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Article on Neglect by Andrew M. Leeds, Ph.D.

Leeds, A. M. (2024). The impacts of neglecting neglect in psychotherapy research and practice and a role for positive affect in repair. Academia Mental Health and Well-Being, 1(3), 0. https://doi.org/10.20935/mhealthwellb7427

Open Access: https://doi.org/10.20935/mhealthwellb7427


Andrew M. Leeds, Ph.D., Sonoma Psychotherapy Training Institute, Santa Rosa, CA 95404, USA. E-mail: andrewmleeds@gmail.com

Abstract

Childhood emotional neglect (CEN) and childhood physical neglect (CPN) are often overlooked in research due to challenges in defining and detecting these forms of maltreatment. Despite being identified through standardized intake forms, CEN and CPN are often overlooked in organized clinical settings. CEN has been shown to significantly impact subsequent mental health issues in both prospective and retrospective studies. Sensitive periods have been identified during which CEN and CPN have greater impacts on later symptoms of post-traumatic stress disorder, depression, and shutdown dissociation. Notably, CEN has been identified as a more specific predictive factor for shutdown dissociation in adults than early-childhood maltreatment. To address these issues, clinicians must gain a greater awareness of the role of CEN and CPN and develop effective strategies for identifying and treating their long-term effects. Survivors of CEN can enhance their self-concept and their interpersonal interactions through clinical interventions aimed at enhancing their capacity to tolerate and assimilate positive emotional states.

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Five Interviews from the Journal of EMDR Practice and Research Volume 18, Number 4, 2024

From a note by Derek Farrell and Jenny Rydberg, Editors of the Journal of EMDR Practice and Research

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Rydberg, J. A. (2024). An Interview With Ignacio (Nacho) Jarero. Journal of EMDR Practice and Research, 18(4), 163-165. https://doi.org/10.1891/emdr-2024-0050

URL: https://doi.org/10.1891/emdr-2024-0050

Jenny Rydberg, University of Lorraine, Inserm, INSPIIRE, Nancy, 54000, France. E-mail: jarydberg@gmail.com

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Farrell, D. (2024). An Interview With Ad de Jongh. Journal of EMDR Practice and Research, 18(4), 166-169. https://doi.org/10.1891/emdr-2024-0051

URL: https://doi.org/10.1891/emdr-2024-0051

Jenny Rydberg, University of Lorraine, Inserm, INSPIIRE, Nancy, 54000, France. E-mail: jarydberg@gmail.com

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Rydberg, J. A. (2024). An Interview With Penny Papanikolopoulos. Journal of EMDR Practice and Research, 18(4), 170-173. https://doi.org/10.1891/emdr-2024-0052

URL: https://doi.org/10.1891/emdr-2024-0052

Jenny Rydberg, University of Lorraine, Inserm, INSPIIRE, Nancy, 54000, France. E-mail: jarydberg@gmail.com

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Farrell, D. (2024). An Interview With Matthew Kiernan. Journal of EMDR Practice and Research, 18(4), 174-177. https://doi.org/10.1891/emdr-2024-0053

URL: https://doi.org/10.1891/emdr-2024-0053

Jenny Rydberg, University of Lorraine, Inserm, INSPIIRE, Nancy, 54000, France. E-mail: jarydberg@gmail.com

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Rydberg, J. A. (2024). An Interview With Andrew M. Leeds. Journal of EMDR Practice and Research, 18(4), 178-187. https://doi.org/10.1891/EMDR-2024-0054

URL: https://doi.org/10.1891/EMDR-2024-0054

Jenny Rydberg, University of Lorraine, Inserm, INSPIIRE, Nancy, 54000, France. E-mail: jarydberg@gmail.com

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Recent Articles

Akyol, C. C., Kutlu, M., & Korkmazlar, Ü. (2024). Case report: Online eye movement desensitization and reprocessing approach in children: a case series. Front Psychiatry, 15, 1391980. https://doi.org/10.3389/fpsyt.2024.1391980

Open Access: https://doi.org/10.3389/fpsyt.2024.1391980

Canan Citil Akyol E-mail: canancitil@gmail.com

Abstract

OBJECTIVE: The aim of this study was to examine the use of Eye Movement Desensitization and Reprocessing (EMDR) in online counseling for children with single-incident trauma.
METHOD: A qualitative case study method was employed. The research was conducted with two volunteering children and their parents. The sessions were transcribed by the authors, and code names (Ipek and Eylül) were assigned to protect the participants' identities. İpek's traumatic memory was explored through drawing pictures with tactile bilateral stimuli and Eylül's traumatic experience was addressed using tactile bilateral stimuli during the EMDR therapeutic story technique. The Child Revised Impact of Events Scale (CRIES-8) was used for pre-test, post-test, and follow-up testing to support the session descriptions.
RESULTS: The results indicated that post-traumatic symptoms were reduced and remained at a low level for an extended period in both clients.
CONCLUSIONS: It is suggested that future studies should explore various bilateral stimulation methods in online EMDR, conduct larger-scale studies with children who have experienced different types of traumatic events, and investigate the impact of various EMDR protocols on children.

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Bal, F., & Kırış, M. (2024). Effectiveness of Eye Movement Desensitization and Reprocessing-EMDR Method in Patients with Chronic Subjective Tinnitus. Brain Sci, 14(9), 918. https://doi.org/10.3390/brainsci14090918

Open Access: https://doi.org/10.3390/brainsci14090918

Fatih Bal fatihbal@sakarya.edu.tr

Abstract

This research aimed to investigate the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) method on chronic subjective tinnitus. The research was planned as an observational study. The study group comprises individuals who applied to the training and research hospital in Ankara between 2019 and 2020 and were aged between 15 and 60 years old. They were identified as having tinnitus. The study samples were determined as 36 participants selected through purposeful sampling. The samples of the 36 participants included in the study. 12 were assigned to the 1st Group EMDR and Masking Group, 12 to the 2nd Group Masking and EMDR Group, and 12 to the 3rd Control Group. The study's dependent variable was the tinnitus levels of the participants, and the independent variable was EMDR and the Masking method. The dependent variable data of the study was collected with the Visual Analog Scale and Tinnitus Handicap Inventory (THI). EMDR and Masking methods used as independent variables in the study were conducted in eight sessions for two months. As a result of the Wilcoxon Sign test used to determine whether the EMDR Method is effective on tinnitus severity level, the difference between tinnitus severity level pretest and post-test median scores of tinnitus patients was found to be statistically significant. Our research findings show that the EMDR method reduces and improves chronic subjective tinnitus, and further studies with a larger sample size could confirm our results.

