Adolescent dating violence may lead to adverse health behaviors. We examined associations between sexual teen dating violence victimization (TDVV) and sexual risk behaviors among U.S. high school students using 2013 and 2015 National Youth Risk Behavior Survey data (combined n = 29,346). Sex-stratified logistic regression models were used to estimate these associations among students who had dated or gone out with someone during the past 12 months (n = 20,093). Among these students, 10.5% experienced sexual TDVV. Sexual TDVV was positively associated with sexual intercourse before age 13, four or more lifetime sexual partners, current sexual activity, alcohol or drug use before last sexual intercourse, and no pregnancy prevention during last sexual intercourse. Given significant findings among both sexes, it is valuable for dating violence prevention efforts to target both female and male students.

The authors define peer tutoring and describe the types of peer tutoring reported in the literature. An organizational typography of peer tutoring in school classrooms is presented, and the variables that influence patterns, nature and effectiveness of peer interaction are explored. Cognitive models of peer tutoring approaches that follow either Piagetian theories of cognitive conflict or Vygotskian theories of co-construction are compared and the similarities and differences of each model interrogated. The influences each model may have on cognitive and affective development, as well as metacognition, are illustrated. The authors discuss knowledge transfer issues to facilitate the development of effective models of peer tutoring in the classroom practice of teachers in schools. Finally, areas for future research and development are highlighted.

We compared how 61 seventh graders, with low or high prior knowledge in mathematics, capitalized on two self-regulated learning approaches—generic versus context specific—to (a) enhance self-regulated learning, (b) foster procedural knowledge of routine algebraic tasks, and (c) transfer knowledge to novel mathematical problem solving. The generic approach was based on “IMPROVE” question prompts for comprehension, connection, strategy, and reflection modeled in a free context. The context-specific approach was based on what, when, why, and how (WWWH) question prompts directed explicitly to specific examples in a particular mathematical content area. Findings indicated no difference between the two approaches regarding short-term effects on algebraic procedural tasks; however, differential effects emerged between the two approaches on the self-regulation measure and on long-term transfer to novel tasks (near and far) among students with low or high prior knowledge. The practical and scientific significance of this study are discussed.

Justification: Recent studies showed that neurocognitive insight difficulties occur in subjects with schizophrenia. However, little is known about the different profiles of neurocognitive insight, their relations with neurocognitive functioning, and their specific links with mood factors and outcomes. Aim: The study explored profiles of relationships between objective and subjective cognition in persons with schizophrenia spectrum disorders (SSD) and associations with quality of life (QoL), stigmatization, and mood factors. Method: Participants were 69 outpatients with an SSD. Cluster analysis (Ward method) was performed to explore profiles of interactions between subjective complaints and objective cognitive performances. Analyses of variance (ANOVAs) were then conducted to compare groups on anxiety and depression levels, stigmatization, and QoL. Results: Cluster analysis produced 3 groups: high cognitive impairment/moderate cognitive complaints (N = 26), good cognitive functioning/moderate cognitive complaints (N = 22), and moderate cognitive impairment/high cognitive complaints (N = 21). The second group has higher objective QoL, and the third group has higher levels of anxiety, depression, and stigmatization. Our results show that (a) not all patients with SSD have neurocognitive insight difficulties, (b) relation between objective and subjective cognition is not linear, and (c) differences between profiles may have theoretical and clinical implications.

The main theoretical and practical applications of Rational Emotive Behavior Therapy (REBT) and Cognitive Therapy (CT) are examined and found to be similar to each other in most respects, but REBT bases its concepts of improved treatment of neurotic disorders and of severe personality dysfunctioning largely on philosophical, existential, and humanistic bases, while CT tends to align them with empirical results of outcome studies. Both REBT and CT, however, use philosophic and empirical outcome studies to construct and validate their theories.

This article describes the development and refinement of a measure designed to assess salient aspects of the psychotherapeutic process. The VPPS consists of seven scales which can be grouped under the headings of: Exploratory Processes, Patient Involvement, and Therapist-Offered Relationship. Its reliability and other psychometric properties are considered satisfactory so that the instrument can be recommended for operational use.

Principles and procedures for supervising cognitive behavioral therapy (CBT) were broadly defined in 2 early seminal texts almost 15 years ago (Liese & Beck, 1997; Padesky, 1996) and updated more recently (Beck, Sarnat, & Barenstein, 2008; Newman, 2010). However, the actual practice of CBT supervision often shows poor fidelity to this model (Townend, Iannetta, & Freeston, 2002) with notable deficiencies in the use of direct observation, standardized observational rating systems, and experiential methods in supervision (Milne, 2008). The advent of more specific competency statements on CBT supervision has been a significant leap forward (Falender et al., 2004; Roth & Pilling, 2008) but poses some practical challenges to clinical supervisors in terms of transferring broad competency statements into actual supervisory practice. We address the need for more rigor in CBT supervision within a university training clinic setting and outline some promising ingredients for this specification drawing on competencies, metacognition, and experiential learning theory.

This article reviews the fledgling psychopathy development and intervention literatures. We conclude that long-term, intensive, multiple systems interventions, which integrate cognitive-behavioral and motivation-enhancement techniques, provide the greatest promise for youths exhibiting psychopathy features.

Acceptance and commitment therapy (ACT) for anxiety disorders is a type of cognitive behavioral therapy that focuses on decreasing the behavior regulatory function of anxiety and related cognitions, and has a strong focus on behavior change that is consistent with client values. In this case series, 3 consecutive referrals seeking treatment for anxiety disorders at a private practice were treated with 9–13 sessions of ACT. In-session exposure therapy was not included to determine the effects of ACT without the compounding effects of already proven treatment procedures. The treatment procedure was identical across disorders to test the use of a unified treatment protocol for anxiety disorders: panic disorder with agoraphobia, comorbid social phobia and generalized anxiety disorder, and posttraumatic stress disorder. All participants showed clinical improvement in their specific anxiety disorders as rated on multiple standardized assessments after treatment, with gains maintained at follow-up (8 months or more). Time series assessments, taken throughout treatment, of anxiety and avoidance behaviors showed large decreases in avoidance but not in anxiety, suggesting ACT was effective by changing the way participants responded to anxiety rather than anxiety itself.

Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.

Although studies have assessed the association between affective dysfunction and parental bonding, little research has assessed the information processing characteristics of individuals with disrupted parental bonding. The current study investigated differences in attentional processing between individuals with relatively poor versus secure parental bonding, and also assessed this processing in conjunction with a mood priming procedure that has been used in previous vulnerability research. Using a Stroop procedure, results indicated that poorly bonded individuals were less distracted by depressive information than were individuals reporting a secure bonding history. Results also suggested that avoidance of anxious information in the poorly bonded group was uniquely associated with maternal overprotection. These results suggest that poorly bonded individuals may cope with their increased vulnerability by avoiding some types of affectively linked information, and that some of this avoidance may be linked to perceptions of a mother who is overly intrusive.

