PTSD in child victims of abduction. 470 To attend school.
Having been a victim of kidnapping over the last 3 months.
Have been held captive for 24 hours.		 M = 55%
F = 45%		 10–18 Addictions (alcohol, drugs).
Psychosis.
Severe suicidal ideation.		 Snowball Nigeria
Hetherington & Gentile (2022) Case study Somatic Experiencing + art therapy To understand which interventions are most useful for dealing with developmental trauma 1 No information M = 100% 13 No information Convenience Italy
Nicotera & Viggiano (2021) Quasi-experimental Mind-Body Self-Regulation Yoga (MBSFY) To understand the benefits of the approach for the target group.
To understand whether the approach is feasible.		 52 To be incarcerated in a facility of the juvenile correctional system. F = 100% 13–21 Severe safety risk (acute aggression or self-injurious behaviour).
Difficulty tolerating group experience.		 Convenience USA
Raider et al. (2008) RCT Structured Sensory Intervention for Traumatized Children, Adolescents and Parents – Adjudicated and at-Risk Youth (SITCAP-ART) To assess the effectiveness of the approach with young detainees. 23 To have an history of multiple trauma exposure M = 55%
F = 45%		 16–17   Convenience USA
Warner et al. (2014) Quasi-experimental Sensory Motor Arousal Regulation Treatment (SMART) To examine the effectiveness of SMART with adolescents with histories of complex trauma in residential care 31 Youth in residential treatment settings M = 10%
F = 90%		 13–20 No information. Convenience USA
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Table 2.

Procedures.

    Intervention        
Study Variables Experimental group Control group Instruments Pre-test Post-test Follow-up
Berman (2019) Nuclear:
Trauma-based OCD symptoms.		 20 SE sessions NA Interview.
Video recording.		 _ X _
Other:
No information.
Burns (2016) Nuclear:
Self-esteem and hostility		 6 DMT sessions Waiting list Rosenberg Self-Esteem Scale.
Cook-Medley Hostility Scale;		 X X _
Other:
No information
Chettiar & Mascarenhas (2024) Nuclear:
Aggression, depression and anxiety		 12 DMT sessions Waiting list Buss-Perry Aggression Questionnaire.
Rosenberg Self-esteem Scale.
Revised Child Anxiety and Depression Scale (short version).		 X X _
Other:
Self-esteem
Davis & Aylward (2023) Nuclear:
anxiety, depressive symptoms, resilience, cortisol levels.		 3–12 sessions of Trauma-Informed Yoga No information Adverse Childhood Experiences – Teen Questionnaire (under evaluation).
Generalized Anxiety Disorder Scale (GAD-7) (α = 0.79-0.91).
Patient Health Questionnaire for Depressive Symptomatology for Adolescents (PHQ-A) (α = 0.84).
Connor-Davidson Resilience Scale (CD-RISC). Salivary cortisol analysis.		 X X _
Other:
Sleep.
Ezeh et al. (2023) Nuclear:
PTSD Symptomatology		 20 dance therapy or art therapy sessions Waiting list International Trauma Questionnaire (α = 0.72) X X X (6 months)
Other:
No information
Hetherington & Gentile (2022) Nuclear:
No information		 2 years of art therapy + SE _ Interview. _ _ _
Other:
No information
Nicotera & Viggiano (2021) Nuclear:
Mindful awareness and attention;		 8 MBSRY sessions _ Mindful Attention and Awareness Scale-Adolescents (MAAS-A) (α = 0.88).
Mind-Body Life Skills Questionnaire (MBLSQ) (α = 0.80).		 X X _
Other:
No information
Raider et al. (2008) Nuclear:
Trauma-related symptoms		 10 SITCAP-ART sessions Waiting list Trauma Symptom Checklist (α = 0.82-0.87).
Youth Self Report (α = 0.87).
Child and Adolescent Questionnaire (α = 0.82).		 X X _
Other:
Depression;Anxiety.
Warner et al. (2014) Nuclear:
Internalization symptoms
Somatic complaints
Anxiety
Depression		 9 months of SMART intervention Weekly verbal psychotherapy sessions Trauma History Profile (THP)
Child Behaviour Check List (CBCL).
Posttraumatic Stress Disorder Reaction-Index (PTSD-RI).		 X X _
Other:
Hyperarousal
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We also present relevant information for the assessment of quantitative studies (Table 3).

