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Book of the month

Journal Articles

Alter-Reid, K., Colelli, G., & Simons, N. (2014). When disaster strikes our local communities: U.S. EMDR trauma recovery network coordinators reflect on lessons learned. Journal of EMDR Practice and Research, 8(4), 205-214. doi:10.1891/1933-3196.8.4.205

Karen Alter-Reid, PhD, 979 Summer Street, Stamford, CT 06905. E-mail: Karen.alterreid@gmail.com

Abstract

As a result of a dramatic surge of community-wide traumatic events over the last years, we have seen an increase in eye movement desensitization and reprocessing (EMDR)-trained clinicians in the United States who want to volunteer as responders to their own or neighboring communities in the wake of disaster. This grassroots movement was followed by the Trauma Recovery/Humanitarian Assistance Program's (TR/HAP) development of an organizational structure for Trauma Recovery Networks (TRNs) to provide EMDR training and treatment in their own local, affected areas. The personal stories of disaster response interventions by TRNs in Fairfield County, Connecticut, and New York City in 2012–2013 are examples of two decades of HAP team “experiences along the way.” Lessons learned from the inside out are shared to encourage other developing networks in the logistical, emotional, and spiritual preparation for community disaster work. With the unfolding of TR/HAP's development of a National Trauma Recovery Network, there is an opportunity to ensure efficient and effective disaster responses by properly trained and prepared local EMDR clinicians. TRN chapters and their teams continue to increase awareness in local communities of the healing possibilities of acute and longer term trauma symptoms through early intervention with EMDR treatment.

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Carriere, R. C. (2014). Scaling up what works: Using EMDR to help confront the world's burden of traumatic stress. Journal of EMDR Practice and Research, 8(4), 187-195. doi:10.1891/1933-3196.8.4.187

Rolf C. Carriere, 554 Route de Naz-Dessus, 01170 Echenevex, France; E-mail: r_carriere@hotmail.com

Abstract

Global estimates of trauma exposure, classified under the heading “Four Violences,” demonstrate that the world faces a mental health crisis of truly epidemic proportions. Given the extent, severity, and consequences of trauma-based disorders (including posttraumatic stress disorder) worldwide for individuals, communities, and societies, the current minimal global public health response needs to be addressed. An important part of the response should involve the implementation of timely treatment both during and after a crisis. Eye movement desensitization and reprocessing (EMDR) therapy offers a potentially scalable intervention that combines effectiveness, efficiency, affordability, and acceptability—essential preconditions—for launching an ambitious global trauma therapy plan. An overview of both challenges and solutions to effective scaling up and global implementation is provided, including the areas of policy, funding, and ethics. This article concludes with a list of activities (including research) that should be initiated without delay as part of starting up a global trauma therapy plan.

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Ehring, T., Welboren, R., Morina, N., Wicherts, J. M., Freitag, J., & Emmelkamp, P. M. (2014). Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse. Clinical Psychology Review. doi:10.1016/j.cpr.2014.10.004

Thomas Ehring, Institute of Psychology, University of Münster, Fliednerstr. 21, 48149 Münster, Germany. Email: thomas.ehring@uni-muenster.de

Full text available: http://www.sciencedirect.com/science/article/pii/S0272735814001500

Abstract

Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusively focused on studies evaluating the efficacy of psychological interventions for PTSD in adult survivors of childhood abuse. Sixteen randomized controlled trials meeting inclusion criteria could be identified that were subdivided into trauma-focused cognitive behavior therapy (CBT), non-trauma-focused CBT, eye movement desensitization and reprocessing, and other treatments (interpersonal, emotion-focused). Results showed that psychological interventions are efficacious for PTSD in adult survivors of childhood abuse, with an aggregated uncontrolled effect size of g =1.24 (pre- vs. post-treatment), and aggregated controlled effect sizes of g =0.72 (post-treatment, comparison to waitlist control conditions) and g =0.50 (post-treatment, comparison with TAU/placebo control conditions), respectively. Effect sizes remained stable at follow-up. As the heterogeneity between studies was large, we examined the influence of two a priori specified moderator variables on treatment efficacy. Results showed that trauma-focused treatments were more efficacious than non-trauma-focused interventions, and that treatments including individual sessions yielded larger effect sizes than pure group treatments. As a whole, the findings are in line with earlier meta-analyses showing that the best effects can be achieved with individual trauma-focused treatments.