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Burger, S. R., Hardy, A., Verdaasdonk, I., van der Vleugel, B., Delespaul, P., van Zelst, C., de Bont, P. A. J., Staring, A. B. P., de Roos, C., de Jongh, A., Marcelis, M., van Minnen, A., van der Gaag, M., & van den Berg, D. (2024). The effect of trauma-focused therapy on voice-hearing: An experience sampling study. Psychol Psychother. https://doi.org/10.1111/papt.12556

Open Access: https://doi.org/10.1111/papt.12556

Simone R. Burger, Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Room MF-B543, Van der Boechorstraat 7 1081 BT Amsterdam, The Netherlands. E-mail: s.r.burger@vu.nl

Abstract

BACKGROUND: Trauma and post-traumatic stress are involved in the aetiology and maintenance of voice-hearing. It has been proposed that trauma-focused therapy (TFT) might affect voice-hearing, but previous studies are limited and remain undecided.
OBJECTIVES: We aimed to investigate the effect of TFT on voice-hearing in people with PTSD and psychosis using experience sampling method (ESM). A secondary aim was to explore how changes in voice-hearing are related to changes in PTSD. DESIGN: This is an adjunct longitudinal ESM study of a sub-group of participants (N = 39) from a randomised controlled trial that compared TFT to a waiting-list control group.
METHODS: Voice-hearing participants filled in 10 daily voice-hearing-related questionnaires for six consecutive days at baseline and post-treatment at pseudo-random times during the day. PTSD symptom severity was assessed at baseline and post-treatment. Multilevel linear regression was used to test the effect of TFT on voice-hearing and to analyse the relationship between changes in voice-hearing and changes in PTSD.
RESULTS: The intention-to-treat analysis showed a significant interaction effect between time and treatment condition (p < .00001) with a small effect size (dppc2 = -0.27), indicating a larger decrease in voice-hearing in the TFT group than in the waiting-list control group. Also, a significant association was observed between changes in PTSD symptoms and changes in voice-hearing (p < .00001).
CONCLUSIONS: Our findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can alleviate distressing voices.

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Butler, S.-J., & Ramsey-Wade, C. (2024). How do clients experience intensive EMDR for post-traumatic stress? An interpretative phenomenological analysis. European Journal of Trauma & Dissociation, 8(4), 100479. https://doi.org/10.1016/j.ejtd.2024.100479

Open Access: https://doi.org/10.1016/j.ejtd.2024.100479

Christine Ramsey-Wade, E-mail: christine.ramsey-wade@uwe.ac.uk

Abstract

Background: Several studies of the intensive delivery of Eye Movement Desensitization and Reprocessing (EMDR) have indicated it to be an effective treatment for Post-Traumatic Stress Disorder (PTSD), providing improved client experience, faster reduction in symptoms, greater symptom reduction, and reduced dropout rates as compared to non-intensive EMDR. However, there is a dearth of studies that describe this non-traditional approach to the delivery of EMDR psychotherapy from the patients’ perspective.
Procedure: This qualitative study explores the experiences of patients who undertook intensive EMDR for post-traumatic stress. Interviews were conducted with 10 participants and analysed using Interpretative Phenomenological Analysis (IPA).
Main findings: The data revealed two Personal Experiential Themes (PET) and four experiential statements. ‘The importance of psychological safety’ generated sub-themes of ‘A protected space’ and ‘The importance of a continued connection’. ‘The changing self’ generated two sub-themes of a ‘Wow! moment’, and ‘Living the way I always wanted’.
Conclusion: Results show that intensive EMDR can be experienced as safe, facilitating agency and engagement while affecting meaningful change.

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Ellenbroek, N., Nuijs, M. D., & Matthijssen, S. J. M. A. (2024). The effectiveness of a remote intensive trauma-focused treatment programme for PTSD. Eur J Psychotraumatol, 15(1), 2408960. https://doi.org/10.1080/20008066.2024.2408960

Open Access: https://doi.org/10.1080/20008066.2024.2408960

Suzy J. M. A. Matthijssen, E-mail: s.matthijssen@altrecht.nl

Abstract

Background: Limited research has addressed the efficacy of remote intensive trauma-focused treatment programmes.
Objective: This study aims to assess the effectiveness of a remote intensive treatment programme in reducing symptoms of Post-Traumatic Stress Disorder (PTSD), general psychiatric symptoms, symptoms of depression, and the interference of PTSD symptoms in daily life among individuals diagnosed with PTSD.
Method: A cohort of 26 patients diagnosed with PTSD underwent a six-day remote treatment programme, which included prolonged exposure, Eye Movement Desensitisation and Reprocessing (EMDR), physical activity, and psycho-education. PTSD symptoms, general psychiatric symptoms, symptoms of depression, and interference of PTSD symptoms in daily life were assessed at screening, pre-treatment, post-treatment, 1-week, 4-week, and at 6-month follow-up.
Results: A significant decrease in PTSD symptoms, measured by the CAPS-5 and PCL-5, was observed from screening to 4-week follow-up (respectively, d = 1.42, d = 1.15), and sustained improvements were noted at 6-month follow-up (respectively, d = 1.70, d = 1.29). Additionally, a significant decrease in general psychiatric symptoms (d = 1.18), symptoms of depression (d = 0.85), and interference of PTSD symptoms in daily life (d = 0.92) was found from pre-treatment to 4-week follow-up. At 4-week follow-up, 56% of the participants no longer met the criteria for PTSD according to the CAPS-5, 73.1% showed improvement, and no patients worsened based on the Reliable Change Index.
Discussion: The results of this study demonstrate that a remote intensive trauma-focused treatment was effective in reducing PTSD symptoms and secondary outcomes in individuals with PTSD due to multiple traumatic experiences. To enhance the robustness of these findings, future studies should incorporate controlled designs, larger sample sizes, and extended follow-up durations. Intensive trauma-focused treatment can be performed remotely. Remote intensive trauma-focused treatment is successful in reducing PTSD symptoms. Remote intensive trauma-focused treatment is successful in reducing general psychiatric symptoms, symptoms of depression, and interference of PTSD symptoms in daily life. Symptom decrease was maintained at 4-week and 6-month follow-up.

