The Inverted eye movement desensitization and reprocessing (EMDR) Standard Protocol for complex post-traumatic stress disorder (C-PTSD) is a structured way to assist these clients to reduce their symptoms to the point where they are stable enough to work with more and more of their old memory clusters of the past, such as most often childhood abuse, neglect, and numerous secondary traumas after that. The protocol seems to be especially useful in clients with psychiatric hospitalization histories or inpatient settings. There are three foci for the Inverted Standard Protocol for unstable C-PTSD based on inverting the EMDR Standard Protocol to meet the needs of unstable C-PTSD clients: the future, the present, and the past. The constant installation of present orientation and safety (CIPOS) method assists clients in reducing the stress of triggers of older trauma material in a more controlled manner without getting overwhelmed by the old material.
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- Go to chapter: The Inverted EMDR Standard Protocol for Unstable Complex Post-Traumatic Stress Disorder
The Wedging or Strengthening Technique has been modified in Germany and is called the Absorption Technique to create resources to deal with what the client is concerned about in the future, or having stress about working with eye movement desensitization and reprocessing (EMDR) in the future, a present trigger or even an intrusive memory. Having clients imagine a strength or skill that would help them during the problem often helps them to reduce their anxiety. Focusing on a specific strength or coping skill may create a wedge of safety or control that will assist clients with the difficult situation in the future. During the Future Phase of the Inverted Protocol for Unstable complex post-traumatic stress disorder (C-PTSD) use the Absorption or Wedging Technique to develop as many different resources for the different issues about which the client might be concerned.
Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations
Scripting is a way to inform and remind the Eye Movement Desensitization and Reprocessing (EMDR) practitioner of the component parts, sequence, and language used to create an effective outcome. As EMDR is a fairly complicated process, this book provides step-by-step scripts that will enable beginning practitioners to enhance their expertise more quickly. The book is separated into nine parts. The Client History part represents the first of the eight phases of EMDR treatment. The ability to gather, formulate, and then use the material in the intake part of treatment is crucial to an optimal outcome in any therapist’s work. Part II includes an important element of the Preparation Phase that addresses ways to introduce and explain EMDR, trauma, and the adaptive information processing (AIP) model. The importance of teaching clients how to create personal resources is the topic of Part III. Here, an essential element of the Preparation/Second Phase of EMDR work is addressed to ensure clients’ abilities to contain their affect and remain stable as they move through the EMDR process. Part IV shows how to work with clients concerning the targeting of their presenting problems when the usual ways do not work such as usage of drawings to concretize clients’ conceptualization of their issues and usage of an alternative initial targeting method. Part V includes protocols that have been scripted based on the material that appears in Francine Shapiro’s EMDR textbook. Parts VI and VII address EMDR and early intervention procedures for man-made and natural catastrophes for individuals and groups. Performance enhancement and clinician’s self-care are dealt with in the final two parts of the book.
This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. Client history taking is an important part of well-prepared clinicians’ understanding of their clients. The Time Line Script is based on a number of personal communications with other EMDR clinicians. Start with the best events and ask for the negative events in the session. When all of the memories are gathered, it is helpful to plot them onto a “Positive and Negative Memories Map”. This Map allows for a visual presentation along the time line of the client’s life and offers a window into what the important landmarks of the client’s life were for the clinician and client to see together.
This book provides a standard that reflects the basic elements of the 11-Step Standard Procedure; and the Standard 3-Pronged EMDR Protocol as they are applied to different populations. The diverse population includes children and adolescents; couples; clients suffering with complex post-traumatic stress disorder and dissociative disorders; clients with anxiety; clients who demonstrate addictive behaviors; clients who deal with pain; clinicians themselves. The book serves as a basis to encourage research into these various applications for EMDR. It is divided into seven parts. Part I is devoted to the scripted EMDR protocols such as olfactory stimulation, which are used to develop resources for children and adolescents who may have suffered traumatic events in their life. The protocols take into account the particular difficulties of this developmental group and help minimize common difficulties and major hurdles. Part II describes scripted EMDR protocols designed by couples therapists and sex therapists to further the progress of their patients precisely targeting templates of relational interaction, anxiety, or sexual dysfunction. Part III concerns the scripted protocols for dissociative disorders and complex post-traumatic stress disorder. The protocols represent the structured scripted efforts of many trauma therapists over a considerable number of years. Parts IV and V of the book address the concretization of much needed scripts for the EMDR treatment of addictions and pain—two interconnected public health worries. Part VI looks at the world of people’s adaptation to fears and tackles the usage of scripted protocols to detoxify the impact of specific phobias. Part VII demonstrates the usage of scripted EMDR protocols in clinician care and in the management of secondary post-traumatic stress disorder and vicarious traumatization.
