Review of ART

Clinical Protocol
 Overview of the ART Clinical Protocol

 Emerging psychotherapy for PTSD and related comorbidities.

 Developed from components of existing evidence-based therapies and
use of eye movements.
 Delivered in 1-5 sessions with no homework or medication.
 Patient does not need to verbally disclose or write about details of their
prior traumatic experiences.
 Sets of “calming” eye movements are used routinely throughout each
session.
 Patient “replaces” negative images in the brain with positive images.
 Overview of ART Clinical Protocol
 Delivered in 1-5 sessions, and with no homework
 Three major evidence-based components:
1) Imaginal Exposure (IE) (E. B. Foa et al., 1999; E.B. Foa, Rothbaum, Riggs, & Murdock, 1991).
Recall (verbally or non-verbally) details of the traumatic event (scene) while
focusing attention on physiological sensations, thoughts, and emotions.
2) Imagery Rescripting (IR) (Hackman, 2011)
Imagine changing (replacing) the traumatic scene (imagery and sensory
components) from negative to positive (like the “director” of a movie).
3) Use of Eye Movements (Purves, Augustine, & Fitzpatrick, 2001)
Participant follows therapists’ hand back and forth moving their eyes from left to
right, with 40 bilateral eye movements performed per set – used in both the IE
and IR components.
Directive – not free associative
 Overview of ART Clinical Protocol

•Separates the physiological sensations

from the narrative or memory

•Replaces disturbing images

with positive images

Delivered in 1-5 sessions; no homework

~1500 clinicians trained worldwide

Laney Rosenzweig, LMFT (2008)
~50,000 cases performed
 Typical Components of an ART Session
1: Frame a problem (“trauma”) into an ART scene
2: Process physiological sensations
3: Imaginal exposure (first time through the scene)
4: Imaginal exposure (second time through the scene)
5: Desensitization achieved
6: Imagery rescripting (the “Director” intervention)
7: Imagery rescripting (continued)
8: Assessment and closeout
 Brief Video of ART Session
 Veteran who served in Afghanistan

 Three major traumas causing symptoms of

re-experiencing, nightmares, hyperarousal,
and sleep dysfunction (currently on Ambien)

Traumas:
First shot on a human
Near fatal shooting of young Afghan girl
Vehicular homicide

Successfully treated in 2 sessions

 Video Clips of ART Session
 Postal worker mauled by a dog while
delivering mail

 Multiple surgeries and weeks of

hospitalization

 Unable to work

Successfully treated in 1 session

 Some Clinical Applications of ART
 Post-traumatic stress disorder
 Anxiety and panic attacks
 Prolonged grief
 Phobias
 Depression
 Substance Abuse
 Obsessive Compulsive Disorder
 Acute stress disorder (e.g. cancer diagnosis)
 Chronic pain
 Others

Much more research is needed for “Off-label”

use of ART and special populations
 References
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999). A comparison of exposure therapy, stress
inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting
and Clinical Psychology, 67, 194-200.

Foa, E. B., Rothbaum, B. O., Riggs, D., & Murdock, T. (1991). Treatment of post-traumatic stress disorder in rape victims: A comparison
between cognitive–behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715-723.

Hackman, A. (2011). Imagery rescripting in posttraumatic stress disorder. Cognitive and Behavioral Practice, 18, 424–432.

Purves, D., Augustine, G. J., & Fitzpatrick, D. (2001). Neuroscience (Second ed.): Sunderland: Sinauer Associates.