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Hafkemeijer, L., de Jongh, A., Starrenburg, A., Hoekstra, T., & Slotema, K. (2024). EMDR treatment in patients with personality disorders. Should we fear symptom exacerbation? Eur J Psychotraumatol, 15(1), 2407222. https://doi.org/10.1080/20008066.2024.2407222

Open Access: https://doi.org/10.1080/20008066.2024.2407222


Laurian Hafkemeijer, E-mail: l.hafkemeijer@ggz-delfland.nl

Abstract

Background: Clinicians are often hesitant to use trauma-focused therapy for patients with personality disorders (PDs) because of concerns that the pathology may worsen.
Objective: Exploring trajectories of change and individual exacerbations in psychological distress and suicidal thoughts in patients with a PD without comorbid posttraumatic stress disorder (PTSD) during EMDR therapy or waiting time.
Method: In a randomized controlled trial, the effectiveness of five sessions of EMDR therapy was compared with a waitlist in 97 outpatients. Acute suicidal patients were not included in this study. Psychological distress and suicidality scores were measured on a weekly basis during the EMDR and waiting list (WL) periods and at 3-month follow-up. Data were analysed in a descriptive manner for individual patients, and hierarchical cluster analysis was used to identify patterns of change among clusters of patients. Mann-Whitney U and chi-squared tests were used to explore differences in specific patient characteristics between the found clusters of patients.
Results: Patients generally improved, and no clusters of patients deteriorated during the EMDR therapy. Session-to-session exacerbations occurred in both the EMDR (psychological distress: 10.0%; suicidal thoughts: 28.0%) and WL group (psychological distress: 28.0%; suicidal thoughts: 43.5%). Two percent of patients in the EMDR group and 8.7% of patients in the WL condition showed an increase in psychological distress, whereas 2.0% of patients in the EMDR group and 10.9% of patients in the WL condition showed an increase in suicidal thoughts posttreatment compared to baseline.
Conclusions: These results show that although individual exacerbations in psychological distress and suicidal thoughts occur, these were less likely to occur in response to EMDR therapy compared with no therapy. Continuation of therapy following exacerbation led to a decrease in psychological distress and suicidal thoughts in most patients. This is the first study exploring trajectories of change and individual exacerbations in patients with a personality disorder (PD) without comorbid posttraumatic stress disorder (PTSD) during EMDR therapy or waiting time. The results show that although individual exacerbations in psychological distress and suicidal thoughts occur, these were less likely to occur in response to EMDR therapy compared with no therapy. The patients generally improved, and no clusters of patients deteriorated during EMDR therapy. Continuation of therapy following exacerbation led to a decrease in psychological distress and suicidal thoughts in most patients. Only two percent of patients in the EMDR group showed an increase in psychological distress and suicidal thoughts posttreatment compared to baseline.

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Havermans, D. C. D., Cations, M., Woudsma, J. S., Janssen, I., Collet, J., Gerritsen, D. L., Hoeboer, C. M., Olff, M., & Sobczak, S. (2024). Impact and Needs in Caregiving for Individuals With Dementia and Comorbid Posttraumatic Stress Disorder Living in Nursing Homes. Int J Older People Nurs, 19(6), e12653. https://doi.org/10.1111/opn.12653

Open Access: https://doi.org/10.1111/opn.12653

Demi C. D. Havermans E-mail: d.havermans@maastrichtuniversity.nl

Abstract

What does this research add to existing knowledge in gerontology?
○ Recognition of possible PTSD is essential for a trauma-sensitive approach in individuals with dementia in nursing homes.
○ Research in this area is needed and feasible.
○ The current article mentions available treatment
possibilities and care approaches in individuals with both possible PTSD and dementia in nursing homes.
• What are the implications of this new knowledge for nursing care for and with older adults?
○ By improving the understanding and needs of individuals with dementia and possible PTSD, nursing staff can adapt their care accordingly.
○ Nursing staff are better able to accept and understand the challenging behaviour when it is clear what caused the behaviour (e.g., fear).
• How could the findings be used to influence practice, education, research, and policy?
○ The current findings emphasise the need to enhance knowledge of PTSD in individuals with dementia in nursing homes as well as its impact on both the individuals themselves and nursing staff.
○ With an increasing number of individuals with dementia, educating nursing staff will be important to distinguish neuropsychiatric symptoms and possible PTSD symptoms, and improve care approaches.

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Höfel, L., Eppler, B., Haas, J.-P., & Hügle, B. (2024). Duration of effect in treatment of methotrexate intolerance in juvenile idiopathic arthritis using Eye Movement Desensitization and Reprocessing (EMDR) can be improved by Bi-lateral Alternating Stimulation Tactile (BLAST) wristbands. Pediatr Rheumatol Online J, 22(1), 95. https://doi.org/10.1186/s12969-024-01024-9

Open Access: https://doi.org/10.1186/s12969-024-01024-9

Boris Hügle E-mail: boris.huegle@rheumazentrum-rlp.de

Abstract

BACKGROUND: Methotrexate (MTX) intolerance in juvenile idiopathic arthritis (JIA) frequently leads to discontinuation due to anticipatory and associative gastrointestinal symptoms. Eye Movement Desensitization and Reprocessing (EMDR) has successfully been used in MTX intolerance, with lasting effects but frequently diminishing efficacy over time. BLAST (bi-lateral alternating stimulation tactile) wristbands utilize a similar process to EMDR. The aim of this study was to determine if utilization of BLAST wristbands could improve and prolong the effect of EMDR on patients with MTX intolerance.
METHODS: Consecutive patients admitted to the German Center for Pediatric and Adolescent Rheumatology with JIA and signs of MTX intolerance from October 2016 until March 2024 were included in this study. Treatment was performed using an adapted 8 phase EMDR protocol implementing BAST wristbands. Initial patients were treated with EMDR, subsequent patients additionally with BLAST wristbands. Health-related quality of live was determined using the PedsQL. Measurements of MISS (Methotrexate Intolerance Severity Score) and PedsQL were taken at 4 time points: directly before and after (MISS only) treatment, as well as 4 and 12 months after treatment. Changes in MISS and PedsQL were compared using descriptive statistics and repeated measures ANOVA.
RESULTS: 87 patients with MTX intolerance were included, 53 in group 1 without BLAST wristbands and 34 in group 2 which were concurrently treated with BLAST wristbands. All patients reported marked improvement of MTX intolerance symptoms (mean MISS score group 1: 15.0 ± 5.5 before treatment, 1.3 ± 1.5 after treatment, group 2: 16.8 ± 5.6 and 2.5 ± 2.5, respectively). After 4 and 12 months, MISS in group 1 was 8.1 ± 7.1 and 8.7 ± 8.4, and in group 2: 7.1 ± 6.3 and 6.5 ± 5.7. A repeated measures ANOVA showed a significant difference between the MISS results over time (F(3,114) = 64.6, p < 0.001), and also demonstrated a significant difference of the PedsQL results between the two groups over time (F(2,64) = 8.9, p < 0.001).
CONCLUSION: Treatment with Eye Movement Desensitization and Reprocessing (EMDR) could present an effective treatment of MTX intolerance, and using BLAST wristbands, further potential improvement is possible.

