Can ART Be Used Adjunctively While a Client Stays With Their Primary Therapist?
Yes, Accelerated Resolution Therapy, or ART, can sometimes be used adjunctively while a client continues therapy with their primary therapist.
This is important.
Many clients already have a meaningful relationship with a therapist. They may be doing valuable work. They may feel attached, known, supported, and understood.
They may not want to start over.
They may not need to start over.
And their therapist may not want to refer them out in a way that feels like the client is being handed off or lost.
Adjunctive ART offers another possibility.
A client can remain with their primary therapist while doing focused ART work around a specific memory, image, trigger, grief scene, betrayal, medical trauma, or emotional response that has not shifted enough through talk therapy alone.
The goal is not to replace the existing therapy.
The goal is to support it.
What does adjunctive ART mean?
Adjunctive ART means that ART is used as a focused addition to the client’s ongoing therapy.
The client continues working with their primary therapist for the broader therapeutic relationship, emotional support, relational patterns, coping, insight, identity work, or ongoing care.
At the same time, the client may work with an ART-trained therapist for a specific target.
That target might be:
a traumatic memory,
a grief image,
a betrayal discovery,
a medical trauma,
an intrusive image,
a body-based trigger,
a panic-linked memory,
a public speaking fear,
a shame memory,
or a relationship moment that still feels emotionally charged.
The ART work is focused.
The primary therapy remains the client’s ongoing therapeutic home.
Why adjunctive ART can be reassuring for therapists
Therapists are understandably protective of their clients.
A referral can feel complicated when the client is already attached, vulnerable, or doing meaningful work.
A therapist may wonder:
Will this disrupt our relationship?
Will the client feel abandoned?
Will the ART therapist understand the larger treatment?
Will they oversell ART?
Will they try to take over the case?
Will they appreciate the work we have already done?
These are reasonable concerns.
Adjunctive ART should be collaborative in spirit, clinically thoughtful, and respectful of the existing therapy relationship.
The point is not to compete with the primary therapist.
The point is to offer focused work around something that may benefit from a different therapeutic access point.
Why clients may need something adjunctive
Sometimes weekly therapy is helping, but one particular issue remains stuck.
A client may be making real progress in many areas while still feeling activated by one target.
For example:
They understand why they freeze in conflict, but their body still shuts down.
They know the betrayal was not their fault, but they still replay the discovery.
They have grieved deeply, but one image from the loss keeps intruding.
They understand their trauma history, but one memory still feels present.
They have insight into medical anxiety, but their body panics before appointments.
They know the relationship is over, but one scene still pulls them back.
This does not mean the therapy has failed.
It may mean the client needs an additional focused intervention.
ART can address what insight alone may not shift
Many clients who seek ART are highly insightful.
They are not confused about why they feel the way they do.
They may be able to explain their attachment patterns, family dynamics, trauma responses, shame, grief, and protective strategies with great clarity.
But insight does not always change the nervous system response.
Knowing why you freeze does not always stop the freeze.
Knowing why you fawn does not always stop the fawn.
Knowing why you panic does not always stop the panic.
Knowing why you replay something does not always stop the replay.
ART may be helpful because it works with distressing memories, images, emotions, sensations, and meanings in a structured, experiential way.
That can complement the insight and relational work already happening in ongoing therapy.
Adjunctive ART may help with specific stuck points
Adjunctive ART is often most appropriate when there is a clear focus.
This does not mean the client’s life or history is simple.
It means the ART work is organized around a defined target.
Examples include:
“I cannot stop seeing the hospital room.”
“I keep replaying the moment I found out.”
“My body panics before medical appointments.”
“I know I am safe now, but that memory still feels present.”
“I freeze every time I need to confront someone.”
“I understand the loss, but one image is unbearable.”
“I can talk about it calmly, but my body still reacts.”
“I know it was not my fault, but I still feel shame.”
These are the kinds of stuck points that may respond well to focused adjunctive work, when the client is clinically appropriate for ART.
ART does not require the client to retell every detail
One reason ART may be appealing as an adjunctive therapy is that it does not require the client to retell every detail of the trauma.
This can matter for clients who:
feel ashamed,
are afraid of being overwhelmed,
have already told the story many times,
do not want to disclose every detail to another provider,
worry about being judged,
feel protective of the material,
or struggle to put the experience into words.
The ART therapist still needs enough information to assess fit, understand the focus, and guide the work responsibly.
