Exposure, Relaxation and Rescripting Therapy

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Joanne L. Davis · 2001 · University of Tulsa

What it is

Exposure, Relaxation, and Rescripting Therapy (ERRT) is a brief cognitive behavioural treatment for chronic trauma-related nightmares and the sleep problems that go with them. Davis developed it at the University of Tulsa, starting in 2001, where her TRAPT lab (Trauma Research Assessment Prevention…

Format

• Format and dose
• Published manual (2008): 3 sessions, given individually or in groups. One clinician summary describes them as about 60 minutes each. The programme site gives 60–120 minutes depending on individual or group delivery.

Who practises it, and how they are trained or regulated

• Version followed: Joanne L. Davis's ERRT as published in Treating Post-Trauma Nightmares: A Cognitive Behavioral Approach (Springer, 2008/2009; three-session manual), with the current University of Tulsa format (weekly 90-minute sessions over 4–5 weeks) and the adaptations ERRT-M (military and veterans), ERRT-B (bipolar disorder) and ERRT-C (children) noted where they differ. The book's session scripts and the…

Evidence status, as the guide reports it

• Other adaptations. ERRT-B (also written B-ERRT; bipolar disorder): a modified five-week version piloted with 7 trauma-exposed adults with bipolar disorder, 6 of whom reported no nightmares at 3-month follow-up (Miller, Davis & Rhudy, 2018, Dreaming). ERRT-C (children and adolescents aged 5–17): 5…

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?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• over-breathing or dizziness. Slow down and normalise.
• attributing gains to luck. Point out the skills the client used.
• endless revising as a form of avoidance; agree a version to rehearse this week.
• n/a beyond standard mindfulness cautions for trauma survivors (offer eyes-open options and choice).
• a client who names a theme to please you. Check it fits by asking how they would feel in the dream if that theme were resolved.

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.