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Hoppen, T. H., Wessarges, L., Jehn, M., Mutz, J., Kip, A., Schlechter, P., Meiser-Stedman, R., & Morina, N. (2024). Psychological Interventions for Pediatric Posttraumatic Stress Disorder: A Systematic Review and Network Meta-Analysis. JAMA Psychiatry, e243908. https://doi.org/10.1001/jamapsychiatry.2024.3908

URL: https://doi.org/10.1001/jamapsychiatry.2024.3908

Thole H. Hoppen, PhD, Institute of Psychology, University of Münster, Fliednerstr. 21, 48149 Münster, Germany E-mail: thoppen@uni-muenster.de

Abstract

IMPORTANCE: Pediatric posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder, yet a comprehensive network meta-analysis examining psychological interventions is lacking. OBJECTIVE: To synthesize all available evidence on psychological interventions for pediatric PTSD in a comprehensive systematic review and network meta-analysis.
DATA SOURCES: PsycINFO, MEDLINE, Web of Science, and PTSDpubs were searched from inception to January 2, 2024, and 74 related systematic reviews were screened.
STUDY SELECTION: Two independent raters screened publications for eligibility. Inclusion criteria were randomized clinical trial (RCT) with at least 10 patients per arm examining a psychological intervention for pediatric PTSD compared to a control group in children and adolescents (19 years and younger) with full or subthreshold PTSD.
DATA EXTRACTION AND SYNTHESIS: PRISMA guidelines were followed to synthesize and present evidence. Two independent raters extracted data and assessed risk of bias with Cochrane criteria. Random-effects network meta-analyses were run. MAIN
OUTCOME AND MEASURES: Standardized mean differences (Hedges g) in PTSD severity.
RESULTS: In total, 70 RCTs (N = 5528 patients) were included. Most RCTs (n = 52 [74%]) examined trauma-focused cognitive behavior therapies (TF-CBTs). At treatment end point, TF-CBTs (g, 1.06; 95% CI, 0.86-1.26; P < .001), eye movement desensitization and reprocessing (EMDR; g, 0.86; 95% CI, 0.54-1.18; P < .001), multidisciplinary treatments (MDTs) (g, 0.88; 95% CI, 0.53-1.23; P < .001), and non-trauma-focused interventions (g, 0.95; 95% CI, 0.62-1.28; P < .001) were all associated with significantly larger reductions in pediatric PTSD than passive control conditions. TF-CBTs were associated with the largest short-term reductions in pediatric PTSD relative to both passive and active control conditions and across all sensitivity analyses. In a sensitivity analysis including only trials with parent involvement, TF-CBTs were associated with significantly larger reductions in pediatric PTSD than non-trauma-focused interventions (g, 0.35; 95% CI, 0.04-0.66; P = .03). Results for midterm (up to 5 months posttreatment) and long-term data (6-24 months posttreatment) were similar.
CONCLUSIONS AND RELEVANCE: Results from this systematic review and network meta-analysis indicate that TF-CBTs were associated with significant reductions in pediatric PTSD in the short, mid, and long term. More long-term data are needed for EMDR, MDTs, and non-trauma-focused interventions. Results of TF-CBTs are encouraging, and disseminating these results may help reduce common treatment barriers by counteracting common misconceptions, such as the notion that TF-CBTs are harmful rather than helpful.

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Larsen, S. E., Ranney, R. M., Matteo, R., Grubbs, K. M., & Hamblen, J. L. (2024). What’s in a treatment name? How people with posttraumatic stress disorder (PTSD) symptoms interpret and react to PTSD treatment names. J Trauma Stress. https://doi.org/10.1002/jts.23108

URL: https://doi.org/10.1002/jts.23108

Sadie E. Larsen, National Center for PTSD, 163 Veterans Drive, White River Junction, VT 05001. E-mail: sadie.larsen@va.gov

Abstract

Prior research has rarely examined how people understand or react to the names of psychological treatments. In the case of evidence-based psychotherapies for posttraumatic stress disorder (PTSD), such reactions may be relevant to the low rates of uptake of such treatments. Participants who screened positive for PTSD (n = 887) completed questions assessing their initial reactions to PTSD treatment names as well as how a different name would affect their openness to treatment. In addition, they gave brief responses to open-ended questions about the reason for their initial reactions, and content analysis was used to better understand these reasons. The results indicated that among the treatment name options, cognitive processing therapy (CPT) and present-centered therapy (PCT) were viewed most positively. Approximately 40% of the sample preferred plain language alternatives for treatment names. Content analyses focused on descriptions of the treatments-which could be accurate or inaccurate-as well as whether respondents evaluated a treatment name itself as positive or negative. Some names conveyed treatments more accurately (e.g., CPT and written exposure therapy) than others (e.g., eye movement desensitization and reprocessing and prolonged exposure [PE]). Some names were also evaluated more positively (e.g., PCT) than others (e.g., PE). The general term "trauma-focused therapy" was seen as positive and clear. Addressing the ways patients react to psychological terms and treatment names could help clarify misperceptions about evidence-based psychotherapies and promote more widespread uptake of effective treatments for PTSD.

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Magne, H. (2024). Effect of eye movement desensitization and reprocessing therapy in a patient with anxiety and burning mouth syndrome. Gerodontology, 41(3), 433-435. https://doi.org/10.1111/ger.12738

URL: https://doi.org/10.1111/ger.12738

Hugues Magne, Private Practice, Pain & Neuropsychiatry, 2B, Avenue de Royat, 63400 Chamalières, France. E-mail: dr.hugues.magne@gmail.com

Abstract

OBJECTIVE: To propose an alternative treatment for burning mouth syndrome (BMS).
BACKGROUND: BMS is a serious condition that negatively affects the physical and emotional health of the elderly. Pharmacological interventions are not always appropriate in this population and may have significant side effects.
MATERIALS AND METHODS: We present the case of an 86-year-old woman who has been suffering from BMS for 30 years and has been experiencing impaired quality of life, particularly sleep disturbances. Because standard pharmaceutical medications failed to alleviate the patient's pain, we proposed EMDR as an alternative therapeutic approach. Baseline measures included depressive symptoms, anxiety symptoms, daytime and nighttime pain and sleep quality. To anticipate anxious thoughts associated with pain, seven 45-min EMDR sessions were conducted.
RESULTS: Therapy resulted in reduced anxiety symptoms (-30%), improved pain control (-10% daytime, -60% nighttime) and improved sleep quality (+50%). This positive effect lasted for 4 months, and no serious negative effects were observed.
CONCLUSION: EMDR therapy may help older adults with BMS improve their pain and psychological management.

