Saturday, Oct. 29
10:45 – 11:45 (1 hr)
Meeting Room: Sheraton Hall C (Lower Concourse)
Eric Vermetten*, MD, PhD; Lisa Burback, MD; Olga Winkler, MD; Suzette Bremault-Phillips, OT, PhD; Col (ret’d)

CanMEDS Roles:

1. Medical Expert
2. Scholar
3. Professional

At the end of this session, participants will be able to: 1) Appreciate factors associated with the complexity of post-traumatic stress disorder (PTSD) and treatment resistance among military members and veterans; 2) Identify key components of multimodal, motion-assisted memory desensitization and reconsolidation (3MDR) and their significance to PTSD treatment; and 3) Describe the potential of virtual reality in the personalization of exposure-based treatment of PTSD.

Veterans with post-traumatic stress disorder (PTSD) often do not fully benefit from current evidence-based treatments. Persistent avoidance of traumatic memories and low therapy engagement are associated with reductions in treatment effectiveness and require alternative treatment approaches. In this workshop, we will introduce, demonstrate, and present evidence for an innovative treatment: multimodal motion-assisted memory desensitization and reconsolidation (3MDR). This therapy changes the context in which exposure is delivered by combining virtual reality, a dual attention task, and movement, personalizing treatment with patient-selected pictures and music. Results from two randomized controlled trials will be presented, in which veterans with treatment-resistant PTSD received 6 sessions of 3MDR followed by either 10 weeks or 16 weeks of treatment as usual. Comparisons of these groups on PTSD symptom severity, comorbid symptoms, and neuropsychological functioning, measured at baseline, posttreatment, 12-week follow up, and 16-week follow up will be shown. Results demonstrated a significant change in one-half the veterans, with treatment-resistant PTSD receiving 3MDR. We will also share new results from Canadian research studies on 3MDR. The treatment process was perceived as a breakthrough, resulting in increased treatment effects over time during longitudinal follow up. In this workshop, we will show video vignettes and demonstrate 3MDR to attendees, allowing experience-based learning about the intervention, including the virtual reality supported immersive environment, treadmill walking, dual task processing, memory reconsolidation, and meaning making. The critical role of personalized images and music will be discussed, as will the role of the clinician as therapist and coach.

References:

1. van Gelderen MJ, Nijdam MJ, Haagen JF, et al. Interactive motion-assisted exposure therapy for veterans with treatment-resistant posttraumatic stress disorder: a randomized controlled trial. Psychother Psychosom 2020;89:215–27.
2. Bisson JI, Van Deursen R, Hannigan B, et al. Randomized controlled trial of multi‐modular motion‐assisted memory desensitization and reconsolidation (3MDR) for male military veterans with treatment-resistant post-traumatic stress disorder. Acta Psychiatrica Scandinavica 2020;142:141–51.