A psycholinguistic account of motivational interviewing (MI) is proposed. Critical to this view is the assumption that therapists and clients are natural language users engaged in a constructive conversation that reveals and augments relevant information about the status of future change in a client’s substance abuse. The role of client speech acts—most notably, verbal commitments—during MI is highlighted. How commitments can be signaled in client speech or gestures is discussed. How these commitment signals can inform therapeutic process and subsequent behavioral outcome is then put forth. Using natural language as a measure, a MI process model is presented that not only posits a mediational role for client commitment in relating underlying factors of desire, ability (self-efficacy), need, and reasons to behavior, but also a pivotal role as a need-satisfying enabler of a social-cognitive mechanism for personal change.

Adler’s Individual Psychology (IP) and Cognitive Behavior Therapy (BT) have many common precepts and suppositions. This paper delineates many of these commonalities and suggests areas in which the therapists may learn from each other.

This study adopted a self-presentation perspective to examine cognitive factors involved in maintaining social anxiety in men in heterosexual situations. The self-regulatory appraisals of 25 socially anxious and 25 nonanxious men were compared using a modified version of the Articulated Thoughts in Simulated Situations (ATSS) procedure (Davison, Robins, & Johnson, 1983). Subjects viewed videotapes of two enacted situations between a male actor and a female actor which differed on whether the individuals were strangers or acquaintances. The subjects were instructed to identify with different male actors who depicted contrasting styles of self-presentation. In contrast to nonanxious men, socially anxious subjects consistently made pessimistic self-appraisals, articulating more negative self-focused thoughts, and displaying negative self-other biases. However, nonanxious men showed equivalent levels of self-focused negative thoughts in response to representations of a protective style of self-presentation. Unexpectedly, for all subjects, the less intimate first meeting situation elicited more negative self-focused thoughts than did the more intimate dating situation. The findings are discussed in terms of self-regulatory components of self-presentational styles and the implications for treatment of social anxiety.

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.

Medications to treat attention deficit/hyperactivity disorder (ADHD) can increase students’ ability to stay awake to cram for exams. Although popularly viewed as “academic steroids,” there is no evidence that ADHD medications promote complex cognitive functioning or scholarship. To the contrary, compelling new evidence indicates that ADHD drug treatment is associated with deterioration in academic and social-emotional functioning. Yet, ADHD diagnosis and drug treatment have risen unabated for decades. Today, ADHD medications are so prevalent on college campuses that students falsely perceive these drugs as relatively benign and freely use them for nonmedical reasons, resulting in record numbers of adverse events and deaths. This article describes the nature of the ADHD drug abuse epidemic, rules some colleges have implemented to manage risk, and actions that any educational institution may consider to combat ADHD drug abuse and to promote student health and campus safety.

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.

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.

Offense-related trauma refers to a trauma reaction following the perpetration of a violent offense. This research explores the lived experience of offense-related trauma, in two forensic patients. The meaning and understanding these individuals make of their own coping strategies, triggers, and treatment, and how this contributes to their behavior, was explored using a semi-structured interview and analyzed using Interpretative Phenomenological Analysis. Two super-ordinate themes emerged from the data: “Journey to Forgiveness” and “Living with the Whole Me.” These themes and their subthemes highlight the nuances of offense-related trauma and raise the question of how processes such as complicated grief and associated shame can impact on recovery and rehabilitation. The implications of the findings for professionals providing treatment in forensic settings are considered.

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.

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.

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.

Numerous studies have identified links between psychopathology and a history of traumatic life events and dysfunctional attachment relationships. Hence, given the possible traumatic origins of this pathology, it may be useful to provide a trauma-focused intervention such as the eye movement desensitization and reprocessing (EMDR) therapy. This article illustrates a clinical case by describing the positive results of the EMDR therapy in the recovery of unremitting anorexia nervosa in a 17-year-old inpatient. She had previously been hospitalized on 4 occasions in the previous 4 years and received both psychodynamic and cognitive-behavioral therapy. At pretreatment, the client weighed (28 kg, 62 lb) and had a body mass index of 14. She was designated with a dismissing attachment style on the Adult Attachment Interview. EMDR therapy was provided for 6 months in hospital, in twice weekly 50-minute sessions and consisted of standard procedures primarily focusing on her relational traumas, interspersed with psychoeducational talk therapy sessions, and integrated with ego state therapy. At the end of treatment, the client weighed (55 kg, 121 lb) and had a body mass index of 21.5. She no longer met diagnostic criteria for anorexia nervosa, and her attachment style had changed to an earned free-autonomous state of mind. She reported an increase in self-confidence and in her ability to manage various social challenges. Results were maintained at 12 and 24 months follow-up. The treatment implications of this case study are discussed.

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.

Constructed as a barrier to treatment adherence, ambivalence is typically pathologized in qualitative research on “bipolar disorder”—seen as something to be feared and eradicated. Here, I critically review this position, arguing that it is constructed through a “lens of risk” that problematically presumes people have a chronic mental illness that requires lifelong pharmaceutical intervention. I then draw on the accounts of three young women who have been diagnosed with bipolar disorder to demonstrate how people’s concerns, questions, and dreams could instead be seen as a site of expertise about diagnostic and treatment practices; in turn using their ambivalence to stitch together an alternative analytic “lens of desire” through which to re-view accounts of bipolar disorder. Overall this article is thus both a commentary on mainstream research practices in psychology and an experiment with how we might look differently; believing that perhaps the real risk associated with people’s ambivalence is its ability to force us—psychologists and psychiatrists—to question the ways in which we do madness.

This article documents the murder, by psychiatrists, of a quarter of a million patients, mostly diagnosed as “schizophrenic,” in Europe during the second world war; and the sterilization of hundreds of thousands more internationally, including in the USA and Scandinavia. These sterilizations and murders were justified by biological psychiatry’s unsubstantiated hypothesis that the conditions involved are genetically determined. Gas chambers in the six psychiatric hospitals involved, in Germany, were subsequently dismantled and moved, along with the psychiatrists and their staff, to help establish some of the Holocaust’s concentration camps, in Poland. The avoidance of these facts and their profound implications, by the profession of psychiatry, internationally, over subsequent decades, is discussed. An inspirational trauma-focussed alternative to the pessimistic, unscientific ideology of biological psychiatry, involving psychiatrists 60 years later, is presented.

Studies that attempt to models stress have been limited by the ambiguity surrounding the stress concept. To address this conceptual lacuna, this article proposes a new approach to conceptualizing stress. Through a historical survey of ideas relating to stress, clarity will be brought to the conception of stress through a synthesis of insights on the nature of stress arousal, particularly focusing on the dynamic of generation of stress in the mind. Stress, resulting from both positively and negatively appraised events, is experienced in proportion to the certainty with which we assess an impact to something to which we have attachment (Sanskrit, upãdãna), whether physical or ideological. Ultimately, this ancient conception of the psychological dynamic of stress has borne fruit in philosophy, religion, and psychotherapy, making it a sound candidate for a fundamental psychological conception of stress.

This article examines a 2006 European Court of Human Rights judgment concerning educational discrimination against Roma children in the Czech Republic and the involvement of educational psychologists in the case. The court held the school to be the proper final arbiter on the question of the best interests of the child regarding educational placement. Based largely on culturally biased psychological testing results, the Roma children in question were declared mentally handicapped by educational psychologists. On that basis, they were placed in a segregated school for the intellectually disabled where the curriculum was quite deficient. Despite statistical evidence of the overrepresentation of Roma children in such segregated Czech schools, and of widespread discrimination against Roma in schools and in the larger society, the court rejected the claim that the children’s right to an education had been violated. The implication for psychologists and educators internationally, to avoid becoming pawns contributing to an oppressive human rights situation, is discussed.

