{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:01:15Z","timestamp":1790744475514,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Various evidence-based trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) are available and several commonalities have been identified. Yet, these trauma-focused psychotherapies also have important differences. This raises the question whether several trauma-focused methods can be combined in one treatment format. Thus far, systematic efforts to combine multiple trauma-focused treatment methods have been limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the rationale, structure, and application of a highly intensive treatment format integrating four trauma-focused psychotherapies, illustrated by two case presentations. The study was descriptive and was not designed to evaluate clinical effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Description of a structured treatment format that integrates prolonged exposure (PE), eye movement desensitization and reprocessing therapy (EMDR), brief eclectic psychotherapy for PTSD (BEPP) and narrative exposure therapy (NET) in a highly intensive dose. Sessions were performed twice a day over the course of 1 week. This format was conceptualized in the context of a documentary series on an online ongoing education platform for therapists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A combat veteran with PTSD and a survivor of long-term physical and sexual abuse with PTSD completed the 1-week program. Their treatment courses illustrate how the components of PE, EMDR therapy, BEPP, and NET can be organized and applied within a single intensive format. In non-standardized interviews conducted for the accompanying documentary, both participants described different functions and perceived contributions of the 4 treatment approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The case descriptions demonstrate that the proposed integration of four trauma-focused approaches could be applied as planned in two individual treatment trajectories of patients with severe PTSD. Patients' reflections were not collected or analyzed as formal qualitative data and cannot be used to establish treatment effectiveness, safety, or general feasibility of the treatment format. Prospective studies incorporating standardized outcome assessments, systematic adverse event monitoring, and formal qualitative evaluations are required to systematically investigate the treatment program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1932004","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:51:35Z","timestamp":1790743895000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Synergizing strengths of four trauma-focused treatments in a highly intensive integrated program for posttraumatic stress disorder: rationale and two case descriptions"],"prefix":"10.3389","volume":"17","author":[{"given":"Mirjam J.","family":"Nijdam","sequence":"first","affiliation":[{"name":"ARQ Centrum'45, ARQ National Psychotrauma Center","place":["Oegstgeest\/Diemen, Netherlands"]},{"name":"Department of Psychiatry, Amsterdam Public Health and Neuroscience, Amsterdam University Medical Centers","place":["Amsterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold P. R.","family":"Gersons","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Amsterdam Public Health and Neuroscience, Amsterdam University Medical Centers","place":["Amsterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad","family":"de Jongh","sequence":"additional","affiliation":[{"name":"Research Department, Psychotrauma Expertise Center (PSYTREC)","place":["Bilthoven, Netherlands"]},{"name":"Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University","place":["Amsterdam, Netherlands"]},{"name":"School of Psychology, Queen's University","place":["Belfast, Northern Ireland"]},{"name":"Institute of Health and Society, University of Worcester","place":["Worcester, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruud A.","family":"Jongedijk","sequence":"additional","affiliation":[{"name":"ARQ Centrum'45, ARQ National Psychotrauma Center","place":["Oegstgeest\/Diemen, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"van Minnen","sequence":"additional","affiliation":[{"name":"Research Department, Psychotrauma Expertise Center (PSYTREC)","place":["Bilthoven, Netherlands"]},{"name":"Behavioral Science Institute (BSI), Radboud University","place":["Nijmegen, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim R.","family":"Wind","sequence":"additional","affiliation":[{"name":"ARQ Centrum'45, ARQ National Psychotrauma Center","place":["Oegstgeest\/Diemen, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","unstructured":"Akwa\n              G. G. Z\n            \n          \n          Zorgstandaard Psychotrauma- En Stressorgerelateerde Stoornissen. [Clinical Guideline Psychotrauma- and Stressor-Related Disorders]\n          \n          2020"},{"key":"B2","unstructured":"APA Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults\n          \n          2025"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1774240","DOI":"10.1080\/20008198.2020.1774240","article-title":"A systematic review of factors associated with outcome of psychological treatments for post-traumatic stress disorder","volume":"11","author":"Barawi","year":"2020","journal-title":"Eur. J. Psychotraumatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1824381","DOI":"10.1080\/20008198.2020.1824381","article-title":"Prevention and treatment of PTSD: the current evidence base","volume":"12","author":"Bisson","year":"2021","journal-title":"Eur. J. Psychotraumatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s10608-018-9938-1","article-title":"A review of the role of negative cognitions about oneself, others, and the world in the treatment of PTSD","volume":"43","author":"Brown","year":"2019","journal-title":"Cogn. Ther. Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1037\/0033-295X.107.2.261","article-title":"The construction of autobiographical memories in the self-memory system","volume":"107","author":"Conway","year":"2000","journal-title":"Psychol. Rev."},{"key":"B7","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.cpr.2017.07.003","article-title":"An empirical review of potential mediators and mechanisms of prolonged exposure therapy","volume":"56","author":"Cooper","year":"2017","journal-title":"Clin. Psychol. Rev."},{"key":"B8","doi-asserted-by":"publisher","first-page":"104069","DOI":"10.1016\/j.brat.2022.104069","article-title":"Optimizing exposure therapy with an inhibitory retrieval approach and the OptEx Nexus","volume":"152","author":"Craske","year":"2022","journal-title":"Behav. Res. Ther."