But ART does not depend on repeated verbal narration.
For some clients, this makes trauma work feel more possible.
How adjunctive ART can support the primary therapy
When ART is helpful, the client may return to ongoing therapy with less emotional charge around a specific target.
That can open space for deeper integration.
The primary therapist may then help the client explore:
what changed,
what feels different,
what the client notices in relationships,
what boundaries become possible,
what grief now feels like,
what meaning the client makes of the experience,
how parts of the client responded,
and how to live differently after the stuck point shifts.
ART may help move the target.
Ongoing therapy may help the client live into the change.
Both roles matter.
Adjunctive ART and IFS-informed therapy
Adjunctive ART can also pair well with IFS-informed therapy.
Many clients have parts that feel differently about doing trauma work.
One part wants relief.
Another part is afraid of opening it up.
One part wants to move forward.
Another part feels loyal to the pain.
One part trusts the therapist.
Another part does not want anyone near the story.
One part wants to stop replaying the image.
Another part believes replaying it is necessary to stay safe.
IFS-informed preparation can help clients approach ART with more compassion and less internal pressure.
The goal is not to force protective parts out of the way.
The goal is to understand what they are trying to prevent and move at a pace that respects the client’s system.
Adjunctive ART for grief
Adjunctive ART may be useful when a client is grieving and also carrying traumatic images connected to the loss.
For example:
the moment they found out,
the final days,
a hospital scene,
an image of suffering,
a phone call,
a funeral memory,
guilt about a decision,
or a goodbye they did or did not get to have.
ART is not meant to erase grief.
Grief is not pathology.
But sometimes traumatic images interfere with the natural movement of grief.
Adjunctive ART may help reduce the intensity of specific images or scenes so the ongoing therapist can continue supporting the client’s grief, meaning-making, attachment, and adjustment.
Adjunctive ART for betrayal trauma
Betrayal trauma often involves intrusive replay.
The client may keep returning to:
the discovery,
the lies,
the timeline,
the confrontation,
the imagined details,
the humiliation,
the loss of trust,
or the moment everything changed.
Ongoing therapy may be essential for helping the client sort through attachment, boundaries, anger, grief, decision-making, and self-trust.
Adjunctive ART may help target the specific images or emotional responses that continue to hijack the client.
The work can be both focused and respectful of the larger therapy process.
Adjunctive ART for medical trauma
Medical trauma may show up as panic, avoidance, body mistrust, anger, hypervigilance, or fear before appointments.
Clients may have experienced:
a frightening diagnosis,
emergency care,
surgery,
medical dismissal,
invasive procedures,
hospitalization,
infertility treatment,
birth trauma,
chronic illness,
or a loss of control in a medical setting.
A client may understand intellectually that the event is over while their body still responds as if it is happening again.
Adjunctive ART may be useful when the client has a specific medical memory, image, sensation, or future fear that remains charged.
Adjunctive ART for high-functioning clients
Many clients who seek adjunctive ART are high-functioning.
They work.
They care for others.
They hold responsibility.
They appear capable.
They may not want open-ended additional therapy.
They may already have a primary therapist and a full life.
But privately, they may be carrying something that keeps taking up space.
For these clients, adjunctive ART can feel more aligned than starting over with a new weekly therapist.
It offers a focused intervention for a specific issue while preserving the care they already have.
When adjunctive ART may not be appropriate
Adjunctive ART is not right for every client.
It may not be appropriate when a client is actively unsafe, in acute crisis, significantly unstable, or needing a higher level of care.
It may also not be the right time if the client needs more stabilization, substance use treatment, psychiatric support, or ongoing weekly containment before focused trauma work.
Other clinical factors may require careful assessment, including significant dissociation, psychosis, active mania, seizure history, traumatic brain injury, or medication-related concerns.
A thoughtful ART referral should include assessment.
ART should not be treated as a universal answer.
How therapists can frame adjunctive ART to clients
Therapists can frame adjunctive ART in a way that preserves the therapeutic relationship.
For example:
“We have done important work around this, and I wonder whether a focused adjunctive ART session or intensive could help with the specific image or trigger that still feels stuck. This would not replace our work. It could support it.”
Or:
“You would continue therapy here. ART would be focused on that one memory or response that keeps getting activated.”
This kind of language helps clients understand that the referral is not a rupture.
It is an additional resource.