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.

Research indicates that EMDR is effective for the treatment of posttraumatic stress disorder (PTSD), with numerous studies showing a high percentage of symptom remission after 3 sessions. The case of a tsunami survivor with acute PTSD is presented. Treatment for overt trauma symptoms was completed within 3 sessions, including all 8 phases and the 3-pronged protocol (i.e., past, present, future targets). One EMDR session was sufficient to process the trauma and alleviate the related symptoms, while another session was necessary for re-evaluation and processing present triggers and future templates. Resource installation was particularly helpful to prepare him for those future situations that had been generating anxiety as a result of his traumatization.

Until the 1930s, the term “autism” was not mentioned in the literature. Until then, vaccination programs did not exist in the United States. Leo Kanner applied the term “early infantile autism,” detailing 11 cases of children born in 1931. He thought these children seemed like they inhabited a world of one, hence the term “autism,” originally derived from Bleuler (1911). Kanner furnished the following description: “aloneness that, whenever possible, disregards, ignores, shuts out anything that comes to the child from the outside.” He initially claimed parents of children with autism were often cold and humorless perfectionists (Kanner, 1943), considering them to be “emotional refrigerators,” a characterization that haunted him, one he deeply regretted and ultimately recanted. There has been a significant rise in autism. Some of this is probably due to looser definitions, widened to include a broad “spectrum” of behaviors. However, even when I tightened up the criteria for inclusion, I still was able to observe a rather sizeable—in fact, dramatic and alarming—increment. Curious about why this might be so, I began to investigate. I discovered a great deal of secrecy, nontransparency, obstructionism, mystification, and even falsification of data in which people in high places were engaged. This article is intended to disclose facts heretofore obscured, hidden, or reassembled in fanciful ways and to raise questions and make scientific statements and social commentary on this highly important issue. Possible sources of toxicity are listed.

This review provides the groundwork for a basic understanding of articles written about eye movement desensitization and reprocessing (EMDR), including a brief overview of theory and practice. It documents EMDR’s established efficacy in the treatment of posttraumatic stress disorder and specifies specific subsets of this population in need of further investigation. The article also provides a review of recent studies evaluating a range of EMDR’s clinical applications and outlines new directions for research investigations and for developments in clinical practice. It concludes with an overview of current research evaluating pre- and post-neurobiological changes, and mechanisms of action. Specific recommendations for future areas of investigations are outlined, and rigorous evaluation is strongly encouraged.

Self-harm is frequently a trauma-driven coping strategy that can be understood from the perspective of the adaptive information processing (AIP) model and treated with eye movement desensitization and reprocessing (EMDR) therapy (Shapiro, 1995, 2001). Self-harm is often connected with memories of adverse and traumatic life experiences. Identifying and processing these memories with EMDR therapy can put an end to the self-injurious behavior. In addition, self-harm is often based on a lack of regulation skills, and these skill deficits can be addressed in EMDR therapy as well. In this article, the authors describe strategies for treating self-harm throughout the 8 phases of EMDR. Although there is no single approach that applies to all cases, the therapist needs to take a careful history of self-harm, its historical origins, and its triggers and functions in the present to formulate a treatment plan. Often, in the authors’ experience, self-harm functions as a self-soothing strategy that redissociates traumatic affect from childhood. Treatment strategies for Phases 3–8 of EMDR therapy are illustrated through case vignettes.

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.

The diagnosis of posttraumatic stress disorder (PTSD) covers a wide range of conditions, ranging from patients suffering from a one-time traumatic accident to those who have been exposed to chronic traumatization and repeated assaults beginning at an early age. While EMDR and other trauma treatments have been proven efficacious in the treatment of simpler cases of PTSD, the effectiveness of treatments for more complex cases has been less widely studied. This article examines the body of literature on the treatment of complex PTSD and chronically traumatized populations, with a focus on EMDR treatment and research. Despite a still limited number of randomized controlled studies of any treatment for complex PTSD, trauma treatment experts have come to a general consensus that work with survivors of childhood abuse and other forms of chronic traumatization should be phase-oriented, multimodal, and titrated. A phase-oriented EMDR model for working with these patients is presented, highlighting the role of resource development and installation (RDI) and other strategies that address the needs of patients with compromised affect tolerance and self-regulation. EMDR treatment goals, procedures, and adaptations for each of the various treatment phases (stabilization, trauma processing, reconnection/development of self-identity) are reviewed. Finally, reflections on the strengths and unique advantages of EMDR in treating complex PTSD are offered along with suggestions for future investigations.

The standard protocol of eye movement desensitization and reprocessing (EMDR) therapy has been well established as an efficacious brief treatment for posttraumatic stress disorder (PTSD), addressing past, present, and future aspects of a traumatizing event. This article provides instruction in the administration of the EMDR Life Stress Protocol, which targets a significant recent experience or a life scenario that is not necessarily remarkable as a stand-alone event (getting up every morning with dread, feeling anxious about leaving the house) and which causes distress and impaired function such as has been commonly reported during the COVID-19 crisis. This protocol involves minor but significant modifications within EMDR therapy’s standard procedures. It uses the present-day experience as the Target Memory while accessing briefly, the memory network of historical experiences that inform the client’s reactions to their present circumstances. Successful processing is immediately followed by a Future Template to generate an alternative pattern of response, optimizing the client’s capacity to respond adaptively to continued life demands. The EMDR Life Stress Protocol differs from EMDR’s various recent events protocols, which seek to reduce posttraumatic symptoms following a recent traumatic event or crisis. Those protocols focus on the critical incident and ancillary events, and typically do not intend to activate memory networks of related historical experiences. The article describes case conceptualization to offer a rationale for this approach and provides a detailed description of this protocol, illustrated with case examples, highlighting its application both as a psychotherapy approach and as a brief intervention.

Practitioners of psychiatry and psychology have played an important role in the sterilization of tens of thousands of Americans throughout the past century. This article examines a number of questions relating to the origin and continuation of sterilization as a treatment and preventive. What social and medical beliefs lead to the use of sterilization as a treatment and preventive for both the individual and society? What ills are being treated and prevented? Who becomes a candidate for sterilization? To what degree are ethical concerns raised, and what is the response to these concerns? And finally, Who is the client—the individual, potential children, or society?—and how do practitioners distinguish the interest of the individuals from that of their potential children and society?

A telling arena for observing ethical human behavior is the human treatment of nonhuman animals. How one treats or mistreats animals is a decision mostly grounded in his or her ethical beliefs. This article examines animal ethics and discusses the value of intrinsic motivation through the lens of teaching a freshman animal ethics. In addition, this opinion piece argues the merit of the pass/fail paradigm in lieu of the traditional grading paradigm by using the triad of Kohn’s (1999) intrinsic motivation, Thorndike’s (1913) law of readiness, and Bandura’s (1997) social cognitive notion of self-regulation while exploring the human ethical notions related to learning about animal rights.

