About Intensives

What are Intensives?

Intensives are a time you set aside from regular life.


A time to do deep work.


A safe space for getting past barriers that have been stopping you from having the life you want.


Intensive Sessions are a self-care wellness retreat!

 

Intensives are not weekly recurring therapy sessions...they're an alternative to traditional 50-minute sessions. The 50-minute "therapy hour" evolved out of the managed care system, and there is no research to support that this session length is optimal or even effective. Historically, psychoanalysts met with patients for hours-long sessions, often several times a week, but Intensives are so much more than Freud's version of therapy! They are far more directive and interactive, with a goal of true healing rather than simply expressing thoughts and emotions or learning coping skills.

  • Extended or adjunct therapy (2 hours): Longer sessions over time in conjunction with working with your own therapist
  • Mini-Intensive - (2 hours) Do some deep work and will likely need several sessions over time
  • Single Issue Intensive – Half-day (3.5 hours) to One-Day (7 hours): When working with single traumatic event or resolving a life issue or stuck place
  • Theme Changing Intensives – Two to three days (14-21 hours): Process multiple traumatic incidents, attachment wounds, and lifelong negative beliefs

In the many years that I've been providing EMDR Therapy and other trauma-informed treatment, I've struggled with the frustration (both my client's and my own) of the limits of the 50-minute therapy session. It's just enough time to "rip off the Band-Aid" and get to some real work, and then it's time to close up and end the session.The momentum is lost. There's no resolution. We start again next time, only to do the same thing.

Intensive sessions eliminate this constant reopening of the wound, because we're able to get to the core of the issue and heal and resolve it without stopping for artificial time limits. In Intensive Sessions, we don't spend time catching up on what happened in the past week...we pick a focus / theme / target and we work on it until the charge is gone from it and you're able to integrate it however it needs to be integrated. That is true healing.

Intensive Sessions are specialized psychotherapy, using longer session lengths and focusing on:  specific events or experiences, larger issues like chronic abuse, or long-term beliefs about yourself. Longer session lengths allow enough time and space to find resolution in a single setting, instead of chipping away at a problem gradually over the course of weeks and months. It's a bit like getting into the deep end of the pool instead of dabbling your toes in the water.

There is no long-term commitment with Intensives. They are scheduled for a half day, a full day, or up to three days, depending on your themes, issues, and goals. You may only need one Intensive Session, or you may decide to schedule another at a future date.

Why Choose Intensives Over Regular Therapy?

Very often, clients are able to resolve issues and barriers in one Intensive Session. This is because we can "go deep" and stay there until we get to the other side, rather than starting and stopping many times. Less time is spent opening and closing sessions, so there is more time to do the actual work. The results of an Intensive Session can equal weeks or months of weekly therapy. This means time and money savings, faster increases in life satisfaction, and faster elimination of suffering. You also aren't left with managing anxiety on your own that may get triggered between weekly sessions, because we work through the root cause of the anxiety in the Intensive.

Are Intensives right for me?

Example situations for using Intensives Treatment:

Single Incident or Experience Intensives -
1/2 to 1 Day

Childhood, Past, and Chronic
Trauma Intensives - 1 to 2 Days

Stuck Themes/Issues Intensives - 1 to 2 Days

First Responder / Medical Worker /
Helper & Compassion Fatigue Intensives
1/2 to 3 Days

Theme-Changing Intensives - 2 to 3 Days

These are only a few examples of the many themes, issues, and beliefs that can be worked through and healed using Intensives...
See more Possible Targets for Intensive Sessions below.

Intensives can also focus on negative thoughts, aka Negative Cognitions. If you don't know why you think or feel this way, but you do, then an Intensive can help you understand and change the negative beliefs about yourself.

 

What to expect before, during, and after an Intensive?

Before the Intensive

To make sure you get the best experience possible during your Intensive Session, we do some prep work before hand. The process starts with contacting me to set up a free 20-minute consultation where you can ask questions and decide if Intensives are a fit for you. From there, we schedule a 50-minute Intake Session. During the Intake we get clarity on your goals for the Intensive, and we also make sure you're set for all of the technology issues that might happen in an online Intensive. We choose an Intensive Session length and schedule it!

Between the free consultation and the Intake Session, I'll send you some forms and assessments to fill out. This will help with the Intake Session. All forms and assessments are located in my secure client portal.

During the Intensive

All Intensives have some common beginning and ending elements, including breaks as need throughout the session. There are also some different elements, depending on the length of session and the goals you want to work on.

