Screen technique

1. Introduction

Version followed: David Muss's Rewind Technique (Muss 1991; Muss 2002 protocol), as delivered in the Astill Wright et al. (2023) RCT and described in Muss-trained practice. Three lineage variants are given beside it where their steps differ: Bandler's NLP visual-kinaesthetic dissociation (V/KD, "fast phobia cure"), the Human Givens (HG) Rewind Protocol (Griffin and Tyrrell), and Reconsolidation of Traumatic Memories (RTM; Gray and Bourke). Every step below is labelled [Muss], [NLP], [HG] or [RTM].

The screen technique, also called rewind or V/KD, is a brief imagery procedure for intrusive trauma memories (flashbacks, nightmares, intrusive images) and for single-event phobias. The client imagines watching the event as a film from a safe, detached position. The film starts before the event, "when all was well", and runs to its end. The client then steps into the film at the end and rewinds it at speed back to the safe start. It is done with little or no verbal disclosure of the trauma. [source: Psychology Tools; Astill Wright et al. 2023; Muss 2002 as described in the MJCP paper; HGI]

How change happens: the developers and later researchers propose that briefly reactivating the memory from a distanced viewpoint makes it changeable (reconsolidation). Rewinding to a safe starting point then updates the memory's sequence and emotional charge, so recall becomes voluntary and stops being involuntary, without the memory being erased. Prolonged exposure works by extinction; rewind is not thought to. Distance (screen, projection booth) keeps arousal low enough for the person to stay with the material. HG adds that deep relaxation is required so the procedure does not deepen the trauma pattern. The mechanism is proposed, not established. [source: Psychology Tools; MJCP paper; Springer 2024 analogue study; HGI] [uncertain: mechanism]

Status: Rewind is a single, brief, manualised-in-training procedure, not a full therapy. Clinicians normally use it inside a formulation-led trauma treatment. Psychology Tools advises using it within a formulation-driven approach, and the RCT authors call their evidence preliminary. [source: Psychology Tools; Astill Wright et al. 2023]

2. Framework

Rewind has no formal "phases" in the way phase-based trauma therapies do. The structure below arranges the steps the sources describe into five stages. The stage names are mine [synthesis]; the contents are cited.

Stage A: Assessment and target selection (start of session 1, or a prior assessment session)

Goal: confirm that intrusive re-experiencing of a specific, finished event is the main problem, and identify the target memory or memories.
Muss's protocol uses the Impact of Event Scale (IES), with treatment indicated at a score of 25 or above. The RCT used CAPS-5 diagnosis of PTSD; RTM's pilot required PTSD plus a flashback or nightmare in the past month. [source: MJCP paper citing Muss 2002; Astill Wright et al. 2023; HDIAC slides]
Move on when: the event is over (no ongoing threat or abuse), a clearly bounded memory has been chosen, and the client consents after hearing the rationale. Rewind "is not expected to work" while the trauma is ongoing. [source: MJCP paper] [synthesis: the consent and risk criteria]

Stage B: Preparation (same session)

[Muss] Introduce the technique; client closes their eyes. [source: MJCP paper; Astill Wright et al. 2023]
[HG] Induce deep relaxation and a pleasant/safe place, briefly activate the anxiety to confirm the "trauma template" is engaged, then deepen relaxation again. [source: HGI pages]
[NLP] Set up the cinema and projection booth. [source: Graham English wiki]
Move on when: the client can picture the screen and report enough distance to keep watching. [synthesis]

Stage C: Rewind proper (core of each treatment session)

Forward viewing from the detached position, from the safe start to the safe end. Then enter the film at the end and rewind fast to the start. Repeat.
[Muss] Forward recall lasts about 2 minutes (a few minutes per the MJCP paper); rewind about 10 seconds. A few practice runs come first. [source: Astill Wright et al. 2023; MJCP paper]
[NLP/RTM] Associated reverse run in about 2 seconds or less. [source: Graham English wiki; Brookdale/HDIAC RTM slides]
[HG] Alternate rewind (associated) and fast-forward (watching on screen) at the fastest comfortable speed until the scenes evoke no emotion. [source: HGI node/284]
Move on when: SUDs and the client's report show the memory no longer evokes significant distress, or the session's time is used up. [source: HG "until no emotion"; RTM SUDs checks]

