TL;DR: Learn how virtual Accelerated Resolution Therapy (ART) works, what the research says, and how to prepare for a session.
If you've been carrying something heavy for a long time, the idea of starting trauma therapy can feel like a lot. Add a busy schedule, a long commute, or simply not wanting to sit in a waiting room, and it's easy to keep putting it off.
So one of the questions I hear most often is: Can trauma therapy actually work online?
The short answer is yes, for many people it can. And one approach that adapts especially well to video sessions is Accelerated Resolution Therapy, or ART. Here's what you should know before you begin.
What is Accelerated Resolution Therapy?
Accelerated Resolution Therapy is a brief, structured trauma therapy developed in 2008 by Laney Rosenzweig, LMFT. It draws on elements you may have heard of in other approaches, such as guided eye movements (similar to EMDR) and techniques from cognitive-behavioral and brief psychodynamic therapy, but it has its own distinct protocol.
A few features set ART apart:
• It's designed to be brief. Many clients notice meaningful changes in a small number of sessions, often somewhere between one and five, though everyone's path is different.
• You don't have to tell me the details. You can work through a painful memory without describing it out loud. For many people, this alone makes therapy feel possible.
• It works with images, not just words. Using sets of slow, side-to-side eye movements, you revisit a memory while noticing what happens in your body. Then, through a process called Voluntary Image Replacement, you choose new images to replace the distressing ones. The facts of what happened stay with you, but the images that used to trigger fear, shame or panic lose their charge.
• You stay in control. You decide what we work on, how fast we go, and what your new images look like. I guide the process; you direct the content.
ART was first developed to treat trauma and PTSD, and it's also used for anxiety, grief, phobias, intrusive images, and the kind of chronic stress that can build up into burnout.
Can ART really be done over video?
Yes. Because ART relies on eye movements and imagery rather than physical touch or special equipment, it translates naturally to a secure video platform.
In a virtual session, I use a software that projects a ball which moves across the camera's view, and you follow it with your eyes, just as you would in my office. We pause between sets so you can notice what's shifting in your body and your mind.
Many clients find that being at home actually helps. You're in a familiar space, you don't have to drive home right after an intense session, and you can build in quiet time afterward to rest.
What does the research say?
The best-known study of ART is a randomized controlled trial led by researchers at the University of South Florida and published in Military Medicine in 2013. It included 57 service members and veterans with combat-related PTSD, many of whom had already tried other treatments. Those who received ART had significantly greater reductions in PTSD symptoms, depression, anxiety and trauma-related guilt than the comparison group, and treatment took much less time than standard approaches.
A 2017 review in Current Psychiatry Reports described ART as effective, efficient and versatile, while noting that the research base is still relatively small and more high-quality trials are needed. Newer studies are underway, including a Mayo Clinic trial looking at ART for grief among family caregivers.
Research specifically comparing online ART with in-person ART is still limited. However, the wider body of research on telehealth trauma therapy is encouraging: several well-established trauma treatments have been shown to work about as well by video as they do face-to-face. Many trained ART therapists, myself included, offer it virtually.
Is virtual ART a good fit for you?
Online ART can be a great option if:
• You have a private, quiet space where you won't be interrupted for about 60 to 90 minutes
• You have a reliable internet connection and a device with a camera (a laptop or tablet works better than a phone)
• You'd like trauma therapy that doesn't require you to retell every detail
• Your schedule, location or energy makes in-person sessions hard to sustain
• You want focused, goal-oriented work rather than open-ended talk therapy
In-person care, or a different level of support, may be a better starting point if you are in an active crisis, are currently unsafe at home, don't have a private place to talk, or experience severe dissociation that makes it hard to stay grounded without someone physically present. We'll talk through this together during your consultation, and if virtual ART isn't the right fit, I'll help you find what is.
How to prepare for a virtual ART session
A little preparation goes a long way:
1. Choose your space. Pick a room with a door you can close. Let anyone you live with know you need privacy.
2. Set up your screen. Position your device at eye level, about an arm's length away, so you can comfortably follow movements across the screen. Turn off notifications.
3. Have comfort items nearby. Water, tissues, a blanket, or anything that helps you feel grounded.
4. Plan for afterward. Give yourself 20 to 30 minutes after the session to rest, walk, or journal before jumping back into work or family life.
5. Share your location and a support contact. At the start of telehealth, I'll ask where you are and who to contact in an emergency. This is standard practice and part of keeping you safe.
What happens in a session?
While every session is tailored to you, a typical ART session looks something like this:
• Check-in and focus. We identify what you'd like to work on and how distressing it feels right now.
• Relaxation and body awareness. We start with sets of eye movements to help your nervous system settle.
• Processing the memory. You privately visualize the scene from beginning to end, with eye movements, noticing sensations in your body as they come and go.
• Rescripting. You create new, more peaceful images to replace what was distressing.
• Closing. We check in on how the memory feels now, scan for any leftover tension, and make sure you're grounded before we end.
Many people are surprised at how different a memory feels by the end, still remembered, but no longer overwhelming.
Questions to ask any online ART therapist
When you're choosing a therapist, it's okay to ask:
• Are you trained and certified in Accelerated Resolution Therapy?
• Are you licensed in the state where I live? (For telehealth, your therapist generally needs to be licensed where you are located during the session.)
• What video platform do you use, and is it HIPAA-compliant?
• What's your plan if our connection drops or I become very distressed during a session?
• How many sessions do you usually recommend for concerns like mine?
A good therapist will welcome these questions.
Frequently asked questions
Is ART the same as EMDR? No. Both use eye movements, but ART follows a different, more directive protocol and places a strong emphasis on replacing distressing images. ART also doesn't require you to describe the memory out loud.
Will I lose my memory of what happened? No. You'll still know what happened. What changes is the emotional and physical reaction the memory triggers.
What if my connection drops mid-session? We'll agree on a backup plan before we start, such as switching to a phone call, so you're never left in the middle of processing.
Can ART help with burnout or relationship stress, not just "big" trauma? Often, yes. Painful moments at work, in a relationship, or in childhood don't have to be dramatic to keep showing up in your body. ART can help with those, too.
Ready to explore virtual ART?
You don't have to keep carrying this on your own, and you don't have to leave home to start healing.
I offer virtual Accelerated Resolution Therapy for adults located in Florida and Massachusetts. If you're curious whether ART might help you, I invite you to schedule a free consultation at tiffanycastellanos.com. We'll talk about what you're hoping to change and whether online ART is the right fit.
References
• Kip, K. E., Rosenzweig, L., Hernandez, D. F., et al. (2013). Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD). Military Medicine.
• Waits, W., Marumoto, M., & Weaver, J. (2017). Accelerated Resolution Therapy (ART): A review and research to date. Current Psychiatry Reports, 19(3), 18.
• Mayo Clinic. Accelerated Resolution Therapy for Early Maladaptive Grief: A Clinical Trial (NCT05624879). ClinicalTrials.gov.