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Mesman, C., Van Der Horst, I., Spijker-Verkerk, F., & Bunt, J. E. (2024). Eye movement desensitisation and reprocessing (EMDR) therapy in preterm children with selective mutism. BMJ Case Rep, 17(10), e260548. https://doi.org/10.1136/bcr-2024-260548

URL: https://doi.org/10.1136/bcr-2024-260548

Dr Jan Erik Bunt; E-mail: j.bunt@etz.nl

Abstract

Very preterm birth and treatment in neonatal intensive care cause stress early in life of the infant and may subsequently lead to psychological and behavioural traumas. Previous studies show positive outcomes of eye movement desensitisation and reprocessing (EMDR) therapy on trauma in children in general. This case report describes two girls that were born at very premature age (with birth weights of approximately 1000 g). They required intensive treatment in the neonatal intensive care. In early childhood, they presented with selective mutism (SM). We treated them with EMDR therapy because we hypothesised that trauma from the postnatal period had caused post-traumatic stress disorder. The EMDR therapy resulted in a long-lasting improvement in speech, social skills and communication. This is the first case report of development of SM in ex-premature infants that were treated with EMDR therapy in early childhood.

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O’Doherty, L. J., Carter, G., Sleath, E., Brown, K., Brown, S., Lutman-White, E., Jackson, L., Heron, J., Kalsi, P. T., Ladeinde, O. C., Whitfield, D., Caswell, R., Gant, M., Halliwell, G., Patel, R., & Feder, G. (2024). Health and wellbeing of survivors of sexual violence and abuse attending sexual assault referral centres in England: the MESARCH mixed-methods evaluation. Health Soc Care Deliv Res, 12(35), 1-133. https://doi.org/10.3310/CTGF3870

Open Access: https://doi.org/10.3310/CTGF3870

Lorna J O’Doherty, E-mail: lorna.odoherty@coventry.ac.uk

Abstract

BACKGROUND: One million people in England and Wales experience sexual violence and abuse each year, with nearly half experiencing serious sexual offences; around 30,000 survivors access sexual assault referral centres.
OBJECTIVES: This research was commissioned by National Institute for Health and Care Research to evaluate access, interventions and care pathways for survivors, especially those provided through sexual assault referral centres.
DESIGN, SETTING, PARTICIPANTS: The sexual assault referral centres care pathway was investigated through six sub-studies. There were two Cochrane Reviews (4274 participants). Seventy-two providers and 5 survivors were interviewed at eight sites; the children and young people study involved 12 participants from two sexual assault referral centres. A cohort study involving three-wave data collection over 1 year (21 sites; 2602 service users screened, 337 recruited) used a multilevel modelling framework to explore risk factors for burden of post-traumatic stress disorder symptoms at baseline and change at 1 year. We analysed costs and outcomes and conducted a narrative analysis (41 survivors). We worked closely with survivors and prioritised the safety/welfare of participants and researchers.
RESULTS: Cochrane Reviews identified large effects from psychosocial interventions for post-traumatic stress disorder and depression. Sexual assault referral centres delivered a high-quality frontline service for survivors but groups experiencing domestic abuse and some ethnic and cultural minorities were under-represented. The qualitative research emphasised inter-agency collaboration for survivor benefit. The cohort study identified a risk 'triad' of adverse childhood experiences, poor mental health and economic deprivation, which was associated with baseline trauma burden. There were important improvements in trauma symptoms a year later. These improvements were unrelated to different sexual assault referral centre models. Costs and other outcomes were also similar across models. Harmful policing and justice practices/procedures were identified by 25% of participants. In this context, trauma-competent interviewing techniques, regular/timely updates and conveying case decisions with care signalled good practice.
LIMITATIONS: The cohort study lacked a comparison group, reducing confidence in the finding that access to sexual assault referral centres explained the reduction observed in post-traumatic stress disorder.
CONCLUSIONS AND FUTURE WORK: Barriers to access call for concerted efforts to implement trauma-informed universal health services. The risk 'triad' underscores the value of holistic approaches to care at sexual assault referral centres and timely follow-on care. Poor mental health was the main barrier to service access beyond sexual assault referral centres. The persistence of trauma symptoms a year after accessing sexual assault referral centres signals urgent need for tackling counselling wait-lists, expanding support options and commitment to lifelong care. Multidisciplinary evaluation of sexual assault referral centres for better health provides a foundation for advancing trauma-informed practices in the context of sexual violence and abuse.

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Phillips, A. R., Halligan, S. L., Bailey, M., Birkeland, M. S., Lavi, I., Meiser-Stedman, R., Oram, H., Robinson, S., Sharp, T. H., & Hiller, R. M. (2024). Systematic review and meta-analysis: do best-evidenced trauma-focused interventions for children and young people with PTSD lead to changes in social and interpersonal domains? J Psychotraumatol, 15(1), 2415267. https://doi.org/10.1080/20008066.2024.2415267

Open Access: https://doi.org/10.1080/20008066.2024.2415267

Alice R. Phillips, University of Bath, Claverton Down, Bath BA2 7AY. E-mail: alice.phillips@psych.ox.ac.uk

Abstract

Objective: Young people with post-traumatic stress disorder experience difficulties in social and interpersonal domains. We examined whether the best-evidenced treatments of PTSD for children and young people (Trauma-focussed Cognitive Behavioural Therapy or Eye Movement Desensitisation and Reprocessing; aged 5-25) improve social or interpersonal factors in randomised controlled trials, compared to a comparator condition.
Method: The review was preregistered on PROSPERO (CRD42023455615; 18th August 2023). Web of Science Core Collection, EMBASE, CINAHL, Pubmed, PsycINFO, Cochrane Central Register of Controlled Trials and PTSDPubs were searched, and data were extracted for social and interpersonal outcomes post treatment. A random effect meta-analysis was conducted to obtain between-group pooled effect size estimates.
Results: The search resulted in 792 studies, of which 17 met our inclusion criteria (N = 2498). Our meta-analysis included 13 studies which investigated social skills and functioning, revealing a small but non-significant effect favouring the evidence-based treatment versus comparison (g = .20, 95% CI [-0.03, 0.44], p = .09). We narratively synthesised six studies which reported other social-related outcomes (e.g. perceptions of social support), and four out of six reported improved social domain outcomes for the evidence-based PTSD treatment condition. There was a large amount of heterogeneity, with no evidence that this could be explained by moderators.
Conclusion: Few trials report on social and interpersonal outcomes, and where they are reported the evidence is mixed. It may be that trauma-focused therapies for PTSD need to be adapted in some circumstances, so that they address social and interpersonal deficits often seen in children and young people with PTSD. We used a systematic review and meta-analysis to see whether the best treatments for PTSD in children and young people (aged 5–25) improve social or interpersonal factors. These treatments include Trauma-Focused Cognitive Behavioural Therapy and Eye Movement Desensitisation and Reprocessing.Our meta-analysis looked at 13 studies and found a small but not significant improvement in social functioning for those who received the evidence-based treatments compared to other conditions.We found that few studies report on social and interpersonal outcomes, and when they do the results are mixed. Trauma-focused therapies for PTSD might need to be adjusted to better address social and interpersonal issues in young people.