Stage D: Testing and future rehearsal

Test by having the client try to bring back the old response. [NLP/RTM] [HG/NLP] Rehearse future encounters with the feared situation. [RTM] Build and practise an alternative version of the event. [source: Graham English wiki; HGI; RTM slides]

Stage E: Review and further sessions

[Muss] Usually 1–3 sessions of about 30–40 minutes (Muss 2002, as reported in the MJCP paper). The RCT gave up to three 60-minute video sessions, dropping sessions 2–3 if distressing symptoms had resolved, and "refining" the rewind if significant symptoms continued. [source: MJCP paper; Astill Wright et al. 2023]
[RTM] Typically three 90-minute sessions. [source: HDIAC/Brookdale slides]
[HG] Session count not stated. [uncertain]
Multiple traumas: treat each in a separate session, or in the same session when related, for example repeated abuse by the same perpetrator. [source: MJCP paper citing Muss]
End criteria: intrusions and nightmares about the treated event stop, the event no longer triggers arousal, and it is recalled "like JUST another memory" (RTM). Muss's account is that involuntary recall stops while voluntary recall stays intact. [source: Brookdale RTM slides; MJCP paper]

Training: in the RCT, experienced NHS therapists had 2.5 days of training, had to treat two PTSD cases satisfactorily first, and then received fortnightly group supervision from the developer. HG College runs a two-day workshop. NLP and hypnotherapy courses vary in content and are not standardised. [source: Astill Wright et al. 2023; HGI] [uncertain: NLP/hypnotherapy course content]

3. Guiding principles

Brief activation, not prolonged exposure. Keep the forward run short (about 2 minutes [Muss]) and do not dwell on hotspots; the aim is to reactivate the memory, not habituate to it. [source: Psychology Tools; Astill Wright et al. 2023]
Safety bookends. The film always starts before the event, when all was well, and the rewind always ends there. Never start or stop the film mid-trauma. [source: Astill Wright et al. 2023; MJCP paper; Graham English wiki]
Distance first, then association. The client watches from a detached viewpoint (screen, CCTV, projection booth) and steps into the film only at the end, for the rewind. If the client is too "in it" during the forward run, add distance. [source: Graham English wiki; HGI node/284]
The memory must actually be activated. HG states that the method "cannot work" if the client is emotionally cut off; reconnect them with the feeling before proceeding. [source: HGI]
Low arousal throughout (HG emphasis). HG treats deep relaxation as essential. Muss's version and the RCT did not use a relaxation induction. In practice: choose a version deliberately, and if you skip relaxation, keep arousal low through distance and speed. [source: HGI; Astill Wright et al. 2023] [uncertain: which is better is untested]
Content-free working. The client need not narrate the trauma aloud. Ask only for start and end points and ratings, which protects clients who cannot or will not disclose and reduces vicarious exposure for the therapist. [source: HGI; Springer 2024; Psychology Tools]
Speed matters. The rewind is fast (about 10 seconds [Muss]; 2 seconds or less [NLP/RTM]), and repeats get faster. Encourage the "fastest comfortable speed". [source: Astill Wright et al. 2023; Graham English wiki; HGI node/284]
Client control. The client holds the imagined remote control and can pause, shrink or stop the picture. [source: HGI; Graham English wiki]
Include the feared might-have-been. [Muss] The forward recall includes what the client feared would happen next but did not. [source: Astill Wright et al. 2023; MJCP paper]
Treat finished events only. Do not use while the threat is ongoing. Deal with current safety first. [source: MJCP paper] [synthesis: safety-first sequencing]
Repeat and refine as needed; stop when done. Repeat within a session if the response is incomplete. Offer further sessions only while significant symptoms remain. [source: MJCP paper; Astill Wright et al. 2023]
Test, don't assume. Check the result by deliberate attempts to re-access the memory and by symptom review. [source: Graham English wiki; RTM slides]
Formulation-led use. Use rewind as one tool within a trauma formulation, not as a stand-alone cure-all. [source: Psychology Tools]
Practitioner competence. Both HG and the RCT stress trained, experienced practitioners and supervision on early cases. [source: HGI; Astill Wright et al. 2023]

