Supervisión de casos es un nuevo apartado regular del Journal of EMDR Practice and Research. En este artículo, una terapeuta de desensibilización y reprocesamiento por movimientos oculares (EMDR) describe brevemente un caso complicado en el cual un hombre, “George”, fue derivado a tratamiento EMDR por una depresión que había comenzado hacía más de dos años. Después de haber procesado completamente con EMDR todos los recuerdos traumáticos que había descrito, George continúa gravemente deprimido y la terapeuta pregunta cómo puede proceder de manera eficaz con el tratamiento. Tres especialistas responden por escrito. La primera especialista, Robin Shapiro, describe una lista exhaustiva de posibles etiologías, que incluyen causas de apego, de trauma temprano, genéticas y otras causas biológicas, además del tratamiento de EMDR, de estados del ego o médico adecuado para cada una. El segundo experto, Arne Hofmann, analiza el tratamiento impartido y hace sugerencias de blancos alternativos para el tratamiento y sugiere que la terapeuta podría trabajar con la creencia “nada cambiará” y probar con el protocolo invertido de EMDR. El tercer experto, Earl Grey, recomienda que el terapeuta se centre en trabajar los traumas de “t” pequeña, aún si el paciente indica que apenas tiene perturbación y explica la manera de desarrollar e implementar una “secuencia reparadora de blancos de la vida”.
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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.
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.
- Go to chapter: The Inverted EMDR Standard Protocol for Unstable Complex Post-Traumatic Stress Disorder
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.
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.
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.
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.
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.
Finding a certified eye movement desensitization and reprocessing (
EMDR) therapist is an important step in receiving effective treatment. For organic causes of depression, it is helpful to consult with a primary care physician or psychiatric specialist. EMDRtherapy is important to consider when there are depressive relapses. There are nine randomized controlled studies that show that EMDRtherapy is successful or equivalent to other therapies and more studies are in process. There is a clear connection between the effectiveness of EMDRtreatment and the qualification of therapists. Professional qualifications, as well as quality training, are important in EMDR. Please consult regional EMDRassociations for information on qualified therapists. Positive chemistry is important for a good treatment outcome as well.
Treating Depression With
EMDRTherapy: Techniques and Interventions introduces EMDRDeprEnd, a pathogenic memory-based EMDRtherapy approach. DeprEnd has been demonstrated in a number of studies and meta-analyses to be at least as effective as—and often more effective than—other guideline-based therapies in treating depression, including cognitive behavioral therapy. EMDRDeprEnd is particularly helpful with chronic and recurrent depression that does not respond well to other treatments. Written by the international research team who developed this quick-acting and efficient therapy, this book provides clinicians with the evidence-based tools they need to integrate EMDRDeprEnd into their practices. Treating Depression With EMDRTherapy explains a step-by-step approach to processing the pathogenic memory structures that are the basis of most depressive disorders and ways to address both Depressive and Suicidal States. Real-world case studies incorporate the often-co-occurring trauma-based disorders found in depressive patients. These are practical “how-to” chapters, including one devoted to drawing integration with numerous examples of actual patient drawings as clients go through the EMDRprocess. Abundant illustrations enhance understanding of stress- and trauma-based depressive disorders and the successful interventions that improve client outcomes. Protocol scripts for therapist and client also help prepare readers to provide optimal treatment to their clients.
The Symptom Event Map is one of the most helpful tools for treatment planning in the DeprEnd Protocol for the treatment of depression as it charts depressive episodes and their intensity, Episode Triggers, and Compensation Zones. The Symptom Event Map is made of two unrelated maps: the symptom map charts the intensity of the depressive episode(s), and the trauma map plots the stressful life events, including or not including Criterion A incidents with their appropriate Subjective Units of Distress (
SUD) levels. The Symptom Event Map is an effective tool to chart the course of depressive episodes and identify the Episode Triggers. Viewing the image of the course of the depressive events, including Compensation Zones of full recovery, help clinicians with their treatment planning and case conceptualization. It also points out the targets that will be helpful in relapse prevention. This chapter introduces the Symptom Event Map and provides a case example.
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.
