Adaptive Disclosure

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Brett Litz, Lebowitz, Gray

What it is

Adaptive Disclosure is a brief, manualised, emotion-focused psychotherapy that Brett Litz and colleagues developed for active-duty service members and veterans with war-zone trauma. The first trials ran with Marines and Sailors at Camp Pendleton and Naval Medical Center San Diego. It mixes…

Format

• Format. Individual, face-to-face, 90-minute sessions. AD was designed as 6 sessions (the pilot used six 90-minute sessions) and was expanded to 8 for the Marine trial to match CPT-C's treatment hours. The trial protocol scheduled sessions twice weekly for weeks 1 to 4, then weekly, with up to 2…
• Phase A: Assessment, conceptualisation and Session 1.

Who practises it, and how they are trained or regulated

• Variant: AD-MIL. It adds skills training and behavioural contracting aimed at obstacles to occupational, relationship and family roles.

Evidence status, as the guide reports it

• Adaptive Disclosure is a brief, manualised, emotion-focused psychotherapy that Brett Litz and colleagues developed for active-duty service members and veterans with war-zone trauma. The first trials ran with Marines and Sailors at Camp Pendleton and Naval Medical Center San Diego. It mixes…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the same issues as in 4.20.
• plans that are too large. Shrink them until success is likely.
• pressure to disclose everything to everyone. The person decides.
• a person who says no such figure exists. Use the fallback in 4.11.
• contact with the family can be emotionally risky. Rehearse it first.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.