Gestalt Cognitive behavioral Guided imagery Eye movement desensitization reprocessing (EMDR) Brief psychodynamic Exposure therapy (imaginal exposure)
As described they the Rosenzweig Center for Rapid Resolution, “ART works directly to reprogram the way in which distressing memories and images are stored in the brain so that they no longer trigger strong physical and emotional reactions.” With roots in a variety of existing evidence-based treatment practices, ART has been found to be an effective treatment for depression, anxiety, panic attacks, and PTSD.
Background on PTSD
Post-traumatic stress disorder (PTSD) affects approximately 13 million people at any given time in the United States, which is roughly 5 percent of the population. With so many people suffering, it is important for the mental health community to consider innovative methods to help people find healing. It has been suggested that people who experience trauma wait as long as two years after their realization of pain from the trauma to seek help. Two years is a long time to experience that kind of pain and, by the time people are seeking help, they are often feeling a sense of urgency to find relief. PTSD can feel debilitating and impact functioning in everyday life. According to the American Psychiatric Association, an estimated one in 11 people will be diagnosed with PTSD in their lifetime. Women are twice as likely as men to experience symptoms of post-traumatic stress disorder. People who are challenged with PTSD can experience symptoms such as:
Intense and disturbing thoughtsOverwhelming emotionsFlashbacksNightmaresNight terrorsFeelings of detachmentSadnessAngerIsolation
PTSD in Veterans
It is estimated that one in five service members coming home from Afghanistan and Iraq will suffer from post-traumatic stress disorder. They experience similar debilitating symptoms when they return home, plagued with graphic memories, images, nightmares, and overwhelming emotions. Since service members may come home to family and friends who have not been through similar experiences, those suffering from PTSD can feel isolated and misunderstood. It can be difficult to ask for or accept help, especially if they fear that people around them will not understand. Service members who struggle with PTSD may turn to drugs, alcohol, and even suicide in an attempt to escape their distress. Methods of traditional talk therapy can certainly be helpful, such as cognitive-behavioral therapy. However, there are innovative methods being developed and researched that can seemingly cut down on the healing time for clients and with very little distress for them in the counseling process.
Evidence-Based Practice
Being relatively new, and with a limited research data base, the innovative treatment model, accelerated resolution therapy was federally recognized as an evidence-based treatment model by the National Registry of Evidence-Based Programs and Practices (NREPP) in 2015. The NREPP found ART to be an effective psychotherapy model in the treatment of:
PTSDDepressionStressPersonal resilience
In addition, NREPP classified ART to be a promising therapy technique for the symptoms of:
Phobia Panic Anxiety Sleep and wake disorders Disruptive and antisocial behaviors General functioning and well being
Eye Movement
One key element of accelerated resolution therapy is eye movement. Healing is targeted through the use of the client’s rapid eye movement, similar to what they would experience while dreaming. During a session with an ART therapist, clients will be asked to follow the therapist’s hand back and forth laterally through their line of vision. As they are attending to this external stimuli, the movement of the therapist’s hand, it has been found that clients become more relaxed and more easily able to access internal stimuli, which would include distressing images of a traumatic event. As these images are accessed, ART focuses on helping clients heal the emotional and physical reactions associated with those experiences. Clients have been said to find relief in one to three sessions with this type of therapy.
ART vs. EMDR
Another type of therapy is called eye movement desensitization and reprocessing (EMDR). Although both of these effective treatment techniques involve eye movement to help reduce distress from traumatic memories, ART is different in that it focuses more directly on how negative images from trauma are connected with emotional and physical reactions. There are specific methods that a clinician will use in treatment sessions with clients based on their presenting issues, such as PTSD, sexual abuse, or addiction. ART is designed to be a brief model of therapy treatment. Clients have been known to experience relief from their distress in one session, rather than having to participate in several sessions before experiencing change. As more people find themselves challenged with debilitating symptoms that impact their lives and relationships, finding a treatment model that can offer symptom relief in a short period of time is invaluable.
One Image at a Time
Accelerated resolution therapy allows clients to focus on one presenting issue at a time. The treatment model is designed to help clients resolve that particular issue within one to three sessions. Once a client has effectively found healing and symptom relief around that image or issue, they can then move onto the next. For clients with trauma history, this can be comforting to know that there is a method and direction to treatment, rather than feeling as if all layers of their experience will need to be processed at once. Processing multiple layers of trauma can be quite overwhelming for clients and can even block people from continuing the healing process.
