This book offers practical guidance and strategies to avoid the common pitfalls of eye movement desensitization and reprocessing (EMDR) practice through the 8-phase protocol. It proposes to guide those therapists into a safer way of working while encouraging them to access accredited training and supervision for their practice. The scope of the book is limited to EMDR practice with adults. Phase 1 of the standard EMDR protocol is history taking. It is important to determine whether the client is appropriate for EMDR selection. The therapist needs to help the client to identify and practice appropriate coping strategies that will support the client throughout the therapy. Therapists need to address any fears that the client (or therapist) may have about the later desensitization. Failing to do this can result in problems later. Many of the clients that come for EMDR will have a history of complex trauma or a chaotic childhood. The treatment plan needs to identify specific targets for reprocessing. This will be a three-pronged approach that includes the past memories that appeared to have set the pathology in process, the present situations that, and people who, exacerbate this dysfunction, and the desired future response, emotionally, cognitively, and behaviorally. Clients and therapists need to understand the rationale for selecting a particular target utilizing prioritization and clustering techniques as illustrated with the case study. Choosing the correct target can involve some detective work, but this will be time well spent. The book guides practitioners on how to identify the components of a memory network for reprocessing. It then focuses on the assessment phase and the importance of negative cognitions (NCs) drawing heavily on illustrative case vignettes.
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This book was conceived out of the authors' shared vision to synthesize key neurobiological developments with effective developments in clinical practice to offer both understanding and practical guidance for the many practitioners working to heal people burdened with traumatic sequelae. It is unique in bringing in all levels of the brain from the brainstem, through the thalamus and basal ganglia, to the limbic structures, including the older forms of cortex, to the neocortex. The book looks at the neurochemistry of peritraumatic dissociation (PD) and explores the effects on neuroplasticity and the eventual structural dissociation. Individual chapters focus on the definition of PD and tonic immobility (TI) and their associations with posttraumatic psychopathology, and review disturbances in self-referential processing and social cognition in posttraumatic stress disorder (PTSD) related to early-life trauma. Separate chapters focus on the modulatory role of the neuropetides in attachment as well as autonomic regulation, and highlight mesolimbic dopamine (ML-DA) system as central to the experiences of affiliation, attachment urge when under threat, attachment urge during experience of safety, and to the distress of isolation and/or submission. The book while increasing awareness of different parts of the self and ultimately creating a more stable sense of self, also incorporates psychoanalytic, cognitive behavioral, and hypnotic methods, as well as specific ego state, somatic/sensorimotor therapies, eye movement desensitization and reprocessing (EMDR), and variations of EMDR suitable for working with trauma in the attachment period. The latter methods are explicitly information-processing methods that address affective and somatic modes of processing.
This book is intended to provide to the eye movement desensitization and reprocessing (EMDR) clinician advanced tools to treat children with complex trauma, attachment wounds, and dissociative tendencies. It covers key elements to develop case conceptualization skills and treatment plans based on the adaptive information processing (AIP) model. A broader perspective is presented by integrating concepts from attachment theory, affect regulation theory, affective neuroscience, and interpersonal neurobiology. These concepts and theories not only support the AIP model, but they expand clinicians’ understanding and effectiveness when working with dissociative, insecurely attached, and dysregulated children. The book presents aspects of our current understanding of how our biological apparatus is orchestrated, how its appropriate development is thwarted when early, chronic, and pervasive trauma and adversity are present in our lives, and how healing can be promoted through the use of EMDR therapy. In addition, it provides a practical guide to the use of EMDR within a systemic framework. It illustrates how EMDR therapy can be used to help caregivers develop psychobiological attunement and synchrony as well as to enhance their mentalizing capacities. Another important goal of the book is to bring strategies from other therapeutic approaches, such as play therapy, sand tray therapy, Sensorimotor Psychotherapy, Theraplay, and Internal Family Systems (IFS) into a comprehensive EMDR treatment, while maintaining appropriate adherence to the AIP model and EMDR methodology. This is done with the goal of enriching the work that often times is necessary with complexly traumatized children and their families.
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 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.
The incidence of sexual assault and harassment experienced by members of the U.S. Armed Forces has reached epidemic proportions. Its victims often suffer from devastating, lifelong consequences to their careers, health, relationships, and psychological well-being. This book is written for mental health clinicians to help in understanding and treating military sexual trauma (
MST). It addresses the complex circumstances of victims of sexual abuse in the military and how clinicians can meet the unique challenges of treating these clients. The book describes how MST differs from other forms of military trauma such as combat, and discusses its prevalence, neurobiology, and social contexts as well as unique stressors of betrayal, injustice, struggles with issues of reporting and disclosure, and impact on relationships and sexuality. It reviews current evidence-based interventions and offers insights on treating specific symptoms within MST, such as post-traumatic stress disorder (PTSD), anxiety, substance abuse, sleep disorders, and sexual dysfunction. Chapters discuss how a variety of psychotherapies can be used to treat MST, including prolonged exposure, cognitive processing, Eye Movement Desensitization and Reprocessing ( EMDR), Seeking Safety, acceptance and commitment therapy, and somatic experiencing, as well as the Warrior Renew MST group therapy program. Clinicians who work with veterans and active duty personnel will find the book an essential guide to working with MST survivors.
