Accelerated Resolution Therapy

Accelerated Resolution Therapy (ART)

Woman sitting in airplane and looking out the windowAccelerated resolution therapy, or ART, is a type of therapy that combines principles from several traditional forms of psychotherapy to reduce the effect of trauma and other psychological stressors. Using techniques such as rapid eye movement and image rescripting, this approach works to recondition stressful memories, changing how they are stored in the brain to improve overall mental health.

People seeking therapy to reduce the impact of symptoms related to traumatic or stress-inducing memories or increase their capacity for resilience within a relatively short timeframe may find ART beneficial.

History and Development

Accelerated resolution therapy was developed in 2008 by licensed marriage and family therapist, Laney Rosenzweig. ART was born from Laney’s experience with several treatment modalities, including eye movement desensitization and reprocessing (EMDR). Through her training and practice using EMDR, Laney found rapid eye movement beneficial in treatment but determined that modifying it could enhance the process. Rosenzweig created a set of standardized and directive guidelines based on multiple therapeutic frameworks, establishing ART as a treatment method.

In 2015, the National Registry of Evidence-based Programs and Practices (NREPP) officially recognized ART as an evidence-based practice, and the Substance Abuse and Mental Health Services Administration (SAMHSA) named ART an effective psychotherapy for posttraumatic stress (PTSD), depression, and personal resilience.

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Theory and Principles

ART incorporates elements of several treatment modalities, including EMDR, Gestalt, cognitive behavioral therapy (CBT), and brief psychodynamic therapy (BPP). From these therapeutic frameworks, ART employs techniques like rapid eye movement, exposure, imagery rescripting, and guided imagery. Using these methods, ART practitioners can help change the way stress-inducing images are stored in the brain, reducing their negative physical and emotional effects. 

To grasp the fundamentals of ART, it may help to understand how it is implemented. ART interventions can be used concurrently with other treatments, including pharmacotherapy. Individuals in therapy set the pace of ART sessions, choosing which memories are shared and when. Although the use of rapid eye movement mimics the eye movements that occur during dreams, ART does not involve hypnotherapy. Additionally, therapists do not assign homework, and ART does not require people to recall or process traumatic memories between sessions.

Although ART bears some resemblance to treatment modalities like EMDR and CBT, there are several aspects of ART that make it unique, including the following:

  • Specific and Efficient: The methods applied in ART have been shown to produce a faster recovery. Accelerated resolution therapy is designed to be delivered in one to five sessions, each around 60 to 75 minutes long, over the course of a 2-week period. Research has indicated that many people experience positive results within this time frame. The techniques incorporated during sessions are structured to provide quick relief of symptoms as they arise. There are also specific, tailored interventions that target certain issues like trauma, abuse, or smoking cessation.
  • Directive and Interactive: As therapists encourage people in therapy to recall traumatic memories, they use CBT techniques like in vivo exposure to guide the triggered response. The therapist works to reduce any physiological distress accompanying traumatic memories by instructing the person to pause the recall processing. Individuals are encouraged to develop solutions to their traumatic experience during interactive portions of ART. As a memory is recalled, the therapist helps them shift the memory to something more positive, often by employing imagery rescripting. 
  • Voluntary Memory Replacement: ART helps people change feelings associated with traumatic memories, but not the facts. In ART, this type of image rescripting is called voluntary memory/image replacement. Individuals in therapy are encouraged to replace the traumatic memory with a more positive one of their own imagining. They may recall the details of the trauma but no longer feel the same physical, emotional, or visceral response.

A Typical ART Session

A person who begins accelerated resolution therapy is often informed that they are in control of what happens. To begin a typical ART session, a therapist may start by asking the person to do a full body scan. After establishing a baseline for their physical status, the therapist could ask them to recall the distressing memory or image. Individuals are told to visualize the traumatic event in its entirety, not worrying about any gaps in memory. Rapid eye movement can be utilized at this stage, not only to facilitate visualizing the event, but also to help with any strong emotional or physical sensations that occur during this part of the process. The memory recall segment of the session can last anywhere from 30 seconds to 10 minutes.

