EMDR Research News December 2018

In this posting there are 17 new articles to report related to EMDR therapy. 4 articles have links to the open access full text article.

There is 1 updated Treatment Guideline
  • ISTSS PTSD Prevention and Treatment Guidelines Methodology and Recommendations

1 Randomized Controlled Trials
  • Comparing the effect of EMDR with guided imagery on pain severity in patients with rheumatoid arthritis

5 Case Series reports
  • Add-on EMDR Therapy for Adults with PTSD Who Failed to Respond to Initial Antidepressant Pharmacotherapy
  • Trauma Stabilisation as a Sole Treatment Intervention for Post-Traumatic Stress Disorder in Southeast Asia
  • The EMDR Integrative Group Treatment Protocol in a Psychosocial Program for Refugee Children
  • The therapeutic value of trauma stabilisation in the treatment of post-traumatic stress disorder - A Southeast Asian Study
  • An Integrative EMDR and Family Therapy Model for Treating Attachment Trauma in Children

5 are individual case reports
  • EMDR in the Treatment of Adolescent Obsessive-Compulsive Disorder
  • The Implementation of Resource Development and Installation (RDI) for an Adolescent with Non-Suicidal Self Injury
  • Emotionally focused therapy and EMDR: An integrated treatment to heal the trauma of infidelity
  • Trust and Attunement-Focused EMDR With a Child
  • EMDR Intervention for a 17-Month-Old Child to Treat Attachment Trauma: Clinical Case Presentation

3 are Review or Meta-analysis articles
  • Efficacy of EMDR Therapy for Children With PTSD: A Review of the Literature
  • An Overview of Trauma-Informed Care and Practice for Eating Disorders
  • Effectiveness of Trauma-Focused Psychological Therapies for Treating Post-traumatic Stress Disorder Symptoms in Women Following Childbirth

2 are an Analogue (non-clinical) outcome study
  • Dual-tasking during recall of negative memories or during visual perception of images: Effects on vividness and emotionality
  • Effects of “Visual Schema Displacement Therapy” (VSDT), an abbreviated EMDR protocol and a control condition on emotionality and vividness of aversive memories


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 IngentaConnect.


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Bae, H., Kim, D., Cho, Y., Kim, D., & Kim, S. H. (2018). Add-on Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Adults with Post-traumatic Stress Disorder Who Failed to Respond to Initial Antidepressant Pharmacotherapy. J Korean Med Sci, 33(48), e306.

Daeho Kim, M.D., Department of Psychiatry, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdon-gu, Seoul 04763, Korea. E-mail: dkim9289@hanyang.ac.kr

Abstract

This study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with post-traumatic stress disorder (PTSD) who continued to be symptomatic after more than 12 weeks of initial antidepressant treatment. Scores for the Clinician Administered PTSD Scale (CAPS) were rated pre- and post-EMDR and at a 6-month follow-up. After an average of six sessions of EMDR treatment, seven of 14 patients (50%) showed more than a 30% decrease in CAPS score and eight (57%) no longer met the criteria for PTSD. Our results indicate that EMDR could be successfully added after failure of initial pharmacotherapy for PTSD.


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Beer, R. (2018). Efficacy of EMDR Therapy for Children With PTSD: A Review of the Literature. Journal of EMDR Practice and Research, 12(4), 177-195. doi:10.1891/1933-3196.12.4.177

ReneĢe Beer, EMDR Europe Accredited Child & Adolescent Trainer, Gaasterlandstaat 24, 1079 RH Amsterdam, The Netherlands. E-mail: reneebeer01@gmail.com


Abstract

The rationale is synthesized for the urgency of empirical studies demonstrating the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with posttraumatic stress disorder (PTSD), symptoms of PTSD, or other trauma-related symptoms. This literature review examined 15 studies (including nine randomized clinical trials) that tested the efficacy of EMDR therapy for the treatment of children and adolescents with these symptoms. All studies found that EMDR therapy produced significant reductions in PTSD symptoms at posttreatment and also in other trauma-related symptoms, when measured. A methodological analysis identified limitations in most studies, reducing the value of these findings. Despite these shortcomings, the methodological strength of the identified studies has increased over time. The review also summarized three meta-analyses. The need for additional rigorous research is apparent, and in order to profit from experiences of the past, the article provides some guidelines for clinicians seeking to conduct future research in their agencies.


