3MDR treatment in an adolescent with PTSD: a case report

Abstract

Background: As Posttraumatic stress disorder (PTSD) in adolescents significantly impacts their well-being, effective treatment is of great importance. Little is known, however, about the novel, multi-modal virtual reality supported, exposure-based psychotherapeutic interventions such as 3MDR in this population. Objective: To describe the 3MDR treatment of an adolescent with PTSD who did not respond to previous exposure-based PTSD interventions. Method: A 14-year-old girl diagnosed with PTSD received six sessions of 3MDR embedded in family therapy. Result: The patient tolerated the 3MDR intervention very well. Personalized music and self-selected pictures appeared to be a good fit, contributing to enhanced engagement in and adherence to the therapy. She no longer met criteria for PTSD post-intervention, and at 18 months follow-up. Conclusion: This case report suggests that 3MDR has potential as a trauma treatment for adolescents with treatment-resistant PTSD.

Virtual realities, real recoveries: exploring the efficacy of 3MDR therapy for treatment-resistant PTSD

“…No studies have investigated the effect of 3MDR therapy for non-military veterans with TR-PTSD until recently, where Hoekstra et al (2023) conducted a case-study on a Dutch 14-year-old adolescent named Petra who was experiencing TR-PTSD in relation to a severe car-accident and mother’s drug abuse. Personally chosen music and images proved to be a suitable combination for Petra, fostering increased involvement in and commitment to the intervention and supported Petra to express and experience the emotions that were associated with the traumatic events she had been involved in ( Hoekstra et al, 2023 ). PTSD-symptom severity was assessed using CAPS-5.…”

“…Reflecting on the 3MDR treatment, she described it as overwhelming and emotionally intense because unlike in her EMDR sessions, she could not avoid or pretend like she had done in EMDR sessions. Also, in contrast to the EMDR session, she did not worry about the impression she was making on the therapist during 3MDR ( Hoekstra et al, 2023 ). This lack of concern reportedly facilitated a greater sense of openness, allowing her to let go of defenses.…”

“…In the qualitative studies presented, it emerges that 3MDR facilitated access to memories and emotions that had not yet been available. In Hoekstra et al (2023) , for example, Petra reported that her self-selected music had a very special role in enabling access to previously inaccessible emotions. In van Gelderen et al (2020b) , it was also specifically mentioned that the combination of self-selected music and images was crucial for this access.…”

“…Apart from military veterans, other target groups for the therapy could be survivors of other severe traumas leading to TR-PTSD, such as terrorist attacks and car accidents. Hoekstra et al (2023) based on the results of their case study suggest that 3MDR may be well suited for young patients with TR-PTSD, as they are used to extensive exposure to the digital world and self-selected music and images for repeated exposure may feel natural to them. It remains to further investigation to establish to which extent 3MDR could help patients with incomplete memories (amnesia) for the traumatic events they were exposed to; van Gelderen et al’s (2018) case study indicated that 3MDR enabled recalling new aspects of traumas.…”