R-TEP FAQs

Cheerful Heart Mental Health Counseling PLLC | www.cheerfulheartmhcpllc.com

What is R-TEP? A Specialized EMDR for Medical Trauma Protocol

R-TEP stands for Recent Traumatic Episode Protocol. Elan Shapiro and Brurit Laub developed this advanced application of EMDR for medical trauma. They are the same researchers behind GTEP and GREP2. This protocol specifically supports people who recently experienced a traumatic or deeply distressing event, usually within the last few weeks or months.

Most trauma protocols target memories that have had time to consolidate, meaning experiences that happened in the distant past that the nervous system already fixed in place. R-TEP is different. We created it for the immediate aftermath of a difficult event. During this raw window, the nervous system has not yet settled. In that window, the right kind of support can make an enormous difference in how your brain integrates the experience, or how stuck it becomes.

For women with endometriosis, that window might look like the days or weeks after an emergency room visit, a difficult diagnosis, a surgical complication, or a frustrating appointment with a provider who dismissed your pain again.

How is R-TEP different from GTEP and GREP2?

All three EMDR-based protocols offer group or structured individual options. However, they each serve a different moment in the healing process.

GREP2 focuses purely on resources and does not process trauma at all. t builds internal stability, calm, and resilience. This forward-facing work equips you for whatever comes next. GTEP, on the other hand, processes traumatic memories that have had time to consolidate. It targets experiences from weeks, months, or years ago that still carry an emotional charge. Finally, R-TEP targets recent events. If the distressing event happened within approximately the last one to three months and still actively affects you, R-TEP is the exact protocol built for that window.

In plain terms: GREP2 builds you up, R-TEP helps with what just happened, and GTEP works with what has been sitting with you for a while. Many women move through more than one of these protocols depending on what they need at different points in their journey.

How can R-TEP help me as a patient with endometriosis?

Endometriosis care often involves experiences that land hard and fast. You might face a sudden ER visit during a severe flare, or a laparoscopy that reveals more disease than anyone expected. Perhaps a provider says something so dismissive it leaves you questioning your own experience, or you receive a diagnosis without any real support or follow-up

Without a proper outlet, your body stores these experiences in ways that could leave your nervous system reactive. You might notice intrusive thoughts about what happened, avoidance of anything connected to the event, heightened reactivity, difficulty sleeping, or a sense of being stuck in what you felt in that moment.

This specialized framework of EMDR for medical trauma can help you by:

• Reducing the acute distress connected to a recent traumatic medical experience.

• Interrupting the way traumatic material consolidates in the nervous system before it becomes a more fixed, chronic pattern.

• Helping your system move toward integration and resolution while the event is still fresh.

• Providing structured support in the days or weeks after something difficult, rather than waiting until symptoms become more entrenched.

• Giving you tools to regulate your nervous system in the aftermath of a traumatic experience.

• Connecting you with others who are also navigating recent medical trauma, so you are not sitting with it alone.

What happens in an R-TEP session?

You can use R-TEP individually or join a structured group format. In a group setting, facilitators keep sessions small and carefully pace them to maintain safety. Sessions typically run 90 minutes to 2 hours.

First, your facilitator establishes grounding resources to ensure you have tools to self-regulate if the process becomes activating. Next, you privately identify the distressing experience you want to work with (you do not have to share the content of this with the group). The protocol then guides you through a structured process of working with the recent event, using bilateral stimulation to help your nervous system move through the material rather than staying stuck in it. Finally, sessions end with grounding, stabilization, and a forward-facing exercise to support your ability to navigate similar situations in the future.

The R-TEP process offers more structure than open-ended trauma processing. The protocol intentionally manages the pace so that it does not overwhelm you. Your facilitator monitors this closely and adjusts as needed.

Do I have to describe what happened?

You do not share the details of your experience with the group. You process everything internally. Your facilitator guides you through structured prompts and bilateral stimulation sets. Meanwhile, you work with your own material privately throughout.