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Farrell, D. (2014). Developing EMDR therapy in Pakistan as part of a humanitarian endeavor. Journal of EMDR Practice and Research, 8(4), 233-239. doi:10.1891/1933-3196.8.4.233

Derek Farrell, University of Worcester, Psychological Sciences, Henwick Grove, Worcester WR2 6AJ, United Kingdom. E-mail: d.farrell@worc.ac.uk

Abstract

The empirical justification for the use of eye movement desensitization and reprocessing (EMDR) therapy as part of the repertoire of interventions used in response to humanitarian endeavors continues at a pace. A devastating earthquake, measuring 7.6 magnitude on the Richter scale, occurred in Northern Pakistan in October 2005. In response, the first EMDR Humanitarian Assistance Program to be facilitated by an academic institution was established. This article highlights how 3 research projects assisted in the continued development of EMDR therapy in Pakistan to the point where presently more than 125 Pakistani mental health professionals have now been trained; it now has its own EMDR National Association and is an active participant within EMDR Asia.

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Fernandez, I., Callerame, C., Maslovaric, G., & Wheeler, K. (2014). EMDR Europe humanitarian programs: Development, current status, and future challenges. Journal of EMDR Practice and Research, 8(4), 215-224. doi:10.1891/1933-3196.8.4.215

Isabel Fernandez, Center of Psychotraumatology, via Vitruvio 43, 20124, Milan, Italy. E-mail: isabelf@tin.it

Abstract

The efficacy of eye movement desensitization and reprocessing (EMDR) therapy has been well established by numerous scientific studies over the past 25 years. The ability to achieve a rapid resolution of trauma symptoms often after only a few EMDR sessions allows clinicians to treat many survivors in a very short period of time. This makes EMDR an ideal intervention after a catastrophic event. The main objective of this article is to describe how European EMDR Associations have provided interventions in emergency situations. Natural and man-made disaster relief projects in Italy, Greenland, and the Netherlands are highlighted. EMDR Europe Humanitarian Assistance Program (HAP) projects sponsored by Austria and Sweden in the Ukraine and Estonia have provided trainings for clinicians. National EMDR Europe associations have developed initiatives in many other areas of the world, such as in Vietnam (EMDR Italy), Cuba (EMDR Spain and Italy), in Pakistan (EMDR United Kingdom and Ireland), in China (EMDR Germany), and in Kenya (EMDR Germany). These projects illustrate the resilience of the populations affected and the generosity of the EMDR Europe community.

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Gelbach, R. (2014). EMDR humanitarian assistance programs: 20 years and counting. Journal of EMDR Practice and Research, 8(4), 196-204. doi:10.1891/1933-3196.8.4.196

Robert Gelbach, PhD, 64 Hall Street, Hamden, CT 06517. E-mail: robertgelbach@yahoo.com

Abstract

EMDR Humanitarian Assistance Programs (HAP) was created in 1995 by EMDR clinicians who had offered pro bono care and training for therapists in Oklahoma City after a terrorist attack. HAP set its mission to bring evidence-based trauma therapy to communities that were underserved or that had suffered disasters. HAP's training programs, which are low-cost, are provided by volunteers and target clinicians in public or nonprofit agencies. HAP currently reaches about 2,000 trainees annually. Similar HAP training programs in developing countries reach about 200 clinicians annually and aim to build local communities of practice that are sustainable. HAP has responded to disasters worldwide, with both training and treatment, but increasingly directs most disaster aid to the United States as new sister organizations appear and respond to disasters in other regions of the world. In recent years, HAP has aimed to promote emergence of its Trauma Recovery Network (TRN)—local voluntary teams of clinicians who stress preparedness as a key component of disaster response. Three TRN chapters in 2010 had grown to 20 in 2013 and will soon double, providing new options for service to HAP's more than 1,500 registered clinician volunteers.

