Accelerated Resolution Therapy (ART)

An Innovative Mental HealthIntervention to Treat PTSD

Presented by:Kevin E. Kip, Ph.D.

kkip@health.usf.edu

July 20, 2017

Workshop Outline

Part I: Review of Trauma-Focused Therapies and ART Evidence Base

Part II: Review of the ART Clinical Protocol

Part III: Theoretical Basis of Memory Reconsolidation and Eye Movements (i.e. how ART may work)

Sir Peter Medawar (1979)

“I cannot give any scientist of any age better advicethan this: the intensity of the conviction that ahypothesis is true has no bearing on whether it is trueor not.

The importance of the strength of our conviction isonly to provide a proportionately strong incentive tofind out if the hypothesis will stand up to criticalevaluation.”

http://nobelprize.org/nobel_prizes/medicine/laureates/1960/medawar-bio.html

Post-Traumatic Stress Disorder (PTSD)

DSM-V – symptom clusters (all 4): (APA, 2013)

1) Re-experiencing memories of traumatic event, recurrent dreams related to it, flashbacks, or other intense or prolonged psychological distress

2) Avoidance of distressing memories, thoughts, feelings or external reminders of the event

3) Negative cognitions and mood--- distorted sense of blame of self or others --- estrangement from others or markedly diminished interest in activities --- inability to remember key aspects of event

4) Arousal – aggressive, reckless, or self-destructive behavior, hyper-vigilance, or related problems

Prevalence of PTSD in United States

Lifetime prevalence of PTSD – 6 to 9% among persons in US (Kessler, 2005)

Prevalence of PTSD ~2-fold higher in women

Since September 11, 2001, >2.6M American military personnel deployed to Iraq, Afghanistan, or both.

900,000 deployed more than once.

From OIF/OEF/OND conflicts, prevalence estimates of PTSD range from 2%-31% (different sampling and study methodologies) (Ramchand et al., 2010)

IOM Report 2012: 20% OIF/OEF/OND veterans (~520,000) suffer from PTSD (Institute of Medicine, 2012)

Prevalence of PTSD in UK Service Personnel

Prevalence of PTSD in UK Service Personnel

No change in prevalence of PTSD and alcohol misuse since time from end of deployment

US studies have shown an increase in the prevalence of PTSD in relation to post-deployment time (Milken, 2007)

First Line Trauma Therapies

Institute of Medicine (IOM), (Institute of Medicine, 2012)

Trauma-focused cognitive behavioral therapy (CBT) is rated as the only first-level treatment for PTSD.

Pharmacotherapy has accumulated some empirical support.

Core Components of Trauma Focused Therapy:

Narration Cognitive restructuring In vivo exposure Stress inoculation (e.g. relaxation) skills Psycho-education

Current Evidence Based Treatments

Cognitive Processing Therapy (CPT) Focuses on modifying dysfunctional thoughts, beliefs, and expectations by

identifying, challenging, and replacing maladaptive cognitions.

Prolonged Exposure Therapy (PE) Repeated exposure to feared, yet safe, stimuli and memories surrounding the trauma.

Aims for patient to experience decrease in fear and an increase in mastery.

Eye Movement Desensitization Reprocessing (EMDR) Involves exposure and cognitive therapy, but with additional bilateral stimulation,

usually in the form of eye movements.

Stress Inoculation Training (SIT) Teaches anxiety-management skills including relaxation training, breathing retraining,

positive thinking and self-talk, assertiveness training, and thought stopping.

First Line Trauma Therapies

NICE Guidelines for Treatment of PTSD

For Treatment of PTSD >3 Months After Trauma:

Offer course of trauma-focused psychological treatment (TF-CBT) or eye movement desensitisation and reprocessing (EMDR)

Provide treatment on individual outpatient basis

Non-trauma-focused interventions, such as non-directive therapy or relaxation, should not be routinely offered

Pharmacological treatments should not be used as routine first-line treatment for adults

Pharmacological treatments can be considered as an adjunct to psychological treatment

Reality of Evidence Based Treatments

Review of treatment dropout and non-response rates in 55 studies of empirically supported treatments for PTSD:

“A careful review of empirically supported psychotherapies for PTSD indicates that these therapies have relatively large dropout or non-response rates.”