Table 3.

Quality of quantitative studies.

    Statistical power      
Study Randomized clinical trial A priori A posteriori Validity/fidelity instruments Effect sizes N = constant
Burns (2016) _ _ _   X Yes
Chettiar & Mascarenhas (2024) _ _ _ _ _ Yes
Davis & Aylward (2023) X _ _ X _ Yes
Ezeh et al. (2023) X X _ X X 18 drop-out
Nicotera & Viggiano (2021) _ _ _ X _ Yes
Raider et al. (2008) X _ _ X _ 5 drop-out
Warner et al. (2014) _ _ _ _ _ -_
X – reported
_ – Missing information		          
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No inferential statistical testing was performed in this study.

3. Results

3.1. Descriptive analysis

Out of 90 studies identified at the beginning, nine met the eligibility criteria (Figure 1). Table 1 shows some of their main characteristics.

These studies involved samples made up of boys and girls (ages 10–21) ranging from N = 1 to N = 470. In five of the nine studies analysed, the samples were made up exclusively or mostly of boys.

Bearing in mind the trauma classification mentioned before, eight of the nine studies samples were made up of adolescents with type II trauma, meaning repeated, prolonged and sometimes chronic exposure to trauma (Ford & Courtois, 2020; Lofthouse et al., 2024).

In terms of study design, there was some diversity in the studies: 7 studies were quantitative (four of which were quasi-experimental, and three were RCTs). Two qualitative case studies were also included. The quantitative studies were analysed and critically evaluated (Table 3).

There is some heterogeneity in settings, although about 50% of the studies were carried out in the USA.

Regarding the procedure (Table 2), there is some diversity in the BMOIs that were used: in two studies Somatic Experiencing was the main or complementary intervention; Dance-Movement Therapy (DMT) was used in three studies; two studies based their intervention in different forms of Trauma-Informed Yoga; and two other studies used sensory regulation interventions.

There was a great variability in the length of the interventions, which ranged from a minimum of 3–12 sessions (Davis & Aylard, 2023) to a 2-year intervention programme (Hetherington & Gentile, 2022). Most studies (7 out of 9) implemented intervention programmes with a minimum of 8 sessions. All studies but one (Burns, 2016) showed positive effects on trauma symptoms and comorbidities as well as on arousal/reactivity despite the length of the intervention.

In the included studies, only three relied on individual intervention (Berman, 2019; Hetherington & Gentile, 2022; Warner et al., 2014).

The variables analysed in the selected studies are diverse, although all the studies analysed the effectiveness of interventions on trauma-related symptoms. Three studies specifically analysed the effects of interventions on reducing traumatization symptoms. Four studies analysed common comorbidities of PTSD, namely depression and anxiety.

In 50% of the studies included, the impact of the approaches was analysed in terms of variables related to psychophysiological patterns of self-regulation, an area greatly impacted by trauma (Van de Kamp et al., 2019).

Regarding the psychometric instruments used (21), there was great diversity, considering the different variables analysed in each of the studies. Only three studies used instruments that specifically assess traumatization (International Trauma Questionnaire, Trauma Symptom Checklist, Trauma History Profile, Posttraumatic Stress Disorder Reaction-Index).

3.2. Effectiveness

As stated previously, the objective of this scoping review is to analyse the research produced on BMOIs and to synthesize their effects on trauma-based symptoms in adolescents. Overall, we found that 8 of the 9 included studies described a reduction in trauma-based symptoms following BMOIs and/or positive changes in other variables under analysis.

