Individual Intensive Trauma Therapy (IITT)
About This Program
Target Population: Adults (ages 18 to 80) with trauma-related disorders that do not have active substance abuse disorders
IITT is an outpatient program that is an alternative to psychiatric hospitalization for people with trauma-related disorders. All sessions are individual, conducted by one of the 3 or 4 therapists assigned to each client. The focus is on trauma processing. Clients may not live in the area and will stay at a local hotel for one to two weeks while receiving therapy. Clients are carefully screened for dissociative regression. If a person is unable to perform activities of daily living, an anti-regression regimen is provided to prepare him/her for treatment. A person is not accepted into the program until the regression has been reversed.
Each treatment day consists of morning rounds, guided imagery, art therapy, a “re-presentation”, externalized dialogue, and wrap-up. Each course of treatment is tailored to the individual within the general framework of the program’s theoretical framework and specific procedures.
The goals of Individual Intensive Trauma Therapy (IITT) are:
- Substantial reduction or elimination of intrusive, avoidant, and anxiety symptoms
- Reduction in frequency of disturbances of consciousness (depersonalization and derealization)
- Amelioration of suicidal urges, command hallucinations, and self-mutilation
- Repair of traumatic dissociation
The essential components of Individual Intensive Trauma Therapy (IITT) are:
- Many individuals with a history of multiple traumas have difficulty tolerating inpatient psychiatric programs because they are frequently triggered when hearing about others’ traumas. The IITT program provides one- and two-week programs as a substitute for hospitalization. All sessions are individual ones in a marathon format of 7 hours per day.
- Detailed intake process:
- Obtaining a thorough trauma history along with family, medical, and psychiatric history
- Screening for dissociative regression
- Using specific assessments to compare a potential client’s scores with others who have successfully completed the program [the Dissociative Experiences Scale, the Trauma Recovery Scale, and the Dissociative Regression Scale (IITT program assessment)]
- Consulting with referring therapist to determine client’s suitability for IITT
- Interviewing of the prospective client by the Clinical Coordinator via telephone or Skype (often several times) which included reviewing history and assessments, and discussing treatment recommendations
- Psychoeducation material about dissociation including showing videotape of the Instinctual Trauma Response (IITT’s theoretical model)
- Additional assessments done on site as part of our outcome studies
- Individual sessions with one of 3 or 4 rotating therapists (all trained in specific trauma processing procedures)
- Morning rounds and afternoon wrap-up sessions with entire treatment team
- “Foundation” (preverbal) traumas processed first then others are done in chronological order
- Trauma processing using the following procedures in order:
- Guided imagery sessions using the “hidden observer” so client will not re-live the traumas (Note: Some people object to guided imagery for various reasons, including religious ones. The program can be done without using guided imagery.)
- Art therapy using a “graphic narrative” of the trauma which is a series of drawings following the structure of the Instinctual Trauma Response (startle, thwarted intention of fight/flight, freeze, altered state of consciousness, body sensations, automatic obedience, and self-repair).
- “Re-presenting” of the client’s story (putting the graphic narrative on the wall and having the client watch and listen as a therapist tells the story)
- Reversing dissociation through an “externalized dialogue.”
- Identifying and mapping internal parts
- After completing the program, a person’s scores should be:
- 80 or less on the Symptom Check List (SCL-45)
- 74 or less on the Toronto Alexithymia Scale (TAS)
- 20 or less on the Dissociative Experiences Scale (DES)
- Treatment summary for hometown therapist with specific recommendations for follow-up
Individual Intensive Trauma Therapy (IITT) directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:
- Suicidal impulses or ideation; PTSD symptoms (arousal, avoidant, and intrusive symptoms) such as trauma voices, command hallucinations, recurring nightmares; dissociation, depersonalization, derealization; self-injury; impulsive behavior; and eating problems due to trauma
Services Involve Family/Support Structures:
This program involves the family or other support systems in the individual's treatment: Psychoeducational sessions about the effects of trauma on the brain and on behavior are provided for family members or friends.
30-35 hours per week of individual therapy for one or two weeks, Monday through Friday
One week or two weeks depending on trauma history and presenting symptoms; clients can return for another one or two weeks at a later date
This program is typically conducted in a(n):
- Outpatient Clinic
This program does not include a homework component.
Resources Needed to Run Program
The typical resources for implementing the program are:
A team of 3-4 Master’s-level therapists; video cameras; TV monitors for playing back parts of the therapy sessions; art materials; individual therapy rooms; and one or two larger rooms with a large bulletin board for pinning up graphic narratives
Education and Training
Prerequisite/Minimum Provider Qualifications
Social workers, licensed professional counselors, and art therapists with a Master’s degree in the specific profession, respectively
Education and Training Resources
There is a manual that describes how to implement this program , and there is training available for this program.
- Linda Gantt
phone: (304) 291-2912
Training is obtained:
At Intensive Trauma Therapy, Inc.’s location in Morgantown, WV, or onsite at the agency that is receiving the training
Number of days/hours:
Part I – 4 days of didactic and experiential sessions (total of 30 hours); Part II – 5 days of a practicum in Intensive Trauma Therapy, Inc.’s clinic during which the trainee follows one client through a week of Individual Intensive Trauma Treatment. The trainee will spend a total of 40 hours in the clinic for this part of the training.
Relevant Published, Peer-Reviewed Research
Gantt, L., & Tinnin, L. W. (2007). Intensive trauma therapy of PTSD and dissociation: An outcome study. The Arts in Psychotherapy, 34(1), 69-80.
Type of Study:
One group pretest/posttest
Number of Participants: 77
- Age — 13-69 years
- Race/Ethnicity — 76 Caucasian and 1 Other
- Gender — 77% Female
- Status — Participants were individuals with posttraumatic stress disorder (PTSD).
Location/Institution: West Virginia
Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined Individual Intensive Trauma Therapy, an intensive outpatient treatment program to treat patients with PTSD and/or dissociative disorders. The treatment methods relied heavily on art therapy, hypnosis, and video therapy. Measures utilized include the Dissociative Experiences Scale (DES), the Symptom Check List-45 (SCL-45), the Toronto Alexithymia Scale (TAS), the Impact of Events Scale (IES), and the Dissociative Regression Scale (DRS). Results indicated 45% of the participants met criteria for recovery, 44% were improved, 8% were unchanged, and 3% were worse after treatment. The improvement in scores on the posttreatment measures was robust and statistically significant for all groups of patients. There was no significant difference between the various diagnostic categories in terms of improvement or recovery. Limitations include lack of a comparison or control condition, performance bias, and selection bias.
Length of postintervention follow-up: 1 week, 3 months, and 6 months.
Gantt, L., & Tinnin, L. (2007). Intensive trauma therapy of PTSD and dissociation: An outcome study. The Arts in Psychotherapy, 34, 69-80.
Gantt, L., & Tinnin, L. (2009). Support for a neurobiological view of trauma with implications for art therapy. The Arts in Psychotherapy, 36, 148-153.
Tinnin, L., Bills, L., & Gantt, L. (2002). Short-term treatment of simple and complex PTSD. In M. B. Williams & J. Sommer (Eds.), Simple and complex post-traumatic stress disorder: Strategies for comprehensive treatment in clinical practice (pp. 99-118). New York, NY: Haworth.
Date Research Evidence Last Reviewed by CEBC: June 2015
Date Program Content Last Reviewed by Program Staff: June 2013
Date Program Originally Loaded onto CEBC: June 2013