Play therapy has been recognized in the counseling profession as a developmentally appropriate model for working with children and adolescents. This book provides a comprehensive introduction to structured, prescriptive approaches to play therapy to those desiring to gain more information and knowledge about the use of different directive play therapy modalities. It introduces the unique integration of play therapy and different theoretical models and encompasses the essential concepts and practices of directive play therapy. Most importantly, the book shares some guidelines for planning and selecting toys and materials for a directive approach. It also incorporates settings and skills necessary for effective implementation and addresses common questions asked about the use of these. The book provides the exploration and detailed description of various theoretical approaches to directive play therapy: post-Jungian directive sandtray in play therapy, solution-focused play therapy, eye movement desensitization and reprocessing and play therapy, directive play therapy techniques in trauma-focused cognitive behavioral therapy, child parent relationship therapy, creativity in play therapy using technology, directive filial therapy models with very young children, humanistic sandtray therapy with children and adults, and directive approaches to working with parents. The distinctive techniques and processes of each of these approaches are explained. Finally, case examples are given to demonstrate their application and implementation.
A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors, and Consultants, 2nd Edition
The book describes updated information on mechanisms of action of eye movement desensitization and reprocessing (
EMDR) therapy. It delivers clear, concise treatment guidelines for students, practicing clinicians, supervisors, clinic directors, and hospital administrators involved in the treatment of those with posttraumatic stress disorder (PTSD), Specific Phobias, and Panic Disorder. In EMDR therapy, various strategies can be employed to support the goals of stabilization and symptom reduction. Some stabilization strategies commonly used in EMDR therapy were developed in other traditions such as progressive relaxation, self-hypnosis, biofeedback, and meditation. The book provides an overview of the standard eight-phase model of EMDR therapy and the general three-pronged protocol that provides the framework for the specific treatment protocols for diagnostic groups. It briefly touches on clinical situations where the general principle of treatment planning based on the three-pronged protocol must give way to an initially inverted protocol for treatment planning that starts with reprocessing targets in the future, then on the present, and addresses past targets only after significant treatment gains have been achieved. The book explores the theoretical and practical aspects of the EMDR therapy approach to case formulation, treatment planning, and selecting and preparing patients with PTSD and other post-traumatic syndromes for EMDR reprocessing. Screening for a possible dissociative disorder is essential before offering EMDR reprocessing on either traumatic targets or resource installation. Case studies with transcripts illustrate the different protocols and further guide practitioners of EMDR therapy in informed decision-making.
Cultural Competence and Healing Culturally Based Trauma With EMDR Therapy:Innovative Strategies and Protocols
Underscoring the importance of cultural competence, this book focuses on using eye movement desensitization and reprocessing (EMDR) therapy with specific populations, particularly those groups typically stigmatized, oppressed, or otherwise marginalized in society. Drawing on social psychology research and theory as well as social justice and social work principles, it delivers general protocols for EMDR intervention for recovery from the internalized effects of cultural mistreatment. Employing best-practice methods for cultural competence as EMDR therapy is introduced to new cultures worldwide, the editor and esteemed EMDR clinician-authors relay their experiences, insights, guidance, and lessons learned through trial and error while adapting EMDR interventions for cross-cultural competency and therapeutic effectiveness. The book defines cultural competence and validates the need for a multi-culturally aware approach to psychotherapy that embraces authentic socialidentities and attends to the impact of socially based trauma. Chapters address using EMDR therapy to heal the trans-generational impact of anti-Semitism, working with the LGBT population, treating an immigrant woman suffering from social anxiety, healing individuals with intellectual disabilities, thetraumatizing effects of racial prejudice, harmful cultural messages about physical appearance, EMDR therapy attuned to specific cultural populations andsocially based identities, and many other scenarios. The book is replete with step-by-step treatment guidelines to help clients recover from traumatic life events, dos and don’ts, and common adaptive and maladaptive cultural beliefs.
Unhealed trauma causes distress in the body. When the nature of the distress overrides a person’s existing system for coping, or the trauma is not processed, survivors may numb themselves or seek a more pleasurable experience to escape. Such behavior is a completely natural response to unprocessed trauma. This book continues challenging the existing paradigms for treating addiction and related issues. Despite the longstanding existence of professional treatment in North America, recidivism is high. People are still dying at alarming rates not just from the opioid crisis that dominates news headlines, also from the impact of alcohol, cocaine, nicotine, and other maladaptive behaviors. Moreover, the social isolation and collective trauma caused by the
COVID-19pandemic added fuel to an already raging fire, revealing massive cracks in a system for care that is barely functional. In the authors’ assessment, no single drug, substance, or behavior is the culprit—the real issue is the untreated trauma that lurks underneath, causing people to seek out the relief of these substances in the first place. The literature and practice knowledge in the field of addictions have long identified untreated posttraumatic stress disorder as a relapse risk factor. There is a rich history of eye movement desensitization and reprocessing ( EMDR) therapy’s role in helping to heal addiction at a holistic level due to the long-established connection between unprocessed trauma and addiction. EMDRtherapists must remember that EMDRtherapy is a complete system of psychotherapy and ought to be honored as such when conceptualizing cases connected to compulsive behavior, substance use disorders, or other addictions.