Research on CRM is expanding rapidly. CRM was derived from body-based psychotherapy and developed by Elaine Miller-Karas and colleagues after survivors of natural disasters (tsunami, earthquake, and hurricanes) received brief, somatically-based interventions and subsequently demonstrated high rates of PTSD resolution. Persons who have endured chronic or cumulative trauma, have also demonstrated significant improvement in mental health accompanied by continued daily use of CRM’s emotional stabilization skills. In CRM’s first randomized controlled trial (RCT) of 77 hospital nurses, the CRM group demonstrated reduced secondary traumatic stress and physical complaints and improved emotional well-being and resiliency after a single 3-hour CRM class; nurses used the simple CRM techniques of tracking body sensations and grounding during tense or chaotic clinical situations, codes, and with dying patients. Research has also been conducted at Loma Linda University in international settings.

The Community Resiliency Model, an interoceptive awareness tool to support population mental wellness, 1-7. Linda Grabbe, Ingrid M. Duva and William C. Nicholson (2023).


The objective of this article is to describe the Community Resiliency Model (CRM)®, a sensory- focused, self-care modality for mental well-being in diverse communities, and CRM’s emerging evidence base and neurobiological underpinnings as a task-sharing intervention. Frieden’s Health Impact Pyramid (HIP) is used as a lens for mental healthcare interventions and their public health impact, with CRM examples. CRM, a sensory awareness model for self-care and mental well-being in acute and chronic stress states, is supported by neurobiological theory and a growing evidence base. CRM can address mental wellness needs at multiple levels of the HIP and matches the task-sharing concept to increase access to mental health resources globally. CRM has the potential for making a significant population mental health impact as an easily disseminated, mental health, self-care modality; it may be taught by trained professionals, lay persons, and community members. CRM carries task-sharing to a new level: scalable and sustainable, those who learn CRM can share the wellness skills informally with persons in their social networks. CRM may alleviate mental distress and reduce stigma, as well as serve a preventive function for populations facing environmental, political, and social threats.  (Click Here)

Building resilience and improving wellbeing in Sierra Leone using the community resiliency model post Ebola. International Journal of Mental Health, 1–13. Aréchiga, A., Freeman, K., Tan, A., Lou, J., Lister, Z., Buckles, B., & Montgomery, S. (2023).


Complex emergencies and disasters often result in a cascade of human suffering, which expose survivors to multiple traumatic situations and have a sizeable mental health impact. If available, most trauma treatments concentrate on addressing the cognitive or psychological aspects of trauma, which lacks the biological component of trauma that is central to human resiliency and wellness. The Community Resiliency Model (CRM) was created to increase mental health resources in underserved communities with complex trauma histories by teaching individuals to regulate their nervous system. Sierra Leone, one of the world’s poorest countries has a traumatic history of a 15-year civil war, frequent floods, and the 2014 Ebola outbreak. In the context of a lack of resources and ever-present stigma, many experience negative mental health with an estimated treatment gap of 98%. Our study set out to determine the immediate and six months effectiveness of a CRM intervention for Sierra Leonean community members in the aftermath of Ebola. Results indicated significant improved depression, anxiety, PTSD symptoms, and resiliency post intervention, which were mostly maintained 6-months later. These findings suggest CRM may be an effective way to address mental health issues that arise after disasters in low resourced settings. 

Practical resiliency training for healthcare workers during COVID-19: Results from a randomized controlled trial testing the Community Resiliency Model for well-being support. BMJ Open Quality, 11(4), e002011. Duva, I. M., Higgins, M. K., Baird, M., Lawson, D., Murphy, J. R., & Grabbe, L. (2022).

