Treating domestic violence ptsd with quick remap
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Transcript of Treating domestic violence ptsd with quick remap
www.remapinstitute.org www.remap.net
Treating Domestic Violence PTSD -- Quick REMAP
Case Study
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Assault by an Ex-BoyfriendPTSD Case
• He was drunk (and on drugs)• She found Cocaine in his closet—flushed it• He became enraged and lost control—threw
her into a wall (11 bruises)• She fled to bathroom, called 911 and his sister• He kicked the door in—threatened to kill her
and the police if they came• He grabbed the phone was ranting
www.remapinstitute.org www.remap.net
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Assault by an Ex-BoyfriendPTSD Case
• He then fell unconscious—fell like a board• His sister arrived—he woke-up and got violent
again—tore a cabinet door off and threw it • His sister got him to leave—the apartment
was wrecked• Police came with hands on their guns—
he was gone• Later he tried to commit suicide
www.remapinstitute.org www.remap.net
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Treatment with Quick REMAP
• One session• Three rounds of treatment:– Quick REMAP 12-point Protocol– Quick REMAP 4-point Protocol– Quick REMAP 12-point Protocol
• 55 minutes in length
www.remapinstitute.org www.remap.net
See Introducing Quick REMAP
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Psychological Measures• Subjective Units of Distress Scale (SUD)• State-Trait Anxiety Inventory (STAI-s)• Impact of Event Scale (IES-r)• Physical Symptoms of Emotional Distress
Physical Measures• Heart Rate Variability Analysis
www.remapinstitute.org www.remap.net
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Treating an Assault Related PTSD CaseSUD
05-03-07 05-15-07 05-22-07 06-27-07
Treating an Assault Related PTSD Case with Quick REMAP
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Pre Tx Post Tx Follow-up Follow-up
Su
bje
cti
ve
Un
its
of
Dis
tre
ss
(S
UD
)
www. remapinstitute.org www.remap.net
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Treating an Assault Related PTSD CaseSTAI-s
05-03-07 05-15-07 05-22-07 06-27-07
Treating an Assault Related PTSD Case with Quick REMAP
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Pre Tx Post Tx Follow-up Follow-up
Sta
te-T
rait
An
xie
ty In
ve
nto
ry
(ST
AI-
s)
www. remapinstitute.org www.remap.net
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Treating an Assault Related PTSD CaseIES-r
05-03-07 05-22-07 06-27-07
Treating an Assault Related PTSD Case with Quick REMAP
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Pre Tx Follow-up Follow-up
Imp
ac
t o
f E
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nt
Sc
ale
(IE
S)www. remapinstitute.org www.remap.net
Physical MeasuresHeart Rate Variability Analysis (HRV)
In addition to the following slides, further information on HRV and the meaning of the measures that were used can be found in the REMAP Pilot Study –
Soothing the Sympathetic Nervous System with the REMAP process: Results from Treating 8 Trauma Survivors
And Measuring Treatment Effect with Heart Rate Variability Analysis
www. remapinstitute.org www.remap.net
Using HRV to measure the effect of treatment
with Quick REMAP• Electrocardiograph (ECG) data obtained during
three different 5 minute recordings:– Baseline (neutral-positive thoughts – walk in park)– Pre-Treatment (the traumatic event) 55 minutes of treatment with Quick REMAP
– Post Treatment (the traumatic event) All 3 recording took place within 80 minutes
www. remapinstitute.org www.remap.net
Recordings were made while:• Client breathed normally• Sat comfortably upright• Refrained from movement and• Without talking
ECG signals were measured:• With special conductive electrodes• Placed at both wrists and one ankle
www. remapinstitute.org www.remap.net
MEDICORE
SA 3000p
Heart Rate Variability
Analyzer
Instrument Used to Measure HRV
www. remapinstitute.org www.remap.net
FDA Approval
Medical Device
www. remapinstitute.org www.remap.net
Detailed RESULTS
• The results of the first 3 recordings were compared to assess whether there were any quantifiable changes in the SNS (Sympathetic Nervous System) and PNS (Para-Sympathetic Nervous System) activity as revealed through the HRV measures.
• The following is a summary of 3 HRV components and a comparison between pre-treatment and post treatment results.
www. remapinstitute.org www.remap.net
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ResultsPhysical Measures of Heart Activity (ECG/HRV)
Heart Rate
67.7
82.4
63.8
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45
50
55
60
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75
80
85
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Baseline Trauma Pre Tx Trauma Post Tx
Be
ats
pe
r M
inu
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Walk in the Park Traumatic Memory Traumatic Memory
05-15-07w
ww
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ResultsPhysical Measures of Heart Activity (ECG/HRV)
Para-Sympathetic Activity
68.6
40.3
76.7
0
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20
30
40
50
60
70
80
90
1 2 3
Baseline Trauma Pre Tx Trauma Post Tx
RM
S-S
D (
mill
ise
co
nd
s)
Walk in the Park Traumatic Memory Traumatic Memory
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ResultsPhysical Measures of Heart Activity (ECG/HRV)
05-15-07
Sympathetic vs. Para-Sympathetic Balance
0.63
1.63
0.87
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
1 2 3
Baseline Trauma Pre Tx Trauma Post Tx
LF
/HF
Ra
tio
(n
orm
aliz
ed
un
its
)
Walk in the Park Traumatic MemoryTraumatic Memory
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Follow-up Report on 05-22-07
• She got home on 05-15-07 (after treatment) and all distress was gone
• No panicky feelings that week• No nightmares that week• It was “just an event in the past”• “Felt very indifferent to it”• Her current boyfriend noticed that she was
not “freaking-out” and yelling if he accidentally startled her
www. remapinstitute.org www.remap.net
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Follow-up ResultsPhysical Measures of Heart Activity (ECG/HRV)
06-05-07
Heart Rate
83.7 82.6
40
45
50
55
60
65
70
75
80
85
1 2
Baseline Trauma Follow-up
Be
ats
pe
r M
inu
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Walk in the Park Traumatic Memory
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Physical Measures of Heart Activity (ECG/HRV)
Para-Sympathetic Activity
33.3 34.5
0
10
20
30
40
50
60
70
80
90
1 2
Baseline Trauma Follow-up
RM
S-S
D (
mill
ise
co
nd
s)
Walk in the Park Traumatic Memory
Follow-up Results 06-05-07w
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Physical Measures of Heart Activity (ECG/HRV)
Sympathetic vs. Para-Sympathetic Balance
0.480.43
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1 2
Baseline Trauma Follow-up
LF
/HF
Ra
tio
(n
orm
aliz
ed
un
its
)
Walk in the Park Traumatic Memory
Follow-up Results 06-05-07w
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• The REMAP Institute provides training for psychotherapists who want to develop skills in working with Quick REMAP, the REMAP process and the REMAP Visual Field Treatment. The training is designed to build skills in the treatment of anxiety disorders including PTSD.
http://remapinstitute.org/training/quick-remap-level-1-workshop/ Quick REMAP Distance Learning Materials
• For individual treatment visit www.remap.net or look for therapists certified in Quick REMAP.
www. remapinstitute.org