What is accelerated resolution therapy?

Accelerated resolution therapy (ART) is a brief, evidence-based psychotherapy that combines elements from several established therapeutic modalities to recondition stressful memories, and reduce physical and emotional reactions to traumatic memories. 

Developed in 2008, accelerated resolution therapy uses techniques such as eye movement desensitization and reprocessing (EMDR), cognitive behavioral therapy (CBT), Gestalt therapy, and guided imagery. 

Summary

• Accelerated resolution therapy (ART) is an evidence-based psychotherapy developed by Laney Rosenzweig, MS, LMFT, in 2008 that combines rapid eye movements with image rescripting to help clients process trauma in 1-5 sessions, averaging 3.7 sessions.

• ART trauma therapy uses voluntary image replacement (VIR) to help clients replace distressing traumatic images with positive ones while retaining factual memory, offering faster treatment outcomes compared to traditional trauma therapies.

• When therapists use ART for PTSD treatment, research has shown significant effectiveness with 61% response rates and 94% completion rates, making it particularly valuable for clients who struggle with traditional exposure-based treatments.

• ART training requires that mental health clinicians complete a 3-day basic training program, with advanced and enhanced training available, plus certification through the International Society of Accelerated Resolution Therapy (IS-ART).

• Clinical benefits include helping clients who are living in survival mode transition to adaptive functioning without requiring detailed trauma disclosure, making it an excellent option for private practice therapists serving trauma survivors.

Core therapeutic principles

Accelerated resolution therapy is unique because it involves therapists guiding the client to replace the negative images in the mind that cause the symptoms of post-traumatic stress with positive images of the client's choosing. 

This process, known as voluntary image replacement (VIR), allows clients to maintain factual memories while eliminating the emotional and physiological distress associated with traumatic experiences.

ART trauma therapy operates on the understanding that traumatic memories are often stored as images in the right hemisphere of the brain, which connects directly to emotional and survival centers. 

By utilizing bilateral eye movements similar to those experienced during REM sleep, accelerated resolution therapy facilitates the processing and reconsolidation of these memories in a more adaptive way.
‌

How accelerated resolution therapy works

The therapeutic process follows a structured protocol that includes:

Assessment and preparation

Therapists identify specific traumatic scenes or distressing memories to address while ensuring client safety and readiness.

Eye movement activation

Clients follow the therapist's hand movements horizontally while silently recalling the traumatic experience, typically lasting 30 seconds to 10 minutes.

Image rescripting

Through the voluntary image replacement process, clients create new, positive imagery to replace distressing visual memories.

Integration and closure

The session concludes by ensuring clients can access their original memory without significant distress and can readily shift to their newly created positive imagery.

Clinical applications and effectiveness

ART for PTSD: Research outcomes

Through an intention-to-treat (ITT) analysis, accelerated resolution therapy demonstrated a 61% response rate (defined as at least a 10-point drop on the PTSD Checklist [PCL]) and a 94% completion rate. 

In comparison,  established PTSD therapies typically show response rates of 49% to 70% and completion rates of 60% to 65%.

Furthermore, a systematic review from 2024 examining the efficacy of accelerated resolution therapy for the treatment of PTSD among adults found significant reductions in symptoms of PTSD between pre- and post-intervention. Significant reductions were reported in symptoms of depression, mental distress, anxiety, and sleep dysfunction.

Treating clients living in survival mode

Many trauma survivors exist in a chronic state of hypervigilance and dysregulation, essentially living in survival mode. 

Accelerated resolution therapy offers particular advantages for these clients:

• Rapid symptom relief: The condensed treatment timeline helps clients exit survival mode more quickly than traditional therapies, reducing the prolonged exposure to triggering material.

• Client control: Clients maintain complete control over what they choose to share, reducing re-traumatization risks while still achieving therapeutic benefit.

• Immediate coping strategies: The eye movement techniques provide clients with immediate tools for self-regulation that can be used outside of sessions.