For a full description of the research, you can go to this link
(Free article for anyone–link) Practical resiliency training for healthcare workers during COVID-19: results from a randomized controlled trial testing the Community Resiliency Model for well-being support ABSTRACT ABSTRACT Objective To introduce the Community Resiliency Model (CRM) as mental well-being support for healthcare workers working through the height of the COVID-19 pandemic. Design Randomized controlled trial with a no treatment control group. Setting Two large urban health systems in the Southern United States between October 2020 and June 2021. Participants Eligible participants were currently employed as healthcare workers within the participating healthcare systems. 275 employees registered and consented electronically in response to email invitations. 253 participants completed the baseline survey necessary to be randomized and included in analyses. Intervention Participants were assigned 1:1 to the control or intervention group at the time of registration. Intervention participants were then invited to 1-hour virtual CRM class teaching skills to increase somatic awareness in the context of self and other care. Main outcome measures Self-reported data were collected rating somatic awareness, well-being, symptoms of stress, work engagement and interprofessional teamwork. Results Baseline data on the total sample of 275 (53% nurses) revealed higher symptoms of stress and lower well-being than the general population. The intervention participants who attended a CRM class (56) provided follow-up survey data at 1 week (44) and 3 months (36). Significant improvement for the intervention group at 3 months was reported for the well-being measures (WHO-5, p<0.0087, d=0.66; Warwick-Edinburgh Mental Well-Being Scale, p<0.0004, d=0.66), teamwork measure (p≤0.0002, d=0.41) and stress (Secondary Traumatic Stress Scale, p=0.0058, d=46). Conclusion Baseline results indicate mental health is a concern for healthcare workers. Post intervention findings suggest that CRM is a practical approach to support well-being for healthcare workers during a crisis such as this pandemic. The simple tools that comprise the model can serve as a starting point for or complement self-care strategies to enhance individual resilience and buffer the effects of working in an increasingly stressful work environment.

Duva IM, Murphy JR, Grabbe L. A Nurse-Led, Well-Being Promotion Using the Community Resiliency Model, Atlanta, 2020-2021. Am J Public Health. 2022;112(S3):S271-S274. doi:10.2105/AJPH.2022.306821


The wrath of COVID-19 includes a co-occurring global mental health pandemic, raising the urgency for our health care sector to implement strategies supporting public mental health. In Georgia, a successful nurse-led response to this crisis capitalized on statewide organizations’ existing efforts to bolster well-being and reduce trauma. Partnerships were formed and joint aims identified to disseminate a self-care modality, the Community Resiliency Model, to organizations and communities throughout the state. (Am J Public Health. 2022;112(S3):S271–S274.

COVID-19 exacerbated stress and trauma universally, creating a secondary pandemic that increased demand for mental health care in a system on the verge of crisis. An intense and immediate need for population well-being support resulted, and subsequent requests for resiliency training quickly followed. In response, three nurses in Georgia certified to teach the Community Resiliency Model (CRM) fast-tracked existing efforts to share this mental wellness training program across their state.


Impact of a Resiliency Training to Support the Mental Well-being of Front-line Workers: Brief Report of a Quasi-experimental Study of the Community Resiliency Model(Medical Care 2021)

Background: Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health.

Methods: Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8).

Results: Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d=0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d=0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d=0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week (d=0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves.

Conclusions: After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.

Exploring the Usability of a Community Resiliency Model Approach in a High Need/Low Resourced Traumatized Community. Community Mental Health Journal. Freeman, K., Baek, K., Ngo, M., Kelley, V., Karas, E., Citron, S., & Montgomery, S. (2021).


This study tested the usability of a non-stigmatizing community-based trauma intervention delivered by trained community members. The Community Resiliency Model (CRM) was taught to a high-crime, low-income community designated as a Mental Health Provider Shortage Area (19 MPSA score). Five groups of Latino, African-American, LGBTQ, Asian Pacific Islander, and Veteran participants (N-57) with a history of complex/cumulative traumas and untreated posttraumatic stress undertook a five-day 40-h CRM training with master trainers. Measures included Treatment Relevance, Use and Satisfaction (TRUSS), Brief CRM Questionnaire (Brief CRM), and Symptom Questionnaire (SQ). Participant preparedness to teach CRM to others was high (98%) and sustained at the 3–6 months follow-up with 93% reporting a daily use. Pre-to post comparison analyses showed a significant decrease in distress indicators and increase in wellbeing indicators. CRM’s high usability holds promise for a broader, low cost and sustainable implementation in traumatized and under-resourced communities.

Role of Community Resiliency Model Skills Trainings in Trauma Healing Among 1994 Tutsi Genocide Survivors in Rwanda. Psychology Research and Behavior Management, Volume 14, 1139–1148. Habimana, S., Biracyaza, E., Habumugisha, E., Museka, E., Mutabaruka, J., & Montgomery, S. B. (2021).