Reality of Evidence Based Treatments

Among veterans who begin treatment for PTSD with psychotherapy or medication:

“A high percentage of veterans drop out.”

“Rate of recovery of 60% to 80% among treatment completers declines to about 40% when non-completers are taken into account.”

Interventions for War-Related Posttraumatic Stress DisorderMeeting Veterans Where They Are

Charles W. Hoge, MD JAMA, August 3 2011 – Vol 306, No 5

Reality of Evidence Based Treatments

“The term “gold-standard” evidence-based treatments should be reserved for treatments that evidence both positive results in RCTs, but also feasibility and strong retention in real-world settings

http://www.youtube.com/watch?v=w_bi0eW_WsU&feature=share&list=UUzZzLGbYx9OHlCjN5TTSv4w&index=1

Initial ART Testimonial

Hierarchy for Evidence of a New Psychotherapy

RCT: Randomized Controlled Trial; EBP: Evidence-Based Practice

Federal Classification

Accelerated Resolution Therapy. Classified as evidence-based by the Substance Abuse and Mental Health Services Administration (SAMHSA), National Registry of Evidence Based Programs and Practices (NREPP), November, 2015; http://nrepp.samhsa.gov/ProgramProfile.aspx?id=7

Study 1:

Title: ART for Civilian Psychological Trauma

Design: Prospective Cohort Study

Sample: 80 adults

Assessments: --- Before ART--- After ART--- 2-month follow-up--- 4-month follow-up

Primary Publications:

Kip KE, Elk CA, Sullivan KL, Kadel R, Lengacher CA, Long CJ, Rosenzweig L, Shuman A, Hernandez DF, Street JD, Girling SA, Diamond DM. Brief treatment of symptoms of post-traumatic stress disorder (PTSD) by use of Accelerated Resolution Therapy (ART). Behavioral Sciences 2012; 2(2): 115-134. PMID: 23482431

Kip KE, Sullivan KL, Lengacher CA, Rosenzweig L, Hernandez DF, Kadel R, Kozel FA, Shuman A, Girling SA, Hardwick MJ, Diamond DM. Brief treatment of co-occurring post-traumatic stress and depressive symptoms by use of accelerated resolution therapy. Frontiers in Psychiatry 2013; 4 (article 11):1-12. doi: 10.3389/fpsyt.2013.00011 PMID: 23482431

Characteristic All

(n = 80)

Male

(n = 18)

Female

(n = 62)

Age in years (mean ± SD)

40.0 ± 10.2

41.9 ± 11.8

40.6 ± 9.8

Race (%)

Black or African American 7.5 0.0 9.7

White 88.8 94.4 87.1

Other 3.7 5.6 3.2

Hispanic (%) 28.6 5.6 35.6

PCL-C score (mean ± SD) 54.5 ± 13.0 57.3 ± 14.3 53.7 ± 12.6

Less than 40 (%) 13.8 11.1 14.5

40 to 60 (%) 47.5 38.9 50.0

More than 60 (%) 38.8 50.0 35.5

Traumatic memories still impacting life (%)

1 to 2 19.0 23.57 17.7

3 to 4 31.6 35.3 30.6

5 or more 49.4 41.2 51.6

Previous tx for PTSD/other MH condition (%) 67.9 50.0 73.3

Time lived with traumatic memory(ies) (%)

Less than 1 year 6.3 5.6 6.5

1 to 6 years 13.8 22.2 11.3

7 years or more 80.0 72.2 82.3

Demographic and Presenting Characteristics

PCL-C: 17-item PTSD Checklist; MH: Mental Health

Mean of 3.5 ART Sessions

Self-Report Changes in Symptoms Before and After Treatment with ART

Symptom Measure

Pre-Treatment Versus 2-Month Follow-Up

N Prea 2-Mo.