Unlike high-intensity treatment, in which clients have face-to-face contact with a mental health specialist, clients in low-intensity treatment have limited or no contact with a specialist. Instead, their treatment is usually provided through self-help procedures, which are delivered via (guided) computer programs, books, or “mHealth" apps. Other treatments sometimes considered low-intensity are brief treatments, group therapy, and interventions delivered by nonspecialists. Advantages include effectiveness, accessibility, efficiency, and affordability. Concerns related to safety, engagement, and adherence to self-help programs may be addressed by (asynchronous) therapist guidance. This article describes low-intensity treatments and their relevance for eye movement desensitization and reprocessing (EMDR) therapy. Hundreds of randomized controlled trials (RCTs) have found self-help interventions to be efficacious, with many producing the same level of results as the traditional face-to-face procedure. Guided self-help cognitive behavioral therapy is recommended for the treatment of posttraumatic stress disorder in the guidelines of both the National Institute for Health and Care Excellence and International Society of Traumatic Stress Studies. Only three self-help-EMDR RCTs have been conducted. This author advocates for reconceptualizing EMDR group therapy as “guided self-help-EMDR therapy,” because it is a highly manualized, heavily scripted treatment in which the client works independently on their own material. In this respect, it offers an excellent template for the future development of efficacious low-intensity EMDR interventions. Developing safe, easy-to-use, affordable, and readily available low-intensity interventions will make effective EMDR treatment available to many millions of people around the world.

Given the significant growth in the migration flow of refugees who are fleeing from persecution, terrorism, and war-torn countries to Europe, there is an urgent need for effective interventions for the treatment of this highly traumatized population. EMDR Integrative Group Treatment Protocol (EMDR-IGTP) was provided to 14 child refugees (7 females) in 2016 at a Turkey orphanage near the Syrian border which was housing adult and child Syrian refugees. Treatment was provided in three groups, one each for children aged 3–7 years, pre-adolescents aged 9–12, and adolescents aged 13–18 with three sessions provided to each group. Pre-treatment assessment with multiple measures was compromised by difficulties with translator availability and refugee mobility, resulting in high attrition. When the post-treatment assessment was conducted 45 days later, many refugees had already left the orphanage. The sparse character of the data matrix produced analyzable data for 8 children (mean age 11 ± 3; 4 females) on the Children's Revised Impact of Event Scale (CRIES). Statistical analysis showed a significant decrease in CRIES scores, reflecting a decrease in severity of posttraumatic symptoms.

Supervision de cas est une nouvelle rubrique régulière du Journal of EMDR Practice and Research, où un thérapeute demande de l'aide au sujet d'un cas difficile et où des réponses sont apportées par trois experts. Dans cet article, Amy Robbins (Atlanta, Géorgie), une thérapeute certifiée de la désensibilisation et du retraitement par les mouvements oculaires (EMDR) décrit brièvement le cas difficile d'une femme enceinte qui souhaite traiter un traumatisme subi au cours d'une tornade. La clinicienne demande s'il est indiqué de faire de l'EMDR et quels sont les précautions qu'elle devrait avoir à l'esprit. Le premier expert, Carol Forgash, fournit des informations générales sur la grossesse et la psychothérapie et expose les considérations, les soucis et les contre-indications relatifs au traitement EMDR dans ce cas. Elle recommande que, si le choix se porte sur le traitement EMDR, le thérapeute utilise le protocole de traumas récents pour cibler spécifiquement les souvenirs traumatiques de l'épisode récent de la tornade. Le second expert, Andrew Leeds, commente l'absence d'essais contrôlés randomisés (ECR) ou d'autres rapports scientifiques explorant la sécurité du traitement EMDR chez les femmes enceintes. Il estime que les femmes enceintes présentant des symptômes de stress post- traumatique doivent comprendre qu'il y a de fortes chances pour que l'EMDR améliore leur qualité de vie et que les risques d'effets indésirables sur la stabilité de la grossesse sont probablement faibles, mais qu'ils demeurent cependant inconnus. Le troisième expert, Claire Stramrood, explique que les rares études de cas ayant évalué l'EMDR pendant la grossesse ont rapporté des effets positifs, mais qu'elles concernaient des femmes souffrant d'un état de stress post-traumatique (ESPT) suivant un accouchement. Elle fait valoir qu'après consultation de l'obstétricien, une fois que les femmes ont été informées des risques et bénéfices potentiels, et qu'elles ont donné leur consentement éclairé, elles doivent être en mesure de choisir de commencer ou non la thérapie EMDR au cours de leur grossesse.

This Clinical Q&A article responds to a question about what process to use to access and identify ego states when working with complex trauma. The procedure for implementing Fraser’s Dissociative Table Technique is explained and detailed in 8 clearly defined steps. The author builds on Fraser’s original instructions and adds several innovations for use by EMDR therapists. Tips on implementing this technique are given. The article then concludes with a session transcript to illustrate the use of this powerful tool.

A growing body of literature indicates that eye movement desensitization and reprocessing (EMDR) can be useful in the treatment of addictions. When combined with traditional addictions treatment approaches, EMDR can enhance client stability, prevent relapse, and promote recovery. Clinical decision making about when and how to use EMDR techniques with clients who present with addictions is complicated. The purpose of this article is to explore the use of EMDR interventions with clients presenting various levels of awareness of their addiction as well as varied levels of motivation to change. The authors explore the Stages of Change and suggest appropriate pre-EMDR EMDR interventions at each stage.

La douleur chronique peut réduire considérablement la qualité de vie, engendrant dépression, anxiété et troubles du sommeil ; elle peut déclencher des processus neuroplastiques qui influencent la régulation de la douleur. La présente étude examine le traitement EMDR (Eye Movement Desensitization and Reprocessing) de 38 patients souffrant de douleur chronique, en 12 séances hebdomadaires de 90 minutes. Une batterie de questionnaires auto-administrés, portant sur la qualité de vie, l’intensité de la douleur et le niveau de dépression, a été complétée avant et après le traitement en vue d’une évaluation objective des résultats. L’Entretien clinique structuré du DSM a été administré lors du pré-traitement afin d’identifier les traits de personnalité des participants susceptibles d’influencer la perception de la douleur. Les patients ont manifesté une amélioration statistiquement significative par rapport à leur état initial après 12 semaines de traitement EMDR. Nos résultats suggèrent que l’EMDR constitue un outil efficace pour le traitement psychologique de la douleur chronique, conduisant à une diminution des sensations douloureuses, des affects négatifs en lien avec la douleur, et des niveaux d’anxiété et de dépression. Nous examinons les théories pouvant expliquer les mécanismes par lesquels l’EMDR produit ces effets. Les résultats sont cohérents avec la prémisse sous-jacente de l’EMDR selon laquelle les émotions ont un effet important sur la perception de la douleur.

Over the past 30 years psychiatry has made a paradigm shift within a medical model from a psychological to a biological explanation for mental disorder. Depression is attributed to an imbalance of monoamines in the brain caused by depletion of neurotransmitters at receptor sites. The standard of care for treating depression is prescription of antidepressant medications alleged to correct this chemical imbalance. Research results testing the chemical imbalance theories for depression have been contradictory to the theories. Analyses of data from studies and meta-analyses of the efficacy of antidepressants indicate selective publication fostering an inflated impression of effectiveness and that antidepressants offer little more than placebos. Several sources of error, particularly breaking of the blind, may have determined outcome in studies showing drug/placebo differences. Despite negative results regarding the theory and pharmacotherapy for depression, the frequency of diagnoses of depression and prescription of antidepressant drugs have increased enormously. Economic interests more than science appear to be determining the treatment of depression. Prescription of antidepressant drugs as the standard of care for depression warrants reconsideration. A biopsychosocial model may be more useful than a disease model for conceptualizing and treating depression.

