Protocol for a systematic review of Accelerated Resolution Therapy (ART®) for the treatment of Posttraumatic Stress Disorder (PTSD) in adults
Authors: Storey David Paul , Marriott Emily Claire Shaw 
Published: October 2022

IntroductionPeople who suffer from posttraumatic stress disorder (PTSD) often experience intrusion symptoms, negative alterations in cognitions and mood, alterations in arousal and reactivity and avoidance of stimuli associated with the traumatic event. Accordingly, Accelerated Resolution Therapy (ART®) aims to reduce these symptoms. ART® is a brief type of therapy that uses techniques such as rapid eye movement, in vivo exposure, and image rescripting to recondition stressful memories (Kip et al., 2012). Currently only modest support for ART® in the treatment of PTSD has been established using the Chambless and Hollon (1998) criteria for Empirically Supported Treatments (EST). ART® has yet to be re-evaluated using the criteria for determining an EST that were proposed by Tolin et al. (2015). Furthermore, there have been no systematic reviews conducted on the use of ART® for the treatment of PTSD in adults. We aim to address this gap by providing a systematic review of the evidence for ART® in the treatment of PTSD in adults. In addition, an assessment of risk of bias on the outcomes of ART® on PTSD will be conducted. Methods and analysisThe Cochrane Handbook for Systematic Reviews of Interventions (Higgins et al., 2022) will be used to inform the methods of this review. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P; Moher et al., 2015). Search terms were developed in collaboration with a medical librarian. Five electronic peer-reviewed databases, three registers, and three organization websites will be searched. Eligible articles will be independently assessed against inclusion criteria by two reviewers (EM and DS). A quantitative synthesis of findings will be reported where three or more papers with a low risk of bias report on an outcome of interest. Where quantitative synthesis is not possible a narrative synthesis will be conducted following the synthesis without meta-analysis (SWiM) guidelines (Campbell et al., 2020). A ‘summary of findings’ table will be generated. Risk ratios and 95% CI (dichotomous outcomes) and/or effect size according to the Cohen (1992) formula (continuous outcomes) will be calculated for the primary outcome of each study (i.e., change in symptoms of PTSD or change in severity of PTSD diagnosis).Ethics and disseminationNo ethical issues are foreseen. Findings will be disseminated via journal publication and conference publication(s). Strengths and limitations of this study•The first systematic review of ART® for the treatment of PTSD in adults.•This systematic review will be guided by the Cochrane Handbook for Systematic Reviews (Higgins et al., 2022), and will adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-P) guidelines (Moher et al., 2015). •Risk of Bias will be assessed using the National Institute of Health (NIH) Study Quality Assessment Tools to evaluate potential flaws in the study methods or implementation, including sources of bias, confounding, study power, and other factors (National Institutes of Health, 2021). •If a meta-analysis is possible, this can detect small but clinically significant effects of ART® on PTSD outcomes. If a meta-analysis is not feasible a qualitative synthesis of the findings will be reported using the synthesis without meta-analysis (SWiM) guidelines (Campbell et al., 2020).