ART vs Brainspotting: two eye-based trauma therapies compared

Accelerated Resolution Therapy (ART) and Brainspotting are both offshoots of EMDR, but they use the eyes in opposite ways. ART uses sets of about 40 side-to-side eye movements in a directive, step-by-step protocol that ends with replacing distressing images. Brainspotting has you hold your gaze still on one spot while you mindfully notice whatever comes up. Neither is recommended in the major PTSD guidelines, and both have far less research than EMDR, CPT or prolonged exposure.

I am trained in ART and EMDR, not Brainspotting. If Brainspotting appeals to you, you would need a clinician trained in it.

What Brainspotting involves

Brainspotting was developed by David Grand, PhD, who dates its discovery to 2003. Its developers describe it as building on EMDR and on Somatic Experiencing, a body-focused approach.

In a session, the therapist uses a pointer to find an eye position linked to the issue, watching for reflexive signs such as blinks, twitches or pupil changes. An eye position linked to activation from the issue is called a “brainspot.” You then hold your gaze on that point while mindfully observing whatever arises in your body and mind, often while listening to what the developers call “biolateral” sound.

There is no fixed number of sessions. The developer’s pilot study measured results after three sessions and suggested symptoms should reduce within one to three sessions; that is the developer’s expectation, not an established finding.

What ART involves

ART was developed in 2008 by Laney Rosenzweig, LMFT, who drew on EMDR and modified how the eye movements are used. You briefly bring a scene to mind while following the therapist’s hand back and forth, in sets of about 40 eye movements, with further sets to settle the body sensations the memory brings up. Then, through Voluntary Image Replacement, you replace the distressing images with a scene you choose. You still know what happened.

ART is more structured and more directed by the therapist, with a defined sequence each session. You don’t have to describe the trauma, and there is no homework. Studies used one to five sessions of about 60 to 75 minutes. See the ART session step by step.

Side by side

The evidence, plainly

Neither therapy has the kind of research behind EMDR, CPT or prolonged exposure, and both rely heavily on studies by the people who created or promote them.

Brainspotting. The main PTSD outcome study we could review is a pilot by Hildebrand, Grand and Stemmler (2014) with 22 participants and no comparison group; the developer is a co-author. Its own authors wrote that “the significance of the study is limited,” that “no statement can be made about whether the effects persist long-term,” and that without a comparison group “spontaneous remission can not be excluded.” The developer’s research list also includes a small non-randomized comparison with EMDR and a randomized trial listed for 2025 that we have not been able to review. Brainspotting does not appear in the 2023 VA/DoD guideline.

ART. ART has two randomized trials with published results: one in 57 service members and veterans compared with a non-therapy attention control (Kip and colleagues, 2013), and one in 54 bereaved older caregivers compared with a wait-list (Buck and colleagues, 2020). Both involved researchers connected to ART. A 2024 systematic review found five studies, only one rated good quality, and concluded ART “shows some promise” but “more high-quality studies are needed.” The VA/DoD guideline names ART and rates the evidence insufficient to recommend for or against.

So ART has somewhat more controlled research that we could verify, and it has at least been formally reviewed by the VA/DoD guideline. That is a modest difference. The two have never been compared with each other in a published trial, and ART has not been compared with an established trauma therapy in a published randomized trial; we could not review the Brainspotting trial listed for 2025 to see what it compared.

How people tend to choose between them

The two differ most in structure and in what you do with your attention.

• ART may suit someone who wants a clear structure, a defined target memory, and a clinician who actively guides each step, including a defined closing step.
• Brainspotting may suit someone drawn to staying with, and mindfully observing, whatever comes up in the body, without a set image-replacement step.
• If you have tried one and it didn’t help, the other is different enough that it isn’t simply more of the same, though neither has research on people switching between them.

Whatever you choose, ask the clinician what training they have, how you will both know whether it is working, and what they would suggest if it isn’t. There is a longer list in questions to ask an ART provider.

Further comparisons

ART vs EMDR covers the therapy both of these grew out of. The full comparison table lays out eight approaches side by side. If you would like to talk about whether ART fits what you are dealing with, you can get started here.