This book introduces a new, successful, research-based, and proven approach to treat depressive disorders. In this introduction, we give an overview of the successes and limitations of current guideline-based treatment of depressive disorders as well as a first overview of our 12 years of research in this field. We found that an approach that considers depression as a stress- and trauma-based disorder is critical for treating depressive patients, especially patients who do not respond well to current guideline-based treatment. Eye movement desensitization and reprocessing (
EMDR) therapy is the centerpiece of this new treatment and has already shown its effectiveness in treating depression successfully in a number of controlled studies. This book contains many case studies and information to inform the practice of EMDR-trained clinicians.
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.
Supervision de cas est une nouvelle rubrique régulière du Journal of EMDR Practice and Research. Dans cet article, un clinicien EMDR (désensibilisation et retraitement par les mouvements oculaires) décrit brièvement le cas difficile d'un homme, Georges, qui avait été orienté en EMDR pour le traitement d'une dépression ayant débuté plus de deux ans auparavant. Après traitement de tous ses souvenirs traumatiques, il reste aujourd'hui gravement déprimé et son thérapeute demande comment avancer efficacement. Des réponses sont données par trois experts. Le premier, Robin Shapiro, décrit une liste complète d'étiologies possibles : attachement, traumas précoces, facteurs génétiques ou autres causes biologiques, avec les traitements appropriés (EMDR, états du moi ou médicaments). Le second expert, Arne Hofmann, passe en revue le traitement administré et propose d'autres cibles de traitement, suggérant au thérapeute d'aborder la croyance de son client que “rien ne changera” et d'essayer le protocole EMDR inversé. Le troisième expert, Earl Grey, recommande que le clinicien se concentre sur les traumas “t”, même si le client les trouve peu ou pas perturbants, et explique comment développer et mettre en œuvre un “plan de ciblage réparateur de l'ensemble du cours de la vie”.
- Go to article: Eye Movement Desensitization and Reprocessing as an Adjunctive Treatment of Unipolar Depression: A Controlled Study
Eye Movement Desensitization and Reprocessing as an Adjunctive Treatment of Unipolar Depression: A Controlled Study
Depression is a severe mental disorder that challenges mental health systems worldwide. About 30% of treated patients do not experience a full remission after treatment, and more than 75% of patients suffer from recurrent depressive episodes. Although psychotherapy and medication can improve remission rates, the success rates of current treatments are limited. In this nonrandomized controlled exploratory study, 21 patients with unipolar primary depression were treated with a mean of 44.5 sessions of Cognitive Behavioural Therapy (CBT) including an average 6.9 adjunctive sessions of Eye Movement Desensitization and Reprocessing (EMDR). A control group (n = 21) was treated with an average of 47.1 sessions of CBT sessions alone. The main outcome measure was the Beck Depression Inventory II (BDI-II). The treatment groups did not differ in their BDI-II scores before treatment, and both treatments resulted in significant improvement. There was an additional benefit for patients treated with adjunctive EMDR (p = .029). Also the number of remissions at posttreatment, as measured by a symptom level below a BDI-II score of 12, was significantly better in the adjunctive EMDR group, the group showing more remissions (n = 18) than the control group (n = 8; p < .001). This potential effect of EMDR in patients with primary depression should be examined further in larger randomized controlled studies.
- Go to article: The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction
The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction
Given that 2019 marks the 30th anniversary of eye movement desensitization and reprocessing (EMDR) therapy, the purpose of this article is to summarize the current empirical evidence in support of EMDR therapy as an effective treatment intervention for posttraumatic stress disorder (PTSD). Currently, there are more than 30 randomized controlled trials (RCT) demonstrating the effectiveness in patients with this debilitating mental health condition, thus providing a robust evidence base for EMDR therapy as a first-choice treatment for PTSD. Results from several meta-analyses further suggest that EMDR therapy is equally effective as its most important trauma-focused comparator, that is, trauma-focused cognitive behavioral therapy, albeit there are indications from some studies that EMDR therapy might be more efficient and cost-effective. There is emerging evidence showing that EMDR treatment of patients with psychiatric disorders, such as psychosis, in which PTSD is comorbid, is also safe, effective, and efficacious. In addition to future well-crafted RCTs in areas such as combat-related PTSD and psychiatric disorders with comorbid PTSD, RCTs with PTSD as the primary diagnosis remain pivotal in further demonstrating EMDR therapy as a robust treatment intervention.