Intensives Session Daily Plan

All Intensives start with:

  • Welcome / Any "paperwork" not yet completed / Housekeeping & Orientation

  • Desensitize anxiety/fears about the Intensive if needed

  • Grounding and Centering

  • History taking as needed

Half-Day Intensive (3.5 hours)

One Day Intensive or Day 1 of Multiple Days (7 hours)

Day 2 and/or 3 Intesive (7 hours each)

EMDR Therapy or Brainspotting

  • Finalize the treatment plan we started in the Intake Session

  • EMDR Resourcing - create tools for managing any anxiety

  • Attachment repair work as needed

  • Parts work education as needed

  • Begin working treatment plan with EMDR Therapy or Brainspotting

  • Adjust treatment plan as needed

  • Continue working treatment plan with EMDR Therapy or Brainspotting

  • Learn Trauma Releasing Exercises (TRE)

All Intensives end with:

  • Future Template - imagining yourself and your life now that problems are resolved

  • Grounding and Centering

  • Aftercare plan

After the Intensive

At the end of your Intensive Session, we'll have some time to create your Aftercare Plan. This includes things like:

  • Identify main focus points and themes we worked on and main take-aways.
  • Identify the main focus points, major themes, and take-aways from the session. These include insights, decisions, memories, and conclusions.
  • Collaborate on any suggestions about work that might still be needed.
  • Discussion of what to expect over the next several days as everything settles into new places, like that you may be more tired than normal. Dreams and sleep may be affected. It's a perfect time to take really good care of yourself!
  • Reinforce recommendations:  Be gentle with self. Journal. Talk to friends and loved ones. Allow this all to process.
  • Decide what you'd like me to communicate to your regular therapist if you have one. I can prepare a short report that includes the major themes, if that will be helpful.
  • Talk about the possibility of checkins or touchup sessions with me, if you are interested in those.
  • Complete any Release of Information forms if necessary.

Post-Intensive Assessments

See the assessments section for more information about post-Intensive measurements that help identify changes and gains from the session.

How will I know if the Intensive made a difference?

Assessments and Measurements

Assessments and Measuring Success

There are several ways of measuring change and success after an Intensive. Most clients notice immediate changes, during the Intensive. Changes like:

  • Feeling more calm
  • Almost forgetting what they were upset about
  • Pleasant visions of the future

In addition to subjective measures, we use some objective assessment tools before and after the Intensive. This helps us have some tangible ways of knowing what has changed. The assessments vary depending on the issues you want to work on. We'll decide this during the Intake Session. Here are some examples of things we may measure with assessment tools:

  • Depression
  • Anxiety
  • PTSD symptoms (hypervigilance, flashbacks)
  • Sleep problems
  • Childhood trauma
  • Dissociation
  • Life satisfaction

Do Intensive Sessions Really Work?

Supporting Research

Intensive Sessions have been used in psychotherapy for more than 100 years...Sigmund Freud and his contemporaries met with patients for hours at a time, often several times a week.   Image by Welcome to All ! ツ from Pixabay

Yet, empirical research about EMDR Intensives is in its infancy. As with most psychotherapies, there isn't an easy answer to the question "Does it work?" Several of the "evidence-based" therapies neglect to mention the large drop-out rates for those types of therapy, which often involve prolonged exposure to pain and trauma, or only address symptom relief without resolving the core problem. Therapies often touted as "gold standard" based on research don't work for as much as 50% of the population. They also tend to overlook or bypass the needs of people of color, people from countries outside the US, and women in general.

As a therapist, I certainly see people making significant changes and experiencing wonderful healing through Intensive work. When we pull together the research we do have, there's quite a bit of support for using EMDR Therapy in extended sessions to address specific experiences or life themes. And need for much more research!

Here is a list of studies, books, and reports on EMDR Intensives and related issues, including:

  • Intensive/massed therapy sessions vs. traditional weekly therapy sessions
  • Dropout rates for traditional trauma therapies
  • Use of EMDR Therapy in intensive sessions
  • Efficacy of using EMDR Therapy in online sessions