a Diff

ab ES P

PTSD Checklist (PCL-C) 52 54.1 (12.2) 29.5 (12.0) 24.5 (12.2) 2.01 <0.0001

Brief Symptom Inventory 52 30.1 (14.2) 9.6 (11.9) 20.5 (13.3) 1.54 <0.0001

CES-D (Depression) 51 29.0 (10.7) 13.3 (12.1) 15.5 (11.0) 1.41 <0.0001

Pittsburgh Sleep Quality 47 9.8 (4.6) 6.2 (4.2) 3.6 (4.0) 0.89 <0.0001

Trauma Related Growth

Global Guilt 52 4.6 (2.4) 1.9 (2.0) 2.7 (2.8) 0.98 <0.0001

Distress 52 18.7 (4.0) 8.0 (5.9) 10.7 (5.6) 1.89 <0.0001

Guilt Cognition 52 44.3 (18.3) 24.4 (14.9) 19.9 (19.2) 1.04 <0.0001

Self-Compassion Scale 52 67.2 (16.8) 82.0 (21.1) 14.8 (17.8) 0.83 <0.0001

Alcohol Use (AUDIT) 52 3.0 (3.3) 1.8 (2.1) 1.2 (2.2) 0.50 0.0008

aPresented as mean (standard deviation).

bAll mean differences are coded with positive numbers

reflecting improvements in symptoms. ES: effect size.

0

10

20

30

40

50

60

70

80

Pre-ART Post-ART 2-Month 4-Month Pre-ART Post-ART 2-Month 4-Month

PCL-C (PTSD) CES-D (Depression)

(n=28) (n=19)(n=28) (n=28) (n=28) (n=28) (n=28) (n=19)

Study 2:

Title: ART for Military Psychological Trauma

Design: Randomized Controlled Trial

Sample: 57 U.S. veterans/service members

Assessments: --- Before ART--- After ART--- 3-month follow-up

Primary Publications:

Kip, KE, Rosenzweig L, Hernandez DF, Shuman A, Sullivan KL., Long CJ, Taylor J, McGhee S, Girling SA, Wittenberg, T, Sahebzamani, FM, Lengacher CA, Kadel R, Diamond DM. Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD). Military Medicine 2013; 178: 1298-1309. PMID: 24306011

Kip KE, Shuman A, Hernandez DF, Diamond DM, Rosenzweig L. Case report and theoretical description of Accelerated Resolution Therapy (ART) for military-related post-traumatic stress disorder. Military Medicine2014; 179:31-37. PMID: 24402982

Kip KE, Rosenzweig L, Hernandez DF, Shuman A, Diamond DM, Girling SA, Sullivan KL, Wittenberg T, Witt AM, Lengacher CA, Anderson B, McMillan SC. Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder. European Journal of Psychotraumatology 2014, 5: 24066 – http://dx.doi.org/10.3402/ejpt.v5.24066 PMID: 24959325

Kip KE, Hernandez DF, Shuman A, Witt A, Diamond DM, Davis SE, Kip R, Abhayakumar A, Wittenberg T, Girling SA, Witt S, Rosenzweig L. Comparison of Accelerated Resolution Therapy (ART) for treatment of symptoms of PTSD and sexual trauma between civilian and military adults. Military Medicine, 180: 964-971. PMID: 26327548

Demographic, Military, and Clinical Characteristics by Random Assignment.

Characteristic

All

(n = 57)

ART

(n = 29)

AC

(n = 28)

p-

value

Age in years (mean ± SD) 41.4 ± 12.6 38.9 ± 11.5 44.0 ± 13.4 0.13

Female gender (%) 19.3 17.2 21.4 0.75

Current military status (%) 1.0

Active duty 12.3 13.8 10.7

Reservist 17.5 17.2 17.9

Discharged/veteran 70.2 69.0 71.4

Primary branch of military service 0.09

Army 54.4 65.5 42.9

Navy 21.0 24.1 17.9

Air Force 12.3 6.9 17.9

Marines 12.3 3.5 21.4

Principal location of deployment(s)(%) 0.52

Iraq 40.4 48.3 32.1

Afghanistan 10.5 10.3 10.7

Vietnam 7.0 3.5 10.7

Other 42.1 37.9 46.4

History of head trauma (%) 14.1 41.4 28.6 0.41

On disability for PTSD/other MH (%) 42.1 51.7 32.1 0.18

Previous treatment for PTSD (%) 68.4 65.5 71.4 0.78

Individual therapy 59.7 51.7 67.9 0.28

Group therapy 19.3 17.2 21.4 0.75

Pharmacotherapy 52.6 58.6 46.4 0.43

PCL-M score (mean ± SD) 56.9 ± 15.2 57.4 ± 15.0 56.4 ± 15.7 0.81

Any PTSD screening criteria (%) 93.0 96.6 89.3 0.35 \

Change in PCL-M Score

Mean of 3.6 ART Sessions

Treatment Effect of ART versus Attention Control for Comorbidities of PTSD

Measure of

Comorbidity

Attention Control (n=24) ART (n=26) Effect Size p-valuea

Pre Post Diff 95% C.I. Pre Post Diff 95% C.I. Obs ITT Obs.a ITT

b

CES-D (Depression) 26.9 28.2 1.3 -1.6, 4.2 26.7 14.3 -12.3 -17.1, -7.5 1.39 1.27 <0.0001 <0.0001

