While this film is entirely different in it's tone and feel, it does use the same character (but different actress) and continues the story of The Haunting of Molly Hartley.
Some have stated that The Exorcism of M.H. could stand alone as a movie about an exorcism in an asylum, but I feel it would lose some of it's richness (yes I said richness, I'm in the minority who enjoyed it even though I have my complaints about it).
Bottom line: Don't go in expecting a seamless sequel to the first, because it was created by a different group of people who took the original film in an entirely different direction.
It doesn't feel like the first at all, but it helps to have seen the first film beforehand, imo. The dialogue in this film mentions the first film several times. I think that having the background of the first film makes this one more meaningful, and without it, the Molly of this film has little background.
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