Mental health establishmentarianism (MHE) is rebuked for pursuing the installing of evidence-based practice (EBP) as standard operating procedure for two reasons: (a) EBP precludes a priori including the authentic African personality construct and its associated conceptualizations of psychopathology contained in the Azibo Nosology II (and by logical extension many other non-Eurasian formulations or interpretations about personology and psychopathology), thereby rendering the EBP movement fundamentally an imperialist, colonial, ethnocentric, pseudoetic undertaking; and (b) replete with “false concepts” vis-à-vis African descent people (ADP). The neo-Kraepelinian enterprise pertaining to Diagnostic and Statistical Manual of Mental Disorders nosology alongside the imperialist dictum of “shattering culture” are revealed as integral to accomplishing the installation. In the process of critiquing this underside of MHE, psychopathologists are treated to a novel categorizing of themselves from a sociology of knowledge framework and psychopathology is offered a reframing of how to formulate holistic diagnostic impressions of ADP encompassing authentic culture.

Trauma and co-occurring substance use disorders are disproportionately prevalent in individuals involved in the criminal justice system. The Thurston County Drug Court Program (TCDCP) in Washington State conducted a preliminary study with 220 participants arrested for nonviolent, felony drug-related crimes. All TCDCP participants were required to engage in a structured 12- to 18-month 3-phase program referred to as Program as Usual (PAU). Data was collected from 2004 to 2009 to investigate the efficacy of adding an “Integrated Trauma Treatment Program” (ITTP) component for those endorsing a Criterion A trauma history (68% of TCDCP). The ITTP combined 2 empirically supported trauma therapies in a phased, integrated approach: mandatory Seeking Safety groups followed by voluntary, individual eye movement desensitization and reprocessing (EMDR) therapy. The investigators hypothesized that trauma-specific treatment might improve existing program outcomes, including higher graduation rates and lower postprogram recidivism. One hundred twelve of the initial 150 participants endorsing trauma completed the Seeking Safety groups and were offered individual EMDR therapy. Of those 112, those who selected EMDR therapy (n = 65) graduated at a rate of 91%; those who declined (n = 47) graduated at 57%. Recidivism rates also differed among TCDCP graduates: PAU, 10%; graduates selecting EMDR therapy, 12%; and graduates declining EMDR, 33%. This article summarizes the literature, describes the ITTP program, reports on graduation rates and recidivism outcomes, and discusses possible differences between those who selected and those who declined EMDR therapy. The authors discuss the benefits of including EMDR therapy in drug court programs with recommendations for future research.

Symptome einer Demenz umfassen hauptsächlich neuropsychologische Störungen, insbesondere des Langzeitgedächtnisses. Häufig kommt es jedoch auch zu schweren verhaltensbezogenen und psychologischen Demenzsymptomen (BPSD-behavioral and psychological symptoms of dementia). Bei etlichen Patienten ist BPSD nicht mit Arzneimitteln behandelbar. Manche Charakteristika derartiger BPSD ähneln häufig traumatischen Symptomen und scheinen mit der Erinnerung an verstörende traumatische Ereignisse aus der Vergangenheit verbunden zu sein. Da das Eye Movement Desensitization and Reprocessing (EMDR)-Standardprotokoll nicht unmittelbar auf Patienten mit Demenz anwendbar ist, haben wir ein modifiziertes Protokoll entwickelt, die EMDR-Vor-Ort-Methode (on-the-spot-EMDR). Dieser Beitrag beschreibt das Protokoll und evaluiert dessen Anwendung bei drei Patienten mit mittelschwerer bis schwerer Demenz. Es zeigten sich eindeutige therapeutische Wirkungen und bei allen drei Patienten kam es zu einer deutlichen Verbesserung der BPSD, die bei einer Nachuntersuchung nach sechs Monaten weiterhin festzustellen war. Die Relevanz dieser Erkenntnisse wird besprochen und es werden Vorschläge für die weitere Forschung vorgestellt.

This article introduces the integration of a transpersonal psychological approach into the standard eye movement desensitization and reprocessing (EMDR) protocol. The history and philosophy of transpersonal psychology is explained as an expanded context for healing. The applications of a transpersonal context to EMDR therapy are discussed as it applies to taking the client from trauma to healing beyond adaptive functioning leading to exceptional human functioning, as depicted in Native shamanism and Eastern spiritual tradition where consciousness is awakened. The influence of the consciousness of the therapist is explored, as the convergence of science, psychology, and spirituality address the interpersonal nature of a shared energy field. Elements of transpersonal psychotherapy are presented, and transpersonal therapeutic skills are described to enhance the range of tools of the therapist from egoic intervention to an expanded range of perception based in mindful awareness, attunement, and resonance. Comprehensive case examples take us through the standard EMDR protocol where these two approaches integrate and flow as healing unresolved early trauma becomes the doorway for spiritual awakening.

Five patients with hepatitis C (HCV), three of whom were treated with peginterferon alfa-2 (IFN) and two who were not treated with IFN, developed homicidal ideation (HI) during a 4-year period. Following accepted rules for determining causation, there appeared to be a causal relatedness between IFN use and the development of homicidal ideation for those patients taking IFN. None of these patients attempted a homicidal act while on treatment with IFN, nor in the follow-up period after treatment. The incidence of HI while treated with IFN in our patient population is estimated to be less than 1%. The ability of prescription medication to cause homicidal ideation is reviewed, and legal implications are discussed.

This study investigated the efficacy of eye movement desensitization and reprocessing (EMDR) psychotherapy in treating the primary diagnosis of major depressive disorder by processing past or present trauma that was affecting the quality of life. The 26 diagnosed participants were randomly assigned to 6–8 sessions of EMDR treatment or the waiting list control. Beck Depression Inventory-II, Trauma Symptom Checklist-40, and Quality of Life Index Inventory were used at pre- and postassessment to measure depressive and trauma symptoms and quality of life of the participants for both groups. The targets for EMDR therapy were selected by the participants determining the negative cognitions most strongly associated with reduced functioning and then identifying a related disturbing event. Paired and independent sample t tests were applied for data analysis. Results showed significant improvements on all measures with large effect sizes. At 95% confidence interval, the results found EMDR as an effective treatment for depressive and trauma symptoms and for improving the quality of life of the participants. A generalization effect was found for the depressogenic cognitions, with the number and strength of negative beliefs markedly decreased at posttreatment, even for beliefs not targeted in the therapy. Three-month follow-up interview with the EMDR participants confirmed that the results had been maintained.