BACKGROUND: Mental health among survivors of the 1994 Tutsi genocide in Rwanda remains poor, even after multiple efforts to assist those recovering from this trauma. The Community Resilience Model (CRM) is a biologically based set of skills that can be delivered in community settings by trained lay persons and has shown to significantly improve mental health in a number of settings and populations, though it has not been used with genocide survivors in Rwanda. This study assessed if the CRM training was able to improve mental health among genocide survivors. METHODS: A quasi-experimental design was used to evaluate the CRM intervention among Tutsi genocide survivors from the Huye, Nyamagabe and Nyaruguru districts in Southern Rwanda. Consenting participants completed a questionnaire before and six months after the training to assess their level of trauma, secondary traumatic stress, depression and skills to teach CRM skills to others. RESULTS: The findings revealed significant improvements across all trauma symptoms between the intervention and control group (t = 37, p<0.001). The CRM trainings also resulted in significant within-person declines of depressive symptoms (p < 0.001), perceived secondary traumatic stress (p = 0.003) and trauma-related symptoms (p = 0.002). Training participants also reported significant increases in perceived CRM benefits and satisfaction (p < 0.001). CONCLUSION: The CRM intervention was found to be effective for improving mental health in 1994 Tutsi genocide survivors. Since CRM can be delivered by trained persons to groups of persons in community settings, it has a high potential for successful broader implementation and sustainability, which is critically important in an environment with few mental health resources.


The Community Resiliency Model: A Pilot of an Interoception Intervention to Increase the Emotional Self-Regulation of Women in Addiction Treatment(International Journal of Mental Health and Addiction 2020)

Addiction is associated with trauma, and a body-based approach may help attenuate the long-term impacts of trauma, including addiction and mental disorders. The Community Resiliency Model® (CRM) is a novel, simple, body-based set of sensory awareness skills, which focus on “felt-sense” or interoception. We provided a single 5-h Community Resiliency Model® class in an urban drug treatment center for impoverished women in the Southeastern US. Using a pre-post mixed methods design, we collected data from 20 women on well-being, physical symptoms, anger, depression, anxiety, and spirituality. The post-test revealed that participant somatic complaints, anger, and anxiety symptoms had declined significantly, with a moderate to large effect size; well-being increased significantly, with a small effect size. Participants found the skills and concepts of CRM helpful and shared them with others. CRM is a feasible, inexpensive, and acceptable training that may be valuable for persons with addictions.

The Community Resiliency Model to Promote Nurse Well-Being(Nursing Outlook 2019)

Background: Rising rates of secondary traumatic stress and burnout among nurses signal a crisis in healthcare. There is a lack of evidence regarding effective interventions to improve nurse well-being and resiliency.

Purpose: This study used a randomized controlled trial parallel design to test the effectiveness of a 3-hour Community Resiliency Model (CRM) training, a novel set of sensory awareness techniques to improve emotional balance.

Methods: Registered nurses in two urban tertiary-care hospitals were invited to participate, which entailed attending a single 3-hour “Nurse Wellness and Wellbeing” class; 196 nurses consented and were randomized into the CRM intervention or nutrition education control group to determine if the CRM group would demonstrate improvement in well-being and resiliency, secondary traumatic stress, burnout, and physical symptoms.

Findings: Pre/post data were analyzed for 40 CRM and 37 nutrition group members. Moderate-to-large effect sizes were demonstrated in the CRM group for improved well-being, resiliency, secondary traumatic stress, and physical symptoms. Participants reported using CRM techniques for self-stabilization during stressful work events.

Conclusion: CRM shows promise as a brief resiliency training for hospital-based nurses.

The Trauma Resiliency Model: A “Bottom-Up” Intervention for Trauma Psychotherapy. Journal of the American Psychiatric Nurses Association, 24(1), 76–84. Grabbe, L., & Miller-Karas, E. (2018).


BACKGROUND: The Trauma Resiliency Model (TRM) is an innovative therapeutic approach for trauma. This “bottom-up” somatic approach comprises nine skills that use sensory awareness for emotion regulation and integration. Body-based therapies may be more effective for trauma than currently used cognitive (‘top-down”) and exposure therapies. OBJECTIVE: The purpose of this article is to present TRM and current literature on the neuroscience of trauma and resiliency, and the rationale for body-based therapy. Two case examples illustrate the practical use of TRM therapy. DESIGN: The literature on the neuroscience of trauma, resiliency, and somatic approaches in therapy is reviewed. RESULTS: TRM teaches the biology of trauma responses and the practice of emotion regulation through biologically based skills. Neuroscience theory supports somatic awareness models; however, research on somatic therapies is limited. CONCLUSIONS: Chronic distress from trauma derails the ability to live life resiliently. TRM addresses trauma processing in a gentle and invitational manner and is a novel departure from existing therapies. Despite a paucity of research on body-based therapy, these therapies have strong neurophysiologic underpinnings.

For more information on CRM research, please go to the Trauma Resource Institute website