Brief Symptom Inventory 28.1 24.0 -3.8 -9.5, 1.9 27.1 12.9 -14.2 -20.1, -8.3 0.75 0.72 0.006 0.02

STICSA (Somatic) 20.6 19.7 -0.9 -3.3, 1.5 18.3 15.3 -3.0 -4.9, -1.1 0.41 0.41 0.06 0.19

STICSA (Cognitive) 23.8 22.3 -1.8 -3.6, 0.04 23.7 16.5 -7.2 -9.7, -4.8 1.03 0.97 0.0006 0.002

Pittsburgh Sleep Quality 11.7 11.7 -0.1 -1.0, 0.7 12.8 10.4 -2.4 -4.7, -0.1 0.57 0.48 0.10 0.16

Trauma Related Growth

Global Guilt 5.8 7.2 1.4 0.1, 2.6 8.3 4.7 -3.6 -5.6, -1.6 1.21 1.12 0.0004 0.0004

Distress 14.6 15.8 1.2 -0.5, 3.0 16.4 10.4 -6.0 -8.8, -3.1 1.22 1.13 0.0002 0.0006

Guilt Cognition 20.2 20.8 0.6 -6.1, 7.4 26.7 15.8 -10.9 -19.2, -2.6 0.62 0.59 0.09 0.06

Self-Compassion Scale 71.8 71.6 -0.2 -3.6, 3.3 74.5 86.1 11.5 3.0, 20.1 0.72 0.68 0.007 0.03

Aggression Questionnaire 73.4 75.5 2.1 -5.3, 9.6 82.1 75.1 -7.0 -14.9, 0.9 0.49 0.46 0.19 0.13

ap-value adjusted for baseline measurement.

bBased on student t test and Intention to Treat assuming mean difference of zero

from baseline to post-intervention assessment and standard error from completers with non-missing data.

ART for Pain Secondary to PTSD

ART for Pain Secondary to PTSD

Pooled Data – Primary Trauma Exposure

PTSD treatment response with ART is similar between civilians and military

Study 3:

Title: ART for Military Combat-Related Trauma and Military Sexual Trauma

Design: Prospective Cohort Study

Sample: 140 U.S. veterans/service members

Assessments: --- Before ART--- After ART--- 6-month follow-up

Primary Publication:

Kip KE, D'Aoust RF, Hernandez DF, Girling SA, Cuttino B, Long MK, Rojas P, Wittenberg T, Abhayakumar A, Rosenzweig L. Evaluation of brief treatment of symptoms of psychological trauma among veterans residing in a homeless shelter by use of Accelerated Resolution Therapy (ART), Nursing Outlook 2016;64:411-223.

Characteristics of Study Participants by Residential Status (Quasi Diagnosis of PTSD)

Characteristic

All

(n=89)

Homeless

(n=12)

Community

(n=77)

p-

value

Age in years, mean + SD 43.0+13.2 51.3+8.9 41.7+13.3 0.02

Male gender, % 92.1 83.3 93.5 0.24

Combat Exposure Scale, mean + SD 19.9+9.8 12.0+9.7 21.1+9.2 0.002

Experienced combat-related activity, % 87.5 58.3 92.1 0.006

PCL-M (PTSD checklist), mean + SD 62.9+10.3 63.7+9.8 62.8+10.4 0.79

On disability for PTSD/MH disorder, % 39.1 8.3 44.7 0.02

Screen positive for mild TBI, % 53.9 50.0 48.7 1.0

Five or more traumas impacting life, % 57.6 41.7 60.3 0.34

Guilt associated with trauma(s), % 83.7 83.3 83.8 1.0

Trauma for 11 or more years, % 48.9 83.3 43.4 0.01

Prior psychotherapy 72.6 66.7 73.6 0.73

Treatment Provided, mean + SD

Total sessions of ART 3.7+1.4 4.1+1.0 4.2+0.9 0.57

ART sessions for non-trauma 0.8+0.8 0.4+0.5 0.8+0.8 0.14

Among participants with quasi-diagnosis of PTSD and who completed treatment.