4. Intervention inventory

The items follow session order. Example language is my own illustrative wording unless it is marked as a quotation. Developer scripts are not reproduced; the Muss and HG training scripts are taught on courses. [uncertain: exact developer wording]

4.1 Assessment, screening and target selection [Muss; RCT; synthesis]

Purpose / when: Before any rewind. Confirms that rewind fits the problem: intrusive memories of a finished, bounded event, or a single-event phobia.
Steps:
1. Assess PTSD symptoms with a standard measure. Muss's protocol uses the IES, treating at a score of 25 or above. The RCT used CAPS-5; RTM used the PCL/PSS-I. Do not reproduce the items. [source: MJCP paper; Astill Wright et al. 2023; HDIAC slides]
2. List the intrusive memories, nightmares and triggers. Ask which memory "plays" most often or most intensely. [synthesis]
3. Check that the event is over: no ongoing abuse, harassment, legal threat or contact with the perpetrator that keeps re-traumatising. If it is ongoing, address safety first. [source: MJCP paper; synthesis]
4. Do a standard risk assessment (suicidality, self-harm, substance use, dissociative symptoms, psychosis). If acute risk is present, manage that first. [synthesis: the sources give no exclusion criteria] [uncertain]
5. Note whether the client was a direct victim or an observer/witness/first aider. Muss described a different version for observers (see 4.16). [source: MJCP paper citing Muss 1991a]
6. Get a baseline distress rating (0–10 or SUDs 0–100) for the chosen memory. [source: RTM uses SUDs; synthesis]
Example language (illustrative): "You don't need to tell me what happened in detail. Which memory keeps coming back uninvited? Is anything about that situation still going on now?"
Watch for: multiple traumas from childhood with no bounded single memory, which make for a poorer fit; active dissociative disorder; ongoing threat. Fit is shown by a clearly bounded memory that reliably triggers distress.

4.2 Introducing the technique and consent [Muss; synthesis]

Purpose / when: At the start of the first rewind session. Builds a rationale and gives control to the client.
Steps:
1. Explain briefly: they will picture the event as a film, watched from a safe distance, and then run it backwards fast. They need not describe it aloud. [source: Astill Wright et al. 2023; Psychology Tools]
2. Explain that some distress during the brief forward run is expected, that they can stop at any time, and agree a stop signal (for example a raised hand or saying "pause"). [synthesis; consent steps required for exposure-based work]
3. Explain that the aim is to stop the memory intruding, not to erase it; they will still be able to remember it on purpose. [source: MJCP paper]
4. Obtain and record informed consent, including the option to choose another treatment. [synthesis]
Example language (illustrative): "We're going to treat this memory like a recording. You'll watch it once from a safe seat, then jump in at the end and spool it back to the beginning very fast. You stay in charge of the remote the whole time."
Watch for: the client expecting the memory to vanish completely; fear of losing control. It is working when the client can say back what will happen and agrees to it.

4.3 Relaxation induction [HG; also Hossack & Bentall]

Purpose / when: HG version: always, before the rewind. Hossack and Bentall combined relaxation with V/KD. Muss's version and the RCT did not use it. [source: HGI; Springer 2024; Astill Wright et al. 2023]
Steps (HG outline, my wording):
1. Guide the client into deep physical and mental relaxation, using slow breathing with a longer out-breath, eyes closed, and attention on muscles letting go. HG's exact induction was not available. [uncertain]
2. Watch for physical signs of calm (slower breathing, relaxed face and shoulders) before you go on.
Example language (illustrative): "Let your breath slow down... make each out-breath a little longer than the in-breath... and notice your shoulders getting heavier."
Watch for: a client who can't relax (go more slowly, use eyes-open breathing); a client who drifts into sleep. The induction is working when you see visible physical settling and a low self-rated arousal.

4.4 Pleasant / safe place [HG]

Purpose / when: HG, after relaxation. It gives the client somewhere calm to work from and to return to. [source: HGI node/284]
Steps:
1. Ask the client to imagine a place where they feel completely at ease, real or imagined, and to build in the details of what they see, hear and feel.
2. HG: briefly let the anxiety surface, then return the client to calm in the safe place. [source: HGI node/284]
3. HG places the screen and remote control inside this safe place (see 4.6). [source: HGI node/284]
Example language (illustrative): "Picture somewhere you feel completely safe and comfortable... notice what you can see there, what you can hear, how warm or cool it is."
Watch for: a safe place that contains trauma reminders (help the client choose another); intrusive images. It is working when the client reports calm and can return to the place on cue.