L'objectif de cette recherche est d'évaluer l'efficacité du protocole de traitement intégratif de groupe par la désensibilisation et le retraitement par les mouvements oculaires (PTIG-EMDR) dans la réduction des symptômes d'état de stress post-traumatique (ESPT) liés au diagnostic et au traitement de différents types de cancer chez des femmes adultes. La thérapie intensive PTIG-EMDR a été administrée pendant trois jours consécutifs, deux fois par jour, à 24 femmes adultes diagnostiquées avec différents types de cancer (cancer du col de l'utérus, du sein, du côlon, de la vessie et de la peau) et présentant des symptômes d'ESPT liés à leur diagnostic et à leur traitement. Les données ont été analysées à l'aide d'une ANOVA factorielle sur les effets du PTIG-EMDR, évalués avec le Short PTSD Rating Interview (entretien court d'évaluation de l'ESPT) comme variable dépendante, et le groupe (deux groupes de patientes : phase active et phase de suivi du traitement du cancer) et le temps (quatre intervalles de temps) comme variables indépendantes. Des analyses post hoc ont été effectuées. Les résultats ont montré des effets principaux significatifs pour le temps et le groupe. Aucune interaction importante n'a été observée. Les résultats ont également montré une amélioration subjective globale chez les participantes. Cette étude pilote suggère qu'une administration intensive du PTIG-EMDR peut être un apport valable pour des patients atteints du cancer et présentant des symptômes d'ESPT liés au diagnostic et au traitement. D'autres recherches comportant des études contrôlées randomisées seront nécessaires pour démontrer l'efficacité du PTIG-EMDR sur cette population.

Obsessive-compulsive disorder (OCD) is a debilitating psychological condition that impacts millions of people globally. The front-line psychological intervention for OCD is exposure/response prevention (ERP), however, many individuals do not respond to this treatment approach. Eye movement desensitization and reprocessing (EMDR) is a new therapeutic option which could be effective in treating OCD. This review examined the initial evidence for the effectiveness of EMDR in reducing OCD symptoms. Nine studies were included in the review, including six case studies and three group studies. Results indicate that EMDR is a promising candidate for treating OCD, with all studies showing EMDR therapy resulted in reduced symptoms from baseline. Results also indicated that EMDR may be as effective as ERP, and more effective than selective serotonin reuptake inhibitors (SSRIs) in treating OCD.

Dieser Artikel stellt die ,,Flashforward-Technik” vor, eine spezielle Anwendung von Eye Movement Desensitization and Reprocessing (EMDR). Sie wird zur Behandlung irrationaler Angst eingesetzt; beispielsweise wenn eine andauernde Angst auch nach Bearbeitung der Kern-Erinnerungen vergangener Erlebnisse weiterhin besteht. Der theoretische Hintergrund wird dargelegt und das Verfahren wird, auch anhand von zwei Fallbeispielen, erläutert. Wir beschreiben psychische Zustände und - Probleme, für die der Einsatz von flashforward-fokussiertem EMDR geeignet sein könnte, sowie welche Phase des therapeutischen Prozesses am besten zum Einsatz dieser Methode geeignet ist. Darüber hinaus wird die Flashforward-Technik mit anderen EMDR-Anwendungen und ähnlichen Verfahren in anderen Therapien verglichen. Einige Implikationen werden diskutiert.

Functional neurological disorder (FND) is a common diagnosis in neurology clinics, and there is some evidence psychological therapy can be of benefit. Eye movement desensitization and reprocessing therapy (EMDR) is a well-evidenced treatment for posttraumatic stress disorder (PTSD), and there is increasing evidence that it is beneficial for other conditions. EMDR is a therapy designed to focus on distressing memories, and therefore can be used for non-PTSD presentations where distressing memories are relevant. There is a small amount of case study evidence that EMDR can be used successfully with FND presentations and comorbid PTSD. This article describes two illustrative case examples of people diagnosed with FND who have distressing memories relevant to their presentation. Presenting functional symptoms included functional non-epileptic attacks and functional sensory symptoms. Psychological treatment-as-usual plus EMDR resulted in improvements for both cases and demonstrated that EMDR is a promising additional treatment option for FND presentations, appropriately selected. Recommendations regarding further research are made.

En 2015, plus de 1,5 million de réfugiés sont arrivés en Allemagne, beaucoup d’entre eux gravement traumatisés. La thérapie de désensibilisation et de retraitement par les mouvements oculaires (EMDR) a prouvé son efficacité dans le traitement des symptômes de stress traumatique aigus ou chroniques. Une modification de la thérapie permettant son utilisation en groupe a été développée par E. Shapiro : c’est le protocole EMDR de traitement en groupe d’épisodes traumatiques (G-TEP). Dans cette étude de terrain, nous avons étudié l’efficacité de deux séances d’EMDR G-TEP pour traiter des réfugiés victimes de traumas. Après une séance de psychoéducation, 18 réfugiés provenant de Syrie et d’Irak, arabophones, arrivés en Allemagne au cours des cinq mois précédents, ont été affectés au traitement et/ou à une liste d’attente. On utilisa en pré- et post-traitement l’échelle révisée d’impact des événements (IES-R) et l’inventaire de dépression de Beck (BDI) et les analyses furent conduites à l’aide du test U de Mann-Whitney et des tests planifiés Kolmogorov-Smirnov. Les résultats montrèrent des différences importantes entre le groupe de traitement et le groupe en liste d’attente, avec une baisse significative des notes IES-R (p > .05). Bien que les différences des notes BDI n’aient pas atteint le niveau de signification statistique (p = .06), une baisse importante des notes BDI fut observée dans le groupe de traitement. Ces résultats fournissent une preuve préliminaire indiquant que l’EMDR G-TEP pourrait permettre de traiter efficacement des personnes réfugiées souffrant de traumatismes.

This preliminary study sought to evaluate the potential effectiveness of eye movement desensitization and reprocessing (EMDR) as a treatment modality for generalized anxiety disorder (GAD). Using a single-case design with multiple baselines across four subjects, the effectiveness of 15 EMDR sessions was evaluated. Results indicate that subsequent to targeting the experiential contributors to GAD and the current and anticipated situations that caused excessive worry, the scores of anxiety and of excessive worry dropped to levels below diagnostic threshold and in two cases to full remission of GAD symptoms. At both posttreatment and at 2 months follow-up, all four participants no longer presented with GAD diagnosis. In addition, time-series analyses (ARMA) indicate statistically significant improvement on both daily measures of worry and anxiety over the course of the EMDR treatment.

This article will argue that, rather than being objective and universal treatment appro-aches, counseling and psychotherapy are indigenous/traditional (i.e., cultural) healing methods of the Euro-American West. Therefore, the World Health Organization's Mental Health Gap Action Programme (MHGAP), designed to provide increased access to reportedly highly effective Western mental health treatment services in many low- and middle-income countries, is likely to falter. It can be argued that culturally adapted counseling and psychotherapy will be most effective for individuals in non-Western countries who endorse or are somewhat acculturated to Western understandings and ways of living. Therefore, Western psychological interventions should not be at the forefront of the MHGAP in non-Western countries. Supportive evidence for this perspective is summarized and alternative approaches to promoting global mental health that draw on non-Western indigenous healing practices are presented.