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  • Bongaerts, H., Voorendonk, E. M., van Minnen, A., & de Jongh, A. (2021). Safety and effectiveness of intensive treatment for complex PTSD delivered via home-based telehealth. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2020.1860346/SUPPL_FILE/ZEPT_A_1860346_SM0895.DOC
  • Bongaerts, H., Voorendonk, E. M., Van Minnen, A., Rozendaal, L., Telkamp, B. S. D., & de Jongh, A. (2022). Fully remote intensive trauma-focused treatment for PTSD and complex PTSD. European Journal of Psychotraumatology, 13(2). https://doi.org/10.1080/20008066.2022.2103287
  • Brynhildsvoll Auren, T. J., Gjerde Jensen, A., Rendum Klæth, J., Maksic, E., & Solem, S. (2021). Intensive outpatient treatment for PTSD: A pilot feasibility study combining prolonged exposure therapy, EMDR, physical activity, and psychoeducation. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2021.1917878
  • Carlson, J. G., Chemtob, C. M., Rusnak, K., Hedlund, N. L., & Muraoka, M. Y. (1998). Eye movement desensitization and reprocessing (EDMR) treatment for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 11(1), 3–24. https://doi.org/10.1023/A:1024448814268
  • Daniel Estrada, B., de Jesús Angulo, B., Elena Navarro, M., Jarero, I., & Sánchez-Armass, O. (2019). PTSD, immunoglobulins, and cortisol changes after the provision of the EMDR - PRECI to female patients with cancer-related PTSD diagnosis. American Journal of Applied Psychology, 8(3), 64. https://doi.org/10.11648/J.AJAP.20190803.12
  • de Jongh, A., Amann, B. L., Hofmann, A., Farrell, D., & Lee, C. W. (2019). The status of EMDR therapy in the treatment of posttraumatic stress disorder 30 years after its introduction. Journal of EMDR Practice and Research, 13(4), 261–269. https://doi.org/10.1891/1933-3196.13.4.261
  • De Jongh, A., Resick, P. A., Zoellner, L. A., Van Minnen, A., Lee, C. W., Monson, C. M., Foa, E. B., Wheeler, K., Broeke, E. Ten, Feeny, N., Rauch, S. A. M., Chard, K. M., Mueser, K. T., Sloan, D. M., Van Der Gaag, M., Rothbaum, B. O., Neuner, F., De Roos, C., Hehenkamp, L. M. J., … Bicanic, I. A. E. (2016). Critical analysis of the current treatment guidelines for complex PTSD in adults. Depression and Anxiety, 33(5), 359–369. https://doi.org/10.1002/DA.22469
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  • Greenwald, R., & Camden, A. A. (2022). A pragmatic randomized comparison of intensive EMDR and intensive PC for victims of crime. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/TRA0001176
  • Heinig, I., Knappe, S., Hoyer, J., Wittchen, H. U., Richter, J., Arolt, V., Deckert, J., Domschke, K., Hamm, A., Kircher, T., Lueken, U., Margraf, J., Neudeck, P., Rief, W., Straube, B., Ströhle, A., Pauli, P., & Pittig, A. (2022). Effective—and tolerable: Acceptance and side effects of intensified exposure for anxiety disorders. Behavior Therapy. https://doi.org/10.1016/J.BETH.2022.11.001
  • Hoppen, T. H., Kip, A., & Morina, N. (2023). Are psychological interventions for adult PTSD more efficacious and acceptable when treatment is delivered in higher frequency? A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 95, 102684. https://doi.org/10.1016/J.JANXDIS.2023.102684
  • Hurley, E. C. (2018). Effective treatment of veterans with PTSD: Comparison between intensive daily and weekly EMDR approaches. Frontiers in Psychology, 9(AUG), 1458. https://doi.org/10.3389/FPSYG.2018.01458/BIBTEX
  • Hurley, E. C. (2020). A clinician’s guide for treating active military and veteran populations. Springer Publishing Company.
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  • Kolthof, K. A., Voorendonk, E. M., Van Minnen, A., & De Jongh, A. (2022). Effects of intensive trauma-focused treatment of individuals with both post-traumatic stress disorder and borderline personality disorder. European Journal of Psychotraumatology, 13(2). https://doi.org/10.1080/20008066.2022.2143076
  • Ooms-Evers, M., van der Graaf-Loman, S., van Duijvenbode, N., Mevissen, L., & Didden, R. (2021). Intensive clinical trauma treatment for children and adolescents with mild intellectual disability or borderline intellectual functioning: A pilot study. Research in Developmental Disabilities, 117. https://doi.org/10.1016/j.ridd.2021.104030
  • Peterson, A. L., Blount, T. H., Foa, E. B., Brown, L. A., McLean, C. P., Mintz, J., Schobitz, R. P., Debeer, B. R., Mignogna, J., Fina, B. A., Evans, W. R., Synett, S., Hall-Clark, B. N., Rentz, T. O., Schrader, C., Yarvis, J. S., Dondanville, K. A., Hansen, H., Jacoby, V. M., … Keane, T. M. (2023). Massed vs intensive outpatient prolonged exposure for combat-related posttraumatic stress disorder: A randomized clinical trial. JAMA Network Open, 6(1), E2249422. https://doi.org/10.1001/jamanetworkopen.2022.49422
  • Sciarrino, N. A., & Myers, U. S. (2023). If it’s offered, will they come? Practical considerations when offering intensive PTSD treatment in an outpatient Veterans Affairs PTSD clinic. Bulletin of the Menninger Clinic, 87(1), 46–62. https://doi.org/10.1521/BUMC.2023.87.1.46
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