EMDR Research News April 2019
4 Randomized Controlled Trials
- EMDR plus Standard Care (SC) versus SC alone for PTSD in adults with intellectual disabilities
- EMDR Versus Guided Imagery on Insomnia Severity in Patients With Rheumatoid Arthritis
- Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients
- The Effect of EMDR on Childbirth Anxiety of Women With Previous Stillbirth
12 Review articles
- A Review of the Role of Negative Cognitions About Oneself, Others, and the World in the Treatment of PTSD
- To expose or not to expose? The integrative therapist and PTSD
- Interventions for Cancer-Related Traumatic Stress Symptoms: A Systematic Review
- Treatments of PTSD in Civilian Populations
- Biological clues to an enigmatic treatment for traumatic stress
- Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis
- That which does not kill you—May afflict you? Psychological trauma in bipolar disorder
- Cortisol and alpha-amylase assessment in psychotherapeutic intervention studies: A systematic review
- Cultural adaptations in psychosocial interventions for post-traumatic stress disorder among refugees: A systematic review
- A Systematic Review of Psychological Trauma Interventions for Juvenile Offenders
- Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis
- What do clients say about their experiences of EMDR in the research literature? A systematic review and thematic synthesis of qualitative research papers
1 case series reports
- Flash Technique Group Protocol for Highly Dissociative Clients in a Homeless Shelter: A Clinical Report
2 individual case reports
- The EMDR DeTUR protocol for the treatment of self-injury in a patient with severe personality disorder: a case report
- The Applicability and Effect of EMDR in a Patient With a Mild Stage of Alzheimer’s Disease
- Immediate treatment following the November 13 attacks: Use of an EMDR emergency protocol
- Pre-treatment cortisol awakening response predicts symptom reduction in PTSD after treatment
- Opening the Black Box: Identifying Common Practice Approaches in Urban and Rural Rape Crisis Centers
1 Validation of Fidelity Scales
- Developing the Interrater Reliability of the Modified EMDR Fidelity Checklist
- Neural circuits underlying a psychotherapeutic regimen for fear disorders
- When do anorexic patients perceive their body as too fat? Aggravating and ameliorating factors
4 Theoretical
- Integrating EMDR in psychotherapy
- Synthesis and Realization (Personification and Presentification): The Psychological Process of Integration of Traumatic Memories in EMDR Psychotherapy
- How We Do What We Do: The Therapist, EMDR, and Treatment of Complex Trauma
- Expanding Horizons of Satvavajaya Chikitsa: Through EMDR & CBT
2 Study Protocols
- Testing the leadership and organizational change for implementation intervention in Norwegian mental health clinics: a randomized design study protocol
- A Multicenter Phase II Randomized Controlled Trial to Compare the Effectiveness of EMDR Therapy vs. Treatment as Usual in Patients With Substance Use Disorder and History of Psychological Trauma: A Study Design and Protocol
With each reference below, you will find the citation, abstract and author contact information (when available). Prior quarterly summaries of journal articles can be found on the EMDRIA website and a comprehensive listing of all EMDR-related research is available at the Francine Shapiro Library. EMDRIA members can access recent Journal of EMDR Practice and Research articles in the member’s area on the EMDRIA website. JEMDR issues older than 12 months are available open access on Connect - Springer Publishing Company.
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Annesley, P., Alabi, A., & Longdon, L. (2019). The EMDR DeTUR protocol for the treatment of self-injury in a patient with severe personality disorder: a case report. Journal of Criminological Research, Policy and Practice, 5(1), 27-38. doi:10.1108/JCRPP-11-2018-0034
Citation access: https://doi.org/10.1108/JCRPP-11-2018-0034
Abstract
Purpose: The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT).
Design/methodology/approach: Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a)
Method: In total, 18 one-hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation. Findings The level of urge for each trigger was reduced to 0 which the patient defined as no urge to self-injure. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks.
Practical implications: This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure.
Originality/value: The case report offers an important contribution to an area that requires much further research.
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Baek, J., Lee, S., Cho, T., Kim, S.-W., Kim, M., Yoon, Y., . . . Shin, H.-S. (2019). Neural circuits underlying a psychotherapeutic regimen for fear disorders. Nature. doi:10.1038/s41586-019-0931-y
Citation access: http://dx.doi.org/10.1038/s41586-019-0931-y
Jinhee Baek, Sukchan Lee. E-mail: jsjeong@kaist.ac.kr E-mail: shin@ibs.re.kr
Abstract
A psychotherapeutic regimen that uses alternating bilateral sensory stimulation (ABS) has been used to treat post traumatic stress disorder. However, the neural basis that underlies the longlasting effect of this treatment—described as eye movement desensitization and reprocessing—has not been identified. Here we describe a neuronal pathway driven by the superior colliculus (SC) that mediates persistent attenuation of fear. We successfully induced a lasting reduction in fear in mice by pairing visual ABS with conditioned stimuli during fear extinction. Among the types of visual stimulation tested, ABS provided the strongest fearreducing effect and yielded sustained increases in the activities of the SC and mediodorsal thalamus (MD). Optogenetic manipulation revealed that the SC–MD circuit was necessary and sufficient to prevent the return of fear. ABS suppressed the activity of fearencoding cells and stabilized inhibitory neurotransmission in the basolateral amygdala through a feedforward inhibitory circuit from the MD. Together, these results reveal the neural circuit that underlies an effective strategy for sustainably attenuating traumatic memories.
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Balbo, M., Cavallo, F., & Fernandez, I. (2019). Integrating EMDR in psychotherapy. Journal of Psychotherapy Integration, 29(1), 23-31. doi:10.1037/int0000136
Citation access: http://dx.doi.org/10.1037/int0000136
Abstract
Eye movement desensitization and reprocessing (EMDR) has significantly contributed to psychotherapy in the last 30 years. Studies support EMDR as effective for posttraumatic stress disorder symptoms. It was also applied to other disorders because it can help resolve and reprocess memories of traumatic experiences that can contribute, as risk, precipitating and predisposing factors to the development of mental disorders. What these disorders have in common is the maladaptive processing of information associated with stressful and pathogenic events. EMDR therapy has given a contribution to psychotherapy as an effective method that can help the innate processing system process all aspects of a traumatic experience. After working with traumatic memories that may be part of the patient’s life story, EMDR therapy focuses on current triggers and symptoms and then provides the patient with instruments to deal with future situations that may cause anxiety. While working with this method, it is possible to enhance metacognitive skills and promote a change in dysfunctional emotions, beliefs, and behaviors. These are some common objectives that EMDR therapy shares with most psychotherapy approaches.