Expanded clinical applications

Beyond PTSD, ART trauma therapy has demonstrated effectiveness for:

• Anxiety disorders and panic attacks

• Depression and mood disorders

• Complicated grief and loss

• Obsessive-compulsive symptoms

• Sleep disturbances and nightmares

• Performance anxiety and phobias

• Moral injury and guilt-related trauma

Accelerated resolution therapy has also been classified as a promising therapy for symptoms of phobia, panic, anxiety, sleep and wake disorders, disruptive and antisocial behaviors, and general functioning and well-being.

ART training: Professional development pathway

Prerequisites and eligibility

ART training is available to qualified mental health professionals who meet specific criteria.

Qualifying mental health clinicians must have a master's degree in the mental health field (counseling, marriage and family therapy, psychology, psychotherapy, psychiatry, social work) or a related mental health discipline, and be licensed to practice through their state board or province.

Qualifying graduate students must be enrolled in a master's or doctoral program in the mental health field and must have completed their core graduate academic coursework. They must also be in the final clinical practicum/internship portion of their graduate program.

Training structure and certification

Accelerated resolution therapy training follows a progressive hierarchy designed to build competency systematically:

Basic ART training: A 3-day intensive program that provides therapists/clinicians with the knowledge and skills to effectively implement the use of ART in clinical practice. The training includes lecture, video presentations, live demonstrations, and supervised practicum sessions.

Advanced ART training: Requires previous completion and certification in ART basic training and confirmation of minimum conduct of 30 sessions using ART. This level introduces additional interventions including the Metaphorical Moment technique.

Enhanced training: Specialized techniques for specific populations and conditions, building upon advanced-level skills.

Certification requirements

In order to be certified in accelerated resolution therapy, a trainee will need to follow specific requirements including completing 3-day basic ART training and joining IS-ART. 

Certification involves passing competency assessments and maintaining membership in the International Society of Accelerated Resolution Therapy.
‌

Accelerated resolution therapy script

The basic protocol structure

The accelerated resolution therapy script follows a standardized yet flexible approach that ensures consistent application while allowing for clinical judgment:

• Scene identification: Clients identify a specific traumatic scene or distressing memory to process, focusing on the most disturbing visual aspects.

• Baseline measurement: Therapists assess the client's distress level using standardized scales and note physical sensations or emotional responses.

• Eye movement phases: The therapist guides the client through horizontal eye movements while the client silently reviews the traumatic scene, followed by processing and integration periods.

• Image replacement: The systematic replacement of negative imagery with client-generated positive alternatives using the VIR technique.

• Future templating: Creating positive imagery for future situations that might trigger trauma responses.

Advanced resolution therapy techniques

Advanced practitioners utilize sophisticated interventions that extend beyond the basic protocol:

• Metaphorical interventions: Using symbolic imagery and metaphors to address complex trauma presentations.

• Somatic integration: Addressing body-based trauma responses through targeted eye movement sequences.

• Resource installation: Building positive internal resources and coping imagery to strengthen client resilience.

• Complex trauma protocols: Specialized approaches for clients with multiple traumas or developmental trauma histories.

Clinical considerations for private practice

Client selection and assessment

Accelerated resolution therapy works best with clients who:

• Can tolerate focused attention and eye movements

• Have identifiable trauma-related imagery or memories

• Are motivated for rapid change and symptom resolution

• Can engage in visualization and imagery exercises

Contraindications include active psychosis, severe dissociative disorders, and certain medical conditions affecting eye movement. 

Therapists should conduct thorough assessments to ensure appropriate client selection.

Integration with existing practice

ART trauma therapy integrates well with other therapeutic approaches:

• Complementary modalities: Accelerated resolution therapy can be combined with ongoing therapy, medication management, and other trauma-focused interventions.

• Treatment sequencing: Many therapists use ART for specific trauma resolution while maintaining longer-term therapeutic relationships for other clinical issues.