Eye Movement Desensitization and Reprocessing EMDR Therapy Scripted Protocols and Summary Sheets:Treating Anxiety, Obsessive-Compulsive, and Mood-Related Conditions
This book offers eye movement desensitization and reprocessing (
EMDR) therapy practitioners and researchers a window into the treatment rooms of experts in the fields of anxiety, obsessive-compulsive, and spectrum disorders, and mood-related conditions. It is divided into three parts with 10 chapters that cover working with anxiety disorders, including specific phobia, panic disorder, and the use of a specific procedure in the treatment of anxiety disorder; obsessive-compulsive and related disorders, including obsessive-compulsive disorder, body dysmorphic disorder, olfactory reference syndrome, and hoarding behaviors; and mood disorders, including bipolar disorder, major depression, and postpartum depression. To address the specific needs of their populations, authors were asked to include the types of questions relevant for history taking, helpful resources and explanations needed in the preparation phase, particular negative and positive cognitions that were frequent in the assessment phase and for cognitive interweaves, other concerns during phases 4 (desensitization) through 8 (reevaluation), a section on case conceptualization and treatment planning, and any pertinent research on their work. Consisting of past, present, and future templates, the scripts are conveniently presented in an easy-to-use, manual-style format that facilitates a reliable, consistent procedure. Summary sheets for each protocol support quick retrieval of essential issues and components for the clinician when putting together a treatment plan for the client. These scripted protocols and completed summary sheets can be inserted right into a client’s chart for easy documentation.
Studies show that there is a high risk for relapse in major depression (MD). Each depressive episode increases the risk of relapse by 15” and the episodes get more severe with each relapse. It is the third most common cause for primary health consultation and the leading cause of disability from ages 15 to 44. Research shows that distinct psychosocial stressors precede most of the depressive episodes by 1 or 2 months (episode triggers). Following the Adaptive Information Processing (AIP) model, DeprEnd© is an eye movement desensitization and reprocessing (
EMDR) therapy protocol that addresses an important cause of depression that may also contribute to the maintenance of the symptoms of the disorder: pathogenic memory networks. In the DeprEnd© protocol, four main types of memories are addressed and worked with: classic traumatic memories (Criterion A), often non-Criterion A-based episode triggers, belief systems, and depressive and suicidal states.
In this chapter some practical consequences of the paradigm shift to understand depression as a stress- and trauma-based disorder are discussed. As successful eye movement desensitization and reprocessing (
EMDR) therapy helps to resolve these memories, the authors show how EMDRtherapy works with depressive patients. Randomized controlled trial ( RCT) studies demonstrate that not only is EMDRtherapy for depressive disorders at least equal to other treatments, but there are more complete remissions. The EMDRDeprEnd Protocol is a significant step forward in the treatment of depressive patients and in the reduction of depressive relapses. This is important as the effect of treatment-resistant depression leaves patients at risk for suicide and families to bear the loss of their family member. Improved treatment possibilities would also occasion economic savings. With more knowledge about the importance of childhood memories in the development of depression, we can also do much more for primary prevention of depression.
About 60% of all depressive patients suffer from mental health comorbidities. In many cases, the comorbidity of these depressive patients is posttraumatic stress disorders (
PTSDs), complex PTSD( C-PTSD), and/or moderate to severe dissociative disorders. While structured research in this patient group is still in its infancy, in this chapter we cover what we have learned by treating many of these complex patients. It is clear that the greater the complexity with which patients present, the more psychoeducation, resourcing, and eye movement desensitization and reprocessing ( EMDR) memory reprocessing sessions are needed. Often, complex patients have faced years of treatment and are not diagnosed accurately. Those considered treatment resistant are often patients with a history of trauma/ PTSDor a dissociative disorder. The first step for these patients is to help them understand their disorder and to stabilize them before any EMDRprocessing. We have observed that when these steps are taken, complex and dissociative patients make real progress with their trauma and then their depressive disorder.
When it is time to begin memory processing when treating depressive patients, it is usually best to focus on Episode Triggers first. The Episode Trigger is defined as the stressful and sometimes traumatic event/s that occur/s for most patients 1 or 2 months before the depressive episode starts. Most of these events are not classical traumatic events that that include danger for one’s life, but events that come from stressful interpersonal relationship events like losses, separations, and humiliations. This chapter describes some of the most common patterns of depressive reactions to such events. The use of the Symptom Event Map is encouraged to chart patients’ negative events and their depressive episode(s), according to a timeline. This helps the patient to understand and the therapist to build a treatment strategy. The chapter also describes some of the different types of depression that can be identified on the Symptom Event Map.