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Brennstuhl, M.-J., Bassan, F., Fayard, A.-M., Fisselbrand, M., Guth, A., Hassler, M., . . . Tarquinio, C. (2019). Immediate treatment following the November 13 attacks: Use of an EMDR emergency protocol. European Journal of Trauma & Dissociation, 3(1), 17-21. doi:10.1016/j.ejtd.2018.09.004
Open access: http://dx.doi.org/10.1016/j.ejtd.2018.09.004
Abstract
Objective. – The objective of this article is to report on an emergency posttraumatic treatment following the November 13, 2015 attacks in Paris.
Method. – Thirty-six children and 20 adults were treated with EMDR therapy or debriefing within 48 hours after the attacks. Quantitative assessments were performed pre- and post-treatment and at a 3- month follow-up.
Results. – The EMDR treatment administered to the children and the debriefing used with the adults both showed their efficacy through the reduction on all quantitative measures.
Discussion. – Our results indicate that the EMDR approach and emergency treatment strategies may be promising treatment strategies that are non-invasive and preventive. Although these results should be completed by studies on larger samples with a control group, they remain promising in that they suggest that an emergency psychological treatment based on EMDR procedures may prove effective in preventing the installation of a post-attack posttraumatic stress disorder.
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Brown, L. A., Belli, G. M., Asnaani, A., & Foa, E. B. (2019). A Review of the Role of Negative Cognitions About Oneself, Others, and the World in the Treatment of PTSD. Cognitive Therapy and Research, 43(1), 143-173. doi:10.1007/s10608-018-9938-1
Citation access: http://dx.doi.org/10.1007/s10608-018-9938-1
Abstract
Negative cognitions about oneself, others, and the world are central to the development and maintenance of posttraumatic stress disorder (PTSD). We provide a comprehensive review of the literature examining the change in post-trauma negative cognitions in PTSD treatments. We explore the association between change in cognitions and change in PTSD symptoms and the mediational effect of negative cognitions on PTSD symptoms. A review of over 2000 manuscripts resulted in 65 PTSD treatment articles for review that included a measure of negative post-trauma cognitions and PTSD severity. Several studies found that PTSD treatments are associated with concurrent reductions in PTSD symptoms and negative post-trauma cognitions. Many studies suggest that the degree of reduction in negative post-trauma cognitions is both associated with the degree of reduction in PTSD symptoms and may mediate the change in PTSD symptoms in treatment. PTSD treatments are associated with significant improvements in negative post-trauma cognitions that often precede and predict reductions in PTSD symptoms.
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Cooper, R. Z., Smith, A. D., Lewis, D., Lee, C. W., & Leeds, A. M. (2019). Developing the Interrater Reliability of the Modified EMDR Fidelity Checklist. Journal of EMDR Practice and Research, 13(1), 32-50. doi:10.1891/1933-3196.13.1.32
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.32
Christopher W. Lee, School of Psychiatry, University of Western Australia, 35 Stirling Highway, Crawley, Perth WA, Australia 6009. E-mail: chris.lee@uwa.edu.au
Abstract
Although treatment fidelity measures for eye movement desensitization and reprocessing (EMDR) have been cited in past research, none have been subject to any empirical investigation of reliability. This three- phase study aimed to quantify the interrater reliability of a measure of EMDR treatment fidelity. First, two raters refined the reprocessing section of the EMDR Fidelity Checklist (Leeds, 2016) by developing a descriptive item-by-item scoring system to improve interpretation and reliability. The resultant checklist was piloted on recordings of five EMDR session recordings from the Laugharne et al. (2016) study. The checklist was then revised. Next, the raters used the checklist to assess 15 other recorded EMDR sessions from the same study. The intraclass correlations (ICCs) were in the excellent range for all subscales and total session scores (i.e., >0.75), with an exception of the Desensitization subscale, ICC = 0.69 (0.08, 0.90). Finally, individual items in that subscale were evaluated, finding that five items did not contribute to the ICC. When these were removed/revised, the ICC for this subscale moved into the excellent range, ICC = 0.81(0.43, 0.94). The findings of this study indicate that this checklist may be a reliable measure of treatment fidelity for single reprocessing EMDR sessions with the possible exception of the Body Scan phase. Future research using the checklist with raters who were not involved in checklist development is needed to confirm the generalizability of these findings.
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Dimaggio, G. (2019). To expose or not to expose? The integrative therapist and posttraumatic stress disorder. Journal of Psychotherapy Integration, 29(1), 1-5. doi:10.1037/int0000138
Open access: http://dx.doi.org/10.1037/int0000138
Abstract
Many different treatments are currently available on the market for treating posttraumatic stress disorder (PTSD). The American Psychological Association suggests that some of them have strong evidence, while others can only be suggested. In this introduction I argue that the picture is quite different, with different treatment modalities yielding similar outcomes, but doing so via different paths. I explain here the reasons for having selected some of these treatments for inclusion in this journal Special Issue. Integrative therapists may read the whole range to understand what would best suit each unique person presenting in their office with PTSD.
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Dimitrov, L., Moschopoulou, E., & Korszun, A. (2019). Interventions for the Treatment of Cancer-Related Traumatic Stress Symptoms: A Systematic Review of the Literature. Psycho-Oncology. doi:10.1002/pon.5055
Citation access: https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.5055
Prof Ania Korszun, Centre of Psychiatry, Wolfson Institute of Prevention Medicine, E-mail: a.korszun@qmul.ac.uk
Abstract
Cancer has been reported to trigger symptoms of post-traumatic stress disorder (PTSD) in a substantial proportion of individuals. Despite the significant burden associated with these symptoms, there are as yet no therapeutic guidelines. This systematic review aims to evaluate the effectiveness of interventions for cancer-related post-traumatic stress in order to provide an evidence base for developing appropriate clinical practice.