The potential benefits of the use of a permissive style of clinical hypnosis as a therapeutic medium to enhance eye movement desensitization and reprocessing (EMDR) trauma treatment are explored. A comparative review of hypnosis and EMDR is provided, including putative psychophysiological mechanisms for both. A rationale for integrating clinical hypnosis with EMDR treatment is presented. It is suggested that hypnosis primarily enhances the accessibility of traumatic information while EMDR primarily enhances the reprocessing of traumatic information and that accessibility and reprocessing are reciprocal features. The relative and combined merits of hypnosis and EMDR for resource development are discussed. The author proposes that clinical hypnosis may be incorporated into EMDR without necessarily modifying the eight-stage EMDR protocol apart from modifications that are indicated for special conditions. Three case vignettes are used to illustrate the integrative use of clinical hypnosis and EMDR in the treatment of adults who experienced childhood abuse.

Persuasive design, the use of behavioral psychology in digital devices and applications to alter human behavior, is employed in entertainment and educational technologies that occupy a great proportion of the lives of children and adolescents. A primary purpose of persuasive design is to increase the time spent using social media, video game, and other entertainment technologies in order to increase business revenue. This adds to children's and adolescents' health risks, as excessive recreational screen time has been associated with both physical (sleep, weight) and mental health (depression, anxiety, compulsive use, and inattention) issues for children and adolescents. Given the potential for negative health outcomes, it is necessary for the field of psychology to acknowledge, educate, and take action against the use of persuasive design in platforms typically used by children and adolescents.

A universally accepted operational definition for the term “disease” is not yet established in contemporary psychiatry. In clinical psychology and psychiatry, disease has been used indiscriminately. The term disease has been invoked (even when no systemic etiology or pathology has existed) to describe addictions, a cluster of bizarre symptoms, and to justify crude medically based treatments (e.g., electroshock, lobotomy, involuntary commitment, medication prescription). More recently, sophisticated machines such as CAT scans, PET scans, and MRIs have been used for questionable research conducted to try to identify supposed diseases, to justify the overuse of psychotropic drugs. Economic and industry interests have superseded scientific concerns. To establish scientific rigor in psychiatry and clinical psychology research, an operational definition of disease is proposed.

This article documents one woman’s experience of mental health recovery using a case study approach. Specifically, qualitative data collected through a semistructured interview were triangulated with the medical record to understand more about how this woman experienced a transition from a period of her life marked by severe psychological and emotional impairment to an extended period of time during which she was thriving and did not experience symptoms consistent with her former diagnosis of severe mental illness. This case study offers important implications regarding the importance of trauma-informed care in the field of mental health.

Objective: An empirical examination of the scientific status of psychiatry. Method and Results: Analysis of the publications policy of the major English-language psychiatric journals shows that no journal meets the minimum criteria for a scientific publishing policy. Conclusion: Psychiatry lacks the fundamental elements of any field claiming to be a science. Furthermore, its present policies are likely to inhibit scientific development of models of mental disorder rather than facilitate them. The psychiatric publishing industry is in urgent need of radical reform.

Research in clinical psycho-oncology is becoming an area of key importance in investigating the effects of the interventions of support and/or psychotherapy with patients. This study was conducted with the aim of evaluating the effectiveness of the eye movement desensitization and reprocessing (EMDR) approach compared to a non–trauma-focused cognitive behavioral therapy (CBT) intervention. There were 11 male and 46 female participants, with mixed cancer diagnoses. Thirty-one subjects received EMDR therapy, and 26 received CBT for 12 sessions of 60 minutes each. The Symptom Checklist-90-R (SCL-90-R), COPE inventory, and Davidson Trauma Scale (DTS) were administered at three different times (T0, before intervention; T1, after the sixth session; and T2, after the 12th session); the Karnofsky Performance Status was administered at T0 only. In the EMDR group, a significant improvement was reported for the following 11 of the 17 dependent variables: COPE subscales, Avoidance Strategies and Positive Attitude; all three DTS subscales, Intrusion, Avoidance, and Hyperarousal; and 6 SCL-90-R subscales. In the CBT group, a significant improvement was reported for the following 4 of the 17 dependent variables: COPE subscales Positive Attitude and Transcendent Orientation; two DTS subscales, Intrusion, and Avoidance, with no improvement on any of the SCL-90-R subscales. This innovative study shows the value of trauma-focused treatment for patients with cancer and allows important preliminary suggestions on the usefulness of applying EMDR therapy in an oncological setting, although further research in this context is still needed.

Compassion-focused therapy was developed to enhance physiological systems related to well-being, safeness, and connectedness in people where shame and self-criticism inhibited progress in therapy (Gilbert, 2000; Gilbert & Irons, 2005). This system links attachment experiences with emotion regulation capacities, with integrative capacities of the mind and also with the interplay between different motivational systems, which are played out in multiple self-states (Cortina & Liotti, 2010; Cozolino, 2010; Gilbert, 2009; Liotti & Gilbert, 2011). Hence, a compassionate focus could potentially prove valuable in eye movement desensitization and reprocessing (EMDR), particularly where shame or attachment trauma is involved or for those traumas that have impacted on the structure of the self, for example, dissociation. A structured compassion-focused EMDR (CF-EMDR) seems likely to be particularly useful for therapists wishing to pay positive attention to strengths and well-being. The primary task of the CF-EMDR therapist would therefore be to facilitate a warm and wise relationship to the problems that brought the person to EMDR. This article outlines the potential benefit of a compassionate focus in the processing phases of EMDR to address self-critical blocks, giving clinical examples in tables to illustrate the process and language.

Ethical training is a critical element of graduate education in Psychology. The importance of acculturation to the ethical guidelines of the profession cannot be minimized. Simultaneously, in North America at least, sensitivity to diversity is an important directive in our education of future clinicians. Consequently, it makes sense that understanding international Psychology ethics codes would be advantageous, to at least highlight the cultural context and relativity of ethics codes in general. Professors in Canada and the United States who teach ethics in their respective graduate schools were surveyed about their teaching of such codes and their opinions on the matter. Differences were found between Canada and the United States, although low response rates were noteworthy. The response data is examined qualitatively. Possible explanations for these findings include the possibility that teaching international ethics codes is seen as of limited importance or the use of online questionnaires is not optimal for such endeavors.

Supervision de cas est une nouvelle rubrique régulière du Journal of EMDR Practice and Research. Dans cet article, un clinicien EMDR (désensibilisation et retraitement par les mouvements oculaires) décrit brièvement le cas difficile d'un homme, Georges, qui avait été orienté en EMDR pour le traitement d'une dépression ayant débuté plus de deux ans auparavant. Après traitement de tous ses souvenirs traumatiques, il reste aujourd'hui gravement déprimé et son thérapeute demande comment avancer efficacement. Des réponses sont données par trois experts. Le premier, Robin Shapiro, décrit une liste complète d'étiologies possibles : attachement, traumas précoces, facteurs génétiques ou autres causes biologiques, avec les traitements appropriés (EMDR, états du moi ou médicaments). Le second expert, Arne Hofmann, passe en revue le traitement administré et propose d'autres cibles de traitement, suggérant au thérapeute d'aborder la croyance de son client que “rien ne changera” et d'essayer le protocole EMDR inversé. Le troisième expert, Earl Grey, recommande que le clinicien se concentre sur les traumas “t”, même si le client les trouve peu ou pas perturbants, et explique comment développer et mettre en œuvre un “plan de ciblage réparateur de l'ensemble du cours de la vie”.