Among the studies included, 6 incorporated a control group. In 5 of these 6 studies, significant differences were reported between the experimental and the control group in variables impacted by traumatic experiences. Overall, the experimental groups exhibited fewer PTSD symptoms and reduced symptomatology associated with trauma-based comorbidities such as depression and anxiety. Significant changes in arousal and reactivity patterns as well in other areas affected by trauma were also reported.

To better understand the effects of BMOIs, we categorised the results on effectiveness according to the dependent variables.

3.2.1. PTSD

In 3 studies, PTSD symptoms were specifically analysed using psychometric instruments that assess this diagnostic category (International Trauma Questionnaire, Trauma Symptom Checklist, Trauma History Profile, Posttraumatic Stress Disorder Reaction-Index). All 3 studies showed a significant reduction in symptoms in the experimental group, both at post-test and follow-up, compared to the control groups.

One study (Ezeh et al., 2023) found that children who received Dance-Movement Therapy (DMT) and Art Therapy showed a reduction in PTSD symptoms. However, DMT was more effective than Art Therapy in reducing these symptoms.

Another study (Raider et al., 2008) reported a significant reduction in trauma symptoms at the end of the treatment using the Structured Sensory Intervention for Traumatized Children, Adolescents and Parents – Adjudicated and at-Risk Youth (SITCAP-ART).

A third study (Warner et al., 2014) based on Sensory Motor Arousal Regulation Treatment (SMART) demonstrated a reduction in internalizing symptoms associated with complex trauma.

3.2.2. Trauma comorbidities

Four studies analysed the effects of interventions on depression and anxiety, using a control group. In one of the studies (Davis & Aylard, 2023), there were no significant differences in the reduction of symptoms (anxiety and depression) in the post-test or in comparison with the control group (GAD-7 Cohen's d = −0.19; PHQ-A Cohen's d = −0.06), using Trauma-Informed Yoga.

Three studies found significant differences in these categories in terms of symptom reduction at post-test and in comparison, with the control group. One study (Chettiar & Mascarenhas, 2024) indicates that the intervention (DMT) led to a reduction in depression scores.

Another study (Raider et al., 2008) reported that the participants experienced a significant reduction in mental health symptoms, specifically anxiety and depression, following SITCAP-ART.

The third study (Warner et al., 2014) demonstrated that SMART was effective in reducing symptoms of both depression and anxiety.

Still, in terms of comorbidities, a qualitative study (Berman, 2019), using a case study methodology, analysed the effectiveness of the intervention on trauma-based obsessive-compulsive disorder (OCD), demonstrating its effectiveness in terms of greater control over obsessions and compulsions.

3.2.3. Arousal and reactivity patterns

Knowing that trauma has a profound impact on psychophysiological self-regulation (Van der Kolk, 2014), three studies evaluated the effectiveness of interventions in this category.

A qualitative study (Berman, 2019) indicated that the intervention, Somatic Experiencing, increased the participant’s awareness of his own nervous system dysregulation.

Two quantitative studies using a control group showed that the BMOIs contributed to greater self-regulation. One of these studies (Davis & Aylard, 2023) showed a decrease in cortisol levels (Cortisol Cohen's d = 1.39) and improvements in sleep quality at post-test compared to the control group using Trauma-Informed Yoga. Another study (Warner et al., 2014), based in SMART indicated a decrease in hyperactivation associated with trauma after the intervention and compared to the control group.

3.2.4. Other variables

In addition to the symptomatology presented above, some studies assessed the effectiveness of the interventions on other variables that are crucial to understand how trauma affects adolescents and how the different BMOIs can be valid approaches.

Two qualitative studies (Berman, 2019; Hetherington & Gentile, 2022) indicated that Somatic Experiencing (as the main or complementary intervention), made it possible to increase the participants’ sense of control as well as greater sense of safety.

Four quantitative studies using a control group analysed other variables. Two studies (Burns, 2016; Chettiar & Mascarenhas, 2024) analysed the effects of DMT on self-esteem, with no significant differences in the post-test and between groups.

