Case Studies
Real sessions.
Real children. Real change.
De-identified clinical stories from psychologists using the PPU Card System in practice. These are not testimonials — they are clinical narratives written for other clinicians.
Each story documents what the clinician did, what the child did, and what shifted. Written for peer-to-peer learning.
Age, presentation type, and clinical context retained. All identifying details removed per ethical standards.
Cases from clinical practice
Each narrative follows the same structure so clinicians can quickly find what's relevant to their own work.
The child reached for the third card within ninety seconds. By the end of the session the child was pointing to cards to indicate yes and no. Within four further sessions, the child had moved to Feelings Intensity Scale check-ins and was speaking in short sentences during the Modal Verb phase.
The cards bypassed the verbal demand entirely. Offering three concrete objects — not words, not questions — gave the child a non-threatening point of agency. The reach was the first self-initiated behaviour in the clinical relationship.
Anchor Cards (Deck 3) Clinician moved to Anchor Cards without asking why.
The child pointed to the high-intensity card at session opening. The clinician did not ask why. Instead they moved to Anchor Cards and offered: "You don't have to believe it yet." The child kept the card "I am someone who can ask for space" beside them for the rest of the session.
Removing the demand to verbalise — and removing the demand to believe — created the room for engagement. The Anchor Card became a transitional object within a single session. The child chose the card; the clinician did not assign it.
Modal Sequences (Deck 6) Clinician constructed the three-stage arc with child's chosen card.
The child picked up "I could" from the modal verb spread. The clinician laid out the Modal Sequence: I could → try → BRAVE. The child took the card home. The parent reported the card was placed on the bedside table.
The three-stage arc gave the child a complete story of identity without requiring them to claim it yet. The child could hold the card as aspiration — not assertion. The bedside placement suggests the identity began to function outside the clinical hour.
Verified de-identified submissions from founding practitioners added as confirmed
Share a de-identified case from your practice
If you are a registered clinician using PPU, we would like to include your clinical narrative. Every submission is reviewed before publishing. You retain editorial approval of your entry.
Submissions are reviewed against de-identification standards before publication. Your name, credentials, and consent are required — the child's identity is never published.
Submit a clinical story- Age and presentation type (no name, school, or location)
- Which PPU deck or decks were used and when
- What you did — the specific clinical moves
- What you observed in the child
- Your clinical reflection (2–4 sentences)
- Theoretical frameworks you would attach
- Your name, credentials, and consent to publish
Submissions can also be made via the Case Study Template — a structured document you can complete and send to us directly.
The clinical frameworks referenced across these cases — polyvagal theory, cognitive reappraisal, identity scaffolding, and language-as-regulation — are grounded in peer-reviewed research. Browse the full annotated reference list on the Evidence Base page.
Browse the Evidence Base →Power Phrase Universe cards are educational and social-emotional learning (SEL) tools. They are not a substitute for professional psychological assessment, diagnosis, or treatment. If you or someone you support is in crisis, contact a qualified mental health professional or your local emergency services.