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Brewerton, T. D. (2018). An Overview of Trauma-Informed Care and Practice for Eating Disorders. Journal of Aggression, Maltreatment & Trauma, 1-18. doi:10.1080/10926771.2018.1532940

Timothy D. Brewerton Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA. E-mail: drtimothybrewerton@gmail.com


Abstract


This article reviews concepts and principles of trauma-informed care and trauma-informed practice for those with eating disorders (EDs). EDs are not universally recognized to be associated with traumatic events, despite substantial research evidence indicating that individuals with EDs report very high rates of childhood maltreatment, other lifetime traumatic events, as well as adverse consequences from trauma. Using national representative samples, higher prevalence rates of PTSD and other trauma-related comorbidities have been reported in those with EDs, particularly those with bulimic symptoms (binge eating and/or purging). Evidence suggests that those prone to develop EDs appear to be especially sensitive to the effects of stress/adversity and have high rates of premorbid anxiety disorders, personality traits, and neuropsychological features that predispose them to PTSD and its symptoms. This article also reviews some of the important principles for treating individuals with EDs comorbid for PTSD and other trauma-related disorders, including the necessity of moving beyond sequential treatment to the development of integrated treatment protocols. Integration of existing evidence-based treatments, including family therapy, cognitive behavioral therapy, dialectical behavior therapy, cognitive processing therapy, prolonged exposure, and eye movement desensitization reprocessing are recommended. Recent research suggests that ED clinicians view integrated treatment for individuals with ED and PTSD as a top priority, yet they have several concerns about administering such a treatment. As trauma-informed care is embraced by all clinicians and treatment programs that assess and treat eating and related disorders, better outcomes are anticipated.


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Cuperus, A. A., Laken, M., van Schie, K., Engelhard, I. M., & van den Hout, M. A. (2019). Dual-tasking during recall of negative memories or during visual perception of images: Effects on vividness and emotionality. J Behav Ther Exp Psychiatry, 62, 112-116.

Anne A. Cuperus, Department of Health, Medical and Neuropsychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands. E-mail: Acuperus@gmail.com


Abstract


BACKGROUND AND OBJECTIVES: Several treatments are effective in reducing symptoms of post-traumatic stress disorder. We tested the effectiveness of an experimental intervention that consists of elements from two of these: virtual reality (VR) exposure therapy and eye movement desensitization and reprocessing. The latter is characterized by a dual-task approach: the patient holds a traumatic memory in mind while simultaneously making voluntary eye movements, resulting in reduced vividness and emotionality of the traumatic memory. If the experimental intervention is effective, it could provide a useful approach for highly avoidant individuals.
METHODS: Participants recalled negative memories induced by a VR paradigm. The experimental group viewed VR screenshots that represented these negative memories while carrying out a dual-task. One control group recalled negative memories while carrying out the same dual-task (a standard dual-task condition) and another merely viewed the VR screenshots. Pre-to-post changes in self-rated memory vividness/emotionality were measured.
RESULTS: The results indicate that viewing a screenshot only was outperformed by both dual-task interventions in terms of reductions in vividness/emotionality. Furthermore, the dual-task interventions had a comparable impact on vividness, but the screenshot variant led to greater decreases in emotionality.
LIMITATIONS: Changes in memory vividness/emotionality were only assessed shortly after the interventions and no measures of avoidance behavior were included in the study.
CONCLUSIONS: Looking at an image in VR that represents a memory while carrying out a dual-task may be at least as effective as recalling the memory during the dual-task. Interestingly, visually supporting a negative memory does not seem to prevent memory degrading by dual-tasking.