This article is a digest and critical analysis of Thomas Szasz’s oeuvre based on his better known works. His position is represented by four statements, three of which are discussed in this article; the second was discussed by this author in a review of Szasz’s The Meaning of Mind published in Vol.7(2) of this journal. The four statements are: (1) All disease is underlain by tissue pathology. Without that pathology we do not face disease but only the actions of people that disturb us; (2) The mind is a fiction; (3) Mental illness is therefore a myth, and psychiatric diagnoses are bogus contrivances; and (4) Individuals are moral agents responsible for their behavior, and psychiatry is a fraud and a fake medical specialty.

Depression is one of the most common psychiatric disorders. Postpartum depression affects about 9% of women who give birth. Despite significant advances in research and in pharmacotherapy and psychotherapy, depressive disorders remain difficult to treat. The application of eye movement desensitization and reprocessing (EMDR) therapy to depression has lagged behind its applications to trauma-related and anxiety disorders. I present 2 cases of postpartum depression successfully treated with a combined therapy, where EMDR is integrated into a novel therapeutic framework developed specifically for depressive disorders and based on evolutionary theory of depression, treating depression downhill (TDD). In the integrated TDD-EMDR therapy, I have made adjustments to the standard EMDR protocol such that the choice and nature of targets, the cognitive frame, and the objective for change in affect are determined by TDD framework. The described cases demonstrate the treatment process, including the modifications made to the standard EMDR procedures, and the treatment’s outcome. I identify and discuss the differences between theories of EMDR and TDD.

Eye movement desensitization and reprocessing (EMDR) therapy is a widely used evidence-based treatment for posttraumatic stress disorder (PTSD). The mental processes underlying both PTSD and EMDR treatment effects are often explained by drawing on processes that involve the automatic formation and change of mental associations. Recent evidence that contrasts with these explanations is discussed and a new perspective to PTSD and EMDR treatment effects is proposed that draws on automatic inferential processes and can be readily integrated with the dominant (Adaptive Information Processing) model. This new perspective incorporates insights from cognitive theories that draw on predictive processing and goal-directed processes to elucidate (changes in) automatic inferences that underlie PTSD symptoms and EMDR treatment effects. Recommendations for clinical practice are provided based on this new perspective.

Clinical studies carry with them a paradox: The more obviously efficient an intervention is, the more ethical problems its trials pose. This article discusses the ethical problem of breached equipoise principle because of the perceived effectiveness of a nonblindable verbal technique, crisis dialogue (CD). CD is designed to help establish a therapeutic relationship with persons in a suspected psychotic state. In a pilot randomized controlled study in Yverdon, Switzerland (usual treatment vs. usual treatment + CD), after inclusion of 30 patients, clinicians expressed a consensual opinion that CD was effective in most cases. Following their opinion, the joint clinical and research team decided that the study had to be discontinued and that CD should be tried with all patients for ethical reasons. This poses an ethical problem with potential far-reaching consequences: In this interrupted study, differences between groups in terms of clinical outcome (Brief Psychiatric Rating Scale, Clinical Global Impression), therapeutic alliance (Working Alliance Inventory, Difficult Doctor–Patient Relationship Questionnaire), and patient satisfaction were consistent in favoring CD, but these differences did not reach statistical significance in most measurements. The early interruption of the study because of perceived effectiveness of the intervention can be seen as unethical as well because chances were high that a larger sample would have shown more conclusive results, allowing for faster introduction of CD in various clinical settings with corresponding improvement of patient care.

EMDR protocols, theories, and guides tend to presume or prescribe a monolinguistic approach However, there are many bilinguals whose knowledge of a second language (L2) is sufficiently advanced to allow them to interact with EMDR therapists, but who might also possess memories encoded in a first language (L1), which is strategically useful in EMDR. The objectives of this clinical practice study were to (a) describe the real-world use of EMDR therapy in which the L1 of an EMDR recipient is selectively integrated into processing by a therapist who need not know the recipient’s L1 and (b) demonstrate an adaptation of the standard EMDR therapy protocol to support full resolution of memory material among clients with exposure to more than one language.

The empirical justification for the use of eye movement desensitization and reprocessing (EMDR) therapy as part of the repertoire of interventions used in response to humanitarian endeavors continues at a pace. A devastating earthquake, measuring 7.6 magnitude on the Richter scale, occurred in Northern Pakistan in October 2005. In response, the first EMDR Humanitarian Assistance Program to be facilitated by an academic institution was established. This article highlights how 3 research projects assisted in the continued development of EMDR therapy in Pakistan to the point where presently more than 125 Pakistani mental health professionals have now been trained; it now has its own EMDR National Association and is an active participant within EMDR Asia.

Psychiatric drugs have been a mainstay of treatment for a range of behavioral and emotional problems over the past 6 decades in the United States and around the world. Although their use has skyrocketed, the problems they purport to alleviate have not diminished but, in fact, have increased (Whitaker, 2010a). This article summarizes current evidence for the efficacy of antidepressants, antipsychotics, and stimulants. Findings from meta-analyses, reviews, and major trials do not support widespread use of these drugs.

This article reports the results of two experiments, each investigating a different eye movement desensitization and reprocessing (EMDR) protocol for obsessive-compulsive disorder (OCD) and each with two young adult male participants with long-standing unremitting OCD. Two adaptations of Shapiro’s (2001) phobia protocol were developed, based on the theoretical view that OCD is a self-perpetuating disorder, with OCD compulsions and obsessions and current triggers reinforcing and maintaining the disorder. Both adaptations begin by addressing current obsessions and compulsions, instead of working on past memories; one strategy delays the cognitive installation phase; the other uses mental video playback in the desensitization of triggers. The four participants received 14–16 one-hour sessions, with no assigned homework. They were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), with scores at pretreatment in the extreme range (mean = 35.3). Symptom improvement was reported by participants after 2 or 3 sessions. Scores at posttreatment were in the subclinical/mild range for all participants (mean = 8.5). Follow-up assessments were conducted at 4–6 months, indicating maintenance of treatment effects (mean = 7.5). Symptom reduction was 70.4% at posttreatment and 76.1% at follow-up for the Adapted EMDR Phobia Protocol and 81.4% at posttreatment and at follow-up for the Adapted EMDR Phobia Protocol with Video Playback. Theoretical implications are discussed, and future research is recommended.

Background: Treatment of depression with a single pharmaceutical agent often does not work, and several agents may be tried or combined to increase efficacy. Augmentation involves the addition of one or more medications to an existing antidepressant monotherapy to enhance mood and overall antidepressant response. Approximately 22% of individuals with unipolar depression are prescribed augmentation strategies. This study examined the effectiveness of augmentation strategies. Methods: A Medline search of studies published before January 1, 2007 was conducted to assess the extent of published data on the most frequently prescribed augmentation strategies. Studies with completed original data, sufficient efficacy data, and participants diagnosed with unipolar depression were included. Letters to the editor, preliminary data, data only presented at conferences, and small uncontrolled case reports were excluded. Results: 13 studies contained sufficient data to calculate an effect size. Mean estimated effect size of all 13 studies calculated with random effects was 0.1782 with a 95% confidence interval of −0.2513−0.6076. Conclusions: There are minimal published data examining antidepressant augmentation, and augmentation is a minimally effective treatment option.

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.