Cet article présente la technique éclair, une nouvelle technique utilisée pendant la phase de préparation de la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires) pour faciliter le traitement de souvenirs traumatiques intenses auxquels les patients hésiteraient autrement à accéder. Les premières données, demeurant à confirmer, suggèrent que cette technique pourrait permettre aux patients d’accéder à ces souvenirs d’abord de manière la moins perturbante possible, réduisant leur intensité émotionnelle, afin de pouvoir ensuite les aborder plus pleinement et les traiter à l’aide de la thérapie EMDR. La technique semble aisément tolérée par les patients de tous âges, y compris les enfants ; elle paraît rapide et relativement indolore pour les patients, même ceux qui possèdent des souvenirs cibles particulièrement perturbants ; elle s’enseigne facilement aux cliniciens. Elle se distingue par le fait que les patients qui évitent un souvenir terriblement perturbant peuvent se voir offrir une façon de le traiter sans devoir le ramener clairement à l’esprit. Quatre exemples de cas, dans lesquels quatre cliniciens différents ont utilisé la technique, sont présentés brièvement. Des suggestions sont formulées pour des études à venir. Cet article présente des hypothèses pour expliquer divers mécanismes d’action et évoque les effets en termes de la théorie de reconsolidation mnésique.
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- Go to article: Randomized Controlled Trial: Self-Care Traumatic Episode Protocol, Computerized EMDR Treatment of COVID-19-Related Stress
Randomized Controlled Trial: Self-Care Traumatic Episode Protocol, Computerized EMDR Treatment of COVID-19-Related Stress
Healthcare workers and mental health clinicians are at heightened risk for mental health issues while they support their communities during the COVID-19 pandemic, and early psychological intervention is crucial to protect them. The Self-Care Traumatic Episode Protocol (STEP) is a computerized intervention adapted from the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP). This study evaluated the effectiveness of STEP for mental health clinicians in the context of COVID-19. Thirty-four mental health clinicians were randomly allocated to treatment (n = 17) or waitlist (n = 17). The Generalized Self-Efficacy Scale (GSE) and Depression and Anxiety Stress Scale (DASS-21) were completed by the treatment group at baseline and 1-week follow-up postintervention and by the waitlist group at baseline, preintervention, and 1-week follow-up postintervention. Pre–post comparisons showed a significant decrease in depression, anxiety, and stress for Immediate Treatment, t(15) = −3.64, p < .01, d = .73, and for Delayed Treatment, t(15) = −3.53, p < .01, d = .68, There was also a significant increase in general self-efficacy for Immediate Treatment, t(15) = 2.87, p < .05, d = .46, and Delayed Treatment, t(15) = 3.72, p < .01, d = .56. The randomized controlled trial (RCT) indicated that STEP may be effective in increasing general self-efficacy and reducing symptoms of depression, anxiety, and stress among mental health clinicians in the context of COVID-19. Further research investigating the potential of utilizing the STEP intervention on a larger scale and with other populations is needed.
- Go to article: Eye Movement Desensitization Reprocessing for Children and Adolescents With Posttraumatic Stress Disorder: A Systematic Narrative Review
Eye Movement Desensitization Reprocessing for Children and Adolescents With Posttraumatic Stress Disorder: A Systematic Narrative Review
There is currently a limited number of studies into the efficacy of eye movement desensitization reprocessing (EMDR) therapy with children and adolescents with posttraumatic stress disorder (PTSD). The current study utilizes a systematic narrative review of methodologies and findings of previous literature reviews and meta-analyses as well as analyzing randomized control trials (RCTs) conducted from 2002 to 2018. Following initial scoping of the extent of studies, two systematic literature searches were conducted, firstly for literature reviews and secondly for recent RCTs. Nine databases were utilized. Eight reviews and seven RCTs were identified and analyzed for quality of methodology and outcome as measured by impact on PTSD symptoms. EMDR was found to be efficacious in reducing children's PTSD symptoms compared to waitlist conditions, with similar outcomes to cognitive behavior therapy (CBT). EMDR was effective with both single-event trauma as well as cumulative trauma such as sexual abuse. EMDR was equally effective with girls and boys as well as children from different cultures. EMDR achieved medium to large effect sizes. Reductions in PTSD were maintained at 2-, 3-, 6-, and 12-month follow-up. In conclusion, EMDR was consistently found to be an efficacious treatment for children with PTSD. Recommendations are made for future practice and research.