4.5 Activating the trauma template / brief reactivation [HG; RTM; Muss]

Purpose / when: Before the film. Makes sure the memory is emotionally "live", which reconsolidation accounts require. [source: HGI; RTM slides; Psychology Tools]
Steps:
1. Ask the client to bring the memory to mind briefly and give a distress rating. [RTM: a brief, non-traumatising exposure with a SUDs check] [source: HDIAC slides]
2. If the client reports no feeling (emotionally cut off), gently reconnect them with it, for example by asking what they notice in their body when they think of it. Then return them to relaxation (HG). [source: HGI]
3. Keep this short (seconds, not minutes). [synthesis]
Example language (illustrative): "Just touch on that memory for a moment... what number, 0 to 10? ... Good, now let it go and come back to your safe place."
Watch for: flooding (shorten and add distance), or flat numbness (see 5.4). It is working when the client gives a moderate rating and comes back down quickly.

4.6 Setting up the screen / cinema (dissociated viewpoint) [all versions]

Purpose / when: Creates the distanced position for watching. [source: all sources]
Steps:
1. [Muss] The client imagines sitting in a cinema, watching a recording of the event "as if it had been caught on camera" (CCTV-like). [source: MJCP paper; Astill Wright et al. 2023]
2. [HG] The client imagines a screen and a remote control inside their safe place. [source: HGI node/284]
3. [NLP] The client sits in a theatre and sees a black-and-white still of themselves on the screen. [source: Graham English wiki]
4. Check that they can see the screen and feel at a distance from it. [synthesis]
Example language (illustrative): "Imagine you're in a cinema, comfortable in your seat. On the screen there's a recording of that day, as if a camera had captured it."
Watch for: the client can't imagine visually (accept "sensing" or knowing, which HG explicitly allows); the screen feels too close. It is working when the client describes the screen and reports feeling separate from it.

4.7 Double dissociation: the projection booth [NLP; HG]

Purpose / when: Adds a second layer of distance. It is core to the NLP and HG versions, not part of Muss's version as reported, and optional elsewhere. [source: Graham English wiki; HGI node/284; Springer 2024]
Steps:
1. [NLP] The client imagines floating out of their body up into the projection booth, from where they watch themselves sitting in the seat watching the screen. An optional protective window (glass/barrier) goes across the booth opening. [source: Graham English wiki]
2. [HG] The client floats up and out behind the screen and watches themselves watching it. [source: HGI node/284]
3. Confirm the client can hold both viewpoints (watching themselves watching). [synthesis]
Example language (illustrative): "Now float up and back, into the projection room. From behind the glass you can see yourself down in the seat, watching the screen."
Watch for: confusion about viewpoints (simplify to one layer); clients for whom out-of-body imagery echoes peritraumatic dissociation and frightens them (drop this step). It is working when the client reports feeling further removed and calmer.

4.8 Setting the safe start and safe end points (bookends) [all versions]

Purpose / when: Before the forward run. Fixes the film so that it begins and ends in safety. [source: Astill Wright et al. 2023; MJCP paper; Graham English wiki; HGI node/284]
Steps:
1. Ask the client to choose a moment before the event when all was well. This is the start frame. [Muss: "when all was well"]
2. Ask for a moment after the event when they were safe again, or after it was over. This is the end frame. [NLP: until everything was fine again; HG: after it is over]
3. Have the client nod, or name each point briefly with one word. No narrative is needed. [synthesis]
Example language (illustrative): "Pick a moment that day before anything happened, when things were still OK. Then pick a moment afterwards when it was over and you were safe. Just nod when you have both."
Watch for: no safe end exists, for example the event ended in hospital with ongoing pain (choose the first moment of relative safety, even if it is later); a start point that is already anxious (move it earlier). It is working when both points come with low distress ratings.

