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Case Studywww.remapinstitute.org   www.remap.net
Assault by an Ex-Boyfriend         PTSD Case• He was drunk (and on drugs)• She found Cocaine in his closet—flushed it• He ...
Assault by an Ex-Boyfriend                PTSD Case• He then fell unconscious—fell like a board• His sister arrived—he wok...
Treatment with Quick REMAP                See Introducing Quick REMAP• One session• Three rounds of treatment:  – Quick RE...
Psychological Measures•   Subjective Units of Distress Scale (SUD)•   State-Trait Anxiety Inventory (STAI-s)•   Impact of ...
Treating an Assault Related PTSD CaseSUD                                               www. remapinstitute.org   www.remap...
Treating an Assault Related PTSD CaseSTAI-s                                              www. remapinstitute.org   www.rem...
Treating an Assault Related PTSD CaseIES-r                                             www. remapinstitute.org   www.remap...
Physical Measures         Heart Rate Variability Analysis (HRV)In addition to the followingslides, further information on ...
Using HRV to measure          the effect of treatment            with Quick REMAP• Electrocardiograph (ECG) data obtained ...
Recordings were made while:•   Client breathed normally•   Sat comfortably upright•   Refrained from movement and•   Witho...
Instrument Used toMEDICORE                     Measure HRV SA 3000pHeart RateVariability Analyzerwww. remapinstitute.org  ...
FDA  Approval   Medical   Devicewww. remapinstitute.org   www.remap.net
Detailed RESULTS• The results of the first 3 recordings were  compared to assess whether there were any  quantifiable chan...
Results                 05-15-07                                              Physical Measures of Heart Activity (ECG/HRV...
Results                 05-15-07                                                   Physical Measures of Heart Activity (EC...
Results                 05-15-07                                                            Physical Measures of Heart Act...
Follow-up Report on 05-22-07                  www. remapinstitute.org   www.remap.net• She got home on 05-15-07 (after tre...
Follow-up Results                          06-05-07                                             Physical Measures of Heart...
Follow-up Results                      06-05-07                                                  Physical Measures of Hear...
Follow-up Results                     06-05-07                                                           Physical Measures...
• The REMAP Institute provides training for  psychotherapists who want to develop skills in  working with Quick REMAP, the...
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Treating domestic violence ptsd with quick remap

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Treating Domestic Violence PTSD with Quick REMAP is a case study by Steve B. Reed, LPC, LMSW, LMFT illustrating how the Quick REMAP treatment method can be used to resolve the distress associated with a traumatic assault. Treatment results are measured with the Impact of Event Scale, the State-Trait Anxiety Inventory and Heart Rate Variability Analysis. The slides contain links to more detailed information available on www.remap.net and www.remapinstitute.org.

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Treating domestic violence ptsd with quick remap

  1. 1. Case Studywww.remapinstitute.org www.remap.net
  2. 2. Assault by an Ex-Boyfriend PTSD 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 2
  3. 3. Assault by an Ex-Boyfriend PTSD 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 3
  4. 4. Treatment with Quick REMAP See Introducing 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 4
  5. 5. 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 5
  6. 6. Treating an Assault Related PTSD CaseSUD www. remapinstitute.org www.remap.net Treating an Assault Related PTSD Case with Quick REMAP 10 9 9 Subjective Units of Distress 8 7 6 (SUD) 5 4 3 3 2 1 0 0 0 1 2 3 4 Pre Tx Post Tx Follow-up Follow-up 05-03-07 05-15-07 05-22-07 06-27-07 6
  7. 7. Treating an Assault Related PTSD CaseSTAI-s www. remapinstitute.org www.remap.net Treating an Assault Related PTSD Case with Quick REMAP 80 State-Trait Anxiety Inventory 70 70 60 (STAI-s) 50 43 40 30 25 23 20 1 2 3 4 Pre Tx Post Tx Follow-up Follow-up 05-03-07 05-15-07 05-22-07 06-27-07 7
  8. 8. Treating an Assault Related PTSD CaseIES-r www. remapinstitute.org www.remap.net Treating an Assault Related PTSD Case with Quick REMAP 70 Impact of Event Scale (IES) 60 60 50 40 30 20 10 2 1 0 1 2 3 Pre Tx Follow-up Follow-up 05-03-07 05-22-07 06-27-07 8
  9. 9. Physical Measures Heart Rate Variability Analysis (HRV)In addition to the followingslides, further information on HRVand the meaning of the measuresthat were used can be found in theREMAP Pilot Study –Soothing the Sympathetic NervousSystem with the REMAP process:Results from Treating 8 Trauma SurvivorsAnd Measuring Treatment Effect withHeart Rate Variability Analysis www. remapinstitute.org www.remap.net
  10. 10. 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
  11. 11. 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
  12. 12. Instrument Used toMEDICORE Measure HRV SA 3000pHeart RateVariability Analyzerwww. remapinstitute.org www.remap.net
  13. 13. FDA Approval Medical Devicewww. remapinstitute.org www.remap.net
  14. 14. 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
  15. 15. Results 05-15-07 Physical Measures of Heart Activity (ECG/HRV) Heart Ratewww.remap.net 85 82.4 80 75 Beats per Minute 70 67.7 63.8 65www. remapinstitute.org 60 55 50 45 40 Walk in the Park 1 Traumatic2Memory Traumatic Memory 3 Baseline Trauma Pre Tx Trauma Post Tx 15
  16. 16. Results 05-15-07 Physical Measures of Heart Activity (ECG/HRV) Para-Sympathetic Activitywww.remap.net 90 80 76.7 RMS-SD (milliseconds) 68.6 70 60 50www. remapinstitute.org 40.3 40 30 20 10 0 Walk in 1 Park the Traumatic Memory 2 Traumatic Memory 3 Baseline Trauma Pre Tx Trauma Post Tx 16
  17. 17. Results 05-15-07 Physical Measures of Heart Activity (ECG/HRV) Sympathetic vs. Para-Sympathetic Balancewww.remap.net 1.8 1.63 LF/HF Ratio (normalized units) 1.6 1.4 1.2 1 0.87www. remapinstitute.org 0.8 0.63 0.6 0.4 0.2 0 Walk in the Park Traumatic Memory Traumatic Memory 1 2 3 Baseline Trauma Pre Tx Trauma Post Tx 17
  18. 18. Follow-up Report on 05-22-07 www. remapinstitute.org www.remap.net• 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 18
  19. 19. Follow-up Results 06-05-07 Physical Measures of Heart Activity (ECG/HRV) Heart Ratewww.remap.net 83.7 82.6 85 80 75 Beats per Minute 70 65www. remapinstitute.org 60 55 50 45 40 Walk in the Park 1 Traumatic 2 Memory Baseline Trauma Follow-up 19
  20. 20. Follow-up Results 06-05-07 Physical Measures of Heart Activity (ECG/HRV) Para-Sympathetic Activitywww.remap.net 90 80 RMS-SD (milliseconds) 70 60 50www. remapinstitute.org 40 33.3 34.5 30 20 10 0 Walk in the Park 1 Traumatic Memory 2 Baseline Trauma Follow-up 20
  21. 21. Follow-up Results 06-05-07 Physical Measures of Heart Activity (ECG/HRV) Sympathetic vs. Para-Sympathetic Balancewww.remap.net 0.9 LF/HF Ratio (normalized units) 0.8 0.7 0.6 0.48 0.5 0.43www. remapinstitute.org 0.4 0.3 0.2 0.1 0 Walk in the Park 1 Traumatic2Memory Baseline Trauma Follow-up 21
  22. 22. • 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

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