Your first ART appointment: how to prepare and what to expect

Your first Accelerated Resolution Therapy (ART) appointment starts with an assessment, not with eye movements on your worst memory. The clinician needs to understand what brings you in, your health, your current safety and what you want from therapy, and to check whether ART is a sensible fit. You do not have to describe your trauma in detail to do any of this.

Screening is a normal part of ART. The developer’s organization describes a comprehensive clinical intake as “a good rule of thumb” before starting (Rosenzweig Center for Rapid Recovery), and research studies began with an assessment and referred some people elsewhere, including those who needed “a higher level of care” (Kip et al. 2012).

How to prepare

1. Think about what you want to change. Not the whole story, just the effects. Nightmares, a memory that ambushes you, a place you avoid, a jolt in your body when something reminds you. A short list is useful.
2. Bring your health information. Current medications and doses, and any eye conditions, heart or breathing problems (including asthma), migraines, vertigo or past head injury. These are among the factors the developer’s organization lists for clinicians to consider before ART.
3. Be ready to be honest about alcohol and drugs. Ongoing substance use is also on that list. It is not about judgment. It affects how and when to do trauma work safely.
4. Check your insurance or payment. I am in network with Aetna, UnitedHealthcare, Blue Cross and Blue Shield of Texas, TRICARE, Humana Military and TriWest. Longer sessions can affect what a plan covers, so it is worth calling the number on your card. The insurance page has details.
5. Plan the rest of the day. If you can, avoid booking something demanding straight afterward. Even an assessment can leave you tired.

Do not stop or change any medication on your own before starting. The developer’s organization notes that some medications, such as anti-anxiety medicines and benzodiazepines, may blunt the response to ART. That is something to discuss with me and with your prescriber, not something to act on alone.

What the first appointment covers

• What brings you in and what you would like to be different. You can describe the trauma in general terms, or only by its effects.
• Your history and health, including the medical factors above, and any past therapy: what helped and what did not.
• Current safety. Whether the trauma is ongoing, and whether you have thoughts of harming yourself. If safety is the most pressing problem, that comes first.
• What ART involves, including the brief recall, the eye movements and the image replacement step, so you can decide whether it suits you.
• Alternatives. Where another therapy has stronger evidence for your situation, you should hear about it. For PTSD, the 2023 VA/DoD guideline gives its strongest recommendation to cognitive processing therapy, prolonged exposure and EMDR, and rates the evidence for ART as insufficient to recommend for or against.
• A plan. Session length (ART sessions often run longer than a standard 50-minute session, and we agree the length in advance), where we will meet, and when we will review progress.

For a first course of ART I generally recommend meeting in person, at 8626 Tesoro Drive in San Antonio. Telehealth is available only for people physically in Texas at the time of the session. The research on ART was done in person, and no published study has tested ART delivered by video. The ART online page goes into that.

More in questions to ask an ART provider.

How you might feel afterward

After an assessment, some people simply feel tired. After an ART processing session, reactions vary more. The developer’s organization notes that ART “can resurface some painful emotions with strong physical sensations, such as rapid breathing and pulse rate.”

In the 2013 randomized trial, a small number of participants reported feeling mildly depressed after a session (resolving before the next one), disturbed sleep, increased anxiety or more frequent nightmares. The trial described these as “rare and not serious” (Kip et al. 2013). The VA/DoD guideline makes a similar point about trauma therapy in general: symptoms can increase during trauma processing, but these increases are “typically transitory and not severe.”

Some people feel lighter, some feel flat, some feel nothing much at all. None of these tells you on its own whether ART is working.

Self-care that evening

• Keep the evening quiet if you can. Eat something, drink water, and go easy on plans.
• Go easy on alcohol. It can make sleep and mood harder to read, and harder to manage.
• Move a little. A walk is often enough to help the body settle.
• Have a grounding tool ready in case something surfaces. See grounding techniques for panic and flashbacks.
• Protect your sleep. A predictable wind-down helps. See sleep habits after trauma.
• Write a line or two if anything new comes up, to bring to the next session. You do not have to share it word for word.
• Tell me at the next session how the days in between went, including anything that felt worse.

There is also a printable sheet for before and after a session, and a page for family members who want to know how to help.

If you are ready to book the first appointment, get started.