As the physical and emotional stressors emerge, ART therapists may use a desensitization procedure to reduce the physical and emotional impact of the memories. They may pause the visualization and ask the individual they are working with to do another body scan to slow the stress response. For example, if a woman reports shortness of breath and chest tightness while visualizing an experience of childhood sexual abuse, the therapist may instruct her to forget the scene and focus on her breathing until she is relaxed again. Bringing attention to bodily sensation can provide relief from any intense emotional responses that occur during visualization. Once the person is calm, the process will continue and may repeat, alternating between memory processing and bodily awareness. In this way, the stress response can be reduced gradually.

Throughout the visualization process, the therapist can also encourage the person they are working with to think of solutions for their targeted images or memories. This process, referred to in ART as voluntary image replacement, happens through rapid eye movement, use of metaphors, gestalt techniques, and other interventions that can promote positive sensation. The image rescripting process is similar to EMDR and other methods that treat issues like depression, nightmares, or insomnia and is an element of the ART session crucial to the treatment’s effectiveness. Research indicates that when trauma-related memories are integrated with positive experiences, distressing memories become less intrusive. 

How can ART Help?

Several studies show that in even a few sessions, ART can significantly reduce the symptoms of trauma-related issues. ART can be used to treat a variety of presenting issues, including the following:

Training for ART

According to the official ART website, therapists who receive training in accelerated resolution therapy are promoting their own professional resilience by preventing therapist burnout. ART can allow therapists to see rapid results for those they work with while preventing themselves from absorbing painful details about the trauma, a dynamic beneficial to both therapist and the person in therapy.

Training is regularly offered through the Rosenzweig Center for Rapid Recovery at various locations around the United States and Canada. Brief but intensive 2 to 3 day trainings include basic, advanced, and enhancement levels. Training format includes lecture, video, practicum, and live demonstrations. 

Concerns and Limitations

Due to the nature of trauma work, methods of treatment that target distressing memories are often capable of eliciting intense emotional and physical reactions. Although ART is specifically designed to help people manage these reactions safely, it is important to consider the potential for further trauma. Additionally, because of the likelihood that strong sensations will be experienced during sessions, people with serious physical or psychological conditions should consult their doctor before engaging in this kind of treatment. Any concerns about eyesight should especially be taken into consideration prior to treatment. 

Mental health professionals who choose to employ ART as part of their practice should be thoroughly trained in how to use it, conduct comprehensive assessment, develop solid relationships with the individuals they treat, and ensure they are able to maintain the safety and well-being of those they work with.

References: 

  1. Accelerated Resolution Therapy. (2015, November 22). SAMHSA’s National Registry of Evidence-based Programs and Practices. Retrieved from http://nrepp.samhsa.gov/ProgramProfile.aspx?id=7
  2. Finnegan, A., Kip, K., Hernandez, D., McGhee, S., Rosenzweig, L., Hynes, C., Thomas, M. (2016). Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder. J R Army Med Corps, 162(2), 90-7. doi: 10.1136/jramc-2015-000417
  3. Hoge, C.W. (2015, February 12). Accelerated Resolution Therapy (ART): Clinical considerations, cautions, and informed consent for military mental health clinicians. Walter Reed Army Institute of Research (WRAIR). Retrieved from http://acceleratedresolutiontherapy.com/wp-content/uploads/2016/08/ART-vs-EMDR_by-Hoge.pdf
  4. How ART works. (2016). The Rosenzweig Center for Rapid Recovery. Retrieved from http://acceleratedresolutiontherapy.com/how-art-works/
  5. Kip, K.E., Shuman, A., Hernandez, D.F., Diamond, D.M., Rosenzweig, L. (2014). Case report and theoretical description of accelerated resolution therapy (ART) for military-related post-traumatic stress disorder. Military Medicine, 179(1), 31-7. doi: 10.7205/MILMED-D-13-00229

 

Last updated: 03-08-2018

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