Intensive and massed trauma treatment formats

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Netherlands

What it is

This entry is a family of delivery formats, not a separate therapy. The trauma-focused methods themselves (PE, EMDR therapy, CPT) are delivered according to their own manuals; what the intensive formats change is dose and spacing (daily, often twice-daily, sessions over 1–3 weeks), the team around…

Format

• Eligibility (APPART version): PTSD on CAPS-5, age 18+, enough Dutch to be treated. Excluded: suicide attempt in the 3 months before treatment; medically unable to walk for 30 minutes (for the activity programme). Explicitly not excluded: suicidal ideation, trauma type, comorbidity including…
• Treatment phase: 8 treatment days. 2018 version: 8 days within 11 days. 2022–2023 version: 2 × 4 consecutive days with 3 days off between; days 1–4 inpatient and face to face, days 5–8 fully remote (Zoom). Groups of about 15 start on a Sunday evening; a new group every two weeks.

Who practises it, and how they are trained or regulated

• Referral and intake (pre-phase): referral from a GP, psychologist or psychiatrist; two intake sessions one week apart. Session 1: explanation, CAPS-5, Life Events Checklist (LEC-5), MINI. Between sessions: a digital self-report battery (in the APPART trial: PCL-5, insomnia, depression, emotion-regulation difficulties, dissociation (DES-II), anxiety sensitivity, quality of life, physical activity, SCL-90, personality…
• When to choose massed: the CDP toolkit treats standard spacing as the default because it leaves time for between-session practice, and recommends massed PE when someone needs treatment but lacks time for a standard course (e.g. upcoming deployment, training, relocation) or when competing demands threaten dropout.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• 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?
• 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

• isolation or rumination during unstructured time.
• an index event that is not actually the most distressing one.
• missed online sessions, interruptions at home, family pressure.
• the therapist arguing or persuading instead of asking questions.
• comparison of trauma severity among members; graphic detail in group.

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.