4.2+0.9

ART for Homeless Veterans

-70

-60

-50

-40

-30

-20

-10

0

10Change in PCL-M Score

(n=10)

Mean: -26.1 + 20.7

p = 0.003

Mobile ART Clinical/Research Team

Eagles Healing Nest, Sauk Centre, MN

Mean of 2.7 (± 1.0) treatment sessions

Study 4:

Title: Pilot Study of ART for Chronic Neuropathic Pain

Design: Prospective Cohort Study

Sample: 10 Adults with chronic pain

Assessments: --- Before ART--- After ART--- 1-month follow-up

Primary Publication:

Kip KE, Tofthagen C, D'Aoust R, Girling SA, Harper Y, Rosenzweig L. Pilot study of Accelerated Resolution Therapy for treatment of chronic refractory neuropathic pain. Alternative and Complementary Therapies. December 2016, 22(6): 243-250. doi:10.1089/act.2016.29082.kek.

Pain Outcomes Questionnaire SF-36 Bodily Pain Scale

ART for Chronic Neuropathic Pain

Study 5:

Title: ART Sleep EEG Study

Design: Case Series

Sample: 9 veterans with symptoms of PTSD9 control subjects without PTSD

Assessments: --- Before ART--- After ART

PTSD patients studied before and after treatment with ART

Test protocol consisted of multi-channel surface EEG during a 30-minute daytime nap.

Surface EEG electrodes attached to frontal, central, and parietal sites-both hemispheres.

Measures of brain wave coherence evaluated between adjacent segments.

ART Sleep EEG Study

ART Sleep EEG Study

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC, American Psychiatric Publishing Inc.

Hoge, C. W. (2011). "Interventions for war-related posttraumatic stress disorder: Meeting veterans where they are." JAMA 306: 549-551.

Institute of Medicine. 2012. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment. Washington, DC: The National Academies Press. https://doi.org/10.17226/13364.

Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.

Najavitis, L.M. The problem of dropout from “gold standard” PTSD therapies. F1000Prime Rep. 2015; 7: 43.

Milliken CS, Auchterlonie JL, Hoge CW. Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA. 2007;298(18):.2141–2148

National Institute for Health and Care Excellence. Evidence Update 49 – Post-traumatic stress disorder (PTSD) (December 2013) . https://www.nice.org.uk/guidance/cg26/evidence/evidence-update-pdf-193438333

Ramchand, R., Schell, T.L., Karney, B.R., Osilla, K.C., Bruns, R.M., Caldarone, L.B. Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations. Journal of Traumatic Stress 2010; 23(1); 59-68.

Rona, R.J., Burdett. H., Bull, S., Jones, M., Jones, N., Greenberg, N., Wessely, S., Fear, N.T. Prevalence of PTSD and other mental disorders in UK service personnel by time since end of deployment: a meta-analysis. BMC Psychiatry 2016; 16: 333.

Schottenbauer, M. A., et al. (2008). "Nonresponse and dropout rates in outcome studies on PTSD: review and methodological considerations." Psychiatry 71: 134-169.

ART BibliographyPeer-Reviewed Publications

1. Kip KE, Elk CA, Sullivan KL, Kadel R, Lengacher CA, Long CJ, Rosenzweig L, Shuman A, Hernandez DF, Street JD, Girling SA, Diamond DM. Brief treatment of symptoms of post-traumatic stress disorder (PTSD) by use of Accelerated Resolution Therapy (ART). Behavioral Sciences 2012; 2(2): 115-134. PMID: 23482431

2. Kip KE, Sullivan KL, Lengacher CA, Rosenzweig L, Hernandez DF, Kadel R, Kozel FA, Shuman A, Girling SA, Hardwick MJ, Diamond DM. Brief treatment of co-occurring post-traumatic stress and depressive symptoms by use of accelerated resolution therapy. Frontiers in Psychiatry 2013; 4 (article 11):1-12. doi: 10.3389/fpsyt.2013.00011 PMID: 23482431