4.9 Forward viewing of the film (dissociated) [all versions]

Purpose / when: The brief reactivation itself. It runs from the start frame to the end frame. [source: all sources]
Steps:
1. [Muss] The client lets the film play from the start frame through the usual intrusive recall, with its images, sounds and smells, about 2 minutes ("a few minutes"). The client may stay silent. [source: Astill Wright et al. 2023; MJCP paper]
2. [NLP] The client watches from the booth in black and white, ending on a freeze frame of their younger self, at ease, after the event. [source: Graham English wiki]
3. [RTM] The dissociated black-and-white movie is repeated until the client is comfortable watching. [source: Brookdale/HDIAC RTM slides]
4. Ask for a nod when they reach the end frame. [synthesis]
Example language (illustrative): "Let the film start from that OK moment... let it play through at its own pace, all the way to when it was over... nod when you get to the end."
Watch for: tearfulness, faster breathing or freezing. Some arousal is expected; if it is marked, use distancing controls (4.10). It is working when the client gets to the end frame while staying in the observer seat.

4.10 Distancing controls (adjusting the picture) [NLP; HG; RTM]

Purpose / when: At any point when the client becomes too emotionally involved while watching. [source: Graham English wiki; HGI; RTM slides]
Steps:
1. Make the screen smaller and further away; make the picture grainier or black and white. [source: Graham English wiki; RTM "format changes" (loss of colour/depth, distance)]
2. Pause the film, then restart it once the client feels detached. [source: Graham English wiki]
3. Remind the client they hold the remote control. [source: HGI]
4. If still too distressing, return to the safe place or relaxation before continuing (HG). [source: HGI]
Example language (illustrative): "Press pause. Let the screen shrink and drift further back... drain the colour out... when it feels far enough away, press play again."
Watch for: controls that don't lower arousal at all. If so, stop and switch to grounding (see 5.3). Ratings that fall show the controls are working.

4.11 Including the feared outcome ("what could have happened") [Muss]

Purpose / when: During the forward run in Muss's version. The film includes what the client feared would happen next but did not. [source: Astill Wright et al. 2023; MJCP paper]
Steps:
1. Before the run, ask briefly (no detail needed) whether there was a moment when they thought something worse was about to happen.
2. Ask them to let that feared continuation play as part of the film, then to carry on to the safe end. [source: as above]
Example language (illustrative): "If there was a moment you thought 'this is it' or something worse would happen, let that part play too, then carry on to when it was over."
Watch for: a feared outcome that actually happened (just include it as it occurred). The exact way Muss integrates this step was not available. [uncertain]

4.12 Entering the film at the end (association) [all versions]

Purpose / when: Straight after the forward run, so the rewind is experienced from inside. [source: Astill Wright et al. 2023; Graham English wiki; HGI node/284; RTM slides]
Steps:
1. [Muss] If the client experienced the trauma directly, invite them to enter the screen at the end frame. [source: Astill Wright et al. 2023]
2. [NLP] The client leaves the booth, returns to the seat, and then steps into the freeze frame of their younger self. [source: Graham English wiki]
3. [HG] The client floats back into their body. [RTM] The client steps into the end of the event. [source: HGI node/284; RTM slides]
Example language (illustrative): "Now step into the screen, right at that last moment when it was over. Be there, inside it."
Watch for: distress spiking on entering. Keep this moment brief and go straight to the rewind.

4.13 The rapid rewind [all versions]

Purpose / when: The core change step, run from the end frame back to the safe start frame. [source: all sources]
Steps:
1. Have the client rewind the whole event quickly, in reverse, experienced from inside, back to the start frame. [Muss] About 10 seconds. [NLP/RTM] 2 seconds or less, with sight, sound and feeling, in colour (NLP). [source: Astill Wright et al. 2023; MJCP paper; Graham English wiki; RTM slides]
2. Some therapists count or narrate rhythmically to set the pace. [synthesis] [uncertain: whether Muss does this]
3. Stop at the start frame (all well) and let the client rest there briefly.
4. Ask for a distress rating. [source: RTM SUDs] [synthesis: timing]
Example language (illustrative): "And now rewind, fast, everything going backwards, people walking backwards, sounds reversing, zip, all the way back to that OK moment. ... You're back before it happened. What number now?"
Watch for: the client getting "stuck" partway (encourage them to whizz past it; repeat); a rewind that is too slow and becomes re-living. It is working when the client reaches the start frame and reports lower distress, sometimes with surprise or laughter at the absurd reversed images. [synthesis: the laughter observation]