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Potharst, E. S., Holtkamp, P., Walliser, L., Dommerholt, A. H., van den Heuvel, M. E. N., Spierts, I., & Maric, M. (2024). Improving Infant Mental Health: A Pilot Study on the Effectiveness, Acceptability and Feasibility of Eye Movement Desensitization and Reprocessing (EMDR) Storytelling in Infants With Post-traumatic Distress After Medical Procedures. Eval Health Prof, 1632787241268176. https://doi.org/10.1177/01632787241268176

Open Access: https://doi.org/10.1177/01632787241268176

Eva S. Potharst, Academic Outpatient (Child and Adolescent) Treatment Center of the University of Amsterdam, Banstraat 29, Amsterdam 1071 JW, The Netherlands.
E-mail: EPotharst@uvaminds.nl

Abstract

Although the prevalence of symptoms of post-traumatic stress disorder (PTSD) in infants and young children is similar as in older age groups, and PTSD intervention is as important in this age group, research on PTSD-treatment in infants is very scarce. Eye Movement Desensitization and Reprocessing (EMDR) Storytelling is a trauma-focused treatment that is being used by clinicians for infants with PTSD-symptoms. The aim was to assess the feasibility, acceptability and initial indications of effectiveness of EMDR Storytelling for infants aged 3-24 months with PTSD-symptoms after medical procedures. We included 6 infants and administered personalized items to assess PTSD-symptoms during the baseline, intervention and follow-up phase on a day-to-day basis. Furthermore, we measured PTSD-classification and symptoms at three and four measurement points, respectively. The data was analysed visually and quantitatively. EMDR Storytelling was shown to be feasible and acceptable for all participating families. Parent- and therapist-report showed that four out of the six infants included in the current study showed a clear reduction over time in PTSD-classification, -symptoms, and daily measured PTSD-symptoms. The results concerning the other two infants were mixed. Attention should be paid to cognitive (language) as well as interactional (infant-parent) mechanisms potentially underlying the benefits of EMDR Storytelling.

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Rathore, A., Kalra, N., Tyagi, R., Khatri, A., Srivastava, S., & Khandelwal, D. (2024). Eye movement desensitization and reprocessing therapy as an adjunct to pain management during dental extraction in children - a randomized control trial. J Dent Anesth Pain Med, 24(5), 329-340. https://doi.org/10.17245/jdapm.2024.24.5.329

Open Access: https://doi.org/10.17245/jdapm.2024.24.5.329

Namita Kalra, Professor (SAG), Department of Pediatrics and Preventive Dentistry, University College of Medical Sciences & Guru Teg Bahadur Hospital (University of Delhi), New Delhi, India. E-mail: nkalraucms@yahoo.com

Abstract

BACKGROUND: Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated.
METHODS: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups.
RESULTS: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001).
CONCLUSION: Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

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Rolling, J., Fath, M., Zanfonato, T., Durpoix, A., Mengin, A. C., & Schröder, C. M. (2024). EMDR-Teens-cPTSD: Efficacy of Eye Movement Desensitization and Reprocessing in Adolescents with Complex PTSD Secondary to Childhood Abuse: A Case Series. Healthcare (Basel), 12(19), 1993. https://doi.org/10.3390/healthcare12191993

Open Access: https://doi.org/10.3390/healthcare12191993

Julie Rolling, E-mail: julie.rolling@chru-strasbourg.fr

Abstract

Background: Mental healthcare for children and adolescents with a history of childhood abuse constitutes a major public health issue. Indeed, abuse exposes children to severe and complex post-traumatic stress disorder (cPTSD) but also to neurodevelopmental and psychological repercussions impacting the developmental trajectory. Trauma-focused care is essential to avoid the chronicization of symptoms and disorders.
Objective: The aim of this prospective case series study was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) on complex post-traumatic symptoms and associated psychiatric disorders in adolescents with a history of abuse.
Method: Twenty-two adolescents, aged 12 to 17, who had been abused during childhood were included. All adolescents met ICD-11 criteria for complex PTSD. Subjective measures of PTSD and associated psychiatric disorders were taken before (T0) and after 3 months of EMDR therapy (T1).
Results: The average PTSD symptom score on the CPTS-RI significantly decreased from 40.2 to 34.4 after EMDR, indicating improvement in post-traumatic symptoms. A significant decrease in the average depression score (CDI from 18.2 at T0 to 10.6 at T1), anxiety score (R-CMAS from 21.3 at T0 to 13.3 at T1), emotional regulation score (ALS from 29 at T0 to 10.8 at T1), insomnia score (ISI from 18.5 at T0 to T1 of 9.2 at T1), and harmful use of alcohol and drugs score (ADOSPA from 2.3 at T0 to 0.3 at T1) was observed after EMDR therapy, as well as an increase in quality of life (CBCL 4-16 score from 57.9 at T0 to 77.4 at T1).
Conclusions: The results of this study are encouraging and suggest that EMDR may be effective in the symptom management reducing post-traumatic symptoms and certain comorbid disorders frequently seen in adolescents who have experienced childhood abuse. Further research is needed on adolescent populations suffering from cPTSD (e.g., randomized controlled trials with control groups and other therapies or evaluating the action of the different phases of the study).

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Rzepka, I., Kindermann, D., Friederich, H.-C., & Nikendei, C. (2024). Secondary traumatization in refugee care-EMDR intervention for interpreters (STEIN): a study protocol for a quasi-randomized controlled trial. Trials, 25(1), 643. https://doi.org/10.1186/s13063-024-08480-4

Open Access: https://doi.org/10.1186/s13063-024-08480-4

Irja Rzepka, E-mail: irja.rzepka@med.uni‐heidelberg.de

Abstract

BACKGROUND: By the end of 2022, more than 100 million people worldwide fled their homes. Before, during and after their flight, refugees have high risk of experiencing traumatic events. Accordingly, around every third refugee is affected by posttraumatic stress disorder. For adequate mental health care, the service of interpreters is often urgently needed to overcome existing language barriers. However, repeated exposure with details of traumatic narratives, as experienced by interpreters, can be burdensome and can lead to trauma sequela symptoms in terms of secondary traumatic stress. Only few studies have examined the treatment of secondary traumatic stress to date. Based on the recommendations for the treatment of posttraumatic stress disorder with confrontational methods, this study was designed to evaluate the effectiveness of an eye movement desensitization and reprocessing (EMDR) intervention in a sample of interpreters working in refugee care suffering from secondary traumatic stress symptoms.
METHODS: To evaluate the effectiveness of an EMDR intervention for the treatment of secondary traumatic stress symptoms, a quasi-randomized controlled trial using a waiting group design will be performed. Participants will be treated with a maximum of 6 sessions based on EMDR standard protocol. Primary outcome is the symptom load of secondary traumatic stress, assessed with the Questionnaire for Secondary Traumatization, while secondary outcomes comprise further symptom complexes such as PTSD due to self-experienced traumatic events, depression, anxiety, and somatization as well as quality of life, quality of professional life, and psychological wellbeing that will be assessed with the PDS, PHQ-9, GAD-7, SSD-12, SF-12, PROQOL-5, and WHO-5, respectively.
DISCUSSION: Our primary interest is to determine the efficacy of an EMDR intervention in interpreters affected by secondary traumatic stress, especially how many sessions are needed for significant symptom reduction. Change of associated symptom complexes and quality of life will be investigated. Reprocessing one's own stressful experiences may also contribute to this, which is not the focus of the treatment but relevant to the EMDR protocol. This study aims to assess if EMDR could be an acceptable, effective, and time-efficient method for reducing work-related secondary traumatization.
TRIAL REGISTRATION: German Clinical Trials Register, DRKS00032092, registered 16 June 2023.