- Go to article: Efficacy of EMDR Therapy on the Pain Intensity and Subjective Distress of Cancer Patients
The present study was carried out to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) therapy in treating pain and subjective distress of patients with cancer. A randomized controlled trial was performed on patients with cancer suffering from moderate to severe cancer pain in Yasuj, Iran, in 2019 and 2020. Sixty patients aged 30–60 years who fulfilled the inclusion criteria were selected using a consensus sampling technique. Patients were randomly assigned to EMDR therapy or control groups based on random block allocation. EMDR therapy was administered in six to eight daily 1-hour sessions. The control group received the standard treatment provided by the hospital. A Numeric Pain-Rating Scale (NRS) and the Subjective Units of Disturbance Scale (SUDS) were used to assess pain and subjective distress before and after the intervention in each session. The collected data were analyzed by descriptive statistics, chi-square test, and independent t test using Statistical Package for the Social Sciences (SPSS) version 24. The mean pain intensity and subjective distress score in the experimental group before and after the EMDR intervention were significantly reduced (p < .001). In the control group, no decreases in NRS and SUDS scores occurred at any time (p > .05). Differences in pain scores between the groups were statistically significant (p < .001). EMDR can effectively and sustainably reduce the pain and subjective distress experienced by patients with cancer. Thus, EMDR is a recommended therapeutic option to mitigate pain and subjective distress among patients with cancer.
It has only been in this last decade that trauma-focused treatments (TFT) have been studied in patients with psychotic disorders. Before, the paradigm stated that TFT was contraindicated in these patients because clinicians and researchers assumed the risk of exacerbation of symptoms was too high. The purpose of this article is to examine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy in the treatment of psychosis. To this end, we will present a brief narrative review of the current state of research in this particular field. The results suggest that, contrary to the “no-TFT-in-psychosis” paradigm, TFTs such as EMDR therapy can successfully be used to reduce trauma-related symptoms in patients with psychosis. Moreover, there are now provisional indications that psychotic symptoms such as delusions and hallucinations can be targeted directly and indirectly using EMDR therapy.
This article reports on the first 3 randomly allocated cases treated by the author in an ongoing trial comparing eye movement desensitization and reprocessing (EMDR) with cognitive behavioral therapy (exposure and response prevention) in the treatment of obsessive-compulsive disorder in a U.K. primary care setting. This article describes the treatment and data collection procedures, followed by a summary of each of the 3 cases supported by quantitative and qualitative data. The Adapted EMDR Phobia Protocol (Marr, 2012) was provided, following the trial protocol of 1-hour, 16-session treatment. The Yale-Brown Obsessive Compulsive Scale was administered at every 4th session. At posttreatment, 2 of the 3 cases showed more than a 50% reduction on validated psychometric measures, with symptoms below diagnostic cutoff. The final case started treatment below the diagnostic cutoff on the primary outcome measure and showed a slight improvement. Six-month follow-up data showed maintenance of treatment effects. Transcripts from a semistructured telephone interview carried out by an independent researcher following treatment were analyzed using a 6-stage thematic analysis method, which identified 3 themes: the role of traumatic experiences, role of shame, and importance of therapeutic alliance. This article concludes with a discussion of implications for EMDR practice and theory.