In 2015, more than 1.5 million refugees arrived in Germany, many severely traumatized. Eye movement desensitization and reprocessing (EMDR) therapy has been proven to be an effective treatment for acute and chronic traumatic stress symptoms. A modification for provision in group settings was developed by E. Shapiro: the EMDR Group Traumatic Episode Protocol (G-TEP). In this field study, we investigated the effectiveness of 2 sessions of EMDR G-TEP in treating traumatized refugees. After receiving a psychoeducation session, 18 Arabic-speaking refugees from Syria and Iraq who had come to Germany during the previous 5 months were assigned to treatment and/or waitlist. The Impact of Event Scale-Revised (IES-R) and Beck Depression Inventory (BDI) were administered at pre- and posttreatment. Analysis was conducted using the Mann–Whitney U test and planned Kolmogorov–Smirnov tests. Results showed significant differences between the treatment and the waitlist groups, indicating a significant decline in IES-R scores (p < .05). Although differences in BDI scores did not reach significance (p = .06), a large decline in BDI scores was seen in the treatment group. These results provide preliminary evidence that it might be effective to treat groups of traumatized refugees with EMDR G-TEP.
- Go to article: Caring:The Essence of Professional Nursing Practice and an Integral Component of the Magnet Journey
As the health care system in the United States is becoming increasingly more politically and economically oriented, the concept of political caring needs to be advanced in contemporary nursing practice (Ray, 1989, 2001; Turkel, 2001). The purpose of this article is to present a model outlining the process of policy analysis through a phenomenologica research study illuminating the life world descriptions of experiences of United States Air Force personnel with managed care in the military and the civilian health care system. This process shows how qualitative data are used to give voice to a moral crisis and contribute to health care policy.
This article illustrates the transtheoretical evolution of caring science within complex systems from the discovery of the theory of bureaucratic caring, in 1981, to the emergence of the metatheory relational caring complexity in 2011. The theory of bureaucratic caring, derived from research, is the sentinel grounded theory in the area of caring and economics, and complex healthcare systems in general. Its tenets remain applicable to contemporary nursing practice. Other grounded theories advanced from the original theory, including struggling to find a balance, the paradox between caring and economics, relational complexity, and relational self-organization in workforce redevelopment, as well as professional and patient relational caring questionnaires are presented and discussed.
- Go to article: L'EMDR (désensibilisation et retraitement par les mouvements oculaires) comme traitement d'appoint de la dépression unipolaire : une étude contrôlée
L'EMDR (désensibilisation et retraitement par les mouvements oculaires) comme traitement d'appoint de la dépression unipolaire : une étude contrôlée
La dépression est un trouble mental grave qui constitue un défi pour les systèmes de santé mentale du monde entier. Environ 30 % des patients n'obtiennent pas de rémission complète après le traitement, et plus de 75 % des patients souffrent d'épisodes dépressifs récurrents. Si la psychothérapie et la médication améliorent les taux de rémission, les taux de réussite des traitements actuels sont limités. Dans cette étude exploratoire contrôlée non randomisée, 21 patients souffrant de dépression unipolaire primaire ont été traités avec une moyenne de 44,5 séances de thérapie cognitive comportementale (TCC), avec en moyenne 6,9 séances supplémentaires de désensibilisation et de retraitement par les mouvements oculaires (EMDR). Un groupe contrôle (n = 21) a été traité avec une moyenne de 47,1 séances de TCC sans séance EMDR supplémentaire. Le principal moyen de mesure des résultats a été le Questionnaire de Dépression de Beck (BDI-II). Les scores BDI-II des deux groupes étaient identiques avant traitement et les deux traitements ont produit une amélioration significative. Les patients traités avec les séances d'EMDR d'appoint (p = 0,029) ont cependant obtenu des améliorations plus importantes. Le nombre de rémissions post-traitement, indiqué par un niveau symptomatique inférieur à 12 sur l'échelle BDI-II, était aussi significativement plus élevé dans le groupe ayant bénéficié de séances d'EMDR d'appoint : ce groupe a présenté davantage de rémissions (n = 18) que le groupe de contrôle (n = 8 ; p < 0,001). Cet effet potentiel de l'EMDR chez les patients souffrant de dépression primaire doit faire l'objet d'études contrôlées randomisées plus larges.