Your facilitator may ask you to notice certain things internally, like what you feel in your body, what comes up when you think about the event, or what feels most distressing. However, these are internal cues, not disclosures. The group setting provides nervous system co-regulation and a sense of not being alone in the process, without requiring anyone to narrate their trauma to others.

How Soon Can I Start EMDR for Medical Trauma with R-TEP?

R-TEP targets the period after the acute crisis phase passes. This means you are out of immediate danger and have baseline capacity to engage in a structured process. In practice, this often means anywhere from a few days to a few months after the event.

If you are still in the middle of a medical crisis, GREP2 offers the most appropriate initial support through stabilization and resource-building. Once you have some ground under you, R-TEP can help you process what you went through before the memory embeds itself more deeply.

If you are unsure whether the timing is right for you, reach out before registering and we can talk it through.

Is R-TEP right for me?

R-TEP may be a good fit if you:

• Have had a distressing or traumatic medical experience within approximately the last one to three months.

• Are noticing intrusive thoughts, avoidance, sleep disruption, or heightened reactivity connected to that event.

• Want to address what happened while it is still recent, rather than waiting for symptoms to become more entrenched.

• Are out of the acute crisis phase and have enough stability to engage in a structured process.

• Want support that utilizes EMDR for medical trauma, offers high structure, and does not require you to tell your story out loud.

R-TEP does not target complex or chronic trauma that has accumulated over many years; longer-term individual EMDR or GTEP can better address those specific episodes. If you are unsure which protocol fits your situation, reach out and we can figure it out together.

What if I am still in the middle of treatment?

You can use R-TEP during active treatment, depending on where you are in the process. If you are between procedures or in a relatively stable phase of your medical care, R-TEP can offer meaningful support. If you are in the immediate pre- or post-operative window, GREP2 may serve you better by providing stabilization first.

Your facilitator will talk with you about timing before you join a group to make sure the protocol and the moment align.

What about confidentiality?

Everything shared within the group stays within the group. Participants sign a confidentiality agreement before joining. As a licensed mental health professional, I follow all professional, ethical, and legal standards. Because this is a group setting, no one can guarantee absolute legal confidentiality like in individual therapy, but the group agreement creates a clear, mutual commitment to privacy and respect.

How do I pay for R-TEP?

We accept HSA and FSA cards, and we provide superbills for out-of-network insurance reimbursement. Group rates cost significantly less than individual EMDR sessions, and we offer payment plans upon request.

How do GREP2, R-TEP, and GTEP work together?

These three protocols work at different points in the healing process, and they complement each other well.

Think of GREP2 as what you need to feel resourced and stable, either before, during, or alongside anything else. R-TEP is a targeted application of EMDR for medical trauma that helps when something hard has happened recently and you want to address it before it settles deeper. GTEP helps with traumatic experiences that have had time to consolidate and are still affecting you.

Many women with endometriosis work through more than one of these over time, not because they failed to heal, but because the disease itself keeps generating new experiences that deserve care. No single protocol covers everything. You have a range of tools, and part of this work involves figuring out which one fits your current moment.

About Your Facilitator

Shakira O’Garro, LMHC-D, LPCC, LPC, NCC Founder, Cheerful Heart Mental Health Counseling PLLC

Shakira is a licensed mental health counselor with diagnostic privilege and advanced training in EMDR group protocols, including R-TEP, GTEP, and GREP2. She holds licensure in New York, New Jersey, Pennsylvania, South Carolina, Connecticut, and California, and has built her practice at the intersection of medical trauma, chronic illness, and trauma-informed care for women.

As the creator of the Endo Kin Collective, she offers structured group EMDR for women navigating endometriosis. Clinical rigor and a genuine, lived understanding guide her work with this patient population. She understands the specific harm that happens when medical trauma lacks adequate support.

Her practice, Cheerful Heart Mental Health Counseling PLLC, operates as a private-pay practice grounded in culturally responsive, faith-affirming, trauma-informed care.

www.cheerfulheartmhcpllc.com

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Strength in kinship, hope in healing.