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Cusimano, A. (2018). EMDR in the Treatment of Adolescent Obsessive-Compulsive Disorder: A Case Study. Journal of EMDR Practice and Research, 12(4), 242-254. doi:10.1891/1933-3196.12.4.242

Angela Cusimano, PhD, Palm Beach Family Counseling, LLC, P.O. Box 742584, Boynton Beach, FL 33474. E-mail: angela@pbfamilycounseling.com


Abstract


Most of the empirical evidence supporting the efficacy of eye movement desensitization and reprocessing (EMDR) has been with individuals suffering from posttraumatic stress disorder (PTSD). This case study reports on the successful treatment of obsessive-compulsive disorder (OCD) in a 13-year-old male using the standard three-pronged approach of EMDR in a private practice setting. The current protocol addressed the initial touchstone event, the current level of distress related to that event, as well as anticipation and planning for future feared events. The participant received 15 sessions of EMDR. At 90-day posttreatment follow-up, there was a substantial decrease in OCD symptoms (from moderate to subclinical) as measured by the Children’s Yale-Brown Obsessive–Compulsive Scale, indicating a large effect size (d = 0.81). The current study provides insight into treating OCD in adolescence and how using the three-pronged approach (past, present, and future) of EMDR can be an effective tool. Study limitations and suggestions for future clinical research are discussed.


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Eichfeld, C., Farrell, D., Mattheß, M., Bumke, P., Sodemann, U., Ean, N., . . . Mattheß, H. (2018). Trauma Stabilisation as a Sole Treatment Intervention for Post-Traumatic Stress Disorder in Southeast Asia. Psychiatric Quarterly. doi:10.1007/s11126-018-9598-z


Open access:
http://dx.doi.org/10.1007/s11126-018-9598-z


Abstract


Southeast Asia contains high numbers of traumatised populations arising from either natural disasters or interpersonal violence. Consequently, the need for empirically based trauma treatments, compromised by insufficiency in appropriately trained clinicians and mental health workers, makes the situation more challenging in addressing traumatic sequelae in local populations. In response, the humanitarian/ trauma capacity building organisation, Trauma Aid Germany, trained 37 therapists in psycho-traumatology, based on EMDR Therapy, which included trauma stabilisation techniques. This research analyses the impact of Trauma Stabilisation as a sole treatment intervention for Post-Traumatic Stress Disorder (PTSD) in adults. Each client was screened for PTSD utilising the Harvard Trauma Questionnaire - pre- and post-treatment. Analysis of the data considered only those interventions focussed on trauma stabilisation, including psychoeducation. Participants receiving trauma confrontation interventions were excluded from the data. Trauma stabilisation - as a sole treatment intervention, was highly effective in alleviating PTSD diagnoses. Results demonstrate PTSD symptoms were reduced in both clinical and sub-clinical trauma groups. The data set suggests trauma stabilisation, as a sole treatment intervention, was safe, effective, efficient and sufficient treatment intervention for PTSD. Furthermore, trauma stabilisation interventions have the advantage of being safe, flexible, and adaptable to the cultural and spiritual context in which they were are applied. The research findings also have implications regarding teaching and learning and the potential utilisation of paraprofessionals, and other allied health professionals in addressing the global burden of psychological trauma.


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Furuta, M., Horsch, A., Ng, E. S. W., Bick, D., Spain, D., & Sin, J. (2018). Effectiveness of Trauma-Focused Psychological Therapies for Treating Post-traumatic Stress Disorder Symptoms in Women Following Childbirth: A Systematic Review and Meta-Analysis. Front Psychiatry, 9, 591.

Marie Furuta, Institute of Higher Education in Healthcare Research, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland. E-mail: furuta.marie.8r@kyoto-u.ac.jp


Abstract


Background: Approximately 3% of women in community samples develop posttraumatic stress disorder (PTSD) after childbirth. Higher prevalence rates are reported for high risk samples. Postpartum PTSD can adversely affect women's wellbeing, mother-infant relationships and child development. This study aims to examine the effectiveness of trauma-focused psychological interventions (TFPT), for postnatal women.
Methods: We conducted a systematic review and meta-analysis including all clinical trials which reported post-traumatic stress symptoms for both the intervention and control groups or at least two time-points, pre- and post-intervention. We searched four databases: CENTRAL, MEDLINE, PsycINFO, and OpenGrey. Screening of search results, data extraction, and risk of bias assessment were undertaken independently by two reviewers.
Results: Eleven studies, reported in 12 papers, involving 2,677 postnatal women were included. All were RCTs, bar one case series. Interventions varied in modality, duration and intensity, and included exposure therapy, trauma-focused cognitive behavioral therapy, eye movement desensitization and reprocessing and other psychological approaches. Participants had experienced uncomplicated births, emergency cesarean sections and/or preterm births. Results suggest that TFPT are effective for reducing PTSD symptoms in the short term (up to 3 months postpartum [4 RCTs, n = 301, SMD = -0.50, 95% CI = -0.73 to -0.27]), and medium term (i.e., 3-6 months postpartum [2 RCTs, n = 174, SMD = -1.87, 95% CI = -2.60 to -1.13]). However, there is no robust evidence to suggest whether TFPT can also improve women's recovery from clinically significant PTSD symptoms.
Conclusion: Further larger studies, distinguishing between low and high risk groups, and with adequate follow-up, are needed to establish which TFPT are most effective and acceptable for treating postnatal PTSD.


