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- Go to article: Effectiveness of Metacognitive Instruction on Reading Comprehension Among Intermediate Phase Learners: Its Link to the Pass Theory
The present review examines how resources have been used in trauma-focused psychotherapy with an emphasis on their use in eye movement desensitization and reprocessing (EMDR). Current practices of EMDR-trained clinicians are presented in a historical context and considering a range of contemporary approaches to ego strengthening. This article describes the use of resources as presented in the EMDR literature along with research findings. The review concludes with a call for controlled research on widely used resource-focused procedures and practice guidelines for their use in clinical applications of EMDR.
Le trouble de la personnalité narcissique et le trouble de traits narcissiques sont associés à des conduites égoïstes et à un défaut d'empathie envers les autres. Les patients dont la présentation initiale dans la psychothérapie correspond à l'un ou l'autre de ces tableaux ont un profil égocentrique ; ils manquent d'empathie ou se préoccupent peu de la souffrance qu'ils peuvent provoquer chez d'autres personnes, mais ceci n'est qu'un élément parmi d'autres. Parfois le défaut d'empathie et l'égoïsme ne sont que des défenses. Pour appréhender pleinement ce problème, il faut également avoir conscience des difficultés sous-jacentes à se définir soi-même qui sont à l'origine des manifestations comportementales du narcissisme. Comme c'est le cas pour tout problème psychologique, le traitement EMDR nécessite une compréhension de la manière dont les expériences en début de vie conduisent aux symptômes ultérieurs. La compréhension des voies qui relient les expériences vécues à un jeune âge aux traits narcissiques (y compris les présentations latentes) est essentielle à une conceptualisation de cas adéquate, tout comme il faut cerner les structures mentales défensives qui empêchent l'accès aux expériences défavorables fondamentales sous-jacentes aux symptômes.
- Go to article: EMDR as an Integrative Therapeutic Approach for the Treatment of Separation Anxiety Disorder
This case study reports the use of eye movement desensitization and reprocessing (EMDR) and family therapy for a 10-year-old boy with severe separation anxiety disorder (SAD). It illustrates how the use of the standard EMDR protocol for the boy and his mother combined with family therapy, led to symptom alleviation and restored appropriate developmental functioning as evidenced by behavioral outcomes. The participant initially presented with severe anxiety about separating from his mother, several years after his parents went through a painful divorce. Treatment focused on processing the boy’s disturbing memories of past nontraumatic events in 14 EMDR sessions; his mother received 4 EMDR sessions to address her perceived marital failure and guilt about the effects of her ensuing depression on him. Eight family therapy sessions were used to help the family spend positive time together. Prior to treatment, the child had been unable to play outside, checked on his mother frequently, and could not attend activities without her. At the end of treatment, he was able to play with friends outside, ride his bike around town, engage in after school activities, and sleep over at his friends’ houses. Gains were maintained at 6-month follow-up. Treatment did not include instruction in parenting skills or psychoeducation for the mother, or any exposure therapy for the child.
- Go to article: Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder
Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder
A large proportion (11%–60%) of people with posttraumatic stress disorder (PTSD) also suffer from substance use disorder (SUD). As the high cooccurrence of PTSD and SUD leads to a worsening of psychopathological severity, development and evaluation of integrated treatments become highly valuable for individuals presenting with both diagnoses. Eye movement desensitization and reprocessing (EMDR) therapy may fit these needs. This article summarized all studies that investigated EMDR treatment for SUD, to clarify whether EMDR might be a useful approach. A comprehensive Title/Abstract/Keyword search was conducted on PsycInfo, PsychArticle, PubMed, and Scopus databases. A total of 135 articles were retrieved, and 8 articles met inclusion/exclusion criteria. One RCT and one case study evaluated trauma-focused EMDR; one clinical RCT, one non-clinical RCT, one cross-over study, and one case study evaluated addiction-focused EMDR; and one quasi-experimental and one multiphase case study evaluated the combination of addiction-focused and trauma-focused EMDR. Results show that EMDR treatment consistently reduces posttraumatic symptoms, but that its effects on SUD symptoms are less evident. Although EMDR should be considered as a promising tool for this population due to its possible potential to improve SUD outcomes, further research is needed to see whether EMDR therapy, either trauma-focused or addiction-focused, is effective for SUD. We conclude with suggestions for future research and clinical practice in this area.
- Go to article: “Winter Is Coming!”—Treatment of Obsessive-Compulsive Disorder Imagery After Viewing the Television Series Game of Thrones
“Winter Is Coming!”—Treatment of Obsessive-Compulsive Disorder Imagery After Viewing the Television Series Game of Thrones
This article presents the detailed case of a 27-year-old man who began to suffer from intrusive imagery after watching a brutal scene in the TV series Game of Thrones. The content of the intrusive imagery included images of people with enucleated eyes and was initially accompanied by anxiety about sharp objects. The patient’s mental distress was assessed by the Yale-Brown Obsessive Compulsive Scale and the Impact of Event Scale—Revised, and the patient was diagnosed with obsessive-compulsive disorder (OCD). Eye movement desensitization and reprocessing (EMDR) therapy was provided to treat related distressing memories and the intrusive imagery. As treatment progressed, more complex and layered aspects of the symptom presentation became evident, and EMDR was integrated with other treatments. These included psychodynamic psychotherapy to address his complicated relationship with his father, exposure and response prevention (ERP) therapy to reduce avoidance of sharp objects, and cognitive therapy (CT) for aggressive violent thoughts toward others. The article identifies the various clinical decision points and discusses theoretical conceptualizations and related factors. This clinical case report provides additional support for the body of knowledge on the relationship between traumatic events and imagery in OCD. Therefore, trauma-focused treatments, such as EMDR therapy, which concentrates specifically on those experiences, might be especially effective.
