One of the questions I get asked most often by both clients and providers is:
“Should I start with the Safe and Sound Protocol (SSP) or the Rest & Restore Protocol (RRP)?”
Just like so many questions related to nervous system work…The answer is: it depends. (If you are familiar with my work...you knew that was coming, didn’t you?)
I wish I could give everyone a simple flowchart based on diagnosis.
Autism? Start here.
POTS? Start there.
Trauma? Definitely this one.
But nervous systems simply don’t work that way.
While diagnoses can certainly provide helpful information, they rarely tell the whole story. Two people with exactly the same diagnoses can respond very differently to the same intervention.
So instead of asking, “What diagnosis does this person have?” I ask a series of other questions.
Over time, I’ve developed my own decision-making process. It’s still evolving - as I think all of our clinical reasoning should, especially as we continue learning more about RRP - but these are some of the things I consider.
This is usually the first place I start.
There is actually a tremendous amount of overlap between SSP and RRP in some respects. Both can support nervous system regulation, emotional wellbeing, resilience, sleep, cognitive functioning, and many other areas.
But there are also differences.
Some concerns tend to respond particularly well to SSP. Others often seem to respond more readily to RRP.
That doesn’t mean they always will.
Every nervous system is unique.
Instead, I think of these as probabilities rather than guarantees.
I’m asking myself:“Based on what I know about this person, which approach seems more likely to help them reach their goals?”
It’s an educated guess - not a certainty.
Sometimes someone’s health history influences my recommendation.
For example, if someone has bipolar disorder, I generally recommend starting with RRP.
Why?
Because some of the frequencies used in SSP Core have the potential to trigger mania in susceptible individuals.
That doesn’t mean someone with bipolar disorder can never do SSP. Some people have, very successfully, but it does require working with an especially skilled provider.
It simply means I usually prefer to begin with the approach that carries less risk, build regulation and stability first, and then decide together whether and when SSP makes sense.
There are other situations where physical or mental health conditions can influence my thinking as well.
Again, these aren’t absolute rules.
They’re simply pieces of information that I put together with the overall picture, to help guide the decision.
This is probably one of the hardest things to predict.
Sometimes I meet someone and have a strong sense that SSP will likely be a beautiful fit.
Other times, something tells me that RRP may provide a gentler entry point.
And I'm always open to the possiblity that I might be wrong.
That’s okay.
One of the biggest advantages of these protocols is that starting with one doesn’t prevent you from doing the other later.
If we begin with SSP and it feels like we’re working much harder than I’d like to achieve progress, I may suggest pausing and trying RRP instead.
Likewise, someone may begin with RRP, feel it isn't quite right for them, and later discover that SSP is exactly what helps them take the next step.
Changing direction isn’t failure.
It’s simply following the nervous system’s lead.
Another thing I pay close attention to is a person’s typical nervous system pattern under stress.
When life becomes overwhelming, does their nervous system tend to move more towards sympathetic activation - feeling anxious, wired, restless, panicky, or unable to slow down?
Or are they more likely to shift towards a dorsal vagal response - feeling shut down, disconnected, exhausted, numb, or unable to engage?
For many people, the answer isn’t entirely one or the other. They may move between both patterns or experience different responses depending on the situation.
This information becomes another piece of the puzzle.
It’s rarely the deciding factor on its own, but when combined with someone’s goals, health history, previous experiences, and the overall presentation of their nervous system, it can help guide my thinking about where to begin.
It’s one of the many pieces of clinical reasoning that develops through experience and by looking at the whole person rather than any one characteristic in isolation.
If you’re a provider asking this question, I’d encourage you to consider something else.
Which approach do you currently feel more confident using?
That confidence matters.
Perhaps you’ve got a lot more experience with SSP.
Perhaps you’ve spent more time learning RRP.
Perhaps one approach simply feels more intuitive when working with the kinds of clients you typically see.
Your growing clinical skill is part of the equation too.
As your experience expands, your decision-making process will likely evolve as well.
Mine certainly has.
In my experience…Yes.
Many people ultimately benefit from both SSP and RRP.
They each seem to support the nervous system in different ways, and I often find they complement one another beautifully.
That said, I don’t usually begin both protocols at the same time.
When I combine the two approaches, I always stagger them.I
’ll begin with one protocol first.
Once we’re confident it’s going well, we’ve established a comfortable rhythm, and the nervous system is responding as expected, then I’ll consider introducing the second approach.I
also pay close attention to when I introduce it.
For example, I wouldn’t normally add RRP on the same day that someone moves to a new hour of SSP Core.
Likewise, I generally wouldn’t introduce SSP at the same time someone is advancing to a higher level of RRP.
Why?
Because if someone suddenly experiences increased symptoms, I want to know which change was responsible.
If we change multiple variables at once, it becomes much harder to know what needs adjusting.
By making one change at a time, we can respond thoughtfully rather than guessing.
Ultimately, that usually leads to a smoother, more comfortable experience.
Naturally, other factors also influence my decision about when to introduce a second approach. What’s happening in the client’s life matters. SSP and RRP don’t occur in a vacuum, and the broader context can have a significant impact on how someone’s nervous system responds. Choosing the right timing is often just as important as choosing the right protocol.
People often ask me which protocol is “better.”
I don’t think that’s the right question.
A better question is:“Which approach makes the most sense to try first for this particular person, at this particular point in time?”
Sometimes that’s SSP.
Sometimes it’s RRP.
Sometimes we change our minds along the way.
That’s not a mistake.
It’s simply what happens when we let the nervous system - not rigid rules - guide the process.
The goal isn’t to be right on the first try.
The goal - just as with every other aspect of these approaches - is to listen carefully to what the nervous system is telling us, stay flexible, and let that guide our next step. That’s where the best decisions usually come from.