Methods
Databases searched until April 2018 included, Psych INFO, EMBASE, Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). No restrictions to study design were applied. Participants aged 18 years or older who received their cancer diagnosis in adulthood and had symptoms of cancer-related PTSD were included. Due to significant clinical heterogeneity, a meta-analysis was not performed.
Results
Of 508 unique titles, eight studies met study inclusion criteria: five RCTs, one before-and- after study, one case series and one case study. Interventions were predominately psychological and were administered to patients with a range of cancer types. Eye Movement Desensitisation and Reprocessing and cognitive behavioural therapy-based interventions were associated with reduced symptomatology, however, overall the methodological quality of studies had limitations.
Conclusions
At present there is only weak evidence available for the effectiveness of psychological interventions in reducing symptoms of cancer-related PTSD. The majority of interventions were administered to all cancer patients regardless of whether they showed pretreatment levels of post-traumatic stress. Future studies would be better targeted towards patients with a diagnosis of cancer and who have significant levels of cancer-related post-traumatic symptoms. Higher quality trials are also needed before treatment recommendations can be made.
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Edmond, T. E., Voth Schrag, R. J., & Bender, A. K. (2019). Opening the Black Box: Identifying Common Practice Approaches in Urban and Rural Rape Crisis Centers. Violence Against Women, 1077801219832903. doi:10.1177/1077801219832903
Citation access: https://doi.org/10.1177/1077801219832903
Abstract
This study sought to open the black box of services at rape crisis centers (RCCs), particularly related to counseling, to better understand what is available to survivors in urban and rural settings. Findings from a survey of directors and counselors in Texas RCCs reveal a number of strengths: supporting services for survivors of sexual assault and insights that can help to further advance the implementation of evidence-based trauma treatments in this sector. Although many areas of congruence were found between urban and rural settings, differences were noted that have implications for implementation of evidence-based trauma treatments.
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Egeland, K. M., Skar, A. S., Endsjø, M., Laukvik, E. H., Bækkelund, H., Babaii, A., . . . Aarons, G. A. (2019). Testing the leadership and organizational change for implementation (LOCI) intervention in Norwegian mental health clinics: a stepped-wedge cluster randomized design study protocol. Implement Sci, 14(1), 28. doi:10.1186/s13012-019-0873-7
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30866973
Karina Egeland, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484 Oslo, Norway. E-mail: karina.egeland@nkvts.no
Abstract
BACKGROUND: Alignment across levels of leadership within an organization is needed for successful implementation of evidence-based practice. The leadership and organizational change for implementation (LOCI) intervention is a multi-faceted multilevel implementation strategy focusing on enhancing first-level general and implementation leadership while also engaging with organization upper management to develop an organizational climate for implementation. The aim of the project is to evaluate the effectiveness of LOCI in supporting the implementation of evidence-based treatment for PTSD in child- and adult-specialized mental health clinics in health trusts in Norway.
METHODS: The study design is a stepped-wedge cluster randomized trial with enrollment of clinics in three cohorts. Executives, clinic leaders, and therapists will be asked to complete surveys assessing leadership and implementation climate. Surveys will be completed at baseline, 4, 8, 12, 16, and 20 months. Results from surveys will be shared with executives and clinic leaders to inform the subsequent creation of tailored leadership and climate development plans for enhanced implementation. Patients will complete surveys measuring traumatic events and post-traumatic stress symptoms during the therapy process. Therapy sessions will be audio or video recorded and scored for fidelity as part of training.
DISCUSSION: This study aims to provide knowledge on how to improve leadership and organizational climate to enhance effective implementation of evidence-based treatments in mental health services.
TRIAL REGISTRATION: The study has been registrated in Clinical Trials with ID NCT03719651.
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Grasser, L. R., & Javanbakht, A. (2019). Treatments of Posttraumatic Stress Disorder in Civilian Populations. Curr Psychiatry Rep, 21(2), 11. doi:10.1007/s11920-019-0994-3
Citation access: https://www.ncbi.nlm.nih.gov/pubmed/30734097
Lana Ruvolo Grasser, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA. E-mail: lgrasser@med.wayne.edu
Abstract
PURPOSE OF REVIEW: Posttraumatic stress disorder is a chronic, heterogeneous disorder for which a multitude of psychotherapies, pharmaceuticals, and immerging treatment programs are available. Majority of efficacy studies focus on Caucasian male military populations, which may be a reason why not all patients respond to treatment with long-term positive outcomes. Additionally, effects of treatment on symptom clusters have been neglected. This work reviews treatment of PTSD and its symptom clusters exclusively in civilian populations, which have been historically under-examined in the literature.
RECENT FINDINGS: Exposure therapy stands at the forefront of successful PTSD treatment and offers a more cost-effective solution to pharmacotherapy; however, refugees and patients with comorbid depression may not experience such strong benefits. For exposure therapy and other forms of psychotherapy, non-inferiority studies point to promise of internet-delivered and telemedicine-based methods for reaching populations that may not have access to in-person care. SSRIs are the most widely used pharmaceutical treatment for PTSD; moderate initial benefits are observed yet long-term retention and outcomes may be enhanced by adjunct treatment. Again, refugees are a group that experiences lesser benefit. Research has begun to explore efficacy of treatments for individual symptom clusters, with hyperarousal benefiting most from currently available modalities. Avoidance, intrusion, negative thoughts and beliefs, and dissociation are symptoms requiring more research for focused interventions. Treatment of PTSD has evolved to (1) include equivalent proportions of men and women, along with focused female-exclusive cohorts; (2) explore novel methods of treatment online and in various cultural contexts; and (3) less focus on medication as evidenced by current clinical trials. In addition to further efficacy and safety studies in more diverse ethnic populations, work is needed to examine what therapies are best for targeting specific symptom clusters of PTSD. This research will drive precision treatment, and such research is beginning to point towards underlying mechanisms of pathology and change.
