Since its inception in 1989, eye movement desensitization and reprocessing (EMDR) therapy has evolved from a simple desensitization technique to treat posttraumatic stress disorder to a comprehensive psychotherapy approach that treats a broad range of clinical problems in a variety of contexts and with diverse populations. This position paper is the result of a two-year project by the Council of Scholars' “What is EMDR?” workgroup that was tasked with the particular challenge of defining EMDR therapy, as innovations in the field continue to develop and the need for a consensus definition has become essential. In addition to proposing categories of EMDR therapy, that is, EMDR psychotherapy, EMDR treatment protocols, and EMDR-derived techniques, we identified core elements of EMDR therapy that can serve as a guideline to evaluate future innovations. Additionally, with concepts and procedures evolving over the years, some of the language needed revising to be consistent with current practices. The adoption of these three categories of treatment by the EMDR community would have broad-reaching implications that would generate more qualitative as well as quantitative studies in all categories. For training and clinical practice, it offers clinicians the opportunity to train with a focus on their particular treatment setting in addition to the foundational training that would be universal to all EMDR-trained clinicians. Finally, the interplay in the Council of Scholars between the “What is EMDR?” workgroup and the research, clinical practice, and training and accreditation workgroups will lead to further developments as these areas all inform one another.

The Clinical column is a regular Journal of EMDR Practice and Research feature in which master clinicians answer a question posed by a reader who is requesting assistance with clinical challenges. In this issue’s column, the response is written by Elan Shapiro, who is a psychologist near Haifa, Israel; an EMDR institute facilitator; and an approved EMDR Europe consultant. Readers can send questions for future issues to [email protected]

This article examines existing early EMDR intervention (EEI) procedures, presents a conceptual model, and proposes a new comprehensive protocol: the Recent-Traumatic Episode protocol (R-TEP). A review of research and important professional issues regarding application and parameters are presented. The commonly used EEI protocols and procedures are summarized, with the inclusion of descriptive case examples from the Lebanon war and a review of related research. Then a theoretical model is presented in which traumatic information processing is conceptualized as expanding from a narrow focus on the sensory image (perceptual level) to a wider focus on the event/episode (experiential level) and finally to a broad focus on the theme/identity (meaning level). The relationship of this model to the Recent-Traumatic Episode protocol is articulated and case examples are presented. Theoretical speculations are discussed relating to attention regulation and the Adaptive Information Processing (AIP) model. Further research is encouraged.

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.

Le but de cette étude était d'investiguer l'efficacité de l'intervention EMDR (désensibilisation et retraitement par les mouvements oculaires) rapide à l'aide du protocole EMDR de l'épisode traumatique récent (EMDR recent traumatic episode protocol [R-TEP]) après un événement traumatique dans une collectivité, lors duquel un missile a frappé un bâtiment dans un quartier très fréquenté de la ville. Dans un essai contrôlé randomisé de groupes parallèles avec liste d'attente/traitement reporté, 17 rescapés manifestant une détresse post-traumatique ont été traités avec la psychothérapie EMDR en utilisant le protocole R-TEP. Des praticiens EMDR bénévoles ont effectué le traitement lors de deux journées consécutives. Les participants étaient assignés de manière aléatoire à la condition du traitement immédiat ou à celle de la liste d'attente/traitement reporté. Les évaluations à l'aide de l'échelle Impact of Event Scale-Revised (Échelle révisée d'impact de l'événement [IES-R]) et de l'inventaire bref de la dépression du Patient Health Questionnaire (PHQ-9) ont été réalisées lors du pré- et du post-traitement ainsi qu'au suivi après trois mois. Une semaine post-traitement, les scores du groupe de traitement immédiat s'étaient significativement améliorés sur l'IES-R en comparaison du groupe liste d'attente/traitement reporté qui n'a montré aucune amélioration avant le traitement. Lors du suivi après trois mois, les résultats de l'IESR étaient maintenus et les scores PHQ-9 montraient une amélioration significative. Cette étude pilote apporte des preuves préliminaires qui soutiennent l'efficacité de l'EMDR R-TEP dans la réduction du stress post-traumatique chez les victimes civiles d'hostilités et qui montrent que ce modèle d'intervention, brièvement ajouté aux services locaux à la suite d'incidents traumatiques à grande échelle, fondé sur une intervention EMDR sur deux jours consécutifs, peut être efficace.

The aim of this study was to investigate the efficacy of early eye movement desensitization and reprocessing (EMDR) intervention using the EMDR recent traumatic episode protocol (R-TEP) after a traumatic community event whereby a missile hit a building in a crowded area of a town. In a waitlist/delayed treatment parallel-group randomized controlled trial, 17 survivors with posttraumatic distress were treated with EMDR therapy using the R-TEP protocol. Volunteer EMDR practitioners conducted treatment on 2 consecutive days. Participants were randomly allocated to either immediate or waitlist/delayed treatment conditions. Assessments with Impact of Event Scale-Revised (IES-R) and the Patient Health Questionnaire (PHQ-9) brief depression inventory took place at pre- and posttreatment and at 3 months follow-up. At 1 week posttreatment, the scores of the immediate treatment group were significantly improved on the IES-R compared to the waitlist/delayed treatment group, who showed no improvement prior to their treatment. At 3 months follow-up, results on the IES-R were maintained and there was a significant improvement on PHQ-9 scores. This pilot study provides preliminary evidence, supporting the efficacy of EMDR R-TEP for reducing posttrauma stress among civilian victims of hostility, and shows that this model of intervention briefly augmenting local mental health services following large-scale traumatic incidents, using an EMDR intervention on 2 consecutive days may be effective.

Note de l’Editeur: les Questions & Réponses cliniques sont une rubrique régulière de la revue. Des cliniciens chevronnés y répondent à la question posée par un lecteur face à une difficulté clinique. Dans ce numéro, les réponses viennent de deux cliniciens qui sont superviseurs EMDR certifiés: Farnsworth Lobenstine, travailleur social clinicien qui exerce en libéral à Amherst, Massachusetts, et Elan Shapiro, psychologue libéral de la région de Haïfa, en Israël. Les lecteurs peuvent adresser leurs questions à journal.org.