Research Article
Abstract
This brief narrative review begins with an overview of posttraumatic response and explains the value of early treatment in reducing/eliminating symptoms of distress and possibly preventing the development of posttraumatic stress disorder (PTSD) or other disorders. The article then summarizes the efficacy of eye movement desensitization and reprocessing (EMDR) therapy as an early intervention treatment. It outlines the historical context of EMDR early interventions and describes the three protocols which have research support from randomized controlled trials (RCTs), elaborating on their supportive evidence in seven RCTs conducted within 3 months of the traumatic event. These studies showed that EMDR early interventions significantly reduced symptoms of traumatic stress and prevented any exacerbation of symptoms. EMDR was superior to wait-list and to control conditions of critical incident stress debriefing, reassurance therapy, and supportive counseling. The article also examines the disparate evaluations of EMDR early interventions in the PTSD treatment guidelines, from the International Society for Traumatic Stress Studies, the World Health Organization, and the National Institute for Health and Clinical Excellence. Despite promising clinical experience and initial controlled studies, there are still substantive gaps in the evidence base for EMDR early interventions. The article concludes with recommendations for future research, emphasizing that future trials adhere to the highest standards for clinical research and that they investigate whether EMDR early intervention prevents the development of PTSD or increases resilience.
Tables
Within First Month | ||||||
NICE | TF-CBT | |||||
WHO | ||||||
Within Months 2 and 3 | ||||||
NICE | TF-CBT | |||||
WHO | EMDR | TF-CBT | Stress m | Group CBT | ||
Within Months 1, 2, and 3, Single Session | ||||||
ISTSS | EMDRa | Group 512PMa | ||||
Within Months 1, 2, and 3, Multiple Sessions | ||||||
ISTSS | EMDR | CT | TF-CBT |
Note. CT = cognitive therapy; ISTSS = International Society for Traumatic Stress Studies; NICE = National Institute for Health and Clinical Excellence; TF-CBT = trauma-focused cognitive behavioral therapy, or cognitive processing therapy, cognitive therapy for PTSD, narrative exposure therapy, and prolonged exposure therapy; stress m = stress management; WHO = World Health Organization. Group 512 PM is debriefing “supplemented with cohesion training exercises” such as games requiring team cooperation (ISTSS Guidelines Committee, 2018, p. 22).
a emerging evidence.
Protocol | Study | Time Since Trauma | Trauma Type | Number of Sessions | Conditions N | Comparison of Symptoms at Pre and Post | Comparison of Conditions |
---|---|---|---|---|---|---|---|
PRECI | Jarero, Artigas, and Luber (2011) | Within 14 days | Earthquake | One session 80–130 m | Immediate N = 9 | Significant decrease also at F-Up | Immediate> 4 day waiting |
4-day waiting N = 9 | No change | ||||||
Delayed N = 9 | Significant decrease also at F-Up | ||||||
PROPARA | Jarero, Amaya, Givaudan, and Miranda (2013) | Within 3 months | Related to work as first responders | Two sessions 90 m | PROPARA N = 19 | Significant decrease also at F-Up | PROPARA> Supportive counseling |
Supportive counseling N = 20 | No change | ||||||
R-TEP | E. Shapiro and Laub (2015) | Within 3 months | Fatal rocket attack | Two sessions 90 m | Immediate N = 8 | Significant decrease | Immediate>1 week waiting |
1 wk Wait N = 9 (5) | No change | ||||||
Delayed Tx N = 7 (5) | Significant decrease also at F-Up | ||||||
PRECI | Jarero, Uribe, Artigas, and Givaudan (2015) | Within 25 days | “Technological disaster” fatal explosion in workplace | Two sessions 60 m | Immediate N = 13 | Significant decrease also at F-Up | Immediate> 9 day waiting |
9-day waiting N = 12 | No change | ||||||
Delayed Tx N = 12 | Significant decrease | ||||||
EMDR-RE | Tarquinio et al. (2016) | 48 hours | Workplace violence | One session 90–120 m | EMDR-RE N = 19 | Significant decrease | |
CISD N = 23 | No change | EMDR-RE > CISD | |||||
48-hour waiting | No change | EMDR-RE> 48h waiting | |||||
48-hour delayed EMDR-RE N = 18 | Significant decrease | EMDR-RE =Delayed EMDR REDelayed EMDR-RE > CISD | |||||
R-TEP | E. Shapiro, Laub, and Rosenblat (2018) | Within 3 months | Intense rocket attacks | Three sessions 90m | Immediate N = 13 | Significant decrease | Immediate> 1 month waiting |
1 month Wait N = 12 | No change | ||||||
R-TEP | Gil-Jardiné et al. (2018) | Within 24 hours | Physical injury or acute | One session 60 m | R-TEP N = 42 | At 3 months For PCLS: R-TEP =Reassurance R-TEP >TAU Reassurance > TAU For PTSD diagnosis: R-TEP=reassurance=TAU | |
medical crisis, at risk for PCLS | Reassurance N = 47 | ||||||
TAU, N = 41 |
Note. m = minutes; PCLS = post-concussion-like symptoms; PROPARA = protocol for paraprofessional use; PTSD = posttraumatic stress disorder; R-TEP = recent traumatic episode protocol; TAU = treatment as usual. by the RECI = protocol for recent critical incidents EMDR-RE = recent traumatic event protocol
“>” is significantly superior re symptom improvement and “=” is no significant difference between conditions.
