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.
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.
For phobias, panic disorder and PTSD
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.
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.
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.
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.
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
During the intake and before and after the treatment we measure the blood pressure and heart rate to ensure that these values are correct.
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.
Steps from registration to aftercare
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
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
The steps from registration to treatment
Scientific research on Memrec
Documentary about Memrec
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 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.