SAFE PLACE is both a theoretical model explicating the relationship between sensory processing, disrupted attachment and complex developmental trauma concerns in children and a specific collaborative interdisciplinary intensive 12 treatment program among occupational therapists, psychotherapists, and parents/guardians for children with sensory processing disorder (SPD) and complex trauma-attachment concerns

SAFE PLACE provides a therapeutic framework for service providers and parents/guardians which emphasizes development of body-based regulatory and adaptive functions with co-regulation and intersubjective experiences, deepening of attachment bonds and security, and processing and healing of traumatic experiences in the context of a sensory integration intervention process. Based on the work of Jane Koomar, PhD, OTR/L, FAOTA and Daniel Hughes, PhD, the term “SAFE” in this model of care reflects the sensory component of the model and means Sensory Attunement-Focused Environment, representing the use of safe, supportive, developmentally appropriate, sensorimotor activities and environments that promote play and fun in children’s physical and emotional development.

The attachment component is represented by the term “PLACE”, meaning Playfulness, Love, Acceptance, Curiosity and Empathy, qualities of mindful engagement utilized by collaborating therapists to facilitate secure attachment and trauma healing in the child and family. The terms “SAFE” and “PLACE” together as “safe place” represent the trauma component, highlighting the important process of establishing and maintaining an environment and experience of safety and stability for the child, both within the child him/herself and between the child and others which promotes processing of traumatic reactions. Within such a “safe place” in the presence of kind and trustworthy relationships, children can reclaim their innate capacity to play, look at and process their trauma experiences.

Components of the SAFE PLACE model.


OTA The Koomar Center, in conjunction with the Spiral Foundation, has embarked on a systematic series of projects to further develop and refine the SAFE PLACE theory and intervention program. Below find summaries of SAFE PLACE development projects to date.

OTA The Koomar Center White Paper: A Sensory Integration-Based Perspective to Trauma-Informed Care for Children

This white paper explicated the need for innovative, collaborative interventions for children with sensory processing problems and complex trauma-attachment concerns. It proposes that the SAFE PLACE Program is an ideal answer to this important need.

For a copy of this paper click here.


The SAFE PLACE manual describes the theoretical rationale underpinning the SAFE PLACE frame of reference, the assessment and intervention procedures, and a preliminary fidelity measure for the SAFE PLACE treatment program. It is not yet available for distribution.

SAFE PLACE Validity Video Review

Preliminary validity for the SAFE PLACE model was conducted through a qualitative video review process. Five videos of Collaborative sessions involving occupational therapists, psychotherapists and parents were rated by multiple raters for core qualities of SAFE PLACE. Descriptions of the sessions and interactions among participants were recorded and analyzed using qualitative methods. Qualitative review highlighted the main themes of SAFE PLACE including the importance of each individual, child, parent, occupational therapist and mental health professional to the healing process. Intra-class correlations for the fidelity measure were in excess of .90, indicating high inter-rater validity of the preliminary measure. The SAFE PLACE manual and fidelity measure were updated based on findings of the video review and validity study.

For a copy of this paper click here.

The SAFE PLACE Program: A Program Review – Interim Project Summary

 Preliminary feasibility, acceptability and patient outcomes of the SAFE PLACE program have recently investigated the experiences of one family as they participate in the 12 week SAFE PLACE program. Interim results suggest that the SAFE PLACE program was acceptable to the family, was highly valued and that child and family experienced positive changes during and immediately following the SAFE PLACE intervention. Final results are pending.

For a copy of the interim project summary click here.