- Go to article: The Effect of EMDR Versus Guided Imagery on Insomnia Severity in Patients With Rheumatoid Arthritis
This study compared the effect of eye movement desensitization and reprocessing (EMDR) therapy versus guided imagery on insomnia severity in patients with rheumatoid arthritis (RA). In this randomized controlled trial, 75 patients with RA were selected via convenience sampling before using block randomization to assign patients into three groups comprised of (a) six sessions of EMDR, (b) six sessions of guided imagery, and (c) a control group. The Persian version of the Insomnia Severity Index was implemented at preintervention and 2 weeks' postintervention as the outcome measure. The EMDR group obtained respective pre-and postintervention mean scores of 23.5 ± 5.2 and 11±2.1, whereas the guided imagery group obtained scores of 24 ± 3 and 15.3 ± 2.3, and the control group obtained scores of 24.2 ± 3.3 and 23.6 ± 3. Pairwise comparisons showed statistically significant differences in insomnia severity between patients from each group, with the EMDR group experiencing a greater reduction in insomnia severity than guided imagery. EMDR and guided imagery were both effective in reducing insomnia severity in RA patients, although the degree of insomnia reduction for patients from the EMDR group was greater than that of the guided imagery group.
- Go to article: Exploring Therapists' Experiences of Applying EMDR Therapy With Clients Experiencing Psychosis
Little is known of the usability of eye movement desensitization and reprocessing (EMDR) as an intervention for those experiencing psychosis. This study aimed to explore therapists' experience of using EMDR with this population. A qualitative design was employed using an inductive approach and a thematic analysis. Twenty therapists, who had used EMDR with this client group, took part in a semi-structured interview to explore their experiences of the intervention. Key themes were generated from the data: (a) familiarity with psychosis and EMDR, (b) acceptability of EMDR, (c) the importance of systemic factors, and (d) keeping key therapy principles in mind. Findings highlighted the importance of supervision to build therapist confidence, the value of the multidisciplinary team, and the need for a shift in beliefs surrounding the usefulness of EMDR to the wider system. Recommendations for individuals and services are provided.
- Go to article: EMDR Versus Treatment-as-Usual in Patients With Chronic Non-Malignant Pain: A Randomized Controlled Pilot Study
EMDR Versus Treatment-as-Usual in Patients With Chronic Non-Malignant Pain: A Randomized Controlled Pilot Study
In recent years, different studies have observed a strong association between chronic pain (CP) and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), could be an innovative treatment option. The aim of this pilot study was to assess whether a specific EMDR protocol for CP leads to (a) a reduction in pain intensity, (b) an improvement in anxiety and depressive symptoms, and (c) an improvement in quality of life. 28 CP patients were randomly assigned to EMDR + treatment as usual (TAU; n = 14) or to TAU alone (n = 14). Patients in the EMDR group received 12 psychotherapeutic sessions of 90 minutes over 3 months. Pain intensity was measured using the Visual Analog Scale and the Pain Disability index, quality of life using the EQ-5D-5L, and anxiety and depressive symptoms using the Hamilton Anxiety and Depression Scale. Measures were taken for both conditions at pre- and post-treatment, and a follow-up in the EMDR condition was taken at 3 months post-treatment. Patients in the EMDR group showed significantly reduced pain intensity and improved quality of life and anxiety and depressive symptoms compared to TAU alone at post-treatment. Improvements were largely maintained at 3-month follow-up. This study suggests that EMDR may be an effective and safe psychological intervention to be used within the multidisciplinary treatment plan of patients with CP.
- Go to article: Evidence of the Efficacy of EMDR With Children and Adolescents in Individual Psychotherapy: A Review of the Research Published in Peer-Reviewed Journals
Evidence of the Efficacy of EMDR With Children and Adolescents in Individual Psychotherapy: A Review of the Research Published in Peer-Reviewed Journals
Research on psychotherapy with children is generally underrepresented in the empirical literature. Currently, there are four randomized clinical trials (RCT) evaluating EMDR in individual psychotherapy with traumatized children—two for children diagnosed with PTSD and two for children presenting with symptoms of posttraumatic stress. Since the first case studies of EMDR with children were published in 1993, 19 studies were identified that met the inclusion criteria for this review. The gold standards identified by Foa and Meadows (1997) to assess the methodology of studies designed to treat trauma were applied to the research on EMDR with children. This analysis discusses the challenges to conducting research on psychotherapy with children including the debate regarding the assessment and diagnosis of PTSD in children. Recommendations for future studies designed with methodological rigor are suggested to investigate the efficacy of EMDR with children who have experienced trauma and other mental health symptoms and diagnoses.