4.14 Repetition, fast-forward/rewind cycling and refining [Muss; HG; NLP]

Purpose / when: When distress remains after one rewind. [source: MJCP paper; HGI node/284; Graham English wiki; Astill Wright et al. 2023]
Steps:
1. [Muss] Repeat the rewind several times within the session if the response is incomplete. In later sessions, "refine" it while significant symptoms remain. [source: MJCP paper; Astill Wright et al. 2023]
2. [HG] Alternate an associated rewind with a fast-forward watched on the screen (dissociated), back and forth at the fastest comfortable speed, until the scenes evoke no emotion. [source: HGI node/284]
3. [NLP] Repeat the whole sequence (booth, film, step in, rewind), faster each time. [source: Graham English wiki]
4. Track a rating after each cycle. [synthesis]
Example language (illustrative): "Let's do that again, a little faster... and again... What number now?"
Watch for: ratings that stop falling across 3–4 cycles (see 5.1). It is working when ratings drop steadily toward 0–2.

4.15 Testing the result [NLP; RTM; synthesis]

Purpose / when: At the end of the session, to confirm change.
Steps:
1. Ask the client to deliberately try to bring back the old feeling, by thinking of the event or imagining being in the situation now. [source: Graham English wiki]
2. Take a rating. RTM criteria: the memory feels like "just another memory" with no arousal. [source: RTM slides]
3. Check that voluntary recall is intact: they can still remember what happened. [source: MJCP paper]
Example language (illustrative): "Try to get the old feeling back. Think of that day as hard as you like. What happens?"
Watch for: distress that remains about another part of the event (make it a new target); a different memory that comes up. It is working when the client reports low or no distress on purposeful recall.

4.16 Observer/witness variant [Muss]

Purpose / when: For people traumatised by witnessing (observers, first aiders). Muss is reported to have described a different version for them. [source: MJCP paper citing Muss 1991a]
Steps: The details of this variant are [uncertain]. Do not improvise it as if it were Muss's protocol. One reasonable adaptation is to choose start and end frames in the witness's own timeline (before arriving, after leaving the scene) and run the standard sequence. That is an inference, not the documented variant. [synthesis]
Watch for: the MJCP study had one observer participant whose symptoms had risen at three months. [source: MJCP paper]

4.17 Future rehearsal / future pacing [HG; NLP]

Purpose / when: After the rewind, when the client will meet the feared situation again (for example driving, lifts, the workplace). [source: HGI; Graham English wiki]
Steps:
1. [HG] While the client is still relaxed, have them picture themselves handling the coming situation calmly and confidently. [source: HGI]
2. [NLP] Have the client imagine the next encounter and check for any remaining fear. Advise caution in real encounters, because avoidance has meant they had no chance to learn the skills those situations need, for example after a long period without driving. [source: Graham English wiki]
3. Agree graded real-life re-engagement where needed. [synthesis]
Example language (illustrative): "Imagine next Tuesday, getting in the car and pulling out of the drive... watch yourself doing it calmly. How does that feel?"
Watch for: confident imagery but continued real-world avoidance (add in-vivo steps). It is working when the client resumes the activity.

4.18 Alternative version / new-pattern rehearsal [RTM]

Purpose / when: RTM, after the rewind cycles. [source: Brookdale/HDIAC RTM slides]
Steps:
1. The client creates an alternative version of the event, chosen by them, and practises running it until it feels comfortable. [source: RTM slides]
2. Details of RTM's procedure for this step are [uncertain]. It overlaps with imagery rescripting. [uncertain]
Example language (illustrative): "If you could run a different version of that film, one you'd be comfortable watching, what would happen? Run that version a few times."
Watch for: the client confusing the alternative with what really happened (clarify that it is a practice film, not a rewrite of the facts). [synthesis]

4.19 The "metaphorical safe" [Muss, as reported]

Purpose / when: The MJCP paper describes Muss's protocol as giving the client a "metaphorical safe" that they can open and close at will, so they have control over recall. [source: MJCP paper]
Steps: The paper gives no further detail of how this is used in session. [uncertain] One reasonable reading is to present the treated memory as now stored and opened only by choice. [synthesis]
Example language (illustrative): "That memory is still yours, but it's in a safe now. You can open it when you choose; it doesn't have to open itself."