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Holmes, A. (2019). Biological clues to an enigmatic treatment for traumatic stress. Nature, 566(7744), 335-336. doi:10.1038/d41586-019-00294-8
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30783271
Andrew Holmes is at the Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20008, USA. e-mail: holmesan@mail.nih.gov
Abstract
A treatment called eye-movement desensitization and reprocessing alleviates post-traumatic stress disorder through enigmatic mechanisms. A study in mice offers potential clues into the biological basis of this approach.
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Karatzias, T., Brown, M., Taggart, L., Truesdale, M., Sirisena, C., Walley, R., . . . Paterson, D. (2019). A mixed-methods, randomized controlled feasibility trial of Eye Movement Desensitization and Reprocessing (EMDR) plus Standard Care (SC) versus SC alone for DSM-5 Posttraumatic Stress Disorder (PTSD) in adults with intellectual disabilities. J Appl Res Intellect Disabil, 1-13. doi:10.1111/jar.12570
Citation access: https://www.ncbi.nlm.nih.gov/pubmed/30714684
Thanos Karatzias, Edinburgh Napier University, Edinburgh, UK. Email: t.karatzias@napier.ac.uk
Abstract
OBJECTIVE: To report the results of the first randomized feasibility trial of Eye Movement Desensitization and Reprocessing (EMDR) plus Standard Care (SC) versus SC alone for DSM-5 posttraumatic stress disorder (PTSD) in adults with intellectual disabilities.
METHOD: A total of 29 participants were randomized to either to EMDR + SC (n = 15) or SC (n = 14). Participants completed measures on traumatic stress (PCL-C) and comorbid distress at baseline, 1 week post-treatment and 3-month follow-up.
RESULTS: In the EMDR + SC group, 9 (60%) participants at post-treatment and 7 (47%) participants at 3-month follow-up were diagnosis free. In SC, 4 (27%) at post-treatment and follow-up were diagnosis free. At post-treatment, three participants (20%) dropped out from the EMDR + SC group, and 1 (7%) dropped out from the SC group.
CONCLUSIONS: It is feasible, acceptable and potentially effective to deliver EMDR in this population group.
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Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., . . . Hutton, P. (2019). Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis. Psychological Medicine, 1-15. doi:10.1017/s0033291719000436
Citation access: http://dx.doi.org/10.1017/s0033291719000436
Thanos Karatzias, Edinburgh Napier University, School of Health & Social Care, Edinburgh, UK. E-mail: t.karatzias@napier. ac.uk
Abstract
Background. The 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions.
Methods. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality.
Results. Fifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), expos- ure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g=−0.90 (CBT; k=27, 95% CI −1.11 to −0.68; moderate quality) to g = −1.26 (EMDR; k = 4, 95% CI −2.01 to −0.51; low quality). CBT and EA each had moderate–large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate–large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome.
Conclusions. The development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.
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Kazén, M., Baumann, N., Twenhöfel, J. F., & Kuhl, J. (2019). When do anorexic patients perceive their body as too fat? Aggravating and ameliorating factors. PLOS ONE, 14(2), e0212612. doi:10.1371/journal.pone.0212612
Open access: http://dx.doi.org/10.1371/journal.pone.0212612
Miguel Kazen, InstituteofPsychology,UniversityofOsnabru ̈ck,Osnabru ̈ck,Germany. E-mail: mikazen@uos.de
Abstract
Objective: Our study investigated body image representations in female patients with anorexia nervosa and healthy controls using a size estimation with pictures of their own body. We also explored a method to reduce body image distortions through right hemispheric activation.
Method: Pictures of participants’ own bodies were shown on the left or right visual fields for 130 ms after presentation of neutral, positive, or negative word primes, which could be self-relevant or not, with the task of classifying the picture as “thinner than”, “equal to”, or “fatter than” one’s own body. Subsequently, activation of the left- or right hemispheric through right- or left-hand muscle contractions for 3 min., respectively. Finally, participants completed the size estimation task again.
Results: The distorted “fatter than” body image was found only in patients and only when a picture of their own body appeared on the right visual field (left hemisphere) and was preceded by negative self-relevant words. This distorted perception of the patients’ body image was reduced after left-hand muscle contractions (right hemispheric activation).
Discussion: To reduce body image distortions it is advisable to find methods that help anorexia nervosa patients to increase their self-esteem. The body image distortions were ameliorated after right hemispheric activation. A related method to prevent distorted body-image representations in these patients may be Eye Movement Desensitization and Reprocessing (EMDR) therapy.
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Landin-Romero, R., Moreno-Alcázar, A., Ferguson, G., Pérez, V., & Amann, B. L. (2019). That which does not kill you—May afflict you? Psychological trauma in bipolar disorder. Bipolar Disorders, 0. doi:10.1111/bdi.12766
Citation access: https://doi.org/10.1111/bdi.12766
No abstract available
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Laufer, S., Engel, S., Knaevelsrud, C., & Schumacher, S. (2018). Cortisol and alpha-amylase assessment in psychotherapeutic intervention studies: A systematic review. Neuroscience & Biobehavioral Reviews, 95, 235-262. doi:10.1016/j.neubiorev.2018.09.023
Citation access: http://dx.doi.org/10.1016/j.neubiorev.2018.09.023
Sebastian Laufer, Division of Clinical Psychological Intervention, Freie Universität Berlin, Schwendenerstraße 27, 14195 Berlin, Germany. E-mail: sebastian.laufer@fu-berlin.de
Abstract
Dysregulations of the hypothalamus-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), two of the most prominent stress-responsive systems, have been associated with the development and maintenance of various mental disorders. It has been suggested that these alterations might normalize in the course of psychotherapeutic interventions. We conducted a comprehensive review of psychotherapeutic intervention effects on HPA axis and ANS regulation in adult samples with mental disorders.
