The Change Triangle and AEDP in Under-Resourced Communities
- Heather Sanford, LCSW
- May 9
- 4 min read
Updated: 4 days ago
(Edited from the AEDP "In It Together" Conference Presentation by Heather Sanford, LCSW)
In a system stretched thin and often focused on symptom management, AEDP offers something radically different: hope, transformation, and deep emotional healing. This is the story of how I brought AEDP into a program for people with serious mental illness—and how, together, we discovered that change is possible for everyone.
Good morning. Thank you for being here. Before we dive in, let’s take a few deep breaths together. In through your nose, hold, and slowly out through pursed lips like you’re cooling soup. Again. One more time. Phew. My heart rate just slowed a bit, and I can feel my feet on the ground. That’s how every AEDP group I run begins—deep belly breaths to ease into the body, a gentle invitation to notice.
My journey with AEDP began in 2016, when I became the director of a New York State-licensed outpatient program for adults with serious mental illness and substance use challenges. It was a job I loved—and one that terrified me. I’d spent a lifetime anxious but outwardly high-functioning. Internally, I was drowning. A bad therapy experience had left me wary, but desperation drove me back. That’s how I landed in the office of an AEDP therapist.
She was… different. Not like any therapist I’d ever seen, or how I’d been trained. She offered warmth and space, even when I didn’t know I needed it. She held hope for me when I couldn’t. And slowly, I began to access a world of emotion I’d long avoided. I wasn’t ready to feel yet, but I could think about feeling—and she gently worked with that. Her quiet, attuned presence became a soft landing.
Somewhere in that early healing process, I came across Hilary Jacobs Hendel’s article, It’s Not Always Depression, Sometimes It’s Shame, in The New York Times. I read it to better understand my clients—but ended up understanding myself. I devoured her book in one night. For the first time, my internal world started to make sense.
This knowledge lit a fire in me. I wanted everyone—especially the clients in my PROS program—to have access to this kind of healing. But the population we served was largely on Medicaid or Medicare. Traditional AEDP therapy was simply out of reach.
Then it hit me: I run a mental health program. Within the constraints of regulation, I could build what I believed people deserved. So, I started integrating AEDP into group work.
I created a 12-session psycho-educational curriculum based on Hilary’s work, introducing the Change Triangle and helping participants begin to name emotions. The response was electric. One participant even reached out to Hilary to say she had a fan club in Ithaca. That message led to a connection, and we began working together to evolve the curriculum into Emotions Education 101, balancing teaching with experiential exercises.
We launched Train the Trainer workshops to support others in bringing this to their communities—nonprofits, clinics, colleges. AEDP was becoming more accessible, and I was thrilled. But something still held me back at my own program. Deep down, I feared our participants “couldn’t handle” the experiential work.
That belief changed when I began offering Emotions Education 101 at PROS—the same groups people around the world were attending on Zoom. The participants loved the experiential pieces. They became “glimmer detectives,” excitedly spotting transformance, the innate drive towards healing, in themselves and each other.
Demand grew, and I started a weekly AEDP processing group called Advanced Practice. We began with body awareness and curiosity. Then one day, a portrayal emerged spontaneously. Portrayals, an AEDP technique, use fantasy and imagination to foster healing. I panicked—but all I had to do was stay present and ask, “Is there more?” The group held space with love, and that participant accessed anger for the first time in her life. Afterward she exclaimed, “I feel so much lighter!”
These moments taught me that AEDP is absolutely accessible in community settings. You just need to slow down, simplify a bit, and lead with safety and warmth. I bring my smile, my humor, my whole self—and the group meets me there. Sometimes the richest transformation happens not when someone is speaking, but when they’re listening. Group members begin to hold hope for each other, often before they can hold it for themselves.
I also love using simple exercises to demonstrate neuroplasticity—like crossing your arms the “wrong” way. It feels awkward at first, but with repetition, it gets easier. That’s what healing is: doing something new until it becomes natural.
Working in community mental health is hard. It’s underfunded, under-resourced, and often heartbreaking. But it’s also where some of the most beautiful transformations happen. I’m honored to do this work.
One of my favorite moments came during a group’s meta-processing, another AEDP technique where clients talk about the experience of the session. A young participant said: “I’ll hold all of you with love in my intestines. I would’ve said heart, but there’s more surface area in my intestines, and I feel like I have more room to hold people I care about now.”
That’s AEDP. That’s community. That’s healing.
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