4.20 Multiple traumas and sequencing [Muss]

Purpose / when: When the client has several intrusive memories. [source: MJCP paper]
Steps:
1. Treat each separate trauma in its own session. Related traumas (for example repeated sexual abuse) can be treated in the same session. [source: MJCP paper]
2. Start with the memory that intrudes most, or with the first or worst; the sources don't specify which. [uncertain] Re-rate the others after each one, because some may generalise. [synthesis]
Watch for: a cascade of new memories within one session (park them and schedule them). [synthesis]

4.21 Remote (video) delivery [RCT]

Purpose / when: The RCT delivered all sessions by video call. No protocol adaptations were described. [source: Astill Wright et al. 2023]
Steps [synthesis]: Before starting, confirm the client's location, a private space, an emergency contact and what to do if the connection drops. Keep the client's eyes closed but their camera on. Agree a visible stop signal. End with grounding while still connected.
Watch for: connectivity problems, which the RCT linked to attendance and dropout. [source: Astill Wright et al. 2023]

4.22 Review and decision on further sessions [Muss; RCT]

Purpose / when: At the next contact, about a week later. [uncertain: interval]
Steps:
1. Re-measure (IES/PCL) and ask about intrusions and nightmares since the session.
2. If distressing symptoms have resolved, stop; the RCT skipped sessions 2–3 in this case. If significant symptoms remain, repeat and refine the rewind on the same or a new target, up to about three sessions. [source: Astill Wright et al. 2023; MJCP paper]
3. If there is no response after about three sessions, review the formulation and consider an established trauma-focused therapy (TF-CBT, EMDR). [synthesis]

5. Handling problems

The primary sources say little about problem management. Apart from the cited points, this section is my own synthesis drawn from general trauma-focused practice. [synthesis unless tagged]

Contraindications, safety and consent (exposure-based method)

Do not use while the trauma is ongoing (current abuse, harassment, stalking); rewind is not expected to work there. [source: MJCP paper] Address safety and practical protection first. [synthesis]
Defer rewind and stabilise first when there is: acute suicidal risk or recent self-harm; active psychosis; current substance dependence that impairs session work; severe dissociative disorder; pregnancy-related or medical conditions where acute arousal is unsafe (check with the medical team). [synthesis; the sources list no exclusions] [uncertain]
Suicide/self-harm: follow standard risk-assessment practice at intake and at every session. If risk rises, pause trauma work, make a collaborative safety plan, and use lethal-means counselling (safe storage and removal of means), involving others as needed. [synthesis]
Consent: explain the brief distress, the stop signal, the alternatives (TF-CBT, EMDR), and that the evidence is preliminary. [source: Astill Wright et al. 2023 for evidence status; synthesis for the consent content]
Legal proceedings: rewind aims to change how the memory feels, not its content. Where testimony is pending, discuss the timing with the client and their legal adviser, as with any memory-focused therapy. [synthesis] [uncertain]

5.1 Stuck: ratings stop falling

Check the target: is a different hotspot, or a different memory, now driving the distress? Make it a new film with its own start and end frames. [synthesis]
Check the bookends: is the start frame truly safe and the end frame truly over? Move them. [synthesis]
Increase speed and distance (smaller, black-and-white, booth). Alternate fast-forward and rewind (HG). [source: HGI node/284; Graham English wiki]
Check for meaning-based distress such as guilt, shame or moral injury. These may not shift with rewind and need cognitive work. [synthesis]
After about three sessions with no response, move to an established trauma-focused therapy. The RCT reported non-responders and suggested personalising the number of sessions. [source: Astill Wright et al. 2023; synthesis]

5.2 Avoidance and resistance (won't close their eyes, won't go near the memory)

Normalise the avoidance. Stress that no narration is needed and that they hold the remote. [source: HGI "non-voyeuristic"; synthesis]
Eyes open is acceptable: the client can look at a blank wall as the "screen". [synthesis]
Do one rewind of a mildly unpleasant non-trauma memory first, as a practice run; the RCT reports that participants usually practised first. [source: Astill Wright et al. 2023 (practice); synthesis (the neutral-memory choice)]

