Information about Kindt Clinics and the Memrec method, for referrers

As a healthcare provider, you will find information about the Memrec method and referral to Kindt Clinics on this page.

Memrec is a short and effective treatment method for phobias and certain forms of panic disorder and PTSD. The method was developed in scientific research by Prof. Dr. Merel Kindt and colleagues at home and abroad. Memrec has been used in practice at Kindt Clinics since 2018. In addition to her ongoing research at the UvA, Merel Kindt is closely involved with Kindt Clinics.

At Kindt Clinics we treat in the basic mental healthcare. We work uncontracted and we have no waiting list.

Refer

Referral to Kindt Clinics can be done in the following ways:

At the intersection of clinical psychology and neuroscience

Memrec consists of a short exposure and the single use of a beta blocker (40 mg propranolol). This means that the treatment is on the cutting edge of clinical psychology and neuroscience. In contrast to the traditional use of medication, which is aimed at reducing anxiety, Memrec's beta-blocker is only taken once after a short confrontation with the fear.

Psychologists work at Kindt Clinics. Because of the medication, a general practitioner is also involved with Kindt Clinics. She provides medical screening before treatment and prescribes the propranolol.

The combination of exposure and a pill characterizes the Memrec method
In which cases is Memrec a suitable treatment method?

For phobias, panic disorder and PTSD

Memrec is suitable for phobias, panic disorder and PTSD. For each of these anxiety disorders, the method has several conditions for a successful treatment.

Phobias

Memrec is suitable for almost all specific phobias. The condition is that we can actually briefly confront someone with his or her fear. This means that we cannot treat more general fears such as separation anxiety, performance anxiety or the fear of becoming ill. The method is effective for phobias of an animal, injection phobia, claustrophobia, fear of heights, and fear of driving.

To the general page about phobias >>

Panic disorder

It must also be possible to evoke fear in a panic disorder. In most cases this means that we must be able to induce a panic attack during treatment. The panic attack should peak within a few minutes and then diminish. Memrec is only suitable if the panic attacks occur in specific situations. If panic plays a role continuously, Memrec is not suitable as a method.

To the general page about panic >>

NB The UvA is investigating the application of Memrec to broader panic complaints. The research group of Prof. Merel Kindt (PsyPoli) is regularly looking for research participants who want to undergo the treatment.

To the website of PsyPoli >>

PTSD

In PTSD, the emotion is evoked through imaginary exposure. We must be able to fully activate the emotional memory associated with the traumatic experience during the treatment session. This means that Memrec is only suitable for PTSD as a result of one or a few incidents. Memrec is only suitable if the client has vivid memories of the traumatic event. Finally, the client must be willing and able to allow the emotion during the treatment.

To the general page about PTSD >>

Medical screening

In addition to the suitability of the complaint, it is also important that there are no contraindications for the use of a single dose of propranolol (40mg).

Prior to the intake, we therefore perform a medical screening, consisting of a questionnaire and a confirmation from our own GP that there are no contraindications. For this confirmation we use a standard form that also serves as a referral letter.

The main contraindications

  • Age: only suitable for adults (18+)
  • Cardiovascular problems
  • Lung disorders
  • Use of medication contraindicative to propranolol
  • Low blood pressure and / or heart rate
  • Allergy to propranolol
  • Pregnancy

During the intake and before and after the treatment we measure the blood pressure and heart rate to ensure that these values ​​are correct.

Results

The treatment at Kindt Clinics is successful in 9 out of 10 clients. Successful treatment provides freedom. In retrospect, the obstacles often turn out to have been even greater than clients realized beforehand.

Usually one treatment session is sufficient. Sometimes it is not possible to evoke the fear properly the first time. In that case, we will check whether it is possible to do this in another way. A second or even a third attempt is not often necessary, but always possible.

We only start a treatment if we are confident that the method can work for the client. We make use of our own practical experience and the advancing insights from the scientific research of Prof. Dr. Kindt at the UvA. Thanks to an extensive intake and preparation, we maximize the chance of success.

Of the 57 people who completed our evaluation form in 2019, 100% would recommend us

83%

treatments succeeded in one go

34

different fears

90%

treatments succeeded once or twice

7

days waiting list

Steps from registration to aftercare

Step 1 Registration

The referrer or client can contact us for more information. This can be done via email, phone of whatsapp. After that, or instead, the client can choose our self test fill in to determine if the treatment is appropriate.