Similarly, another study (Davis & Aylard, 2023) assessed the effectiveness of the intervention on resilience and found no significant differences in the post-test and in comparison, with the control group (CD-RISC Cohen's d = −0.49).

One study (Chettiar & Mascarenhas, 2024) evaluated the effects of DMT on aggression and anger, showing a decrease after the intervention and in comparison, with the control group. Another study (Burns, 2016) indicated that the DMT programme did not affect participants’ levels of hostility.

Lastly, one study (Nicotera & Viggiano, 2021) analysed the effects of the intervention (Mind–Body Self-Regulation Yoga) on mindful awareness and attention and found significant differences both at post-test and with the control group (MAAS-A Cohen's d = 0.37), suggesting that the intervention facilitated greater self-regulation.

4. Discussion

Body and Movement Oriented Interventions (BMOIs) have been recognized as valuable approaches for trauma intervention. Despite the growing interest in these bottom-up approaches, research on their application in trauma treatment remains limited, particularly in adolescents (Finn et al., 2018). Although this review examined studies published between 2000 and 2024, the majority (seven out of nine) were published between 2019 and 2024. This suggests that research on the effectiveness of BMOIs is still at an early stage (Grabbe & Miller-Karas, 2018).

Nevertheless, the findings indicate that a wide scope of BMOIs have been implemented in adolescent trauma intervention. These include Dance-Movement Therapy (DMT) (Burns, 2016; Chettiar & Mascarenhas, 2024; Ezeh et al., 2023), yoga-based interventions such as Trauma-Informed Yoga and Mind–Body Self-Regulation Yoga (MBSRY) (Davis & Aylard, 2023; Nicotera & Viggiano, 2021), sensory-based interventions such as Structured Sensory Intervention for Traumatized Children, Adolescents and Parents – Adjudicated and at-Risk Youth (SITCAP-ART) and Sensory Motor Arousal Regulation Treatment (SMART) (Raider et al., 2008; Warner et al., 2014), and Somatic Experiencing (Berman, 2019; Hetherington & Gentile, 2022).

This review includes studies with varied intervention types, durations, frequencies, and settings. Although defining the ideal intervention dosage remains challenging (Dias Rodrigues et al., 2022), positive outcomes were observed in studies with as few as three sessions. These findings confirm that BMOIs appear to be effective even within limited short timeframes and in challenging settings, as they seem to promote rapid stabilisation of the nervous system, leading to improvements in self-regulation (Neal, 2020) and symptom reduction.

Research suggests that group interventions tend to be more effective than individual interventions for trauma treatment, particularly in top-down approaches (Çamaş & Anayurt, 2022). However, this scoping review demonstrates that both individual and group BMOIs may positively impact adolescents’ mental health indicators and arousal/reactivity patterns. This suggests that bottom-up approaches may be both effective and versatile in promoting psychophysiological regulation in diverse settings.

4.1. Effectiveness of BMOIs

The findings of this review suggest the effectiveness of BMOI in reducing PTSD symptoms in adolescents, consistent with prior research in adults (Van de Kamp et al., 2019; Van de Kamp et al., 2023). Three studies specifically examined PTSD symptoms (Ezeh et al., 2023; Raider et al., 2008; Warner et al., 2014), demonstrating positive outcomes in both type I (resulting from a single traumatic event) and type II trauma (prolonged exposure to threats to physical and psychological integrity). These results are particularly significant, given the well-documented limitations of trauma-focused cognitive behavioural therapy (CBT) in alleviating symptoms in young people with type II trauma (Lofthouse et al., 2024). This suggest that BMOIs may be promising interventions to work with polytraumatized young people (Warner et al., 2020).

Moreover, sensory-based BMOIS (e.g. SITCAP-ART and SMART) were particularly effective in reducing symptoms of depression and anxiety, frequent comorbidities of PTSD (Van de Kamp et al., 2019). On the other hand, Somatic Experiencing demonstrated effectiveness in addressing trauma-related obsessive-compulsive symptoms. These findings seem to indicate the importance of sensory-based therapeutic activities in facilitating the processing of implicit trauma memories at a sensory level, thereby restoring more effective emotional regulation (Lohrasbe & Ogden, 2017; McGreevy & Boland, 2020; Warner et al., 2020).