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Gilderthorp, R. C. (2014). Is EMDR an effective treatment for people diagnosed with both intellectual disability and post-traumatic stress disorder? Journal of Intellectual Disabilities: JOID. doi:10.1177/1744629514560638

Rosanna C Gilderthorp, Salomons Centre for Applied Psychology, Canterbury Christ Church University, Runcie Court, Broomhill Road, Tunbridge Wells, Kent TN3 0TF, UK. Email: r.c.trigg180@canterbury.ac.uk

Abstract

This study aimed to critically review all studies that have set out to evaluate the use of eye movement desensitization and reprocessing (EMDR) for people diagnosed with both intellectual disability (ID) and post-traumatic stress disorder (PTSD). Searches of the online databases Psych Info, The Cochrane Database of Systematic Reviews, The Cochrane Database of Randomized Control Trials, CINAHL, ASSIA and Medline were conducted. Five studies are described and evaluated. Key positive points include the high clinical salience of the studies and their high external validity. Several common methodological criticisms are highlighted, however, including difficulty in the definition of the terms ID and PTSD, lack of control in design and a lack of consideration of ethical implications. Overall, the articles reviewed indicate cause for cautious optimism about the utility of EMDR with this population. The clinical and research implications of this review are discussed.

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Graca, J. J., Palmer, G. A., & Occhietti, K. E. (2014). Psychotherapeutic interventions for symptom reduction in veterans with PTSD: An observational study in a residential clinical setting. Journal of Loss and Trauma. doi:10.1080/15325024.2013.810441

Glen A. Palmer, St. Cloud VA Health Care System, 4801 Veterans Drive, St. Cloud, MN 56303, USA. E-mail: Glen.Palmer@va.gov

Full text available at: http://www.tandfonline.com/doi/abs/10.1080/15325024.2013.810441

Abstract

Cognitive processing therapy (CPT) and eye movement desensitization and reprocessing (EMDR) therapy were compared for veterans in a posttraumatic stress disorder (PTSD) residential program (N = 51) who received individual EMDR and group CPT, individual CPT and group CPT, or trauma group exposure (TGE) therapy. Analyses revealed an overall significant difference on posttest measures of the PTSD Checklist for individual EMDR/group CPT and individual CPT/group CPT when compared to TGE, with no significant difference found between EMDR and CPT. Depression scores were significantly decreased between pre- and posttest for patients who received individual EMDR/group CPT. Results support EMDR and CPT as clinically effective and complementary treatments in residential PTSD treatment programs.

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Greenwald, R., McClintock, S. D., Jarecki, K., & Monaco, A. J. (2014). A comparison of eye movement desensitization and reprocessing and progressive counting among therapists in training. Traumatology. doi:10.1037/trm0000011

Greenwald, Trauma Institute & Child Trauma Institute, 285 Prospect Street, Northampton, MA 01060. E-mail: rg@childtrauma.com

Abstract

Eye movement desensitization and reprocessing (EMDR) is effective, efficient, and well tolerated, but complex and resource-intensive to learn. Progressive counting (PC) is newer, has similar advantages and is easier to master. The objective of this study was to compare EMDR and PC. One hundred nine therapists in either EMDR or PC training programs worked on several of their own upsetting memories in practicums during the course of the training. For each treated memory they recorded treatment time as well as pre/post memory-related distress ratings; ratings were repeated at 2 and 10 weeks posttreatment via e-mail. Participants also rated the perceived difficulty of the treatment they experienced. Participants in both conditions reported large and significant reductions in memory-related distress, which persisted at 2 weeks and 10 weeks posttreatment. There were no differences in effect size or maintenance of gains. PC was 37.5% more efficient than EMDR, and was rated as being less difficult. Participants were therapists, not distressed individuals; allocation to group was natural and not randomized; and there was no evaluation of treatment fidelity. PC is less resource-intensive than EMDR to disseminate. In this study, PC was as effective as EMDR, more efficient, and perceived as less difficult. If these findings are replicated with distressed participants, PC will become a preferred trauma treatment.