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Hurn, R., & Barron, I. (2018). The EMDR Integrative Group Treatment Protocol in a Psychosocial Program for Refugee Children: A Qualitative Pilot Study.
Journal of EMDR Practice and Research, 12(4), 208-223. doi:10.1891/1933-3196.12.4.208

Russell Hurn, CHUMS, Wrest Park Enterprise Centre, Wrest Park, Silsoe, Bedfordshire, United Kingdom MK45 4HS. E-mail: russell.hurn@chums.uk.com


Abstract


The current study evaluated the eye movement desensitization and reprocessing integrative group treatment protocol (EMDR-IGTP) delivered within a novel psychosocial program for child refugees. One Libyan and seven Syrian children, aged 6 to 11 years 10 months (five boys), received four 3-hour sessions, with IGTP in the second session. The study investigated whether IGTP would be valuable for child refugees whose trauma symptoms failed to reach Child and Adolescent Mental Health Service thresholds. In addition, the project aimed to identify cultural hurdles that may hinder access to Western psychological approaches. Qualitative data were collected from eight children, two therapists (an eye movement desensitization and reprocessing [EMDR] practitioner and a family care worker), and a focus group of four Arab interpreters. The qualitative design involved children completing rating scales at the beginning and end of each session and the Subjective Units of Disturbance (SUD) scale for traumatic memories before and after EMDR-IGTP. Therapists reflected on outcomes in a postintervention report, and the interpreters discussed cultural challenges in a focus group. IGTP appeared to lead to reduced internal distress and perceived increases in emotional awareness for children. Therapists’ reports affirmed reduced disturbance and highlighted the cultural sensitivity of IGTP. The interpreters’ focus group emphasized the challenges of language, the stigma of mental illness, and the differing levels of communicative control across cultures. Future studies of IGTP, embedded within psychosocial programs for refugee children, need to utilize experimental research designs including culturally sensitive outcome measures.


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Ghanbari Nia, N., Afrasiabifar, A., & Behnammoghadam, M. (2018). Comparing the effect of eye movement desensitization and reprocessing (EMDR) with guided imagery on pain severity in patients with rheumatoid arthritis. Journal of Pain Research, Volume 11, 2107-2113.

Open Access:
http://dx.doi.org/10.2147/jpr.s158981

Nasrin Ghanbari Nia, Ardashir Afrasiabifar school of nursing, Yasuj University of Medical Sciences, PO Box: 2591994 Yasuj, Iran. E-mail afrasiabifar@yahoo.com


Abstract


Objective: Previous studies reported the reduction of pain following eye movement desensitization and reprocessing (EMDR) and guided imagery; however, the effectiveness of these modalities was not compared. The current study aimed to compare the effects of EMDR and guided imagery on pain severity in patients with rheumatoid arthritis.
Material and methods: In this randomized controlled trial, 75 patients were selected using non-random method, and then allocated into two intervention groups and one control group. Interventions were conducted individually in six consecutive sessions for the intervention groups. The Rheumatoid Arthritis Pain Scale was used for data collection before and after the interventions. Collected data were analyzed with descriptive and inferential statistics in SPSS. Significance level was considered at P<0.05.
Results: The post-intervention mean scores of physiological, affective, sensory-discriminative, and cognitive pain sub-scales for patients in guided imagery group were 16.3±2.2, 13.9±2.2, 30.6±3.4, and 23.2±3, respectively. The post-intervention mean scores of these sub-scales in the EMDR group were 22±1.5, 18.1±1.8, 39.6±2.8, and 29±1.8, respectively. A significant difference was observed in the mean pain score between EMDR and guided imagery groups, and also between each intervention group and the control group (P=0.001).
Conclusion: Guided imagery and EMDR could reduce pain in rheumatoid arthritis, but pain reduction was more following the EMDR than guided imagery.