- Go to article: Assessment of Psychophysiological Stress Reactions During a Traumatic Reminder in Patients Treated With EMDR
Assessment of Psychophysiological Stress Reactions During a Traumatic Reminder in Patients Treated With EMDR
This study investigates changes of stress-related psychophysiological reactions after treatment with EMDR. Sixteen patients with posttraumatic stress disorder (PTSD) following type I trauma underwent psychometric and psychophysiological assessment during exposure to script-driven imagery before and after EMDR and at 6-month follow-up. Psychophysiological assessment included heart rate (HR) and heart rate variability (HRV) during a neutral task and during trauma script listening. PTSD symptoms as assessed by questionnaire decreased significantly after treatment and during follow-up in comparison to pretreatment. After EMDR, stress-related HR reactions during trauma script were significantly reduced, while HRV indicating parasympathetic tone increased both during neutral script and during trauma script. These results were maintained during the follow-up assessment. Successful EMDR treatment may be associated with reduced psychophysiological stress reactions and heightened parasympathetic tone.
Eye movement desensitization and reprocessing (EMDR) therapy is an established treatment for posttraumatic stress disorder (PTSD), but there is increasing evidence for its use beyond PTSD. EMDR can be effective at treating distressing memories not associated with PTSD, as well as somatic symptoms (like chronic pain), and as such could potentially be used as a treatment for patients with functional neurological disorder (FND). Searches were conducted for published peer-reviewed articles on the use of EMDR for FND. The databases selected and searched were Medline, Embase, Cochrane Library, CINAHL Plus, Web of Science, PsychINFO, PubMed, and Francine Shapiro Library. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Three relevant articles were found. The studies included are one case series and two case studies. Of the five participants included in the studies, four experienced functional non-epileptic attacks; and one experienced functional movement disorder. Four out of the five patients were successfully treated with EMDR. EMDR is potentially a useful treatment of FND, but further research, including controlled trials, is required. The authors propose that EMDR could be useful in treating patients with FND and comorbid PTSD, as well as patients without comorbid PTSD. We discuss the clinical implications and propose how EMDR could fit into the FND treatment pathway.
- Go to article: Randomized Controlled Trial: EMDR Early Intervention With and Without Eye Movements for Learned Helplessness State
Randomized Controlled Trial: EMDR Early Intervention With and Without Eye Movements for Learned Helplessness State
Learned helplessness (LH) is considered a psychological trait, which occurs after repeated exposure to aversive and uncontrollable situations (Seligman, 1975). Such an exposure is found to lead motivational, cognitive, and emotional deficits. LH has also been linked to different psychological disorders such as depression, anxiety, posttraumatic stress disorder (PTSD), and trauma-related depression. Eye movement desensitization and reprocessing (EMDR) therapy has been accepted as an efficacious treatment for PTSD, but evidence for its effectiveness as an early intervention is still preliminary. Also, there is some uncertainty regarding the role of eye movements in EMDR. The current randomized controlled study investigated whether a single 15-minute session of EMDR's Recent Traumatic Episode Protocol (R-TEP) could reduce the effects of laboratory-induced LH. The study further investigated whether R-TEP without eye movements would have the same effect. Using established experimental tasks, an LH state was induced via unsolvable maze tasks with effects measured by the participants' performance in solving anagrams. Results revealed that an LH state was successfully induced by the unsolvable mazes. R-TEP effectively reversed the negative effects of the LH state and was significantly more effective than no treatment controls and the R-TEP condition without eye movements, which was essentially a narrative exposure intervention. Results suggest that R-TEP can be successfully administered immediately following a distressful event, and that eye movements appear to be a necessary component of EMDR in reversing the cognitive, motivational, and/or emotional deficits induced by LH.
This Clinical Q&A section responds to a question about organizing a client’s historical information into a targeting sequence within a treatment plan that is consistent with Shapiro’s (2001) three-pronged protocol. The procedures for identifying and prioritizing treatment eye movement desensitization and reprocessing (EMDR) targets are reviewed in the context of Shapiro’s theoretical model, and various time line models are summarized. The author then presents her EMDR TargetTime Line, which provides a practical simple visual tool for documenting past, present, and future aspects of the presenting problem. It allows the therapist to note if disturbing past experiences present around a core theme, such as negative cognitions, physical symptoms, or situations/persons/circumstances. Three clinical cases are used to illustrate the form’s application with various types of treatment targets.