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Jarero, I., Artigas, L., Uribe, S., & Miranda, A. (2014). EMDR therapy humanitarian trauma recovery interventions in Latin America and the Caribbean. Journal of EMDR Practice and Research, 8(4), 260-268. doi:10.1891/1933-3196.8.4.260

Ignacio Jarero, PhD, EdD, Boulevard de la Luz 771, Jardines del Pedregal, Álvaro Obregón, México City 01900. E-mail: nacho@amamecrisis.com.mx

Abstract

This article presents an overview of the eye movement desensitization and reprocessing (EMDR) Humanitarian Trauma Recovery Interventions in Latin America and the Caribbean and provides the reader with clinical stories from the front lines. During our many years working in the field, we have observed that psychological trauma is a challenging consequence of the multifaceted situations confronting individuals and communities after disasters. In this article, we describe the EMDR humanitarian interventions provided since 1998 in Latin America and the Caribbean to address survivors' psychological distress after natural disasters (e.g., flooding, landslides, earthquakes), man-made disasters, human massacre, and severe interpersonal violence. Treatment has been provided to child, adolescent, and adult survivors, often in community settings, and to first responders and cancer patients. The EMDR early intervention protocols are brief effective interventions that can be used in the field or emergency situations; there is a body of research supporting the use of modified EMDR therapy protocols to treat acute trauma in both group and individual formats (Jarero, Artigas, & Luber, 2011).

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Mattheß, H., & Sodemann, U. (2014). Trauma-Aid, humanitarian assistance program Germany. Journal of EMDR Practice and Research, 8(4), 225-232. doi:10.1891/1933-3196.8.4.225

Helga Matthe ß , Gro ß enbaumer Allee 35 a, 47269 Duisburg, Germany. E-mail: Helga.Matthess@t-online.de

Abstract

Trauma-Aid Germany was founded in 2002 by dedicated eye movement desensitization and reprocessing (EMDR) therapists to help people traumatized by calamities, disaster, or violence to overcome the psychological consequences and regain emotional stability and mental health. Trauma-Aid, also known as the Humanitarian Assistance Program Germany, works in crisis areas abroad, offering nonprofit trainings in EMDR therapy and establishing projects to support and treat trauma victims and survivors. Projects in China, Slovakia, Indonesia, Thailand, Cambodia, Burma, Rwanda, and Haiti, in cooperation with other nongovernmental organizations and the German government, have supported trained participants in the treatment of clients in the respective countries and the initiation of local research projects. The basic principle is to work with networks of local practitioners or mental health worker, experts, and universities to establish structures that will maintain themselves in future. Nearly all countries to which Trauma-Aid Germany has taken training have meanwhile set up their own EMDR organizations, with many local EMDR trainers already trained or in training.

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Mehrotra, S. (2014). Humanitarian projects and growth of EMDR therapy in Asia. Journal of EMDR Practice and Research, 8(4), 252-259. doi:10.1891/1933-3196.8.4.252

Sushma Mehrotra, 8 Horizon View, 138 General J Bho-sle Marg, Nariman Point, Mumbai 400021, India. E-mail: mehrotrasushma@gmail.com

Abstract

This article focuses on the accomplishments of humanitarian projects in Asia using eye movement desensitization and reprocessing (EMDR) therapy. The main thrust of EMDR humanitarian assistance programs has been to train local clinicians to provide EMDR to individuals suffering from the disaster. The article highlights the training projects and the experience of using EMDR therapy after earthquakes in China, India, Indonesia, and Pakistan; after tsunamis in Japan, India, Indonesia, and Sri Lanka; and after accidents and terror attacks in Korea and Pakistan. Detailed descriptions are provided about the responses to the 2001 earthquake in Gujarat; the 2004 tsunami in India, Indonesia, and Sri Lanka; the 2005 earthquake in Pakistan; the 2008 earthquake in China; and the 2011 tsunami in Japan. In addition, the article discusses how Asian EMDR therapists are working together to provide training, respond to crises, and establish professional standards, so that EMDR therapy can be established in Asia and integrated into regular practice. Further, this article describes the creation of EMDR Asia, which brought several Asian countries together and share the development of EMDR therapy in their countries. The challenges faced by EMDR Asia today are discussed in detail.

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Schnyder, U. (2014). Treating intrusions, promoting resilience: An overview of therapies for trauma-related psychological disorders. European Journal of Psychotraumatology, 5, 26520. doi:10.3402/ejpt.v5.26520

Ulrich Schnyder* Department of Psychiatry and Psychotherapy, Zurich University Hospital, Zurich, Switzerland. Email: ulrich.schnyder@access.uzh.ch

Full text available online: http://www.ejpt.net/index.php/ejpt/article/view/26520#Abstract