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Ibadi, A., Kuntoro, I. A., & Iswardani, T. (2018). The Implementation of Resource Development and Installation (RDI) for an Adolescent with Non-Suicidal Self Injury (NSSI). Proceedings from Proceedings of the 1st International Conference on Intervention and Applied Psychology (ICIAP 2017), Paris, France.

Open access:
http://dx.doi.org/10.2991/iciap-17.2018.10

Ike Anggraika Kuntoro, Developmental Psychology Department Faculty of Psychology, Universitas Indonesia Jl. Lkr. Kampus Raya, Depok, Jawa Barat Indonesia, 16424. E-mail: ike.anggraika@ui.ac.id


Abstract


This study examines the application of Resource Development and Installation (RDI) for Non-Suicidal Self Injury (NSSI) as applied to the case of a 16-year-old female adolescent using pre- and post-test design. NSSI, negative feelings and positive resources were assessed before and after RDI sessions were provided. RDI is the second phase of Eye Movement Desensitization (EMDR) therapy provided to a client for psychological stabilization before trauma confrontation sessions. During RDI, the therapist facilitates the client in identifying positive emotions and positive coping strategies to be used when facing problematic or challenging situations that trigger negative emotions. In this study, we applied two RDI techniques to activate and strengthen the client’s positive resources: Point of Power and Absorption Technique. The purpose of the RDI application is to reduce the NSSI by increasing positive resources and decreasing negative feelings, especially anxiety. After the RDI session, the client reported an increase in positive resources and a decrease in negative feelings as evidenced by a decline in scores of the Harvard Trauma Questionnaire (HTQ), the Hopkins Symptom Checklist (HSCL), and the Child Behavior Checklist for Age 4-18 (CBCL/4-18). The client also reported a positive change in behavior, as she feels more able to regulate her negative feelings by diverting her mind into a positive direction and perceiving her feelings more positively.


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(2018). ISTSS PTSD Prevention and Treatment Guidelines Methodology and Recommendations.

Open Access:
https://www.istss.org/treating-trauma/new-istss-prevention-and-treatment-guidelines.aspx


Introduction

1.1. The updated ISTSS PTSD Prevention and Treatment Guidelines Methodology and Recommendations, and Position Papers on Complex PTSD are available to download through the ISTSS website, along with the evidence summaries that generated the recommendations. These documents are key components of the updated Guidelines; the the third edition of Effective Treatments for PTSD, is due to be published at the end of 2019 and will focus on providing practitioners with more detailed guidance on the use of the recommendations and position papers to inform clinical practice.
1.2. This document includes the recommendations and describes the methodology used to develop them. Important issues that should be considered when interpreting the recommendations, and translating them into practice, are highlighted. It was decided to publish the recommendations and position papers in advance of the book as they represent a comprehensive and up-to-date synthesis of high-quality research evidence that is likely to help practitioners in their work. It is, however, important
to highlight that the Effective Treatments for PTSD book will provide the detailed narrative required to assist practitioners to make fully informed decisions about the applicability of the recommendations to specific clinical situations.


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Mathijssen, S. J. M. A., van Beerschotencd, L. M., de Jongh, A., Klugkist, I. G., & van den Houtab, M. A. (2018). Effects of “Visual Schema Displacement Therapy” (VSDT), an abbreviated EMDR protocol and a control condition on emotionality and vividness of aversive memories: Two critical analogue studies. Journal of Behavior Therapy and Experimental Psychiatry.