We searched four databases for psychotherapeutic intervention studies with mentally ill patient samples, assessing cortisol and/or alpha-amylase before and after treatment. Study quality and confounder consideration within biomarker assessment were examined.
Twenty-five studies were included. Psychotherapeutic interventions and biomarker assessment methodology varied substantially between studies. Accordingly, meta-analytical computations were deemed unfeasible. Study characteristics especially regarding cortisol and alpha-amylase assessment and analysis procedures were comprehensively reviewed. Study quality and biomarker confounder consideration ratings were mostly moderate to strong. Based on the results, we provide recommendations regarding intervention design and biomarker assessment methodology to increase comparability of psychotherapeutic treatment effects in future studies.
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Naseh, M., Macgowan, M. J., Wagner, E. F., Abtahi, Z., Potocky, M., & Stuart, P. H. (2019). Cultural adaptations in psychosocial interventions for post-traumatic stress disorder among refugees: A systematic review. Journal of Ethnic & Cultural Diversity in Social Work, 28(1), 76-97. doi:10.1080/15313204.2019.1570891
Citation access: http://dx.doi.org/10.1080/15313204.2019.1570891
Mitra Naseh, School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199. E-mail: mahma024@fiu.edu
Abstract
The aim of this study was to systematically review randomized controlled trials on non-pharmaceutical interventions for post-traumatic stress disorder (PTSD) among adult refugees with a focus on identifying common cultural adaptations and reviewing possible effects of such adaptations on outcomes. The conducted systematic search yielded 11 studies. The strongest support was for eye movement desensitization and reprocessing (EMDR). Commonly used cultural adaptations in the reviewed studies included modifications in personnel and setting context, changes in content, and translation or adaptation of evaluation tools.
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Nia, N. G., Afrasiabifar, A., Behnammoghadam, M., & Cooper, R. Z. (2019). The Effect of EMDR Versus Guided Imagery on Insomnia Severity in Patients With Rheumatoid Arthritis. Journal of EMDR Practice and Research, 13(1), 2-9. doi:10.1891/1933-3196.13.1.2
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.2
Ardashir Afrasiabifar, Imam Sajad Hospital, Yasuj University of Medical Sciences, Yasuj, Iran 25919-94799. E-mail: afrasiabifar.ardashir@yums.ac.ir
Abstract
This study compared the effect of eye movement desensitization and reprocessing (EMDR) therapy versus guided imagery on insomnia severity in patients with rheumatoid arthritis (RA). In this randomized controlled trial, 75 patients with RA were selected via convenience sampling before using block randomization to assign patients into three groups comprised of (a) six sessions of EMDR, (b) six sessions of guided imagery, and (c) a control group. The Persian version of the Insomnia Severity Index was implemented at preintervention and 2 weeks’ postintervention as the outcome measure. The EMDR group obtained respective pre-and postintervention mean scores of 23.5 ± 5.2 and 11±2.1, whereas the guided imagery group obtained scores of 24 ± 3 and 15.3 ± 2.3, and the control group obtained scores of 24.2 ± 3.3 and 23.6 ± 3. Pairwise comparisons showed statistically significant differences in insomnia severity between patients from each group, with the EMDR group experiencing a greater reduction in insomnia severity than guided imagery. EMDR and guided imagery were both effective in reducing insomnia severity in RA patients, although the degree of insomnia reduction for patients from the EMDR group was greater than that of the guided imagery group.
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Piedfort-Marin, O. (2019). Synthesis and Realization (Personification and Presentification): The Psychological Process of Integration of Traumatic Memories in EMDR Psychotherapy. Journal of EMDR Practice and Research, 13(1), 75-88. doi:10.1891/1933-3196.13.1.75
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.75
Olivier Piedfort-Marin, Université de Lorraine, APEMAC/EPSAM, EA 4360, Metz, France. E-mail: olivier.piedfort@gmail.com
Abstract
The theory of the structural dissociation of the personality proposes a precise description of the psychological phenomena involved in the integration of traumatic memories. According to this theory, memories are successfully integrated in a narrative—that is, stored in an adaptive memory network—when there has been synthesis of the different elements (affects, cognitions, images, sensorimotor reactions, behaviors) for each moment of a particular event, and when realization has occurred. Realization implies personification and presentification. Personification is the ability individuals have to feel that they have experienced (traumatic) events. Presentification is the ability to realize that the event took place in the past and is over now. In this article we present these concepts and how they relate to eye movement desensitization and reprocessing (EMDR) psychotherapy and its underlying hypothesis of adaptive information processing. The article describes how EMDR therapists can use these concepts to better understand the reprocessing of their clients and possible blocking of this reprocessing. Understanding the concepts of synthesis, personification, and presentification makes it possible for EMDR therapists to choose the specific supportive interventions and cognitive interweaves that will best support the adaptive information processing. Such psychological phenomena should attract more attention in the future in EMDR clinical research and practice.
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Rapcencu, A. E., Gorter, R., Kennis, M., van Rooij, S. J. H., & Geuze, E. (2017). Pre-treatment cortisol awakening response predicts symptom reduction in posttraumatic stress disorder after treatment. Psychoneuroendocrinology, 82, 1-8. doi:10.1016/j.psyneuen.2017.04.010
Citation access: https://www.ncbi.nlm.nih.gov/pubmed/28482208
E. Geuze, Department of Psychiatry, Utrecht University Medical Center, PO Box A.01.468, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. E-mail address: s.g.geuze@umcutrecht.nl
Abstract
Dysfunction of the HPA-axis has frequently been found in the aftermath of trauma exposure with or without PTSD. Decreasing HPA-axis reactivity to different stress cues has been reported during PTSD treatment. The cortisol awakening response (CAR|i|) is a well-validated, standardized measure of HPA-axis reactivity which can be easily acquired in the clinical setting. Whether CAR|i| changes over time in traumatized individuals are specific to PTSD treatment is unknown. Furthermore, a possible role for the baseline CAR|i| in predicting symptom reduction after treatment in PTSD has not been examined before. To answer these questions, a cohort study was conducted in which the awakening cortisol was measured in both PTSD (N=41) and non-PTSD (N=25) combat-exposed male subjects. Measurements took place at inclusion and 6-8 months after inclusion for both the PTSD and the non-PTSD group. During the 6-8 months interval, PTSD patients received trauma-focused focused psychotherapy, whereas non-PTSD patients received no treatment. We found a decrease in the CAR|i| over time in both groups, suggesting it was not specific to PTSD or the effect of treatment. Therefore, caution is warranted when attributing diminished HPA-axis reactivity over time to effects of PTSD treatment. Second, CAR|i| prior to treatment predicted PTSD symptom reduction (CAPS score change) after treatment, and accounted for 10% of the variance, even when adjusted for changes in depressive symptoms and medication use during the study period. A putative role emerges for CAR|i| as a predictive biomarker of symptom reduction in male individuals with combat-related PTSD.