• Session scheduling: The intensive nature of ART allows for flexible scheduling, including concentrated treatment periods or integration into regular therapy sessions.

Ethical considerations

There are some ethical issues clinicians should consider before recommending accelerated resolution therapy to their clients, including the need for additional research to fully establish ART's net benefits. Patients may also encounter difficulty accessing therapists trained to perform ART-based therapy.

Therapists should:

• Provide informed consent about accelerated resolution therapy's evidence and limitations

• Discuss treatment options thoroughly, considering client preferences and circumstances

• Maintain appropriate boundaries around trauma disclosure and processing

• Ensure adequate training and supervision in ART techniques

Implementing ART in private practice settings

Setting up an ART-focused practice

Successful ART implementation requires:

Physical environment: Comfortable seating arrangements that allow for proper hand movement visibility and client comfort during eye movement exercises.

Session structure: Blocking adequate time (60-75 minutes) for completing ART sessions, as interrupted sessions can be counterproductive.

Client preparation: Clear explanation of the process, setting appropriate expectations, and ensuring clients understand their control over the therapeutic process.

Follow-up protocols: Structured approaches for monitoring treatment outcomes and addressing any emerging issues post-treatment.

Marketing and client education

Private practice therapists can effectively communicate accelerated resolution therapy's benefits:

Educational materials: Providing clear, evidence-based information about ART's effectiveness and process.

Professional networking: Building relationships with referral sources who understand accelerated resolution therapy's applications and benefits.

Outcome tracking: Maintaining data on treatment effectiveness to support practice development and client confidence.

Professional development and supervision

Ongoing competency requires:

Regular consultation: Participation in IS-ART consultation groups and peer supervision.

Continuing education: Staying current with ART research developments and advanced techniques.

Personal therapy: Many ART practitioners benefit from experiencing the therapy personally to better understand the client perspective.
‌

Research developments and future directions

Current evidence base

The number of studies conducted on accelerated resolution therapy is limited, primarily consisting of small studies.

However, the existing research demonstrates consistently positive outcomes.

Recent systematic reviews have identified ART as showing promise for time-efficient clinical treatment, though more high-quality studies are needed to fully establish its evidence base across diverse populations and trauma types.

Emerging applications

Research is expanding into accelerated resolution therapy's effectiveness for:

• Complicated grief and bereavement

• Medical trauma and chronic illness adjustment

• First responder and healthcare worker burnout

• Addiction recovery and relapse prevention

• Performance anxiety in various domains

Neurobiological research

Accelerated resolution therapy is believed to be effective because it leverages the brain’s natural mechanisms for memory consolidation. Memories undergo minor modifications every time we recall them, and memory activation is critical to effective PTSD therapy.

Current neuroscience research is investigating how ART's eye movements and image rescripting affect memory reconsolidation processes at the cellular level, potentially providing stronger theoretical foundations for the therapy's effectiveness.

Clinical recommendations and best practices

For therapists new to accelerated resolution therapyStart conservatively: Begin with clients with clear trauma who have specific identifiable scenes to process rather than complex presentations.

Follow the protocol: Maintain fidelity to the structured approach while developing clinical intuition about when to adapt techniques.

Seek supervision: Regular consultation helps ensure proper implementation and addresses challenging clinical situations.

Document outcomes: Track client progress systematically to build confidence and identify areas for improvement.

For experienced practitioners

Advanced applications: Explore specialized techniques for complex trauma, attachment issues, and comorbid conditions.

Training others: Consider becoming an ART trainer to expand access to this effective treatment.

Research participation: Contribute to the growing evidence base through practice-based research and outcome studies.

Integration strategies: Develop sophisticated approaches for combining accelerated resolution therapy with other therapeutic modalities.

Maximizing client outcomes

Thorough assessment: Ensure clients are appropriate candidates and adequately prepared for accelerated resolution therapy processing.