Suzy J.M.A. Matthijssen, Altrecht GGZ, Nieuwe Houtenseweg 12, 3524 SH, Utrecht, the Netherlands. E-mail address: s.matthijssen@altrecht.nl


Abstract


Background and objectives: Visual Schema Displacement Therapy (VSDT) is a novel therapy which has been de- scribed as a treatment for stress and dysfunction caused by a traumatic event. Although its developers claim this therapy is quicker and more beneficial than other forms of trauma therapy, its effectiveness has not been tested. Methods: We compared the efficacy of VSDT to an abbreviated EMDR protocol and a non-active control condition (CC) in two studies. In Study 1 participants (N = 30) were asked to recall three negative emotional memories under three conditions: VSDT, EMDR, and a CC, each lasting 8 min. Emotional disturbance and vividness of the memories were rated before and after the (within group) conditions. The experiment was replicated using a between group study. In Study 2 participants (N = 75) were assigned to one of the three conditions, and a follow-up after 6–8 days was added.
Results: In both studies VSDT and EMDR were superior to the CC in reducing emotional disturbance, and VSDT was superior to EMDR. VSDT and EMDR outperformed the CC in terms of reducing vividness.
Limitation: Results need to be replicated in clinical samples.
Conclusions: It is unclear how VSDT yields positive effects, but irrespective of its causal mechanisms, VSDT warrants clinical exploration.


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Mattheß, C., Farrell, D., Mattheß, M., Bumke, P., Sodemann, U., & Mattheß, H. (2018). The therapeutic value of trauma stabilisation in the treatment of post-traumatic stress disorder - A Southeast Asian Study. Asian J Psychiatr.

URL:
https://www.ncbi.nlm.nih.gov/pubmed/30340966

Cordula Mattheß, University of Worcester, Henwick Grove, Worcester WR2 6AJ I, United Kingdom. E-mail: Cordula.eichfeld@web.de


Abstract


OBJECTIVE: Southeast Asia suffers from various forms of natural disasters and interpersonal violence. This creates a large trauma population, while at the same time mental health services in this area are limited. The humanitarian organisation Trauma Aid Germany established trauma capacity building by training 37 local therapists in psycho-traumatology, including trauma stabilisation, in Cambodia, Indonesia and Thailand. This analysis examines the impact of trauma stabilisation as a sole treatment for traumatized clients.
METHOD: Clients were screened for PTSD using the Harvard Trauma Questionnaire pre- and post-treatment. Analysis only included clients who had received trauma stabilisation, including psychoeducation, but no confrontation with the traumatic event.
RESULTS: Trauma stabilisation was highly effective in reducing PTSD symptoms, with high remission from PTSD post-treatment. Trauma stabilisation affected all subscales of PTSD and was effective in clinical as well as subclinical traumatized clients.
CONCLUSION: The research supports the notion that trauma stabilisation is a treatment effect for PTSD. It was highly effective in its own in reducing PTSD symptoms. Based on the analysis, trauma stabilisation was a safe, language independent treatment for PTSD sufficiently flexible to be sensitive to the client's context. Therapists can adapt the techniques to the individual client and his cultural, spiritual, developmental, cognitive and situational background. Trauma stabilisation is suitable for implementation in crisis areas. The research has also implications to the potential utilisation of para-professionals.


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Negash, S., Carlson, S. H., & Linder, J. N. (2018). Emotionally focused therapy and eye movement desensitization and reprocessing: An integrated treatment to heal the trauma of infidelity. Couple and Family Psychology: Research and Practice. doi:10.1037/cfp0000107

Sesen Negash, Marriage and Family Therapy Program, San Diego State University, 5500 Campanile Drive, San Diego, CA 92181. E-mail: snegash@sdsu.edu


Abstract


Despite the prevalence of infidelity and the serious harm it causes relationships, scarce clinical literature exists about how to use trauma-informed approaches to help couples in conjoint therapy. Emotionally focused therapy (EFT) and eye movement desensitization and reprocessing (EMDR) have been empirically proven in their own right to be effective in the treatment of trauma and couples, respectively, and were utilized conjointly in this article as a means to heal trauma related to infidelity in couple therapy. The combined EFT-EMDR approach consists of using EMDR as an intervention within specific stages of EFT. A case example is presented to illustrate use of the integrated approach. Suggestions from this article may help couple therapists under- stand the role that trauma plays in maintaining the attachment injury of infidelity and to adequately attend to the traumatic impact of infidelity on both partners.