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Rhoden, M.-A., Macgowan, M. J., & Huang, H. (2019). A Systematic Review of Psychological Trauma Interventions for Juvenile Offenders. Research on Social Work Practice, 104973151880657. doi:10.1177/1049731518806578
Citation access: http://dx.doi.org/10.1177/1049731518806578
Michelle-Ann Rhoden, Florida International University, 11200 SW 8th Street AHC5, Miami, FL 33199, USA. Email: mrhod012@fiu.edu
Abstract
Purpose:
This review discusses the efficacy of trauma-specific interventions among juvenile offenders.
Method:
The reviewers conducted a comprehensive search of trauma intervention studies completed in the United States in peer-reviewed journals, highlighting their methodological rigor by using the risk of bias tool for quantitative studies and Wu, Wyant, and Fraser's guidelines for qualitative studies.
Results:
Sixteen studies met the inclusion criteria; fourteen studies used quantitative and two used qualitative research designs. Nine studies reported medium to large effects on post-traumatic stress disorder (PTSD) symptoms and five assessed externalizing behavioral problems. Eye movement desensitization and reprocessing therapy demonstrated the most rigor and had the largest reductions on PTSD symptoms followed by trauma-focused cognitive behavioral therapy. Art therapy was the most rigorous qualitative study, but the intervention did not focus on reducing trauma symptoms.
Discussion:
Overall, most interventions were effective in reducing participants’ PTSD symptoms, but little is known about their effects on externalizing behavioral problems.
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Rosoff, A. L. (2019). How We Do What We Do: The Therapist, EMDR, and Treatment of Complex Trauma. Journal of EMDR Practice and Research, 13(1), 61-74. doi:10.1891/1933-3196.13.1.61
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.61
Ann Rosoff, The Green House Group, PA, Manchester, NH. E-mail: annlrosoffphd@gmail.com
Abstract
This article discusses strategies for working with patients who present with the specific psychological deficits associated with complex trauma. In order to maintain the patient’s stability, safety, and capacity for adaptive information processing (AIP) during sessions, these treatments require an extremely active therapist who is able to help regulate the pace of therapy and the patient’s participation in it. Attunement to both patient’s and therapist’s experience is a core therapeutic process that enables the treatment. Eye movement desensitization and reprocessing (EMDR) therapists must set the frame of the therapy, help to build and then utilize the capacity for AIP, and establish a relationship capable of coregulating the patient’s state during both resource development and trauma processing. All of these functions can be enhanced using bilateral stimulation (BLS). They are accomplished via specific therapist actions during sessions: assessing and supporting the capacity for AIP, looking for opportunities to strengthen resources and competencies, and staying attuned to empathic resonances and countertransference. Decisions that shape the treatment process and affect its pacing evolve from an integration of multiple factors: the therapist’s attunement to self, patient, and the therapy relationship; and an understanding of complex trauma, dissociation, therapeutic process, and EMDR. Examples of patient–therapist interaction during two EMDR sessions are provided to illustrate therapy process and the use of the treatment relationship in clinical decision-making and coregulation.
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Santarnecchi, E., Bossini, L., Vatti, G., Fagiolini, A., La Porta, P., Di Lorenzo, G., . . . Rossi, A. (2019). Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients. Frontiers in Psychology, 10. doi:10.3389/fpsyg.2019.00129
Open access: http://dx.doi.org/10.3389/fpsyg.2019.00129
Emiliano Santarnecchi. E-mail: esantarn@bidmc.harvard.edu
Abstract
Among the different therapeutic alternatives for post-traumatic stress disorder (PTSD), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) Therapy have shown promising results in helping patients cope with PTSD symptoms. However, given the different theoretical and methodological substrate of TF-CBT and EMDR, a potentially different impact on the brain for the two interventions could be hypothesized, as well as an interaction between trauma-specific PTSD symptomatology and response to a given psychotherapy. In this study, we monitored psychological and spontaneous functional connectivity fMRI patterns in two groups of PTSD patients who suffered by the same traumatic event (i.e., natural disaster), before and after a cycle of psychotherapy sessions based on TF- CBT and EMDR. Thirty-seven (37) PTSD patients were enrolled from a larger sample of people exposed to a single, acute psychological stress (i.e., 2002 earthquake in San Giuliano di Puglia, Italy). Patients were randomly assigned to TF-CBT (n = 14) or EMDR (n = 17) psychotherapy. Clinical assessment was performed using the Clinician-Administered PTSD Scale (CAPS), the Davidson Trauma Scale (DTS) and the Work and Social Adjustment Scale (WSAS), both at baseline and after treatment. All patients underwent a fMRI data acquisition session before and after treatment, aimed at characterizing their functional connectivity (FC) profile at rest, as well as potential connectivity changes associated with the clinical impact of psychotherapy. Both EMDR and TF-CBT induced statistically significant changes in clinical scores, with no difference in the clinical impact of the two treatments. Specific changes in FC correlated with the improvement at the different clinical scores, and differently for EMDR and TF-CBT. However, a similarity in the connectivity changes associated with changes in CAPS in both groups was also observed. Specifically, changes at CAPS in the entire sample correlated with an (i) increase in connectivity between the bilateral superior medial frontal gyrus and right temporal pole, and a (ii) decrease in connectivity between left cuneus and left temporal pole. Results point to a similar, beneficial psychological impact of EMDR and TF-CBT for treatment of natural-disaster PTSD patients. Neuroimaging data suggest a similar neurophysiological substrate for clinical improvement following EMDR and TF-CBT, involving changes affecting bilateral temporal pole connectivity.