5.3 Overwhelm or abreaction during the film

Pause the film, open the eyes, and ground the client (feet on the floor, name five things they can see, slow out-breaths). [synthesis]
Return to the safe place or relaxation (HG). Add distancing. Restart from the start frame. [source: HGI; Graham English wiki]
If the client cannot settle within a few minutes, stop the rewind for this session, close with grounding, and review readiness. [synthesis]
Never end a session mid-film. At least get them back to the start frame or the safe place. [synthesis, consistent with the safety-bookend principle]

5.4 Numbness or dissociation (no feeling, "blank")

HG: the method cannot work while the client is cut off; gently reconnect them with the feeling, then relax them again. [source: HGI]
The RCT authors say the technique aims to elicit dissociative experiences around the trauma (meaning detachment from the memory). Separate this intended observer stance from pathological dissociation such as losing time, depersonalisation, or not responding to your voice. [source: Astill Wright et al. 2023; synthesis]
For pathological dissociation: stop, ground the client with eyes open, and consider stabilisation work before trying again. [synthesis]

5.5 Imagery difficulties

Accept "sensing" or "knowing" the film; HG explicitly allows "sees or senses". [source: HGI]
Use concrete anchors (the colour of a coat, a sound) to help the client locate the frames. [synthesis]

5.6 Non-attendance and dropout

The RCT had high dropout in the delayed arm. The authors attributed part of it to fast improvement, part to acceptability, and part to technology problems. [source: Astill Wright et al. 2023]
Agree in advance that a short review is useful even if they feel better. Offer telephone follow-up. Check technology before remote sessions. [synthesis]

5.7 Ruptures (the client feels unheard because you didn't ask about the event)

Explain that content-free working is designed to protect them, not because you don't care. Offer space to talk about the event, or its impact, if they want to. [synthesis]
If the client feels "processed" too quickly, slow down: more preparation, more consent checks, more formulation. [synthesis]

5.8 Partial response: new memories surface, or symptoms return

Treat each newly surfaced memory as a separate target (Muss: separate sessions for separate traumas). [source: MJCP paper]
If symptoms return after a fresh trauma or ongoing stress, reassess. One participant in the MJCP study with ongoing workplace harassment did not respond. [source: MJCP paper]
Observer/witness trauma: be alert to a poorer response (one observer participant got worse at three months) and to the existence of a separate variant that is not documented here [uncertain]. [source: MJCP paper] [uncertain]

5.9 Modality-specific pitfalls

The rewind turns into re-living. The rewind is too slow, or the client dwells in it. Shorten it to the target time (about 10 seconds [Muss], 2 seconds or less [NLP]) and coach the speed. [source: Astill Wright et al. 2023; Graham English wiki]
Starting mid-event. Always reset to the safe start frame. [source: bookend principle above]
Relaxation dependence (HG). A client who can't reach deep relaxation can use Muss's version, which doesn't require it. [source: Astill Wright et al. 2023; synthesis]
Complex, prolonged trauma with no bounded memories. Rewind is designed for discrete memories. Use it, if at all, for specific intrusive images inside a broader phase-based plan. [synthesis]
Version mixing. Steps from different lineages (NLP booth, HG relaxation, RTM alternative film) are compatible in principle, but none of the mixes has been tested. Record which version you used. [synthesis] [uncertain]
Overclaiming to the client. Present rewind as a promising brief technique with preliminary evidence, not as a guaranteed cure. Promotional sources (HG, RTM) state high success rates that have not been independently verified. [source: Astill Wright et al. 2023; HGI pages; synthesis]
Therapist inexperience. The RCT linked better results to therapist experience and required two supervised cases first. Get training and supervision before routine use. [source: Astill Wright et al. 2023]

Sources

Sources:

Further reading (not drawn on): the RETURN trial protocol (Astill Wright et al., 2021, European Journal of Psychotraumatology, PMC8330760) and the ISRCTN91345822 record. Eligibility and exclusion details from these are therefore missing. [uncertain]