Wednesday, December 11, 2013

Immediate "Accelerated Resolution Therapy" Eases PTSD

When I worked with Vietnam era vets as a volunteer PTSD co-facilitator with the VA, the most common attribute of the men and women in our groups was the length of time it had been since the trauma that caused their distress.  Most often, it had been years since their experience.  As PTSD is known to be a slowly debilitating disease, the people we counseled were well established in the behavior and thought patterns of the illness.

Now it's found that an approach applied immediately after the event can be very effective in resolving the issues and prevent the long-term debilitation of PTSD.  Accelerated Resolution Therapy, or ART, is a brief, safe, and effective treatment for combat-related symptoms of post-traumatic stress disorder (PTSD) among veterans and U.S. service members, researchers at University of South Florida College of Nursing report in a new study. 

They found this newer treatment -- a combination of evidence-based psychotherapies and use of eye movements -- was shorter and more likely to be completed, than conventional therapies formally endorsed by the U.S. Department of Defense and the Veterans Administration.

Kevin Kip, PhD, FAHA, professor and executive director for the Research Center at the USF College of Nursing, led the team of scientists and clinicians who conducted the first randomized controlled trial of ART in a military population. The trial enrolled 57 service members and veterans, primarily from the Tampa Bay area.

"Based on this trial and an earlier study completed at the USF College of Nursing, we believe that accelerated resolution therapy may provide the quickest way to effectively and safely treat post-traumatic stress disorder," Dr. Kip said. "Our goal is to obtain enough evidence and interest to warrant classifying ART as a potential first-line treatment for PTSD among both civilian and military personnel."

"Dr. Kip's work on this project has been phenomenal," said Dianne Morrison-Beedy, PhD,  senior associate vice president of USF Health, and dean of the College of Nursing. "ART has been a cornerstone of RESTORE LIVES at USF Nursing as we continue developing research and education to advance the health care received by veterans, service members and their families."

ART works in two phases to alleviate psychological trauma symptoms and related disorders such as depression and anxiety.

  1. The patient first visualizes in his or her mind a prior traumatic experience which typically elicits uncomfortable physiological sensations like tightness of the chest, increased heart rate and sweating. Then, 
  2. through talk therapy and a series of rapid left-to-right eye movements in which the patient follows the clinician's hand back and forth, the sensations are minimized. In the second phase, and with similar clinician input, the patient "replaces" the distressing images they have seen with positive ones in a way that the original distressing images can no longer be accessed. 
ART is delivered in two to five one-hour sessions, requires no homework, and no written or verbal recall of the traumatic experience.

"Through this therapy, we're able to quiet down and separate physiological symptoms that come with re-envisioning a traumatic experience," Dr. Kip said. "We can also alter or replace the traumatic images and add positive material to them. We are changing how images are remembered in the brain."

It worked well for Brian Anderson, a former Green Beret, 10-year Army veteran and director of the Pasco County Veteran Services and Stand Down program. He had tried an endorsed first-line PTSD treatment known as prolonged exposure therapy, which was very lengthy and worked for a while, but then symptoms like hyper-vigilance returned.

"ART changed my life," Anderson said. "This brief therapy took the bad memories that constantly resurfaced and put them in the proper order or long-term storage; it was almost like I was thinking about a time in history. As a veteran, I would much rather go through a therapy that works, in only a few sessions, than sit through intensive and grueling sessions that last as long as 16 weeks."

PTSD is a prevalent, disabling disorder that can emerge following a life-threatening event or traumatic experience. Those experiences create chronic symptoms such as flashbacks, nightmares, sleep disturbances, mood swings, and loss of interest in life. According to PTSD Foundation of America, one in three troops returning from combat suffers PTSD symptoms, although less than 40 percent seek help. The organization also reports that at least five active duty military members attempt suicide every day.

"Accelerated resolution therapy is giving hope to many veterans who felt like they had no hope," said Lt. Col. (Ret.) Lawrence A. Braue, EdD, director of the USF Office of Veterans Services. "I look forward to the day when this treatment is widely available across the country. USF College of Nursing faculty and staff genuinely care about our veterans, and that means the world to any veteran."
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Story Source:  Kip, Kevin E.; Rosenzweig, Laney; Hernandez, Diego F.; Shuman, Amy; Sullivan, Kelly L.; Long, Christopher J.; Taylor, James; McGhee, Stephen; Girling, Sue Ann; Wittenberg, Trudy; Sahebzamani, Frances M.; Lengacher, Cecile A.; Kadel, Rajendra; and Diamond, David M. Randomized Controlled Trial of Accelerated Resolution Therapy (ART) for Symptoms of Combat-Related Post-Traumatic Stress Disorder (PTSD). Military Medicine, Vol. 178, No. 12, December 2013

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