Research Article
Advertisement
Abstract
The flash technique (FT) is a low-intensity individual or group intervention that appears to rapidly lessen the distress of disturbing and traumatic memories. This paper reports on the safety and effectiveness of group FT with 77 healthcare providers and 98 psychotherapists impacted by working with COVID-19 patients. One-hour webinars included 30 minutes of psychoeducation and two guided 15-minute FT interventions, focused on participants' most distressing pandemic-related memory. Before and after each 15-minute FT intervention, they rated that memory using the 11-point 0-to-10 subjective units of disturbance (SUD) scale. Results from both interventions were highly significant with large effect sizes (p < .001, Hedges' g = 2.01, Hedges' g = 2.39). No adverse reactions were reported. For 35 participants who processed the same memory in both interventions, the pre–post SUD scores from the beginning of intervention #1 to the end of intervention #2 showed a significant reduction with a large effect size (p < .001, Hedges' g = 3.80). For this group, both intervention #1 and intervention #2 showed significant reductions with large effect sizes (p < .001, Hedges' g = 2.00) (p < .001, Hedges' g = 1.18). Follow-up SUD scores were obtained from 58 participants, with the mean disturbance level showing a significant further decrease. These findings provide preliminary evidence that group FT appears to safely provide rapid relief from disturbing memories. FT merits further research.
Figures
Figure 1.
Distribution of subjective units of disturbance (SUD) scores comparing intervention #1 & #2 (N = 111).
View in Context
Figure 3.
SUD scores at four measurements for 15 participants using the same memory for both interventions and providing follow-up.
Note. 1 = Initial SUD; 2 = Post 1st FT; 3 = Post 2nd FT; 4 = Follow-Up SUD
View in ContextTables
TABLE 1.
The Current (March 2021) FT Protocol as Used in EMDR Therapy
| Summary of the Flash Technique | |
|---|---|
| Choose a disturbing memory | It is recommended that FT be initiated at the end of phase 2 (preparation) of the EMDR protocol. The therapist guides the client to identify or select a disturbing memory or image to address, which is referred to as the “target.” The clients are asked to rate the SUD level that the target memory or image would generate if they were to let themselves feel the disturbance, but they are not encouraged to feel the disturbance. Clients are encouraged to “touch on” their disturbing memories without thinking of details or recalling them vividly. |
| Positive engaging focus (PEF) | Clients are asked to focus on imagining an activity, animal, person, memory, or music selection that provides an immediate experience of pleasure and/or is positive and engaging. Examples are provided. If needed, clients are encouraged to listen to a music selection or look at engaging images. |
| Distraction component | Clients are directed to alternately tap one thigh and then the other: “I am going to tap my thighs, and I would like you to copy my movements, tapping your thighs while focusing on the positive engaging activity, memory, or person you have just thought of. Thinking of this will give you an alternative positive focus as a substitute for the disturbing memory. It may be helpful for you to tell me about what you like about it." |
| Flash | While tapping their thighs and focusing on the PEF, clients are periodically prompted by the word “flash” to blink rapidly three to five times. “When I say ‘flash,’ blink your eyes rapidly three, four, or five times, while maintaining your attention on the PEF.” |
| Check-in | After six such prompts, participants are asked to stop tapping and blinking, and, without thinking of the target memory directly, “check in lightly” to notice any change that may have occurred in it. No measurement is suggested unless the client's disturbance appears to have become minimal. The sequence—including tapping, six sets of triple blinks, and checking in for a change in the target memory—is repeated as needed as long as FT is efficiently reducing the SUD level. No measurement of disturbance level is done until the level seems to be substantially reduced. If FT was initiated during phase 2 (preparation) of the EMDR protocol, as is recommended, and disturbance is no longer reducing as a result of FT, proceed to Phases 3 through 8. |
| Instructions during check-ins | During a check-in, clients who are having difficulty describing the change they are experiencing are sometimes told that, for many people, change takes the form of the memory seeming further away. If no change is reported by the second check-in, therapists must consider whether the positive engaging focus (PEF) might be too weak or not sufficiently engaging. If so, it should be strengthened or changed. If the disturbance appears to be gone, the therapist should explore the possibility that one or more disturbing aspects of the target may have been overlooked and remain disturbing. |
| Feeder memories | As is standard in EMDR therapy, if there is an earlier disturbing memory that is being activated by the thought of the target memory, and is causing the target memory to be more disturbing than it would otherwise be, the earlier one should be targeted first. |
| Within standard EMDR | If FT was initiated during the preparation phase (phase 2) of the 8-phase EMDR protocol, phase 3 is initiated after completing the use of FT. |
Note. FT = flash technique.