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Thunnissen, M. R., de Jong, P. J., Weijermans, J., Vet, L. J. J., Rijkeboer, M. M., & Nauta, M. H. (2024). Negative Flashforward Imagery in Adolescent Social Anxiety Disorder: A Pilot Study of Imagery Reports and a Short EMDR Intervention. Clin Psychol Psychother, 31(5), e3063. https://doi.org/10.1002/cpp.3063

Open Access: https://doi.org/10.1002/cpp.3063

Marjolein R. Thunnissen E-mail: m.r.thunnissen@rug.nl

Abstract

Psychological treatments for social anxiety disorder (SAD) in adolescents have shown poorer outcomes than for other anxiety disorders. A relevant factor to consider for improving outcomes may be negative imagery. In this pilot study, we examined negative 'flashforward' imagery of feared catastrophic outcomes in adolescents with SAD and evaluated the feasibility and preliminary outcomes of a short eye movement desensitization and reprocessing (EMDR) intervention targeting this imagery. We used a case series design with a 1-week baseline period. Outcomes included symptoms of social anxiety and avoidance related to selected social situations and features of associated flashforward imagery as the proposed mechanism of change during the intervention. We found that six out of seven assessed adolescents reported to experience flashforwards and rated image distress, vividness and threat appraisal as high. In these six participants (aged 14-17 years old), the short EMDR flashforward intervention appeared feasible and was followed by a decrease in social anxiety and avoidance in five participants, while no notable changes were observed during the baseline period. Furthermore, we observed a decrease in flashforward imagery features in at least five participants. Nonparametric tests of the overall (group-based) changes during the intervention period partially supported these findings. Limitations include the small sample size and the lack of a control group. Results suggest that vivid and distressing flashforward imagery is a common experience and that targeting flashforwards with EMDR may be beneficial in treating social anxiety in youth. Further experimental research on effects and added value to current treatments is necessary. Trial Registration: Dutch Clinical Trial Register (National Trial Register [NTR]): NL8974.

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van der Hoeven, M. L., Bouwmeester, S., Schlattmann, N. E. F., Lindauer, R. J. L., & Hein, I. M. (2024). Family therapy and EMDR after child abuse and neglect: moderating effects of child attachment style and PTSD symptoms on treatment outcome. Eur J Psychotraumatol, 15(1), 2416288. https://doi.org/10.1080/20008066.2024.2416288

Open Access: https://doi.org/10.1080/20008066.2024.2416288

Irma M. Hein, Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, Amsterdam 1105 AZ, the Netherlands. E-mail: i.hein@levvel.nl

Abstract

Background: Effective and appropriate care and treatment for children in order to decrease the psychosocial problems that arose after experiencing child abuse and neglect (CAN) is of vital importance, given the severity of symptomatology that may develop.
Objective: The purpose of the present study was to examine whether attachment style and core cluster Posttraumatic Stress Disorder symptoms acted as moderators for treatment outcomes of a new integrative treatment model for trauma and attachment. In this treatment model, family therapy is combined with EMDR and obstacles for trauma processing are tackled first.
Method: we included children, ages 6-12 years, with a history of CAN, who did not respond to evidence-based trauma treatment. Target treatment outcomes were problems in attachment, posttraumatic stress symptoms, behaviour, and emotion regulation. We conducted a multiple-baseline ABC Single-Case Experimental Design (SCED). We categorized 12 participants into four groups of attachment style and core cluster PTSD symptoms: (1) non-disorganized & re-experiencing; (2) non-disorganized & avoidance/hyperarousal; (3) disorganized & re-experiencing; & (4) disorganized & avoidance/hyperarousal. We compared the four groups with each other and across time, and the interaction between groups and effect over time. We conducted non-parametric permutation tests and estimated q-values for false discovery rate control.
Results: Children with a disorganized attachment style had more severe symptomatology in general, except for posttraumatic stress symptoms. The treatment appeared more effective in targeting and successfully treating children with a non-disorganized attachment style, and specifically children with a non-disorganized attachment style and re-experiencing as core cluster PTSD symptoms.
Conclusion: Our study underlines the complexity of treating children who developed a complicated combination of symptomatology after CAN and calls for the continuous development of innovative interventions. The purpose of the present study was to identify possible moderators for the treatment outcome of children with early childhood abuse in the integrative treatment model for trauma and attachment. Type of attachment style and type of core cluster PTSD symptoms seem to moderate treatment outcomes. This study underlines the complexity of treating children who suffer from a complicated combination of posttraumatic stress symptoms, attachment problems, and behaviour and emotion regulation problems after child abuse & neglect.

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van Namen, D. M., Hilberink, S. R., de Vries, H., Nagelhout, G. E., & van Staa, A. (2024). ‘Please, see me’; Informal and professional support of students with relatives with addiction problems: a three-year longitudinal qualitative study. BMC Public Health, 24(1), 3092. https://doi.org/10.1186/s12889-024-20531-8

Open Access: https://doi.org/10.1186/s12889-024-20531-8

Dorine M. van Namen. E-mail: d.vannamen@maastrichtuniversity.nl

Abstract

BACKGROUND AND AIM: Addiction problems also affect the lives of family members. This study aims to examine: (1) young adult family members' experiences with informal and professional support in coping with the impact of relatives' addiction problems and (2) how these experiences evolve over time.
METHOD: A three-year longitudinal qualitative study. Four rounds of in-depth, semi-structured individual interviews were conducted. Thirty students aged 18-30 years, participated in the study at baseline. 93% participated in at least two interviews, and 80% participated three or four times. The Stress-Strain-Information-Coping-Support model was used, and Directed Content Analysis was applied.
FINDINGS: Five major themes were extracted from the data: (1) Informal support; (2) Educational support; (3) Healthcare support; (4) Resilience factors; and (5) Developments over time. Informal and educational support were more often described as effective than healthcare support, although the number of participants who sought healthcare support increased over time. Effective elements of support included being able to discuss their experiences with people listening without judgment or unsolicited advice and having long-term relationships of trust with people from the social environment and professionals. Participants were mainly treated with Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Learning how to distinguish between accurate and inaccurate thoughts, especially about themselves, was considered effective. Body-oriented therapy was remarkably absent. Finding effective healthcare support was often a long and winding road through various therapies and therapists. Participants were not attracted to peer group interventions but needed advice on how to deal with their relatives. They also needed recognition by their relatives for harm done. This recognition was seldom given.
CONCLUSIONS: It is recommended to train educational and healthcare professionals to recognize the support needs of young people with relatives with addiction problems, to help them cope, or to refer them adequately. We also suggest broadening the scope of professional support offered to AFMs, including body-oriented and cultural interventions.

