The 2013 randomized trial of ART, explained in plain English

The 2013 trial by Kip and colleagues, published in Military Medicine, is the main randomized controlled trial of Accelerated Resolution Therapy (ART). It assigned 57 US service members and veterans with combat-related PTSD symptoms either to ART or to a non-therapy “attention control.” PTSD, depression, anxiety and guilt symptoms fell significantly more in the ART group. But PTSD was measured only by self-report, the comparison was not another therapy, and ART’s developer was a co-author. It is encouraging early evidence, not proof that ART matches or beats established treatments.

Why this one study matters so much

When a website says ART is “evidence-based,” this trial is usually what sits underneath the claim. It was the only randomized trial of ART with results until a small grief trial was published in 2020, and it was the “one study” on which SAMHSA’s former registry based its 2015 listing. It is also the study the VA/DoD guideline examined before concluding the evidence was insufficient. Understanding it tells you most of what you need to know about where ART’s evidence stands.

Who took part

The trial enrolled US service members and veterans with symptoms of combat-related PTSD. The published paper reports on 57 people; SAMHSA’s 2015 registry review lists 29 assigned to ART and 28 to the control condition. About two-thirds (68%) had already had some PTSD treatment before joining. It was run by researchers at the University of South Florida, funded by the Department of Defense, and registered as NCT01559688 (July 2011 to October 2013).

How the trial was designed

1. Random assignment. Participants were assigned by chance to ART or to an attention control, so that the two groups would start out comparable.
2. The ART group. Received ART in an average of 3.7 sessions (give or take about one). According to the pain analysis of this trial, sessions ran approximately 60 to 75 minutes.
3. The attention control group. Received two 1-hour sessions of career counseling or fitness guidance. This controls for simply spending time with a supportive professional, but it is not a trauma therapy, and it was shorter than the ART course.
4. Crossover. After the control period, people in the control group were allowed to switch to ART. That is kind to participants, but it means there was no untreated comparison group left for long-term follow-up.

What it measured and found

The main outcome was PTSD symptoms on the PCL-M, a questionnaire participants fill in about themselves. Secondary outcomes included depression, anxiety, trauma-related guilt and sleep.

According to the paper, PTSD, depression, anxiety and trauma-related guilt fell significantly more with ART than with the control condition, a difference very unlikely to be due to chance (p<0.001). Sleep was also measured; SAMHSA’s 2015 review noted that the sleep result “did not differ significantly” from the control group.

A later analysis of 45 participants from the same trial looked at pain. Pain questionnaire scores fell 16.9 points with ART compared with 0.7 in the control group. SAMHSA’s reviewers also noted a significantly greater increase in pain-related fear in the ART group, and no significant difference in pain intensity.

Dropout and side effects

The paper reports that ART was delivered “in 3.7 ± 1.1 sessions with a 94% completion rate”. The abstract describes treatment-related adverse events as “rare and not serious.” As summarized in a 2024 systematic review, two participants felt mildly depressed after a session (which passed before the next one), two reported disturbed sleep, one reported increased anxiety and one reported more frequent nightmares that were judged probably related to treatment.

Those numbers are small, but they are a useful reminder that ART, like other trauma therapies, can stir things up for a while.

What the trial can tell us

• In this group of service members and veterans, many of whom had already had PTSD treatment, people who received a short course of ART reported larger drops in PTSD, depression and anxiety symptoms than people who received time with a professional but no trauma therapy.
• Most people who started ART in the trial finished it.
• Serious side effects were not reported, though some short-lived worsening was.

What it cannot tell us

• Whether ART works as well as CPT, prolonged exposure or EMDR. It was not compared with any of them. No published trial has made that comparison.
• What a clinician would have found. PTSD was self-reported. This is the specific reason the 2023 VA/DoD guideline gave ART no recommendation: “No RCTs of ART included the critical outcome of clinician-rated PTSD.”
• How long the benefit lasts compared with no treatment. Crossover meant the control group was no longer untreated.
• How much was ART itself. The control condition was shorter and was not a therapy, so some of the difference could reflect more time and more active attention rather than anything specific to ART.
• Whether the result generalizes. 57 people is a small sample, and all were military. The findings may not apply to civilians, children or other kinds of trauma.
• Whether independent researchers would find the same. The study has not been replicated outside the group that ran it.

Connection to ART’s developer

ART’s developer, Laney Rosenzweig, is a co-author of this trial, and it came from the University of South Florida program that did most of the early ART research. In papers published after this trial, including the 2020 grief trial, another co-author, Hernandez, disclosed being paid by the International Society of Accelerated Resolution Therapy (IS-ART) to train clinicians, and the lead author, Kip, disclosed serving on IS-ART’s board without pay.

None of this means the results are wrong. Developers often run the first trials of a new therapy. It does mean the finding still needs to be confirmed by people with no stake in the outcome.

What came after

• 2014: the pain analysis from this trial was published.
• 2015: SAMHSA’s National Registry of Evidence-based Programs and Practices listed ART, based on this one trial. SAMHSA discontinued the registry in 2018.
• 2017: a review in Current Psychiatry Reports described ART’s research as “limited” and called for high-quality randomized trials.
• 2019: a Defense Department evidence brief concluded the evidence was “not mature enough to recommend ART as a front-line treatment for PTSD” in the Military Health System.
• 2020: a second, smaller randomized trial compared ART with a wait-list in older bereaved caregivers.
• 2021: a randomized trial comparing ART with cognitive processing therapy (NCT03384706) was completed. As of September 2026 no results have been posted or published.
• 2023: the VA/DoD guideline rated the evidence insufficient to recommend for or against ART.
• 2024: the only systematic review of ART found five studies, could not run a meta-analysis, and concluded ART “shows some promise” but needs more high-quality studies.

For every study in context, see every published study of ART, summarized, and for the guideline wording, what treatment guidelines say about ART.