Social Worker, Kristen Beattie demonstrates what a session of accelerated resolution therapy looks like.
Fourty-four-year-old Dawn Quelch is a criminal defense lawyer in Napanee and has an expansive 17-year-long career. She struggles with her mental health and has lived with a post-traumatic stress disorder (PTSD) diagnosis for years. She says throughout her wellness and recovery journey, nothing has provided as much healing or relief, as the Accelerated Resolution Therapy (ART) she currently receives through Providence Care's Community Services.
“After my sessions of ART it's like someone turned off all the distraction from the past," explains Dawn. “It's given me more confidence, space and bandwidth to deal with the ongoing things that crop up in life and it has definitely made me a better lawyer. I can maintain a wise mind and be in control, regardless of what comes in my path now."
Born from Eye Movement Desensitization and Reprocessing (EMDR) therapy, ART is an emerging treatment approach in the way clinicians are addressing mental health and addiction, especially if the problem is rooted in trauma.
Providence Care's first clinician to become trained in ART was Dawn's therapist, Manager, Alexandra Mangan who is responsible for Providence Care's Community Outreach team and Psychosocial Rehabilitation Assertive Community Treatment team.
“What is amazing with ART, is how quickly clients experience relief," explains Alexandra. Many individuals are reporting improvement in symptoms after just one session, and others report specific issues resolved within three to five sessions. We are currently using this treatment to address trauma, which we know is a core issue that can cause many other symptoms with varying impact on lives. Adding this modality to our practice has made transformative life changes for some of our clients."
A treatment session in ART is about 90 minutes and happens in a one-on-one setting between the clinician and the client. Within the session, the therapist will ask the client to visualize their traumatic memory from start to finish as if they were watching a movie. While recalling the memory, the clinician will engage the client in bilateral eye movement by having the client focus on their hand moving from side to side. The eye movements simulate the same ones experienced during rapid eye movement (REM) sleep. This helps to calm and soothe the nervous system, allows for memory consolidation and the ability to change the way the client physically responds to the memory in the future.
“ART therapy really is a defanging process," explains Dawn. “The snakes, the bad things, the lizardry memories are still there, but they don't hurt anymore, they don't have that bite. Before, I didn't have any control over my physiological reactions to my memories. The tightening of the chest, the feeling of impending doom or anxiety, the muscle tension, clenching of the jaw, things like that. ART therapy helped my brain tell my body that I wasn't in danger anymore. The memories have had that bite taken out of them."
Kristen Beattie is a social worker with Providence Care who is also a trained ART therapist. She works with a small group of clients in ART and says this new method of therapy is referred to as a bottom-up approach, focusing on the bodily sensations, emotions, images and automatic responses like fight, flight, or freeze within the recalled traumatic experience.
“Memories are vulnerable to change every time they are recalled, so this means that we can actually change the way a memory is stored in the brain by using these bilateral eye movements," explains Kristen. “We also utilize a protocol called voluntary image replacement and that helps the client replace the negative and distressing sensations with more positive ones. The desired outcome is the client will still be able to recall the facts of the event or the incident, but they don't become overly activated with physiological responses."
Dawn explains this memory replacement process as the “director's scene."
“You go back through the scene but instead of it playing out the way that resulted in you being traumatized, you can change anything about that scenario to make it end in a way that you're going to feel good about, it can be complete fiction. You are asked to see how you feel about the memory with the alternate, positive outcome and then you are asked to pair that good feeling with the good outcome to the real, traumatic event and see how that feels. There are some visualizations that take place, but the overall takeaway is that it doesn't matter that the overall good feeling you've paired in your brain with the trauma is fiction, you've convinced your brain waves to pair up the good feeling with the bad memory."
Kristen has a client who has undergone multiple ART sessions who has had similar, positive, experiences as Dawn. This client chose to stay unnamed and says since the ART sessions, he no longer has the same level of anxiety or panic attacks.
“The PTSD I feel or felt in some very painful, damaging experiences that we have covered is either dulled or I just don't care about it anymore. I don't have the will or desire to keep that negativity alive in me and ART helped me find a far more positive mental image/memory that I currently have in my life to remember and replace; something to hold instead of all the buried pent up misery that defines trauma and anxiety."
Providence Care has been offering ART for about 12 months as new clinicians become trained in the therapy on an ongoing basis. Vice President of Community Programs and Long-Term Care, Terry Landry, says as a leader in mental health care, Providence Care has a duty to the community to innovate and keep up with the latest evidence.
“We look at therapies like ART as another tool in the clinician's tool belt on how to best serve their client. It is critical to Providence Care's mission to change and grow. Medicine changes, rehabilitation changes, practices change, innovations occur, and we change the way we move forward making decisions in a very mindful and intentional way to make sure we are always evolving."
Clinicians, Kristen and Alexandra both say the feedback from their ART clients have been dramatic and there's a hope to develop a research study on the impact it is having.
“Before getting my ART training I found it difficult at times to make progress with my clients," says Kristen. “I now have a tool that is rapidly helping clients with complex trauma and I'm seeing significant changes using ART. It is improving my client's quality of life and how they engage in their day-to-day and it is really rewarding."
“ART is an evidence-based therapy new to Providence Care and what we're seeing is really promising." explains Alexandra. “As a service, we will be exploring its impact on client's symptoms to assess the feasibility of offering this intervention at Providence Care with increased capacity."
As for Dawn, she will continue her therapeutic relationship with Alexandra and Providence Care and is grateful for the care she is receiving.
“ART has given me hope and shown me that things do get better and that's huge. The unfortunate reality is that I don't have a lot of connections to health care. I don't have a family doctor, there isn't a walk-in clinic available to non-rostered patients in my community and I don't have benefits that would pay for therapy. I am grateful that I live in a community with organizations like Providence Care where these types of new treatments and approaches are being explored. It is encouraging to know there is a whole team of people dedicated to wellness and recovery. This has really made a huge difference in my life."
Providence Care clinicians plan to evaluate outcome measures like Dawn's to get a better understanding of how ART could make a significant impact in mental health care. ART may not be the right treatment for everyone, however, clinicians are hopeful, encouraged by what they are seeing, and are eager to learn more.