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trauma and exposure homework. The women who were in the delayed Cognitive Trauma Therapy (CTT) group, meaning they waited longer for CTT treatment intervention measures than those who started immediately, did not improve over the six weeks between their first and second pre-therapy assessments. However, 94% of all the women who completed CTT out of both study groups no longer met the requirements for a PTSD diagnosis (Kubany, Hill, & Owens, 2003). While these results are astonishing, cognitive treatment approaches do not treat the body. Memories of the traumatic experience can manifest in the physical body, resulting in re-victimization or resurfacing of trauma symptoms (Levine, 1997). An integrated approach would address all of the necessary components to healing. Physiological approaches. As previously discussed, the effects of trauma induced stress can manifest in the physical body. According to Moraska, Pollini, Boulanger, Brooks, and Teitlebaum (2010) stressful events, as well as prolonged levels of stress, disrupt the body’s natural state of homeostasis through the release of epinephrine and cortisol. The continued release of these hormones creates a different level of homeostasis, resulting in chronic, pathological consequences. Studies have found that massage therapy can interrupt this stress induced pattern of survival (Moraska et al., 2010). THE WELL-EMBODIED PROFESSIONAL 14 A review of literature consisting of 18 randomized control trial study designs, two quasi-experimental designs, and five within-subjects designs (Moraska et al., 2010) was conducted in order to examine the effects of massage therapy with varying populations including those with a history of sexual abuse, eating disorders, pain conditions, HIV, cancer, critical care patients, and healthy adults. These studies revealed an 89% significant reduction in salivary cortisol immediately following a massage therapy session as well as a significant reduction in urinary cortisol from three of the nine published studies using this method of assessment. A reduction in heart rate immediately following a massage therapy session was also documented as being statistically significant. Even though the heart rates did eventually resume back to previous levels as noted prior to a massage therapy session, the reductions were again repeatable (Moraska et al., 2010). While limited research had been found regarding the effects of massage therapy on trauma survivors, the findings of this review capture the overall effects of physiological treatment approaches necessary for this project. It is evident that even though physiological approaches treat the effects of trauma, the cognitive piece is missing. Cognitive changes are crucial in order to prevent re-victimization by helping to change the behaviors associated with the traumatic event, such as a regression of developmental behaviors like thumb-sucking, a need for control, excessive shyness or withdrawal, and bed wetting (Levine, 1997) . Integrated Treatment Approaches The emergence of integrative treatment approaches, as previously defined in the Key Concepts section of this paper, is relatively new and is difficult to find within the literature. Many claim to be integrative, but did not meet the criteria of this study. It appears as if this concept is an “unchartered territory” as only one report was found that integrates massage THE WELL-EMBODIED PROFESSIONAL 15 therapy and psychotherapy into a single, comprehensive session. Regardless of the lack of literature, the qualitative findings of the study were fascinating. In addition, it is a model that can be replicated into a sound clinical practice for treating trauma.

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