Accelerated Resolution Therapy (ART) is an emerging, efficient therapy for PTSD and other psychiatric conditions. It is derived from Eye-Movement Desensitization and Reprocessing (EMDR), but it has a tighter protocol, is more directive, more procedural, and easier to learn. (See Kip et al.1; for a general description of the proprietary ART protocol.) ART has been reported to be effective, efficient, easy on patients, and easy on clinicians.2;
Unlike psychotherapies developed in university or research environments, the ART protocol was created by an experienced masters-level practitioner in private practice.³ For this reason, ART has not had as much research-based validation as EMDR, Prolonged Exposure, and Cognitive Processing Therapy (CPT). There have been three major clinical trials on ART for PTSD, only one of which involved a control group.4-6
Despite consistently showing impressive results, data from these trials must be interpreted with caution. All three studies were conducted by the same research team out of the University of South Florida, all three relied on patient self-report for outcome measurement, and only one study included a control group. A larger, high-quality randomized controlled trial comparing ART to CPT is currently underway at the Cincinnati Veteran’s Affairs (VA) hospital, although published data from this trial are not expected until 2019 or later.7 Nonetheless, against the backdrop of our current PTSD gold standard treatments, which have demonstrated high dropout rates, low remission rates, and low rates of provider use after training, ART at least seems worthy of a look.
In the ART randomized controlled trial, veterans or active duty service members were randomized to receive up to five sessions of ART or two sessions with a fitness coach or a career counselor. Using an intent-to-treat (ITT) analysis, ART demonstrated a 61% response rate (defined as at least a 10-point drop on the PTSD Checklist [PCL]) and a 94% completion rate.5 These are impressive results, given that established PTSD therapies have a response rate of 49% to 70% and a completion rate of only 60% to 65%.8,9 Furthermore, the number of ART sessions needed in this trial was 3.7 ± 1.1. This number is significant not only because it is fewer than the 8 to 15 sessions required by traditional evidence-based therapies for PTSD, but because up to 83% of patients who drop out of these treatments do so before their fifth session.
The key to ART’s efficiency is believed to lie in its exploitation of natural memory consolidation mechanisms. Memories undergo minor modifications every time we recall them, and that memory activation is critical to effective PTSD therapy.10,11 There is evidence to suggest that activating a memory, changing its emotional valence by introducing a novel sensation or stimulus during activation, and reconsolidating it (“putting it away”) within a discrete period of time can modify memory traces at the level of DNA transcription, essentially locking in the changes in a permanent manner.¹² This period of time, or “reconsolidation window,” is believed to be 1 to 6 hours in humans.
Like other reconsolidation therapies, the ART protocol not only extinguishes the patient’s fear response, but it also unwires distressing emotions from the factual memories of the events that created them. Said another way, reconsolidation therapies “fulfill the brain’s requirements for allowing new learning to rewrite and erase an old, unwanted learning—and not merely suppress and compete against the old learning.”13
Dr Waits is Clinical Associate Professor, Uniformed Services University of the Health Sciences and Director for Behavioral Health, Walter Reed National Military Medical Center, Bethesday, MD. The author has no conflicts of interest concerning the subject matter of this article.
1. Kip KE, Shuman A, Hernandez DF, et al. Case report and theoretical description of accelerated resolution therapy (ART) for military-related post-traumatic stress disorder. Mil Med. 2014;179:31-37.
2. Waits W, Marumoto M, Weaver J. Accelerated resolution therapy (ART): a review and research to date. Curr Psychiatry Rep. 2017;19:18.
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5. Kip KE, Rosenzweig L, Hernandez DF, et al. Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD). Mil Med. 2013;178:1298-1309.
6. Kip KE, D’Aoust RF, Hernandez DF, et al. Evaluation of brief treatment of symptoms of psychological trauma among veterans residing in a homeless shelter by use of accelerated resolution therapy. Nurs Outlook. 2016;64:411-423.
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