Does the primary therapist need to coordinate with the ART therapist?
Sometimes coordination is helpful.
Sometimes it is not necessary.
This depends on the client’s preference, consent, clinical needs, and the structure of the work.
With appropriate permission, communication may help clarify the referral focus, support continuity, and make sure the client feels held rather than split between providers.
In other cases, the client may prefer to manage the communication themselves.
Either way, the client’s consent and privacy matter.
What makes adjunctive ART work well?
Adjunctive ART tends to work best when:
the referral question is clear,
the client understands the purpose of the adjunctive work,
the primary therapist is not framed as insufficient,
the ART therapist respects the existing relationship,
the client has enough stability for focused trauma work,
the client has space for integration afterward,
and expectations are realistic.
The aim is not to promise a cure.
The aim is to offer focused support for a particular stuck point.
A referral is not a failure of therapy
Referring a client for adjunctive ART does not mean the therapy has failed.
It may mean the therapy has been thoughtful enough to recognize what the client needs.
Good therapists refer when an additional approach may help.
Good adjunctive providers respect the work that is already happening.
The client should not feel pulled between providers.
The client should feel supported by a larger clinical container.
Adjunctive ART with Laura Geftman, LCSW
I offer adjunctive ART and therapy intensives for adults who are seeking focused support around trauma, grief, anxiety, betrayal, medical trauma, emotional triggers, shame, and feeling stuck despite insight.
Clients may continue working with their primary therapist while seeing me for focused ART or therapy intensive work around a specific target.
I am licensed in Pennsylvania, New Jersey, New York, and Florida.
In-person therapy intensives are available in Ardmore, PA, on the Main Line near Philadelphia.
Virtual ART may also be available for adults located in Pennsylvania, New Jersey, New York, and Florida when clinically appropriate.
For clients in New York City, Ardmore is also reachable by train, making in-person intensive work a realistic option for some clients who want focused support outside the city.
Interested in adjunctive ART for a client?
If you are a therapist considering whether adjunctive ART or a therapy intensive could support one of your clients, you are welcome to reach out to discuss whether the fit may be clinically appropriate.
Laura Geftman, LCSW offers focused ART and therapy intensives for adults in Pennsylvania, New Jersey, New York, and Florida.
In-person intensives are available in Ardmore, PA, near Philadelphia.
Virtual ART may also be available when clinically appropriate.
Suggested Reading
If you are considering adjunctive ART for yourself or a client, these related articles may be helpful:
What Therapists Should Know About Accelerated Resolution Therapy
Therapy Intensives in Ardmore, PA for Philadelphia, Main Line, and NYC Clients
FAQ
Can ART be used adjunctively?
Yes. ART can sometimes be used adjunctively while a client continues ongoing therapy with their primary therapist. The ART work is typically focused on a specific memory, image, trigger, grief scene, betrayal, medical trauma, or emotional response.
Does adjunctive ART replace weekly therapy?
Not necessarily. For many clients, adjunctive ART is used to support ongoing therapy rather than replace it. The client may continue weekly therapy while doing focused ART work with another clinician.
Why would a therapist refer a client for adjunctive ART?
A therapist may refer for adjunctive ART when a client has insight and is doing meaningful therapy but remains stuck around a specific trauma memory, image, trigger, body response, grief scene, betrayal, or emotional reaction.
Does ART require clients to retell their trauma?
No. ART does not require clients to retell every detail of what happened. The therapist needs enough information to understand the focus and assess fit, but ART does not depend on repeated verbal narration.
What kinds of issues may be appropriate for adjunctive ART?
Adjunctive ART may be appropriate for trauma memories, grief images, betrayal trauma, medical trauma, emotional triggers, shame, panic-linked memories, public speaking fears, intrusive images, and specific stuck points when clinically appropriate.
When is adjunctive ART not appropriate?
Adjunctive ART may not be appropriate if a client is actively unsafe, in acute crisis, significantly unstable, needing a higher level of care, or requiring more stabilization before trauma processing. Clinical assessment is important before beginning ART.
Can therapists refer clients to Laura Geftman, LCSW for adjunctive ART?
Yes. Laura Geftman, LCSW offers adjunctive ART and therapy intensives for adults in Pennsylvania, New Jersey, New York, and Florida. In-person intensives are available in Ardmore, PA, near Philadelphia, and virtual ART may be available when clinically appropriate.