This chapter illustrates how Eye Movement Desensitization and Reprocessing (EMDR) can be applied in the treatment of specific fears and phobic conditions. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. Treatment of a fear or a phobic condition cannot be started if the therapist is unaware of the factors that cause and maintain the anxiety response. The main features of a specific phobia are that the fear is elicited by a specific and limited set of stimuli that confrontation with these stimuli results in intense fear and avoidance behavior, and that the fear is unreasonable and excessive to a degree that interferes with daily life. The DSM–IV–TR distinguishes the following five main categories or subtypes of specific phobia: Animal type, Natural environment type, Situational type, Blood, injury, injection type, and other types.
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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 may be particularly useful for phobic conditions with high levels of anxiety, with a traumatic origin or with a clear beginning, and for which it is understandable that resolving the memories of the conditioning events would positively influence its severity. This chapter illustrates how EMDR therapy can be applied in the treatment of specific fears and phobic conditions. It discusses four cases where clients actually underwent the dental treatment they feared, most within 3 weeks following EMDR Therapy treatment. The efficacy of EMDR therapy was also tested in a randomized clinical trial among 30 dental clients who met the DSM-IV-TR criteria of dental phobia, and who had been avoiding the dentist for more than 4 years, on average. Clients in the EMDR Therapy condition showed significant reductions of dental anxiety and avoidance behavior as well as in symptoms of posttraumatic stress disorder (PTSD).
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.
The standard Three-Pronged Protocol for Eye Movement Desensitization and Reprocessing (
EMDR) therapy guides the overall treatment of the client. It consists of a “three-pronged” (past, present, and future) approach in which initially past events, then present issues, and finally anticipated future situations are targeted in therapy. The Flashforward Procedure has appeared to be an effective application of EMDR therapy to deal with the second of the three-pronged approach. It is a procedure to address clients’ irrational fears and anticipatory anxiety responses that persist after the core memories of past events have been fully processed. The fear of future catastrophe is a key component in several psychological conditions--obsessive-compulsive disorder (OCD) and specific phobias. When clients have been carefully prepared and therapists know their clients well, the Flashforward Procedure can become another valuable tool in the EMDR therapist’s toolkit.
Eye Movement Desensitization and Reprocessing EMDR Therapy Scripted Protocols and Summary Sheets:Treating Trauma- and Stressor-Related Conditions
This book is designed to apply what we are learning through research and to support the increasing knowledge and capabilities of clinicians in the method of Eye Movement Desensitization and Reprocessing (
EMDR) Therapy. The book is divided into three parts. The first part covers trauma and stressor-related conditions. Chapters here show how EMDR Therapy is used for a range of disorders, such as reactive attachment disorders, address the issue of child attachment trauma for adults, and discuss EMDR for traumatized patients suffering from psychosis. Other chapters in this section deal with EMDR for adolescents and adults living with ongoing traumatized stress and the treatment of 911 trauma in emergency telecommunicators. The second part of the book focuses on grief and mourning. In the third part, the need for taking self-care for clinicians and prevention of compassion fatigue are explained. The book also contains an appendix, which includes the scripts for the 3-Pronged Protocol that includes past memories, present triggers, and future templates. This section helps clinicians remember the important components of the Standard EMDR Protocol to ensure fidelity to the model.
This chapter describes possible interactions between trauma and psychosis and offers several methods for conceptualizing a case to facilitate the application of eye movement desensitization and reprocessing (
EMDR) in the treatment of people with psychosis. A psychotic disorder is often accompanied by at least one comorbid disorder, such as posttraumatic stress disorder (PTSD), depressive disorder, social phobia, substance abuse and dependence, or obsessive-compulsive disorder. A comprehensive treatment program offered by a multidisciplinary team is recommended. This includes pharmacotherapy, case management, cognitive behavioral therapy (CBT), supported employment, family interventions, and peer support. Standardized treatment protocols are feasible without adaptations and are effective in treating comorbid PTSD. Both antipsychotic medications and medication preventing motor side effects of anti-psychotics can affect cholinergic receptors. It can be difficult to judge the distress that a patient experiences during EMDR, due to some of the negative symptoms of schizophrenia.
When panic disorder is accompanied by severe avoidance of places or situations from which escape might be difficult or embarrassing, it is specified as “panic disorder with agoraphobia”. Despite the well-examined effectiveness of Eye Movement Desensitization and Reprocessing (
EMDR) Therapy in the treatment of posttraumatic stress disorder (PTSD), the applicability of EMDR therapy for other anxiety disorders, like panic disorders with or without agoraphobia (PDA or Pathological Demand Avoidance), has hardly been examined. This chapter illustrates how EMDR therapy can be applied in the treatment of panic disorder with or without agoraphobia. The EMDR protocol for panic disorders with or without agoraphobia is scripted. To determine whether a client suffers from panic disorder with or without agoraphobia, and its severity, a standardized clinical interview, such as the Structured Clinical Interview for DSM-IV Axis I disorders should be administered.