No Heavy Emotional Processing
Some therapeutic treatment models, especially for the treatment of trauma and PTSD, require clients to revisit their traumatic experience, walking the therapist through their memory detail by painful detail. Not surprisingly, this can be uncomfortable for clients, as they are likely already playing their traumatic images over and over again in their mind on a daily basis. The idea of letting someone else into that deep, emotionally painful space can feel overwhelming and stop clients from continuing treatment. ART does require clients to pull up an image in their mind of the experience that is related to presenting symptoms, but the clients do not need to verbalize any of that experience to their therapists during sessions. As many people with PTSD replay traumatic events in their minds on a regular basis, the process of ART does not ask clients to do anything different than what they already do on their own. Their traumatic experience can remain private and the client is not required to be vulnerable with the therapist or share details of their experience if they are not ready. Healing can continue to happen through the process of ART regardless of how much the client is sharing about their trauma.
Active and Engaging
Even though clients are not required to share their trauma in a vulnerable way with their ART therapist, many find the process of accelerated resolution therapy to be an active and engaged process. As described by The Rosenzweig Center for Rapid Resolution, clients report finding comfort in their ART therapist being attuned and engaged with them through the treatment process. Although ART itself is not considered a talk-based therapy, it can still feel conversational in nature as the client and therapist walk through the chosen experience being selected for that particular session. The techniques of ART can also be used to enhance talk-based therapy techniques, helping clients to eliminate blocks to their treatment progress so they can continue processing and healing.
Voluntary Imagery Replacement
ART therapy includes a particular technique within the treatment model called voluntary imagery replacement (VIR) or voluntary memory replacement (VMR). This technique is similar to what some other treatment methods include and is referred to as re-scripting. Clients are asked to use their imaginations to envision alternative outcomes, becoming an engaged author to their experience. ART professionals note that it is important to remember that clients do recognize this new image is not the actual image from their memory. However, using their own creativity to change these images impacts the level of emotional and physical functioning. So, although the event itself does not change, the impact of the event no longer has the same negative impact on their physical and emotional responses to the event.
What Happens in a Session
With so many therapeutic treatment techniques available, especially as one as new and innovative as ART, it can be helpful to walk through what to expect in a counseling session.
Safe Space
Accelerated resolution therapy professionals suggest that the process of this treatment with model is simple. First, the therapist creates a safe space for the client. The idea of creating a safe haven within the therapy room is critical for any therapeutic intervention. Therefore, creating a safe haven for the client is just as critical when beginning work in ART.
Following the Therapist’s Hand
Once the client feels relaxed and ready, they will be asked to visually follow the therapist’s hand back and forth laterally through their line of vision while silently calling up a particular memory that they want to address or heal. It is suggested that this process lasts between 30 seconds and 10 minutes. As the client is engaging in this process of eye movement, the ART therapist is taking time to check in with their client to process any physical and emotional reactions.
Changing the Script
It is important for the therapist to effectively tune in and track what is happening for their client during this time as the client is beginning to relax. As they relax, the client becomes better able to access memory and create or select more positive changes in the images around that event. As the ART therapist continues to gently guide the client through this process, they are encouraged and empowered to begin making any selected changes they wish to the image they have recalled. During this time, the client is able to make changes to the image itself or to any other information surrounding that image. These changes could involve other sensory information such as sounds and smells. The ART therapist continues to stay attuned and engaged with the client as they gently transition them out of that image and back into the present reality of the therapy room.
Path to Healing
As clients continue to work through these images, they can begin to find relief in one to five sessions. One image is focused on at a time, which is an important part of this treatment model. As clients find healing and relief around one image they can then move on to the next and go from there. Clients have reported that, even if they don’t feel very different after the first session, they begin to feel a noticeable change in their emotional and physical responses to the event shortly after, such as the second or third sessions. Considering the complexities of traumatic experiences and the variety of symptoms experienced with PTSD, this model of therapy is notably brief while still being effective. During the process of healing, clients participating in ART therapy are still able to recall the events they have been working on. However, their physical and emotional responses to the recall of that traumatic event will no longer be present for them as they continue to engage in this process. A phrase mentioned within the ART community is, “Keep the knowledge, lose the pain.” It is important to note that actual memories are not being replaced in this model, nor is there any hypnosis involved in this treatment method.
Where to Find an ART Therapist
Accelerated resolution therapy is a new and innovative treatment with some limited evidence supporting its use. As the ART movement continues to grow, clinicians from all over the world are being trained in this method. Developer of ART, Laney Rosenzweig, LMFT, founded the Rosenzweig Center for Rapid Recovery based in Florida. You can find a directory of trained and qualified ART therapists through their website. Clinicians interested in training in ART can find information about upcoming seminars, workshops, and training intensives through the center’s website as well.