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Vock, S., Hofmann, A., Lehnung, M., Böhm, K., Wieland, S., Seidler, G. H., Beiner, E., Hermes, M., Friederich, H.-C., Eich, W., & Tesarz, J. (2024). Towards international collaboration of clinical research networks for EMDR: the EMDR Pain Network Germany. Front Psychol, 15, 1449150. https://doi.org/10.3389/fpsyg.2024.1449150

Open Access: https://doi.org/10.3389/fpsyg.2024.1449150

Jonas Tesarz. E-mail: jonas.tesarz@med.uni-heidelberg.de

Abstract

BACKGROUND: Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment, primarily established for post-traumatic stress disorder (PTSD). While it is increasingly being applied to chronic pain, its efficacy in this area is not yet supported by the same level of evidence as that which exists for PTSD. Studies in this area often show heterogeneous results with small case numbers, and the potential side effects of EMDR in the treatment of chronic pain are not well understood. Systematic documentation of treatment effects, potential predictors of treatment response and non-response, and side effects is crucial for progress in this field.
AIM: The primary aim is to establish a research framework to systematically investigate the delivery of EMDR therapies by outpatient clinicians in the field of pain. This study aims to provide a comprehensive analysis of treatment outcomes, side effects and determinants of treatment effectiveness, whether positive response or non-response.
METHODS: This framework will oversee the documentation and evaluation of EMDR interventions delivered in outpatient settings using an Embedded Continuous Cumulative Evaluation Design (ECCED). It will focus on detailed characterisation of positive and negative therapeutic effects. It will also identify and analyse prognostic factors that influence individual variability in response to treatment. Treatment materials, standardised assessments and an intervision platform for regular exchange will be provided.
DISCUSSION: The establishment of the EMDR Pain Network Germany and an interdisciplinary scientific-clinical platform is essential to promote clinical exchange and understanding of the effects of EMDR in pain therapy. This platform offers standardised treatment protocols, an online data collection system with anonymised data, comprehensive baseline assessments and an intervision platform for regular exchange. The knowledge gained is intended to personalise future therapies and serve as a basis for large randomised clinical trials.

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Went, M., Struik, A., Möller, E., Zijlstra, B. J. H., Dumoulin, A., van Haaften, G., & Rodenburg, R. (2024). Parent-Child EMDR therapy for children aged 0–4 years: Protocol, pilot-data, and case study. European Journal of Trauma & Dissociation, 8(4), 100475. https://doi.org/10.1016/j.ejtd.2024.100475

URL: https://doi.org/10.1016/j.ejtd.2024.100475

Arianne Struik. E-mail: ictc@ariannestruik.com

Abstract

This article describes the Parent-Child EMDR protocol for children (0–4 years) and provides a summary of treatment data of an explorative pilot study with 18 children aged 0–4 years, illustrated with a case study. The Parent-Child EMDR protocol follows the EMDR standard protocol with adaptations only where imperative due to the age of the child and integrating research in the field of infant mental health, attachment, memory, and EMDR and its working mechanisms. As such, it provides an alternative to Storytelling (Lovett, 1999, 2015), which uses a preconstructed narrative predominantly focusing on resourcing and cognitive information. The brief customized treatment consists of a combination of the following components: preparation, EMDR with child and parents, EMDR for the parent, if necessary, parent-child interaction sessions, and parental guidance sessions. Focus lays on the child and parents’ internal associative processes after maximum activation of the child and parent's traumatic material, to allow the child's and parent's inherent capacity to integrate, through associations and by using the adaptive information experienced in their interaction during the session. Through this process, the parent-child interaction and attachment relationships improve, as well as the parent's mentalizing ability and confidence.
In an explorative pilot study, treatment data of 18 children between 0 and 4 years were gathered to obtain insight into the Parent-Child EMDR protocol and its effect on PTSD symptoms. Therapists scored PTSD symptom clusters of the DC 0–5 criteria. All children lost their PTSD diagnosis after treatment. A case example illustrates the use of this protocol in more detail. The Parent-Child EMDR protocol is a promising short and customized treatment to help child and parents overcome their trauma symptoms, resume normal development, and build healthy attachment relationships.

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Wu, J.-Y., Tsai, Y.-Y., Chen, Y.-J., Hsiao, F.-C., Hsu, C.-H., Lin, Y.-F., & Liao, L.-D. (2024). Digital transformation of mental health therapy by integrating digitalized cognitive behavioral therapy and eye movement desensitization and reprocessing. Med Biol Eng Comput. https://doi.org/10.1007/s11517-024-03209-6

URL: https://doi.org/10.1007/s11517-024-03209-6

Lun-De Liao. E-mail: ldliao@nhri.edu.tw E-mail: gs336.tw@gmail.com

Abstract

Digital therapy has gained popularity in the mental health field because of its convenience and accessibility. One major benefit of digital therapy is its ability to address therapist shortages. Posttraumatic stress disorder (PTSD) is a debilitating mental health condition that can develop after an individual experiences or witnesses a traumatic event. Digital therapy is an important resource for individuals with PTSD who may not have access to traditional in-person therapy. Cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) are two evidence-based psychotherapies that have shown efficacy in treating PTSD. This paper examines the mechanisms and clinical symptoms of PTSD as well as the principles and applications of CBT and EMDR. Additionally, the potential of digital therapy, including internet-based CBT, video conferencing-based therapy, and exposure therapy using augmented and virtual reality, is explored. This paper also discusses the engineering techniques employed in digital psychotherapy, such as emotion detection models and text analysis, for assessing patients' emotional states. Furthermore, it addresses the challenges faced in digital therapy, including regulatory issues, hardware limitations, privacy and security concerns, and effectiveness considerations. Overall, this paper provides a comprehensive overview of the current state of digital psychotherapy for PTSD treatment and highlights the opportunities and challenges in this rapidly evolving field.

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