Vermetten Eric, Burback Lisa, Sevigny Phillip R, Nijdam Mirjam J, Winkler Olga, Espejo Emmanuel, Sessoms Pinata, Bright Katherine, Roy Michael J, Brémault-Phillip Suzette
Department of Psychiatry, University Medical Center, Utrecht, The Netherlands.
Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Alberta, Canada.
Psychiatry Clin Psychopharmacol. 2025 Aug 11;35(Suppl 1):S122-S134. doi: 10.5152/pcp.2025.241028.
Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR) is an innovative exposure-based immersive psychotherapeutic intervention for the treatment of post-traumatic conditions such as post-traumatic stress disorder (PTSD) and other related trauma disorders. This manual reviews the theoretical foundations, protocol, and key therapeutic processes of 3MDR, emphasizing its applicability across clinical and research settings. Developed to overcome barriers to traditional trauma-focused psychotherapies, 3MDR combines immersive virtual reality (VR), motion-assisted engagement, and personalized trauma cues to facilitate memory processing and emotional reconsolidation. The 3MDR integrates VR technology, treadmill-assisted movement, and dual-attention tasks to create a dynamic and interactive therapeutic environment. The intervention consists of 3 phases: pre-platform preparation, platform exposure, and post-platform reconsolidation, allowing for structured and progressive trauma processing. Patients engage with self-selected trauma-related images and music, guided by a therapist, to confront distressing memories, reduce avoidance, and foster emotional regulation. The dual-attention task and affect labeling enhance cognitive and emotional integration, while walking promotes a sense of agency and movement through trauma. Clinical research demonstrates 3MDR's efficacy in reducing PTSD symptoms, depression, and anxiety, with high acceptability and low dropout rates among military personnel, veterans, and first responders. Emerging evidence suggests its adaptability for diverse populations, including civilians and individuals with complex trauma histories. This manual provides detailed guidance for implementing 3MDR, underscoring the importance of therapist training, ethical considerations, and continued research to optimize its application and expand access to this promising intervention. This manual should be seen as a companion and not a replacement for training.
多模态运动辅助记忆脱敏与再巩固疗法（3MDR）是一种创新的基于暴露的沉浸式心理治疗干预方法，用于治疗创伤后应激障碍（PTSD）等创伤后疾病以及其他相关创伤障碍。本手册回顾了3MDR的理论基础、方案和关键治疗过程，强调了其在临床和研究环境中的适用性。为克服传统创伤聚焦心理治疗的障碍而开发，3MDR结合了沉浸式虚拟现实（VR）、运动辅助参与和个性化创伤线索，以促进记忆处理和情绪再巩固。3MDR整合了VR技术、跑步机辅助运动和双重注意力任务，以创建一个动态且互动的治疗环境。该干预包括三个阶段：平台前准备、平台暴露和平台后再巩固，允许进行结构化和渐进性的创伤处理。患者在治疗师的指导下，与自我选择的与创伤相关的图像和音乐互动，以面对痛苦的记忆，减少回避行为，并促进情绪调节。双重注意力任务和情感标签增强了认知和情绪整合，而行走则促进了通过创伤的能动感和运动感。临床研究表明，3MDR在减轻PTSD症状、抑郁和焦虑方面具有疗效，在军人、退伍军人和急救人员中具有较高的可接受性和较低的退出率。新出现的证据表明，它适用于包括平民和有复杂创伤史的个人在内的不同人群。本手册为实施3MDR提供了详细指导，强调了治疗师培训、伦理考量以及持续研究的重要性，以优化其应用并扩大对这一有前景的干预措施的获取。本手册应被视为培训的辅助资料，而非替代品。