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Rathore, H. E. (2018). Trust and Attunement-Focused EMDR With a Child. Journal of EMDR Practice and Research, 12(4), 255-268. doi:10.1891/1933-3196.12.4.255

Helen E. Rathore, Southern District Health Board, Child, Adolescent, & Family Service, Invercargill, Southland, New Zealand. E-mail: helenmx5@me.com


Abstract


This qualitative case study explores using eye movement desensitization and reprocessing (EMDR) therapy informed by attachment and neuroscience research about the importance of safety (trust) and relationship (attunement). This was chosen to enable a young child to create vital positive neural networks and process early trauma while remaining within the window of receptivity, despite issues of avoidance and control. A single case study design was used with a 5-year-old child who experienced early traumas. Observable symptoms included separation anxiety, avoidance, compromised motor skills, and compromised speech. Data were obtained from carer, child, and teacher report, notes, observations, case file, ratings of emotions, and behaviors. The data were explored for outcome data points, validity, and protocol adherence. Key findings were that EMDR used with attunement and trust-building strategies appeared to support developmental progress while facilitating pervasive post- traumatic growth. EMDR appears to offer appropriate opportunities for incorporating neuroscience and attachment research in order to facilitate trauma processing. Future research into EMDR story- telling procedures and possible causative relationships between trust-building and attunement with neurodevelopmental markers would be a possible next step.


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Swimm, L. L. (2018). EMDR Intervention for a 17-Month-Old Child to Treat Attachment Trauma: Clinical Case Presentation. Journal of EMDR Practice and Research, 12(4), 269-281. doi:10.1891/1933-3196.12.4.269

Lindy Lee Swimm, Private Practice, Creative Therapy Services, 16289 Mande Lane, Culpeper, VA 22701. E-mail: lindyswimm@riverbendcounseling.net


Abstract


This article explores the effectiveness of treating a 17-month-old male diagnosed with posttraumatic stress disorder (PTSD) and a disrupted secure attachment utilizing eye movement desensitization repro- cessing (EMDR) and an integrative family therapy approach. The child experienced a life-threatening choking incident requiring hospitalization. Pretreatment, the child was inconsolable by his parents when distressed and could not tolerate anything touching his throat. Posttreatment, the child accepts comfort from his parents and allows his mother to kiss his throat. Results demonstrate a reduction or elimina- tion of PTSD symptoms and a return to a secure attachment. This case study underscores Shapiro’s Adaptive Information Processing (AIP) model (2001). Application and customization of the eight phases of EMDR therapy are highlighted along with the Integrative Attachment Trauma Protocol for Children (IATP-C). Treatment consisted of five sessions. Customization included caregiver psychoeducation; EMDR resource development, focused on strengthening attachment and regulating emotion; and facilitating caregiver co-regulation throughout EMDR. The use of EMDR therapy with customization through the IATP-C protocol shows promise as an effective intervention for treating posttraumatic stress symptoms and repairing attachment in very young children.


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Wesselmann, D., Armstrong, S., Schweitzer, C., Davidson, M., & Potter, A. (2018). An Integrative EMDR and Family Therapy Model for Treating Attachment Trauma in Children: A Case Series. Journal of EMDR Practice and Research, 12(4), 196-207. doi:10.1891/1933-3196.12.4.196

Debra Wesselmann, The Attachment and Trauma Center of Nebraska, 638 N 109th Plaza, Omaha, NE 68154. E-mail: deb@atcnebraska.com


Abstract


This case series study investigated the effectiveness of an integrative eye movement desensitization and reprocessing (EMDR) and family therapy model, specifically the Integrative Attachment Trauma Protocol for Children (IATP-C), for improving traumatic stress, attachment relationships, and behaviors in children with a history of attachment trauma; specifically, adopted children with a history of maltreatment and foster or orphanage care. Of the 23 child participants, one family dropped out at 6 months, and 22 completed treatment in 6–24 months. Mean treatment length was 12.7 months. Statistical analysis demonstrated significant improvement in scores on children's traumatic stress symptoms, behaviors, and attachment relationships by the end of treatment. Statistical analysis of secondary measures showed significant improvement in mothers' scores related to symptomology and attitudes toward their child. Gains were maintained for the 15 families who complied with completion and returning of follow-up measures. Limitations of the study include the lack of a control group and small sample size. Future directions include controlled efficacy studies with larger sample sizes as well as exploration of application of the model to a similar population of children in other cultures and to children who are not residing in permanent placements.


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