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Turrini, G., Purgato, M., Acarturk, C., Anttila, M., Au, T., Ballette, F., . . . Barbui, C. (2019). Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiol Psychiatr Sci, 1-13. doi:10.1017/S2045796019000027
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30739625
G. Turrini, Cochrane Global Mental Health and WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona,Verona,Italy. E-mail: giulia.turrini@univr.it
Abstract
AIMS: In the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers.
METHODS: We used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason.
RESULTS: We included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = -0.71; 95% confidence interval [CI] -1.01 to -0.41; I2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = -1.02; 95% CI -1.52 to -0.51; I2 = 89%; 95% CI 82-93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = -1.05; 95% CI -1.55 to -0.56; I2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life.
CONCLUSIONS: Considering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly.
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Valiente-Gómez, A., Moreno-Alcázar, A., Radua, J., Hogg, B., Blanco, L., Lupo, W., . . . Amann, B. L. (2019). A Multicenter Phase II Rater-Blinded Randomized Controlled Trial to Compare the Effectiveness of Eye Movement Desensitization Reprocessing Therapy vs. Treatment as Usual in Patients With Substance Use Disorder and History of Psychological Trauma: A Study Design and Protocol. Frontiers in Psychiatry, 10. doi:10.3389/fpsyt.2019.00108
Open access: http://dx.doi.org/10.3389/fpsyt.2019.00108
Ana Moreno-Alcázar. E-mail: amoreno1@imim.es
Abstract
Background: Psychological trauma has a strong negative impact on the onset, course and prognosis of substance use disorders (SUD). Few trauma-oriented treatment approaches have been trialed, but preliminary evidence exists of the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) therapy in improving clinical symptoms in SUD patients.
Objective: To assess if EMDR therapy leads to: (1) reduced substance consumption; (2) an improvement in psychopathological and in trauma-related symptoms; and (3) an improvement in overall functioning. Our hypothesis is that the EMDR group will improve in all variables when compared to the treatment as usual (TAU) group at 6 and 12-months visits.
Method: In this multicenter phase II rater-blinded randomized controlled trial, 142 SUD patients with a history of psychological trauma will be randomly assigned to EMDR (n = 71) or to TAU (n = 71). Patients in the EMDR group will receive 20 psychotherapeutic sessions of 60 min over 6 months. Substance use will be measured using the Timeline Followback Questionnaire, the Dependence Severity Scale and the Visual Analog Scale. Traumatic events will be measured by The Holmes-Rahe Life Stress Inventory, the Childhood Trauma Questionnaire Scale, the Global Assessment of Posttraumatic Stress Questionnaire, the Impact of Event Scale-Revised and the Dissociative Experiences Scale. Clinical symptomatology will be evaluated using the Hamilton Depression Rating Scale, the Young Mania Rating Scale and the Brief Psychiatric Rating Scale. Functionality will be assessed with the Functioning Assessment Short Test. All variables will be measured at baseline, post-treatment and 12 months as follow-up. Primary outcome: to test the efficacy of EMDR therapy in reducing the severity of substance use. The secondary outcomes: to test the efficacy in reducing trauma-related psychological symptoms and psychopathological symptoms and in improving overall functioning in patients with comorbid SUD and a history of psychological trauma.
Conclusion: This study will provide evidence of whether EMDR therapy is effective in reducing addiction-related, trauma and clinical symptoms and in improving functionality in patients with SUD and a history of trauma.
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van der Wielen, M., Robben, H., & Mark, R. E. (2019). The Applicability and Effect of EMDR in a Patient With a Mild Stage of Alzheimer’s Disease. Journal of EMDR Practice and Research, 13(1), 51-60. doi:10.1891/1933-3196.13.1.51
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.51
Martje van der Wielen, Department of Medical Psychology, Amphia Hospital, P.O. Box, 90157 4800 RL Breda, The Netherlands. E-mail: mvanderwielen@amphia.nl
Abstract
Eye movement desensitization and reprocessing (EMDR) therapy is recognized worldwide as an effective treatment for the symptoms of posttraumatic stress disorder (PTSD) and all kinds of adverse life experiences. The literature on the clinical usefulness of EMDR therapy in people with Alzheimer’s disease is scarce. We present a clinical case study of a woman who was recently diagnosed with Alzheimer’s disease. This patient was suffering from daily flashbacks of her institutionalized mother in a later stage of dementia. According to self-reports, one session of EMDR therapy alleviated the distress associated with her traumatic memory. We discuss the applicability of the EMDR protocol for people with Alzheimer’s disease and highlight possible limitations and adaptations.
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Whitehouse, J. (2019). What do clients say about their experiences of EMDR in the research literature? A systematic review and thematic synthesis of qualitative research papers. European Journal of Trauma & Dissociation. doi:10.1016/j.ejtd.2019.03.002
Citation access: https://www.sciencedirect.com/science/article/pii/S246874991830036X?via%3Dihub
Abstract
Background: Eye movement desensitisation and reprocessing (EMDR) has been shown to be effective in case studies and efficacious in randomised controlled trials for a number of psychological conditions, most notably trauma. Limited research, however, has investigated what clients say about their experiences of EMDR. Therefore, this systematic review aims to assess qualitative empirical studies about clients’ experiences of EMDR.
Data sources: 5 qualitative papers met the inclusion criteria and passed the quality assessment protocol for analysis and synthesis following perusal of the abstracts of 27 empirical studies from a pool of 2489 articles retrieved using key-word searches related to EMDR from 5 electronic academic databases (ASSIA, ERIC, PsycINFO, SCOPUS and Web of Science).