Step 2 Referral and insurance

If the treatment seems suitable, the client will need a referral letter from the GP. We have one for this standard form, on which the GP can immediately indicate whether there are any contraindications to the use of propranolol.

The treatment falls within the basic package care. Kindt Clinics has no contracts with health insurers, so in some cases clients pay a percentage themselves. We therefore advise clients to contact their insurer in advance about the exact one compensation.

Step 3 Intake

The intake with one of our psychologists takes about an hour. The conversation can be via Skype or with us in Amsterdam. The waiting time for an intake is usually 1 to 2 weeks.

Step 4 Treatment session

Treatment usually takes place in the clinic. For fears that we cannot evoke in the clinic, we have fixed addresses in and around Amsterdam. Including the rest period after taking the pill, the treatment lasts approximately 3 hours.

Step 5 Test session

One or a few days after the treatment is the test session to determine whether the treatment has been successful. We take the time to let the client experience that the fear is gone. If possible, we also test whether the effect generalizes to comparable situations (for example, other species of a particular animal, or other types of heights in the case of vertigo).

Step 6 Aftercare

Although the treatment is officially completed after the test session, we like to stay in touch with clients. We encourage clients to practice occasionally in the period after the treatment, in other words: to look up situations that they previously avoided. This helps to gain confidence that the fear is staying away.

More about the Memrec method

Simply put, a Memrec treatment consists of a short exposure and then a single pill (a beta blocker). The execution is tight: without the correct exposure, the beta-blocker has no effect on the anxiety, and without the beta-blocker, the short exposure usually has no effect either.

Exposure: open up the memory trail

During the exposure, the client is actually confronted with his or her fear. However, just experiencing the intense fear is not enough. The client should go a step further than he or she normally would. Because only when there is something new to learn, the relevant memory trail will be open to change. This is necessary to adjust the memory track.

The pill prevents the fear from being stored

When the practitioner estimates that the client has allowed the fear enough to open the memory trail, the exposure stops and the client takes the beta blocker. The pill has a temporary heart rate and blood pressure lowering and is therefore often used as a temporary anxiety inhibitor, but this is not relevant for the treatment. Propranolol temporarily blocks a neurotransmitter in the brain, norepinephrine, that would normally cause the newly activated fear memory to be rewritten in the brain. Because this storage process is disrupted, this fear memory is no longer stored in its old form. The result is that the memory trace becomes weakened or even disappears completely.

A strange sensation

The effect of the treatment is only noticeable after a night's sleep. Only then will the brain have processed the new information and the memory track has changed. To experience the effect of the treatment, the client returns the next day, or a few days later, for a testing session. In 8 out of 10 cases, the treatment was successful in one go. The client immediately notices that the intense fear does not occur. It is often a strange sensation that they can still clearly remember their fear or trauma, but now react much less anxiously.

Because the change is so abrupt, it sometimes takes a while for someone to get used to the new situation. To gain more confidence in the new behavior, we encourage our clients to practice after the treatment.

We try to open the memory trail to change through exposure. The propranolol then ensures that the unrealistic fear is no longer written into the long-term memory

Also view these pages for clients

Treatment process

The steps from registration to treatment

Operation

What exactly is happening in the brain?

Research

Scientific research on Memrec

Documentary about Memrec

In 2018 American documentary maker Lana Wilson made a documentary about Prof. Dr. Merel Kindt and the Memrec method. She has filmed various treatments. Thanks to producer Topic, the documentary can be viewed online for free. The documentary consists of 4 parts of about XNUMX minutes each.

Part 1: A little closer

Part 2: Nightmare in Kabul

Part 3: You did your very best

Part 4: Self-treatment

Contact us or take the self-test to determine if Memrec is suitable

Is Memrec suitable?

Do you have a patient who is curious whether the Memrec method is suitable for his or her complaints? Please feel free to contact us to submit the situation to us.

Do you or your patient want to know whether Memrec is medically suitable? Then the online self-test is the fastest route. In the self-test, the patient can also leave his or her details so that we can contact you.