The Reconsolidation of Traumatic Memories Protocol's adjustments to the remote treatment of injured Ukrainian military personnel in hospital settings.

Due to the Russian invasion of Ukraine and the intense battlefield combat, many Ukrainian defenders have severe gunshot and explosion injuries, which result in broken bones, spinal damage, limb loss, and more. This physically and emotionally intensive experience often leads to acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD). During post-surgical recovery, injured military personnel need trauma-centred psychotherapy, which is often unavailable because of the hospital's setting limitations. The article aims to present adjustments of the Reconsolidation of Traumatic Memories (RTM) (US Patent Pending Number US-2024-0148297-A1) Protocol, a structured non-pharmaceutical neuro-based treatment that targets traumatic memory, to the remote treatment of injured Ukrainian military personnel in hospital settings. This clinical practice paper presents two cases of online administration of the RTM Protocol in hospital settings to demonstrate the main adjustments made for remote work with physically injured military personnel. The patients were referred to receive online RTM Protocol treatment by a surgeon due to the psychiatrist-assigned ASD diagnosis, presenting in repetitive flashbacks and sleep disturbances interfering with the post-surgical recovery. Initial and post-treatment screenings using the PCL-5 showed a significant drop in scores: from 36 to 12 points for the first case and from 41 to 7 points for the second case. The patients reported improvements in their mood and sleep, as well as the disappearance of flashbacks. The main adjustments involved on-site adaptations (using the procedure room, utilising nurse assistance, ensuring a stable Internet connection) and modifications to the procedure (conducting shorter sessions, up to 45 min), delegating some Protocol administration steps to patients, and using military jargon and commands. The online administration of the RTM Protocol shows promise for treating combat-related ASD in hospital settings, providing a structured intervention for recovering military personnel, and ensuring accessibility and effectiveness in resource-limited settings.