Data synthesis: Thematic synthesis was applied to the data to generate over-arching concepts encompassing the primary studies about what clients say about their experiences of EMDR.
Results: 4 super-ordinate themes (and 16 sub-themes emerged from the data): EMDR changes a person, necessary conditions for EMDR to effect change, EMDR method as agent of change and EMDR therapist as agent of change.
Conclusion: EMDR is talked about in a transformative manner, there are conditions which need to be present for EMDR to work and there is an interplay between the EMDR method and therapist as agents of change. Thus, in practice, a pluralistic approach, rather than exclusive reliance on the method, where EMDR protocols, based upon the client’s requirements, are incorporated as a method to carry out the therapeutic tasks to achieve therapeutic goals is supported by this review. In research, the relative paucity of the current qualitative data could be addressed by engaging counselling psychologists, as scientific enquirers and artistic therapists, to expand research into clients’ experiences of EMDR.
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Wong, S.-L. (2019). Flash Technique Group Protocol for Highly Dissociative Clients in a Homeless Shelter: A Clinical Report. Journal of EMDR Practice and Research, 13(1), 20-31. doi:10.1891/1933-3196.13.1.20
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.20
Sik-Lam Wong, 917 The Alameda #4, Berkeley, CA 94707 E-mail: slwmft@gmail.com
Abstract
The Flash Technique is a new protocol for use in the preparation phase of eye movement desensitization and reprocessing (EMDR) to quickly reduce the emotional intensity of traumatic memories, prior to full processing with EMDR. This report presents results from a Flash Technique group for five highly dissociative, currently sober addicts in a men’s shelter. This group was an attempt to provide an affordable, trauma-focused intervention for the homeless. As part of the intake, each client met individually with the therapist for 30 minutes, to learn to use the flash technique to process a traumatic memory. Three inventories were used to measure treatment outcome: the Short PTSD Rating Interview (SPRINT), the Dissociative Experience Survey (DES-II), and the Beck Depression Inventory-II (BDI-II). Clients filled out the surveys 3 weeks before the start of the group and had their individual sessions 2 weeks before the start of the group. The DES and BDI-II were repeated at the beginning of the eighth session of the group. Clients’ surveys showed a decline in scores after seven sessions of therapy: the DES scores dropped from 39.07 (standard deviation [SD] = 23.01) to 20.48 (SD = 10.02) with d = 0.81 and the BDI-II scores dropped from 32.4 (SD = 11.01) to 13.2 (SD = 8.4) with d = 1.74. Pre- and 2-week posttreatment SPRINT surveys showed scores dropping from 28 [SD = 2.05] pretreatment to 15.75 [SD = 5.19] 2 weeks posttreatment, with d = 6.07.
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Yadav, L. J., Tripathi, J. S., & Yadav, R. R. (2018). Expanding Horizons of Satvavajaya Chikitsa: Through EMDR & CBT. International Journal of Research and Analytical Reviews, 5(4), J55-J58.
Citation access: http://ijrar.com/
Abstract
Satvavajaya Chikitsa,, as mentioned by Acharya Charak, is the mental restraint or mind control and is achieved through Gyan(spiritual knowledge)Vigyan( skilled / textual knowledge), Dhairya( fortitude) Smriti (remembrance) and Samadhi (concentration).The real meaning of satvavajya is’’ winning the mind’’ . There is no fundamental differences between Ayurvedic satvavajaya and modern psychotherapy , both involve removal of harmful sense objects of mind and insertion of positive rational thoughts and emotion The second component of Satvavajaya is vigayan where we use CBT as promotion of Vigyan through this technique we restructure the cognition and change the maladaptive behaviour which is similar to satvavajaya chikitsa where mind is refrained from ahita artha and attempts aremadetopromotehitaarthas The article attempt to assimilate and develop the psychotherapeutic techniqueswhich are described in the principles and practices of satvavajaya chikitsa ,The Manas Chikitsa (psychosomatic medicine & neuropsychiatry )Division of Department of kayachikitsa instititute of Medical Sciences ,Banaras Hindu University ,Varanasiis continuously working to explore the satvavajaya chikitsa use of practical psychotherapeutic techniques in clinical setting which will be deliberated here.
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Zolghadr, N., Khoshnazar, A., MoradiBaglooei, M., & Alimoradi, Z. (2019). The Effect of EMDR on Childbirth Anxiety of Women With Previous Stillbirth. Journal of EMDR Practice and Research, 13(1), 10-19. doi:10.1891/1933-3196.13.1.10
Citation access: http://dx.doi.org/10.1891/1933-3196.13.1.10
Mohammad MoradiBaglooei, Qazvin University of Medical Science, Bahonar Boulevard, Qazvin, Iran 34197-59811. E- mail: baglooei@yahoo.com
Abstract
Eye movement desensitization and reprocessing (EMDR) therapy is a form of psychotherapy used for individuals who have experienced stress-related injuries. Having an unpleasant experience of previous childbirth can cause anxiety and fear of labor in women during the next childbirth. The aim of this study was investigating the effect of the EMDR therapy on childbirth anxiety among multiparous women in the next normal pregnancy, following a prior stillbirth. A randomized controlled clinical trial was conducted with 30 pregnant women after they were admitted for delivery in an urban hospital in Qazvin, Iran, in 2016. The participants were selected using a convenient sampling method and then were randomly assigned into two groups, EMDR intervention (n = 15) and usual treatment control (n = 15). The Van den Bergh Pregnancy-Related Anxiety questionnaire was used to collect data before treatment (on admission when recruited for study) and after treatment (within 24 hours after childbirth). The EMDR therapy for the intervention group was performed with a 90-minute session when participants were admitted in hospital for delivery. The control group received only routine care. Data were collected using descriptive and inferential statistics and p < .05 was considered statistically significant. A statistically significant reduction in the mean anxiety in the EMDR intervention group compared to the control group was reported. Also, a reduction in the scores of posttest compared with pretest was observed in the EMDR intervention group (p < .01). The EMDR therapy reduced childbirth anxiety in pregnant women during normal pregnancy, following previous stillbirth.
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