},{"key":"B9","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1002\/jts.23012","article-title":"State of the science: eye movement desensitization and reprocessing (EMDR) therapy","volume":"37","author":"De Jongh","year":"2024","journal-title":"J. Trauma. Stress"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/med-psych\/9780190926939.001.0001","article-title":"\u201cProlonged exposure therapy for PTSD.\u201d","author":"Foa","year":"2019","journal-title":"Emotional Processing of Traumatic Experiences - Therapist Guide, 2nd Edn"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1146\/annurev-clinpsy-021815-093533","article-title":"The efficacy of exposure therapy for anxiety-related disorders and its underlying mechanisms: the case of OCD and PTSD","volume":"12","author":"Foa","year":"2016","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-07109-1_13","article-title":"\u201cBrief eclectic psychotherapy for PTSD,\u201d","author":"Gersons","year":"2015","journal-title":"Evidence Based Treatments for Trauma-Related Psychological Disorders"},{"key":"B13","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1016\/j.brat.2008.04.006","article-title":"How eye movements affect unpleasant memories: support for a working-memory account","volume":"46","author":"G\u00fcnter","year":"2008","journal-title":"Behav. Res. Ther."},{"key":"B14","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1002\/wps.20442","article-title":"The third wave of cognitive behavioral therapy and the rise of process-based care","volume":"16","author":"Hayes","year":"2017","journal-title":"World Psychiatry"},{"key":"B15","unstructured":"PTSD Prevention and Treatment Guidelines Methodology and Recommendations.\n          \n          2019"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2171752","DOI":"10.1080\/20008066.2023.2171752","article-title":"Exposure-based treatments for childhood abuse-related post-traumatic stress disorder in adults: a health-economic evaluation","volume":"14","author":"Kullberg","year":"2023","journal-title":"Eur. J. Psychotraumatol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jbtep.2012.11.001","article-title":"A meta-analysis of the contribution of eye movements in processing emotional memories","volume":"44","author":"Lee","year":"2013","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"B18","doi-asserted-by":"publisher","first-page":"102720","DOI":"10.1016\/j.cpr.2026.102720","article-title":"The role of dosage and intensity in trauma-focused treatments for posttraumatic stress disorder: a meta-analysis","volume":"125","author":"Leithner","year":"2026","journal-title":"Clin. Psychol. Rev."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1729633","DOI":"10.1080\/20008198.2020.1729633","article-title":"Psychological therapies for post-traumatic stress disorder in adults: systematic review and meta-analysis","volume":"11","author":"Lewis","year":"2020","journal-title":"Eur. J. Psychotraumatol."},{"key":"B20","unstructured":"Post-Traumatic Stress Disorder (NICE Guideline NG116)\n          \n          2018"},{"key":"B21","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/jts.21771","article-title":"Hotspots in trauma memories and their relationship to successful trauma-focused psychotherapy: a pilot study","volume":"26","author":"Nijdam","year":"2013","journal-title":"J. Trauma. Stress"},{"key":"B22","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/acps.13520","article-title":"Towards staging differentiation for posttraumatic stress disorder treatment","volume":"147","author":"Nijdam","year":"2023","journal-title":"Acta Psychiatr. Scand."},{"key":"B23","volume-title":"Narrative Exposure Therapy: A Short-Term Treatment for Traumatic Stress Disorders","author":"Schauer","year":"2011"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2818","DOI":"10.3402\/ejpt.v6.28186","article-title":"Psychotherapies for PTSD: what do they have in common?","volume":"6","author":"Schnyder","year":"2015","journal-title":"Eur. J. Psychotraumatol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1002\/jts.22556","article-title":"A systematic review of intensive empirically supported treatments for posttraumatic stress disorder","volume":"33","author":"Sciarrino","year":"2020","journal-title":"J. Trauma. Stress"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/9899034","article-title":"Prevalence and predictors of nonresponse to psychological treatment for PTSD: a meta-analysis","author":"Semmlinger","year":"2024","journal-title":"Depress. Anxiety"},{"key":"B27","volume-title":"Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedure, 3rd Edn","author":"Shapiro","year":"2018"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1516144","DOI":"10.3389\/fpsyg.2025.1516144","article-title":"Feasibility and preliminary effectiveness of a highly intensive inpatient treatment programme with narrative exposure therapy for patients with posttraumatic stress disorder","volume":"16","author":"Strijk","year":"2025","journal-title":"Front. Psychol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1492836","DOI":"10.1080\/20008198.2018.1492836","article-title":"Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder","volume":"9","author":"Van Minnen","year":"2018","journal-title":"Eur. J. Psychotraumatol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"113032","DOI":"10.1016\/j.psychres.2020.113032","article-title":"Sequence matters: combining prolonged exposure and EMDR therapy for PTSD","volume":"290","author":"Van Minnen","year":"2020","journal-title":"Psychiatry Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1783955","DOI":"10.1080\/20008198.2020.1783955","article-title":"Trauma-focused treatment outcome for complex PTSD patients: results of an intensive treatment programme","volume":"11","author":"Voorendonk","year":"2020","journal-title":"Eur. J. Psychotraumatol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1037\/tra0001747","article-title":"Response of patients with complex forms of PTSD to highly intensive trauma treatment: a clinical cohort study","volume":"17","author":"Zepeda M\u00e9ndez","year":"2025","journal-title":"Psychol. Trauma"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1932004\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:51:53Z","timestamp":1790743913000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1932004\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":32,"alternative-id":["10.3389\/fpsyg.2026.1932004"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1932004","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"1932004"}}