Period | Abstract | Full | Total | |
---|---|---|---|---|
Apr 2024 | 133 | 80 | 112 | 325 |
Mar 2024 | 129 | 57 | 53 | 239 |
Feb 2024 | 194 | 67 | 59 | 320 |
Jan 2024 | 189 | 65 | 87 | 341 |
Dec 2023 | 188 | 44 | 70 | 302 |
Nov 2023 | 200 | 82 | 101 | 383 |
Oct 2023 | 130 | 86 | 74 | 290 |
Sep 2023 | 81 | 48 | 68 | 197 |
Aug 2023 | 115 | 51 | 74 | 240 |
Jul 2023 | 129 | 64 | 83 | 276 |
Jun 2023 | 123 | 70 | 99 | 292 |
May 2023 | 116 | 63 | 89 | 268 |
Apr 2023 | 120 | 81 | 84 | 285 |
Mar 2023 | 131 | 71 | 90 | 292 |
Feb 2023 | 173 | 62 | 99 | 334 |
Jan 2023 | 82 | 89 | 92 | 263 |
Dec 2022 | 84 | 47 | 60 | 191 |
Nov 2022 | 113 | 51 | 79 | 243 |
Oct 2022 | 136 | 70 | 92 | 298 |
Sep 2022 | 99 | 41 | 88 | 228 |
Aug 2022 | 82 | 34 | 60 | 176 |
Jul 2022 | 95 | 35 | 40 | 170 |
Jun 2022 | 119 | 57 | 55 | 231 |
May 2022 | 129 | 68 | 58 | 255 |
Apr 2022 | 112 | 56 | 72 | 240 |
Mar 2022 | 108 | 68 | 59 | 235 |
Feb 2022 | 86 | 40 | 45 | 171 |
Jan 2022 | 62 | 39 | 47 | 148 |
Dec 2021 | 80 | 47 | 41 | 168 |
Nov 2021 | 88 | 45 | 38 | 171 |
Oct 2021 | 73 | 43 | 36 | 152 |
Sep 2021 | 83 | 34 | 33 | 150 |
Aug 2021 | 113 | 47 | 29 | 189 |
Jul 2021 | 77 | 17 | 20 | 114 |
Jun 2021 | 22 | 73 | 19 | 114 |
May 2021 | 38 | 88 | 38 | 164 |
Apr 2021 | 41 | 86 | 32 | 159 |
Mar 2021 | 44 | 72 | 22 | 138 |
Feb 2021 | 34 | 72 | 24 | 130 |
Jan 2021 | 130 | 9 | 4 | 143 |
Dec 2020 | 155 | 3 | 1 | 159 |
Nov 2020 | 189 | 8 | 9 | 206 |
Oct 2020 | 155 | 4 | 8 | 167 |
Sep 2020 | 537 | 3 | 3 | 543 |
Aug 2020 | 138 | 3 | 8 | 149 |
Jul 2020 | 225 | 5 | 6 | 236 |
Jun 2020 | 134 | 3 | 6 | 143 |
May 2020 | 123 | 12 | 8 | 143 |
Apr 2020 | 190 | 22 | 20 | 232 |
Mar 2020 | 469 | 9 | 9 | 487 |
Feb 2020 | 1026 | 26 | 36 | 1088 |
Jan 2020 | 961 | 13 | 27 | 1001 |
Dec 2019 | 858 | 6 | 25 | 889 |
Nov 2019 | 19 | 0 | 2 | 21 |