Given that traumatised individuals often exhibit bodily manifestations of emotional dysregulation due to trauma exposure (Laricchiuta et al., 2023), this review suggests that Somatic Experiencing, Trauma-Informed Yoga and SMART may have a positive effect on arousal and reactivity patterns. In the included studies, BMOIs were found to increase awareness of psychophysiological dysregulation in the nervous system, improve self-regulation capacities, and reduce trauma-related hyperactivation, aggression, and anger. These findings seem to indicate that BMOIs can have an important and positive role in modulating psychophysiological indicators associated with trauma (Levine, 2010; Selvam, 2022; Van der Kolk, 2014).

This scoping review also suggests the broader psychological effects of BMOIs, particularly Somatic Experiencing, on variables such as self-control (Berman, 2019) which is significantly affected by trauma, as traumatic experiences are multisensory events that induce fear, helplessness, and/or horror (Kearney & Lanius, 2022). Additionally, BMOIs were found to increase mindful awareness and attention (Nicotera & Vigginao, 2021), which suggests a reduction in dissociative processes commonly seen in trauma survivors (Levine, 2010) as a survival strategy to create distance from traumatic experience (Leech et al., 2024). These findings seem to corroborate the neurophysiological regulation processes that are crucial to understand how BMOIs can impact positively traumatized adolescents (Dana, 2018; Levine, 2010; Porges, 2021; Porges, 2022), as well as the mind–body relation (Almeida et al., 2019; Rosendahl et al., 2021; Selvam, 2022; Tarsha et al., 2020). They also reinforce the importance of somatic regulation as a fundamental component of trauma intervention (Warner et al., 2020).

Despite their demonstrated benefits, BMOIs have limitations. Two studies (Burns, 2016; Chettiar & Mascarenhas, 2024) analysed the effects of DMT on self-esteem found no significant improvements following intervention. Since self-esteem is largely driven by cognitive self-evaluations processes (Chettiar & Mascarenhas, 2024), and bottom-up approaches primarily target arousal regulation (Levine, 2010) through non-verbal means (Neal, 2020), they may be insufficient to address trauma at a cognitive level.

These findings seem to underscore the need for a multi-level, integrative approach to trauma intervention, combining sensory, emotional, and cognitive processing. Traumatization processes involve a complex interplay between cortical and subcortical mechanisms (Invitto & Moselli, 2024). They integrate and combine cognitive, emotional (Laricchiuta et al., 2023), and somatosensory elements that manifest through psychophysiological patterns of hyper – and hypoactivation (Kearney & Lanius, 2022; Punkanen & Buckley, 2021; Soma et al., 2021). These patterns form the foundation of trauma symptoms and comorbidities (Warner et al., 2020), including depression and anxiety (Ford et al., 2021; Joyal et al., 2019), underscoring the need for interventions targeting these nervous system dysregulations.

Given that trauma symptoms primarily stem from nervous system dysregulation (Levine, 2010), interventions relying exclusively on top-down approaches may be insufficient (Van de Kamp et al., 2019). While traditional top-down approaches remain valuable for helping adolescents process, rationalize and assign meaning to their experiences (Raider et al., 2008), their effectiveness can be compromised by trauma-induced neurophysiological dysregulation (Van de Kamp et al., 2023; Van der Kolk, 2014). Consequently, integrating bottom-up approaches that prioritize physiological regulation is essential for creating a foundation upon which cognitive processing can be more effectively facilitated.

These findings apparently reinforce the theoretical principles of bottom-up interventions, emphasising the importance of sequencing in trauma therapy to align with neurobiological principles (Perry & Szalavitz, 2017). Effective intervention strategies should first target self-regulation and arousal stabilization. Only once this foundational stability is achieved should the therapeutic process progress to more verbal and insight-oriented techniques (Perry, 2009). This structured approach ensures that interventions are both developmentally appropriate and responsive to the neurophysiological needs of traumatised adolescents.