Abstract

The efficacy of psychotherapeutic approaches in the treatment of posttraumatic stress disorder (PTSD) can be regarded as empirically demonstrated. Overall, effect sizes appear to be higher for psychotherapy than for medication. Many well-controlled trials with a mixed variety of trauma survivors have demonstrated that trauma-focused cognitive-behavioral therapy (TF-CBT) is effective in treating PTSD. Prolonged exposure therapy (PE) is currently seen as the treatment with the strongest evidence for its efficacy. Cognitive therapy (CT) and cognitive processing therapy (CPT), with their stronger emphasis on cognitive techniques, and Eye Movement Desensitization and Reprocessing (EMDR) seem equally effective. More recent developments include brief eclectic psychotherapy for PTSD (BEPP) and narrative exposure therapy (NET). Emerging evidence shows that TF-CBT can successfully be applied in PTSD patients suffering from severe comorbidities such as borderline personality disorder or substance abuse disorder (Schnyder & Cloitre, 2015). There is also a trend towards developing "mini-interventions," that is, short modules tailored to approach specific problems. Moreover, evidence-based approaches should be complemented by interventions that aim at promoting human resilience to stress. Finally, given the globalization of our societies (Schnyder, 2013), culture-sensitive psychotherapists should try to understand the cultural components of a patient's illness and help-seeking behaviors, as well as their expectations with regard to treatment.

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Shapiro, F. (2014). EMDR therapy humanitarian assistance programs: Treating the psychological, physical, and societal effects of adverse experiences worldwide. Journal of EMDR Practice and Research, 8(4), 181-186. doi:10.1891/1933-3196.8.4.181

Francine Shapiro, PhD, PO 750, Watsonville, CA 95077. E-mail: fshapiro@mcn.org

Abstract

The negative effects of trauma and other adverse life experiences have been shown to interfere with individual, family, and societal functioning. Eye movement desensitization and reprocessing (EMDR) therapy is empirically supported and recommended as a frontline treatment for psychological trauma in numerous practice guidelines. It provides both effective and efficient treatment without the need for detailed descriptions of the disturbing event or homework. This allows field teams to provide culturally sensitive therapy on consecutive days for those in remote areas and in crisis situations. Humanitarian assistance organizations have conducted projects internationally to provide EMDR therapy after both natural and manmade disasters and have helped develop sustainable mental health resources worldwide. This brief introduction provides an overview of current programs, treatment rationale, and a call for future action.

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Zaghrout-Hodali, M. (2014). Humanitarian work using EMDR in Palestine and the Arab world. Journal of EMDR Practice and Research, 8(4), 248-251. doi:10.1891/1933-3196.8.4.248

Mona Zaghrout-Hodali, Head of Counseling and Su-pervision, East Jerusalem YMCA, P.O. Box 25168, Shufat, Jerusalem. E-mail: mzaghrout@ej-ymca.org

Abstract

Humanitarian outreach is a significant part of the practice of eye movement desensitization and reprocessing (EMDR) therapy. The development of training in Arabic and provision of EMDR in areas of ongoing conflict including Palestine, Libya, Syria, and Iraq is described, and brief accounts of clients and therapists illustrate the help that EMDR has brought to survivors of conflict, imprisonment, and torture. Three clients, each with a diagnosis of posttraumatic stress disorder, are briefly presented here: one from a refugee camp in Palestine, one from a Syrian refugee camp in Jordan, and the other from a war zone in Libya.

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Zimmermann, E. (2014). EMDR humanitarian work: Providing trainings in EMDR therapy to African clinicians. Journal of EMDR Practice and Research, 8(4), 240-247. doi:10.1891/1933-3196.8.4.240

Eva Zimmermann, Route-Neuve 7A, 1700 Fribourg, Switzerland. E-mail: ez@renz-zimmermann.ch

Abstract

This article is a nonexhaustive overview concerning the developments of eye movement desensitization and reprocessing (EMDR) therapy in a humanitarian context in Africa. These efforts aimed to promote psychological healing for people suffering after humanitarian crises, wars, and disasters. This article reflects a summary of the contributions obtained from organizations and people working and teaching EMDR therapy in Africa. In addition to explaining the cultural, political, and socioeconomic outcomes of the African context and the special needs of those suffering from trauma and trauma-related symptoms, this article emphasizes the challenges for humanitarian efforts in offering and in teaching EMDR therapy in Africa. The work in four countries is presented to provide specific examples.

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