Clear expectations: Help clients understand the process while maintaining realistic expectations about outcomes.

Safety protocols: Establish clear procedures for managing intense emotional responses during sessions.

Follow-up care: Plan appropriate aftercare and support for clients following ART completion.

Conclusion

Accelerated resolution therapy represents a significant advancement in trauma treatment, offering mental health therapists a powerful tool for helping clients achieve rapid relief from post-traumatic stress disorder and related conditions. 

With its strong emphasis on client control, efficient treatment delivery, and impressive outcome data, ART fills an important gap in trauma therapy options.

For therapists in private practice, ART training offers professional development opportunities that can enhance clinical effectiveness while providing clients with access to cutting-edge trauma treatment. 

The therapy's brief nature and high completion rates make it particularly valuable for practitioners seeking to maximize client outcomes while maintaining sustainable practices.

As research continues to expand our understanding of accelerated resolution therapy's mechanisms and applications, mental health professionals have an opportunity to incorporate this innovative approach into their clinical work, ultimately improving outcomes for trauma survivors who may have struggled with traditional treatment approaches. 

The growing body of evidence supporting ART trauma therapy suggests it will continue to play an increasingly important role in comprehensive trauma treatment.

Sources

• Buck, Hannah G., Cairns, Patricia, Emechebe, Nonye, Hernandez, Diane F., Benbow, Ashley A., O'Hanlon, Cheryl E., Meghani, Salimah H., & Kip, Kevin E. (2020). Accelerated resolution therapy: Randomized controlled trial of a complicated grief intervention. American Journal of Hospice and Palliative Medicine

• Finnegan, Adrian, Kip, Kevin E., Hernandez, Diane F., McGhee, Susan, Rosenzweig, Laney, Hynes, Catherine, & Thomas, Martin. (2016). Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder. Journal of the Royal Army Medical Corps.

• Howe, Edmund G., Antinora, Christine Y., Workman, Robert H., & Savarese, Robert. (2018). Ethical reflections on offering patients accelerated resolution therapy (ART). Military Medicine.  

• International Society of Accelerated Resolution Therapy. (2024). Training and certification in ART.

• Kip, Kevin E., Elk, Chad A., Sullivan, Kimberly L., Kadel, Russell, Lengacher, Cecile A., Long, Carol J., Rosenzweig, Laney, Shuman, Amy, Hernandez, Diane F., Diamond, Dorie M., & Davis, William. (2012). Brief treatment of symptoms of post-traumatic stress disorder (PTSD) by use of accelerated resolution therapy (ART). Behavioral Sciences,

• Kip, Kevin E., Rosenzweig, Laney, Hernandez, Diane F., Shuman, Amy, Sullivan, Kimberly L., Long, Carol J., Taylor, Julie, McGhee, Susan, Girling, Spencer A., Wittenberg, Traci, Sahebzamani, Fatemeh M., Lengacher, Cecile A., Kadel, Russell, & Diamond, Dorie M. (2013). Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD). Military Medicine.  

• Rosenzweig Center for Rapid Recovery. (2024). Accelerated resolution therapy training eligibility. 

• Society of Clinical Psychology, Division 12, American Psychological Association. (2022). Accelerated resolution therapy for posttraumatic stress disorder.

• Storey, David P., Marriott, Emma C. S., & Rash, Joshua A. (2024). Accelerated resolution therapy (ART) for the treatment of posttraumatic stress disorder in adults: A systematic review. PLOS Mental Health.

• Waits, Whitney, Marumoto, Mariko, & Weaver, James. (2017). Accelerated resolution therapy (ART): a review and research to date. Current Psychiatry Reports.

• Waits, Whitney. (2020). Accelerated resolution therapy for PTSD. Psychiatric Times. 

How SimplePractice streamlines running your practice

SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.

If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.

Try SimplePractice free for 30 days. No credit card required.
‌