- Go to article: Évaluation du protocole EMDR de traitement en groupe d’épisodes traumatiques avec des réfugiés : une étude de terrain
Évaluation du protocole EMDR de traitement en groupe d’épisodes traumatiques avec des réfugiés : une étude de terrain
En 2015, plus de 1,5 million de réfugiés sont arrivés en Allemagne, beaucoup d’entre eux gravement traumatisés. La thérapie de désensibilisation et de retraitement par les mouvements oculaires (EMDR) a prouvé son efficacité dans le traitement des symptômes de stress traumatique aigus ou chroniques. Une modification de la thérapie permettant son utilisation en groupe a été développée par E. Shapiro : c’est le protocole EMDR de traitement en groupe d’épisodes traumatiques (G-TEP). Dans cette étude de terrain, nous avons étudié l’efficacité de deux séances d’EMDR G-TEP pour traiter des réfugiés victimes de traumas. Après une séance de psychoéducation, 18 réfugiés provenant de Syrie et d’Irak, arabophones, arrivés en Allemagne au cours des cinq mois précédents, ont été affectés au traitement et/ou à une liste d’attente. On utilisa en pré- et post-traitement l’échelle révisée d’impact des événements (IES-R) et l’inventaire de dépression de Beck (BDI) et les analyses furent conduites à l’aide du test U de Mann-Whitney et des tests planifiés Kolmogorov-Smirnov. Les résultats montrèrent des différences importantes entre le groupe de traitement et le groupe en liste d’attente, avec une baisse significative des notes IES-R (p > .05). Bien que les différences des notes BDI n’aient pas atteint le niveau de signification statistique (p = .06), une baisse importante des notes BDI fut observée dans le groupe de traitement. Ces résultats fournissent une preuve préliminaire indiquant que l’EMDR G-TEP pourrait permettre de traiter efficacement des personnes réfugiées souffrant de traumatismes.
This study was designed to investigate the question of whether psychophysiological changes during EMDR sessions are related to subjective and objective reduction of PTSD symptoms. During-session changes in autonomic tone in relation to session-to-session changes of subjective stress, trauma-related symptoms, and psychophysiological reactions during a traumatic reminder were investigated in 10 patients suffering from single-trauma PTSD. Treatment duration followed each patient’s individual needs and ranged between 1 and 4 sessions, resulting in a total of 24 EMDR treatment sessions from which psychophysiological data were completely recorded. Treatment with EMDR was followed by a significant reduction of trauma-related symptoms, elimination of the PTSD diagnosis in 8 of the 10 participants, as well as by significantly reduced psychophysiological reactivity to an individualized trauma script. Psychophysiological dearousal in sessions correlated significantly with decrease in script-related reactions in heart rate and parasympathetic tone, and with changes in subjective disturbance. Our results indicate that information processing during EMDR is followed by during-session decrease in psychophysiological activity, reduced subjective disturbance and reduced stress reactivity to traumatic memory.
- Go to article: The Current Status of EMDR Therapy Involving the Treatment of Complex Posttraumatic Stress Disorder
Complex posttraumatic stress disorder (CPTSD) is a diagnostic entity that will be included in the forthcoming edition of the International Classification of Diseases, 11th Revision (ICD-11). It denotes a severe form of PTSD, comprising not only the symptom clusters of PTSD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV-TR]), but also clusters reflecting difficulties in regulating emotions, disturbances in relational capacities, and adversely affected belief systems about oneself, others, or the world. Evidence is mounting suggesting that first-line trauma-focused treatments, including eye movement desensitization and reprocessing (EMDR) therapy, are effective not only for the treatment of PTSD, but also for the treatment of patients with a history of early childhood interpersonal trauma who are suffering from symptoms characteristic of CPTSD. However, controversy exists as to when EMDR therapy should be offered to people with CPTSD. This article reviews the evidence in support of EMDR therapy as a first-line treatment for CPTSD and addresses the fact that there appears to be little empirical evidence supporting the view that there should be a stabilization phase prior to trauma processing in working with CPTSD.
