Short answer: more than most therapists realise, but less than the work requires. There are established routes in performing arts health, sport and exercise psychology, and somatic psychotherapy — each substantial, and each covering part of the territory. What remains scarce is training at the intersection: somatic practice specifically applied to performers, athletes, and the task-specific conditions such as focal dystonia that this population presents with.
Below is an honest survey. I have a stake in the conclusion, and I would rather set out the alternatives properly than pretend they do not exist.
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1. Performing arts health and medicine
Organisations working in performing arts health provide clinician-facing education on the physical and psychological health of musicians, dancers and actors. In the UK, BAPAM is the principal body; internationally, the Performing Arts Medicine Association fulfils a similar role, and the journal Medical Problems of Performing Artists is the main literature.
This is the best route into the epidemiology and the medical context — injury patterns, hearing health, focal dystonia as a clinical entity, and the working conditions that shape all of it. Its strength is clinical grounding. Its limitation, for a therapist, is that it is oriented toward medical and physiotherapeutic practitioners; the psychological content tends to be surveyed rather than trained.
2. Sport and exercise psychology
There are well-established accredited pathways in sport and exercise psychology, typically involving postgraduate study followed by supervised practice. In the UK this runs through the British Psychological Society and the Health and Care Professions Council register.
These routes are rigorous and, if you intend to work substantially in elite sport, worth considering seriously. The limitation is orientation rather than quality: the dominant paradigm remains cognitive-behavioural and skills-based — imagery, goal-setting, self-talk, arousal regulation. Useful, and demonstrably effective for a range of presentations. But it works primarily through the thinking brain, which is not where the more entrenched difficulties are organised.
3. Music performance anxiety
Music performance anxiety is the best-researched psychological difficulty in this population. Kenny’s (2011) monograph remains the standard reference and is worth reading whatever route you take.
CPD here is generally delivered through conservatoires, musicians’ health organisations and short courses. It is genuinely useful for the anxiety end of the spectrum. It does not, on the whole, extend to task-specific movement disorders — and treating focal dystonia as severe performance anxiety is a clinical error with real consequences.
4. Somatic psychotherapy trainings
Somatic Experiencing, Sensorimotor Psychotherapy, Hakomi and related trainings are substantial multi-year programmes with established literatures behind them (Levine, 1997; Ogden et al., 2006). They will teach you to work with the body, with activation and regulation, and with trauma physiology.
If you want general somatic competence, these are the serious options. Their limitation for this work is specificity: they are trauma-oriented rather than performance-oriented, and none addresses focal dystonia, task-specific motor reorganisation, or the particular identity structure of people whose sense of self is fused with a practised skill.
5. Trauma-informed practice CPD
Widely available, generally short, and increasingly a requirement in many settings. Worth having. On its own it provides a framework rather than a capability — it will help you avoid harm, but it will not equip you to work with an embouchure that collapses on contact with the mouthpiece.
So where is the gap?
Set those five side by side and the shape of the gap is clear. You can learn the medical context without the therapeutic method. You can learn a rigorous psychological method oriented toward the cognitive. You can learn deep somatic practice oriented toward trauma rather than performance. What is largely missing is training that combines nervous-system-level somatic practice with genuine expertise in performers, athletes, and focal dystonia specifically.
That gap is not accidental. The population is small, the conditions are poorly understood, and the practitioners who work with them successfully have mostly assembled their competence privately over years, from several of the sources above plus a great deal of trial and error. That was my own route, and I would not recommend it if there were an alternative.
What about the certification?
The Focal Dystonia Method and Free to Perform Certification is my attempt to close that gap: eighteen months across two levels, for practitioners wanting to work with focal dystonia and performance blocks at the level of the nervous system.
Level 1 covers the Focal Dystonia Method — the neurobiological mechanisms, the somatic approach, and the practical work with all forms of the condition. Participants go through the client programme themselves, as a personal process rather than as clinical study. Level 2 extends into Free to Perform: stage fright, the yips, performance anxiety, and the wider spectrum of blocks that prevent reliable access to flow.
The first cohort began in October 2026 and is now full. The next cohort begins in April 2028, with a maximum of twelve places. Applications open on 1 September 2027.
It is not a replacement for a core therapeutic training, and I would not accept anyone without one. It is a specialism built on top.
Does this count as CPD?
Eighteen months of structured personal process, live group sessions, consultancy and clinical preparation constitutes substantial continuing professional development by any reasonable measure. But CPD recognition is granted by professional bodies, not by trainers, and requirements vary considerably between organisations. Check with yours before assuming — that is true of every option on this page, mine included.
The Focal Dystonia Method and Free to Perform Certification is the only professional training of its kind for therapists wanting to work at this level. The first cohort began in October 2026 and is now full. The next cohort begins in April 2028, with a maximum of twelve places. Applications open on 1 September 2027. Find full details at ruthslchiles.com/certification.
Frequently Asked Questions
What CPD is available for therapists working with performers and athletes?
The main routes are performing arts health and medicine education, accredited sport and exercise psychology pathways, music performance anxiety training, multi-year somatic psychotherapy trainings such as Somatic Experiencing and Sensorimotor Psychotherapy, and general trauma-informed practice CPD. Each covers part of the territory.
Is there CPD specifically on focal dystonia for therapists?
Very little. Focal dystonia is generally covered within performing arts medicine as a clinical entity rather than taught as a therapeutic specialism. The Focal Dystonia Method and Free to Perform Certification was created specifically to address this gap.
Do I need to be a sport psychologist to work with athletes?
No. Accredited sport and exercise psychology is one route, and a rigorous one, but psychotherapists, counsellors, somatic practitioners and coaches all work with athletes. What matters is a solid therapeutic foundation and training appropriate to the presentation you are working with.
Is Somatic Experiencing good preparation for this work?
It is a substantial training and provides a strong foundation in working with activation, regulation and trauma physiology. Its limitation for this population is specificity — it is trauma-oriented rather than performance-oriented, and does not address focal dystonia or task-specific motor reorganisation.
How many CPD hours does the Focal Dystonia Method certification represent?
The certification runs eighteen months with monthly four-hour live sessions alongside structured personal process, group consultancy and clinical preparation. Practitioners should confirm recognition and hour equivalence with their own professional body, as requirements vary.
Can coaches take this training, or is it only for therapists?
The certification is open to psychotherapists, counsellors, somatic practitioners and coaches with a solid foundation in therapeutic practice. A prior background in performance psychology is not required.
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References
Altenmüller, E., & Jabusch, H.-C. (2010). Focal dystonia in musicians: Phenomenology, pathophysiology, triggering factors, and treatment. Medical Problems of Performing Artists, 25(1), 3–9. https://doi.org/10.21091/mppa.2010.1002
Ioannou, C. I., & Altenmüller, E. (2014). Psychological characteristics in musician’s dystonia: A new diagnostic classification. Neuropsychologia, 61, 80–88. https://doi.org/10.1016/j.neuropsychologia.2014.06.010
Kenny, D. T. (2011). The psychology of music performance anxiety. Oxford University Press.
Levine, P. A. (1997). Waking the tiger: Healing trauma. North Atlantic Books.
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W. W. Norton.