4.2. Limitations and future research

The results obtained through this scoping review are generally consistent with the results indicated by research into the efficacy of BMOIs with adults (Van de Kamp et al., 2019; Van de Kamp et al., 2023). In this sense, BMOIs may be promising approaches for the treatment of trauma-based symptoms in adolescents. However, these results should be interpreted with caution. This scoping review reveals some limitations, namely due to the heterogeneity of the BMOIs that were included here and the small number of studies that were analysed.

There are also limitations regarding the samples. In general, the included studies had small (1-470, M = 78) and unrepresentative samples, therefore not allowing the generalization of the results. In this sense, it is important to highlight that the samples were composed mostly or exclusively of boys and that in eight of the nine included studies addressed type II trauma. In some studies, there was an overlap between interventions (psychotherapeutic and psychopharmacological), which makes it difficult to analyse the therapeutic benefits of BMOIs.

It is also noteworthy to mention the limitations regarding the study designs. Among the nine included studies, only three followed an experimental design and four followed a quasi-experimental design, which limits the analysis on the effectiveness of BMOIs on adolescents with trauma. Also, only one study (Ezeh et al., 2023) did a follow-up evaluation, showing that the effects on PTSD symptoms were maintained after the 6-month evaluation period. These studies relied mainly on self-report measures which should be interpreted with caution, since traumatization processes can limit the perception, identification and communication of feelings (Davis & Aylward, 2023).

Thus, we suggest the replication of studies through RCT study-design and using more representative samples to evaluate the effectiveness of BMOIs as well as physiological measures (e.g. cortisol) in addition to self-report measures. Likewise, we believe that given that there are evidence-based treatments for PTSD, it would be essential to carry out more studies that could compare the therapeutic results obtained through these different intervention modalities. In this sense, we consider it is crucial to investigate about the role that BMOIs could play in trauma intervention as a complementary or preferred approach.

As already mentioned, the application of BMOIs in the field of psychotraumatology is relatively recent and needs further research. Currently, there seems to be evidence indicating that the therapeutic benefits of BMOIs result from increased tolerance to bodily sensations (Selvam, 2022), as well as a positive experience of embodiment (Gerge, 2020). However, these topics need to be analysed in greater detail, namely through methodologies that consider bodily experiences and felt sense as privileged forms of information and, at the same time, of clinical intervention (Changaris, 2021).

5. Conclusions

Traumatization processes significantly interfere with the development of children and adolescents, shaping their life trajectories – particularly in the absence of adequate intervention. Therefore, it is crucial to develop trauma-informed interventions tailored to their specific needs. This scoping review examines the existing evidence regarding the efficacy of Body and Movement-Oriented Interventions (BMOIs) in addressing trauma-related symptoms in adolescents.

The findings suggest that research in still at an early stage. However, they reflect a growing interest and enthusiasm surrounding the application of BMOIs in the context of trauma. This scoping review seems to indicate that BMOIs represent promising approaches for reducing trauma-based symptoms and associated comorbidities. Furthermore, these interventions appear beneficial in supporting the regulation of psychophysiological patterns disrupted by traumatic experiences.

Taken together, these results suggest the importance of adopting an integrative and embodied perspective in trauma therapy – one that brings together insights from psychology, psychophysiology, cognitive neuroscience, and body and movement-based therapeutic practices.

It is important to note, however, that these findings constitute preliminary evidence and do not yet satisfy the methodological rigor or clinical standards required to demonstrate the effectiveness of BMOIs as therapeutic interventions. It is our hope that this review will serve as a foundation for future research enabling a deeper understanding of the role and impact of BMOIs in the field of trauma intervention.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Since all data is already listed in the paper or the supplement, there is no additional material left to be provided online.

Ethics statement

Due to the nature of a literature review, no new data was collected, and no ethics statement is required.

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