The purpose of this phenomenological research was to capture the meaning of caring as experienced by nurse managers during interactions with staff nurses. Data analysis was guided by the phenomenological method (Ray, 1985; van Manen, 1990). Essential themes of growth, listening, support, intuition, receiving gifts, and frustration were described by participants. Variant themes of touch, humor, flexibility, counseling, limitations, and competency also emerged. Interpretive themes of nurses’ way of being, reciprocal caring, and caring moment as transcendence were identified. The unity of meaning, which unfolded, is presented as a poetic expression. Implications for transforming nursing administration into a practice grounded in caring are presented.
Violence and aggression in the workplace is an increasing international concern. No studies have yet determined the most efficacious psychotherapeutic strategies to alleviate the consequences of workplace violence, and none have identified interventions that might fortify workers who are repeatedly exposed to danger. This case series describes the eye movement desensitization and reprocessing (EMDR) treatment of seven bank employees and one transportation worker who suffered repeated acute traumatization. The Impact of Events Scale, the Post-Traumatic Stress Syndrome 10-Questions Inventory, and the Beck Depression Inventory were used to measure changes in symptom severity. Results showed that EMDR effectively reduced symptoms and may provide a possible protective buffer in situations of ongoing workplace violence.
- Go to article: A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression
A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression
Depression, one of the most common mental disorders, is characterized by enormous social costs and limited rates of treatment success, even though psychotherapeutic and pharmacological treatments currently contribute to an increase in the remission rate. In light of recent studies that have shown that traumas and adverse life experiences may represent risk factors for the onset of depression, the therapeutic approach of eye movement desensitization and reprocessing (EMDR) therapy has been seen as potentially effective in the treatment of depression. The purpose of the present brief narrative review is to summarize the current literature on the efficacy of EMDR in patients with depression, in particular by referring to randomized controlled clinical trials (RCTs) that examined depression as a primary outcome. The data examined are updated to March 2019 and count seven RCT studies covering the years from 2001 to 2019. They are heterogeneous by type of intervention and demographic characteristics of the sample. Although the selected studies are few and with different methodological critical issues, the findings reported by the different authors suggest in a preliminary way that EMDR can be a useful treatment for depression.
- Go to article: Caring: The Essence of Professional Nursing Practice and an Integral Component of the Magnet Journey
- Go to article: EMDR and Phantom Limb Pain: Theoretical Implications, Case Study, and Treatment Guidelines
This article reviews the literature on EMDR treatment of somatic complaints and describes the application of Shapiro’s Adaptive Information Processing (AIP) model in the treatment of phantom limb pain. The case study explores the use of EMDR with a 38-year-old man experiencing severe phantom limb pain 3 years after the loss of his leg and part of his pelvis in an accident. Despite treatment at several rehabilitation and pain centers during the 3 years, and the use of opiate medication, he continued to experience persistent pain. After 9 EMDR treatment sessions, the patient’s phantom limb pain was completely ablated, and he was taken off medication. Effects were maintained at 18-month follow-up. The clinical implications of this application of EMDR are explored.
Case Consultation is a new regular feature in the Journal of EMDR Practice and Research. In this article, an eye movement desensitization and reprocessing (EMDR) clinician briefly describes a challenging case in which a man, “George,” was referred for EMDR for treatment of a depression that began more than 2 years previously. After all his reported traumatic memories were completely processed with EMDR, George remains severely depressed and the therapist asks how to proceed effectively with treatment. Responses are written by three experts. The first expert, Robin Shapiro, describes a comprehensive list of possible etiologies, including attachment, early trauma, genetic, and other biological causes and their appropriate EMDR, ego state, or medical treatments. The second expert, Arne Hofmann, reviews the treatment that was provided and makes suggestions for alternate treatment targets, suggesting that the therapist could address the client’s belief that “nothing will change” and try the EMDR inverted protocol. The third expert, Earl Grey, recommends that the clinician focus on addressing small “t” traumas, even if the client indicates that he or she has little to no disturbance and explains how to develop and implement a “restorative life span target sequence.”