TABLE 2.
SUD Score Means (SD) at Pre, Post, and Follow-Up for 58 Participants With Follow-Up
| First FT Intervention | Second FT Intervention | |||||
|---|---|---|---|---|---|---|
| Pre | Post | Follow-up | Pre | Post | Follow-up | |
| Healthcare providers | N = 23 SUD = 8.13 SD = 1.687 | 23 3.48 SD = 1.780 | 23 2.33 SD = 2.054 | 18 5.5 SD = 2.595 | 18 2.5 SD = 2.036 | 18 1.75 SD = 1.784 |
| Mental health providers | N = 33 SUD = 6.91 SD = 1.466 | 33 2.52 SD = 1.661 | 33 1.89 SD = 1.793 | 26 6.42 SD = 2.176 | 26 3.04 SD = 2.181 | 26 1.90 SD = 1.697 |
| All providers | N = 56 SUD = 7.41 SD = 1.660 | 56 2.91 SD = 1.761 | 56 2.07 SD = 1.898 | 44 6.05 SD = 2.372 | 44 2.82 SD = 2.116 | 44 1.84 SD = 1.714 |
| Total | 56 | 56 | 56 | 44 | 44 | 44 |
Article usage
| Period | Abstract | Full | Total | |
|---|---|---|---|---|
| Apr 2024 | 58 | 28 | 15 | 101 |
| Mar 2024 | 47 | 29 | 7 | 83 |
| Feb 2024 | 101 | 13 | 11 | 125 |
| Jan 2024 | 212 | 74 | 13 | 299 |
| Dec 2023 | 84 | 19 | 9 | 112 |
| Nov 2023 | 69 | 16 | 12 | 97 |
| Oct 2023 | 67 | 13 | 10 | 90 |
| Sep 2023 | 22 | 8 | 9 | 39 |
| Aug 2023 | 21 | 10 | 8 | 39 |
| Jul 2023 | 47 | 17 | 10 | 74 |
| Jun 2023 | 46 | 30 | 11 | 87 |
| May 2023 | 31 | 13 | 12 | 56 |
| Apr 2023 | 35 | 29 | 25 | 89 |
| Mar 2023 | 57 | 28 | 14 | 99 |
| Feb 2023 | 57 | 37 | 10 | 104 |
| Jan 2023 | 29 | 17 | 8 | 54 |
| Dec 2022 | 34 | 14 | 6 | 54 |
| Nov 2022 | 65 | 33 | 18 | 116 |
| Oct 2022 | 58 | 42 | 27 | 127 |
| Sep 2022 | 56 | 44 | 6 | 106 |
| Aug 2022 | 43 | 17 | 8 | 68 |
| Jul 2022 | 52 | 19 | 20 | 91 |
| Jun 2022 | 50 | 16 | 18 | 84 |
| May 2022 | 85 | 6 | 10 | 101 |
| Apr 2022 | 97 | 3 | 4 | 104 |
| Mar 2022 | 160 | 7 | 4 | 171 |
| Feb 2022 | 126 | 4 | 8 | 138 |
| Jan 2022 | 116 | 3 | 3 | 122 |
| Dec 2021 | 59 | 2 | 5 | 66 |
| Nov 2021 | 361 | 10 | 8 | 379 |
| Oct 2021 | 930 | 10 | 13 | 953 |
| Sep 2021 | 886 | 12 | 9 | 907 |
| Aug 2021 | 1246 | 18 | 29 | 1293 |
| Jul 2021 | 750 | 19 | 17 | 786 |
| Jun 2021 | 1427 | 40 | 43 | 1510 |
| May 2021 | 2554 | 72 | 120 | 2746 |
| Apr 2021 | 2809 | 0 | 115 | 2924 |
| Mar 2021 | 9 | 0 | 0 | 9 |
Cited by