Research & Evidence Base

Strua's tools are informed by peer-reviewed research, evidence-based clinical manuals, and established therapeutic practices. Below are key sources informing our approach.

Some techniques are supported by clinical tradition or widely used practice guidelines even when technique-specific trials are limited.

Breathing Techniques

Box Breathing (4-4-4-4)

• Ma, X., Yue, Z. Q., Gong, Z. Q., et al. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in Psychology, 8, 874.
• Zaccaro, A., Piarulli, A., Laurino, M., et al. (2018). How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Frontiers in Human Neuroscience, 12, 353.

4-7-8 Breathing

• Weil, A. (2015). Breathing: The Master Key to Self Healing. Sounds True.
• Brown, R. P., & Gerbarg, P. L. (2012). The Healing Power of the Breath. Shambhala Publications.

Physiological Sigh

• Balban, M. Y., Neri, E., Kogon, M. M., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895.

Grounding Techniques

5-4-3-2-1 Senses

• Najavits, L. M. (2002). Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. Guilford Press.
• Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed.). Guilford Press.

Body Scan

• Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Delta.
• Dreeben, S. J., Mamberg, M. H., & Salmon, P. (2013). The MBSR body scan in clinical practice. Mindfulness, 4(4), 394-401.

Safe Place Visualization

• Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy (3rd ed.). Guilford Press.

Cognitive Techniques

Thought Reframing / Cognitive Restructuring

• Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond (2nd ed.). Guilford Press.
• Hofmann, S. G., Asnaani, A., Vonk, I. J. J., et al. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427-440.

STOP Technique

• Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed.). Guilford Press.
• Kabat-Zinn, J. (2012). Mindfulness for Beginners. Sounds True.

Emotional Regulation

TIPP Skills (Temperature, Intense Exercise, Paced Breathing, Progressive Relaxation)

• Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed.). Guilford Press.
• McKay, M., Wood, J. C., & Brantley, J. (2019). The Dialectical Behavior Therapy Skills Workbook (2nd ed.). New Harbinger.

Self-Compassion Exercises

• Neff, K. D. (2011). Self-Compassion: The Proven Power of Being Kind to Yourself. William Morrow.
• Germer, C. K. (2009). The Mindful Path to Self-Compassion. Guilford Press.

Mindfulness & Meditation

Mindfulness-Based Approaches

• Kabat-Zinn, J. (1990). Full Catastrophe Living. Delta.
• Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-Based Cognitive Therapy for Depression (2nd ed.). Guilford Press.
• Goldberg, S. B., Tucker, R. P., Greene, P. A., et al. (2018). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical Psychology Review, 59, 52-60.