3. Kip, KE, Rosenzweig L, Hernandez DF, Shuman A, Sullivan KL., Long CJ, Taylor J, McGhee S, Girling SA, Wittenberg, T, Sahebzamani, FM, Lengacher CA, Kadel R, Diamond DM. Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD). Military Medicine 2013; 178: 1298-1309. PMID: 24306011

4, Kip KE, Shuman A, Hernandez DF, Diamond DM, Rosenzweig L. Case report and theoretical description of Accelerated Resolution Therapy (ART) for military-related post-traumatic stress disorder. Military Medicine 2014; 179:31-37. PMID: 24402982

5. Kip KE, Rosenzweig L, Hernandez DF, Shuman A, Diamond DM, Girling SA, Sullivan KL, Wittenberg T, Witt AM, Lengacher CA, Anderson B, McMillan SC. Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder. European Journal of Psychotraumatology 2014, 5: 24066 –http://dx.doi.org/10.3402/ejpt.v5.24066 PMID: 24959325

6. Kip KE, Hernandez DF, Shuman A, Witt A, Diamond DM, Davis SE, Kip R, Abhayakumar A, Wittenberg T, Girling SA, Witt S, Rosenzweig L. Comparison of Accelerated Resolution Therapy (ART) for treatment of symptoms of PTSD and sexual trauma between civilian and military adults. Military Medicine 2015; 180: 964-971. PMID: 26327548

7. Finnegan A, Kip K, Hernandez D, McGhee S, Rosenzweig L, Hynes C, Thomas M. Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder. Journal of the Royal Army Medical Corps 2016; 162:90-97. PMID 2614210

8. Kip KE, D'Aoust RF, Hernandez DF, Girling SA, Cuttino B, Long MK, Rojas P, Wittenberg T, Abhayakumar A, Rosenzweig L. Evaluation of brief treatment of symptoms of psychological trauma among veterans residing in a homeless shelter by use of Accelerated Resolution Therapy (ART), Nursing Outlook 2016;64:411-223.

9. Kip KE, Tofthagen C, D'Aoust R, Girling SA, Harper Y, Rosenzweig L. Pilot study of Accelerated Resolution Therapy for treatment of chronic refractory neuropathic painAlternative and Complementary Therapies. December 2016, 22(6): 243-250. doi:10.1089/act.2016.29082.kek.

10. Hernandez DF, Waits W, Calvio L, Byrne M. Practice comparisons between accelerated resolution therapy, eye movement desensitization and reprocessing and cognitive processing therapy with case examples. Nurse Education Today 2016; 47:74–80.

11. Waits W, Marumoto M, Weaver J. Accelerated resolution therapy (ART): a review and research to date. Current Psychiatry Reports 2017; 19:18. Published at: doi:10.1007/s11920-017-0765-y

ART Bibliography

Book Chapters

Waits WM, Kip KE, Hernandez DF. Accelerated Resolution Therapy. In Ritchie EC (ed): Posttraumatic Stress Disorder and Related

Diseases in Combat Veterans. Springer International Publishing, Switzerland, 2015; pp 105-121.

Kip KE, Rosenzweig L, Hernandez DF, Shuman A, Witt A, Keller E, Diamond DM. Accelerated Resolution Therapy: A Brief, Emerging

Evidence-Based Treatment for PTSD. In Martin C, Preedy V, and Patel VB (eds): Comprehensive Guide to Post-Traumatic Stress

Disorders. Springer International Publishing, Switzerland, 2016;

Related/Referenced Publications

Interview with Dr. Charles Hoge on PTSD Treatments and a Novel Treatment, Accelerated Resolution Therapy. Australasian Society for

Traumatic Stress Studies (ASTSS). August 2015: 5-9.

Hoge CW, Lies J. Posttraumatic stress disorder: developments in assessment and treatment. Federal Practitioner 2015 (April); 16S-20S.

Federal Classification

Accelerated Resolution Therapy. Classified as evidence-based by the Substance Abuse and Mental Health Services Administration

(SAMHSA), National Registry of Evidence Based Programs and Practices (NREPP), November, 2015;

http://nrepp.samhsa.gov/ProgramProfile.aspx?id=7