In this episode, we break down the basics of the Recent Traumatic Event Protocol. We share our experience with using this technique and guidance on how to determine when you need to use it with your clients.
Shout out to Katherine Keller
***IT IS RECOMMENED THAT YOU SEEK THE ADVANCED R-TEP TRAINING PRIOR TO UTILIZING THIS PROTOCOL WITH YOUR CLIENTS.
The Recent Traumatic Episode Protocol (R-TEP) was first published in 2008 by Elan Shapiro and Brurit Laub. They have, since then, developed the Group Traumatic Episode Protocol (G-TEP).
Elan Shapiro and Brurit Laub
RTEP is used for early EMDR intervention.
- A tool that is incredibly useful.
- The document that we are referencing is: emdrreseachfoundation.org
- It’s used to try and intervene before the brain processes the trauma in a maladaptive way.
- Not going back and trying to change the way it was stored
What is “recent”?
- From the brain’s perspective, recent events can be an event that happened earlier that day or even a year or two ago.
- The difference is, if there’s never been a time for a break from the trauma to allow the nervous system to integrate, then from the body and brain’s perspective, it is still recent.
- It is still held in working memory.
- The question shouldn’t be “How long has it been since the event occurred?” but “Has the trauma been integrated?” If not, then RTEP could be an appropriate tool for the client.
- 4-6 sessions? There’s much more variability than people realize.
Populations that could benefit
- Natural disaster survivors
- Major community trauma
- Fire department or police department
- Recent assault victims
- People in an ongoing legal situations
Phase I- History Taking
- Brief intake of history taking
- Figuring out if the client is ready or if this is an appropriate approach
- Does the client have an extensive history of this type of trauma? If so, this might not be the best approach.
- Trauma is recreated frequently. Trauma from childhood and adolescents can be recreated in adult relationships.
- Determine if this is the right method or if other resources and stabilization needs to occur.
- History taking is more about understanding their personal experience of the event, even if you are already aware of the event that occurred.
Phase II- Preparation
- Sometimes this comes first.
- In this particular case, history taking should come first because it is helpful and not too in depth.
- Containment is an important tool for the client during this time.
- Attention to safety- be aware if the client is activated or if the trauma is continuing.
- Provide resources and tools to establish safety.
Points of Disturbance
- Identify these points
- There’s usually not just one image or point that is disturbing, but rather multiple targets within the same experience.
- We help the clients identify and process these points.
- Traumatic Episode Narrative: The client tells the entire story from the moment they woke up that day to the point they walk into the office.
- As they are telling the narrative, we turn on a continuous bilateral.
- This is different from the standard EMDR method.
- A slow tapping or something moderate… yet it needs to be continuous when they are telling their story.
- The clients let you know what points of disturbance occurred within their story.
- They don’t need to go into extreme detail, rather a title so that the therapist can record the targets.
- We accessed and desynthesize the target. It gives the therapist a list of targets that need to be desynthesized.
- The targets are multiple parts of the same event in recent trauma. Whereas history taking focus on a few targeting events that have occurred over time.
- When something recent occurred, it is stored in the brain differently than an event that occurred a long time ago.
EMD and EMDr
- Once we have a list of targets, we focus and desynthesize the first point.
- EMD doesn’t have the reprocessing piece.
- Constantly keeping the focus on the original point of disturbance.
- We don’t let it associate anywhere passed that point of disturbance
- EMDr we can let the associative memories come back, but only within the points of disturbance that occur in the whole event.
- We don’t want the clients to drift into targets that have occurred in other times of life.
- If this happens, we want to contain it, recognize it and redirect it back to the recent event.
RTEP is used to mitigate the impact of the recent traumatic event.
- We want to do this as quickly as possible.
- Down the road, we may need to let it associate and do that work, but we aren’t going to do that now.
- Let your EMDR clients know that this will feel different.
It’s normal for RTEP clients to go from a 7-8 to a 1-2
- Don’t be surprised if they don’t drop down to a 0.
- But we don’t want them to give us a false 0 for our satisfaction.
Don’t bring in the body scan until you’ve cleared all points of disturbance and have looked at the event as a whole.
- Check if there’s a disturbance at the “zoomed out” level.
- Do bilateral if there is still a point of disturbance.
- Do instillation with positive cognition.
- Do a body scan once this is clear.
- Closure of the episode as a whole
- Follow up and ask “has anything else new come up from what we have already targeted?” If so, what is it?
You want a strong closure at the end of each session
- It usually takes multiple sessions so it’s important that there is closure at the end.
- There are things that could be triggering between sessions.
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