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 introduces the “Flashforward procedure,” which is a specific application of eye movement desensitization and reprocessing (EMDR). It is used for the treatment of irrational fears, for example, when a persisting fear continues after the core memories of past events have been fully processed. A theoretical background is presented, and the procedure is explained, together with 2 illustrative case studies. We describe psychological conditions and mental health problems for which the use of EMDR aimed at client’s flashforward might be appropriate, as well as indicating which stage in the therapeutic process is most applicable for the use of this procedure. Furthermore, the Flashforward procedure is compared with other EMDR applications and similar procedures in other therapies. Some implications are discussed.

Cet article présente la technique éclair, une nouvelle technique utilisée pendant la phase de préparation de la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires) pour faciliter le traitement de souvenirs traumatiques intenses auxquels les patients hésiteraient autrement à accéder. Les premières données, demeurant à confirmer, suggèrent que cette technique pourrait permettre aux patients d’accéder à ces souvenirs d’abord de manière la moins perturbante possible, réduisant leur intensité émotionnelle, afin de pouvoir ensuite les aborder plus pleinement et les traiter à l’aide de la thérapie EMDR. La technique semble aisément tolérée par les patients de tous âges, y compris les enfants ; elle paraît rapide et relativement indolore pour les patients, même ceux qui possèdent des souvenirs cibles particulièrement perturbants ; elle s’enseigne facilement aux cliniciens. Elle se distingue par le fait que les patients qui évitent un souvenir terriblement perturbant peuvent se voir offrir une façon de le traiter sans devoir le ramener clairement à l’esprit. Quatre exemples de cas, dans lesquels quatre cliniciens différents ont utilisé la technique, sont présentés brièvement. Des suggestions sont formulées pour des études à venir. Cet article présente des hypothèses pour expliquer divers mécanismes d’action et évoque les effets en termes de la théorie de reconsolidation mnésique.

The comparative treatment efficiency of eye movement desensitization and reprocessing (EMDR) therapy and prolonged exposure (PE) therapy for the treatment of posttraumatic stress disorder (PTSD) was tested for 20 participants diagnosed with PTSD. Efficiency was operationalized as the total exposure time to traumatic memories during and between sessions; the number of trauma memories processed over the course of therapy; how many sessions were required to resolve the primary trauma; and lower subjective units of disturbance (SUD) levels after the initial treatment session. Participants were randomized to each condition and received 12 90-minute sessions of therapy over 6 weeks. Symptoms were assessed by treatment-blind assessors at posttreatment, and at 3 and 6 months follow-up. Results demonstrated a significant decrease in symptoms posttreatment for PTSD (d = .64), depression (d = .46), anxiety (d = .52) and stress (d = .57) for both groups, which was maintained at 3 months. At 6 months there was a small increase in symptoms compared to the 3-month time point on the Clinician-Administered PTSD Scale (CAPS) but no significant change in any self-report symptoms EMDR was significantly more efficient than PE. EMDR participants had less total exposure time to traumatic memories when homework hours were included (d = .66), reported lower SUD scores after the first session (d = .45), required fewer sessions for the target memory to decrease to near zero distress levels (d = .84), and processed more traumatic memories.

Healthcare workers and mental health clinicians are at heightened risk for mental health issues while they support their communities during the COVID-19 pandemic, and early psychological intervention is crucial to protect them. The Self-Care Traumatic Episode Protocol (STEP) is a computerized intervention adapted from the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP). This study evaluated the effectiveness of STEP for mental health clinicians in the context of COVID-19. Thirty-four mental health clinicians were randomly allocated to treatment (n = 17) or waitlist (n = 17). The Generalized Self-Efficacy Scale (GSE) and Depression and Anxiety Stress Scale (DASS-21) were completed by the treatment group at baseline and 1-week follow-up postintervention and by the waitlist group at baseline, preintervention, and 1-week follow-up postintervention. Pre–post comparisons showed a significant decrease in depression, anxiety, and stress for Immediate Treatment, t(15) = −3.64, p < .01, d = .73, and for Delayed Treatment, t(15) = −3.53, p < .01, d = .68, There was also a significant increase in general self-efficacy for Immediate Treatment, t(15) = 2.87, p < .05, d = .46, and Delayed Treatment, t(15) = 3.72, p < .01, d = .56. The randomized controlled trial (RCT) indicated that STEP may be effective in increasing general self-efficacy and reducing symptoms of depression, anxiety, and stress among mental health clinicians in the context of COVID-19. Further research investigating the potential of utilizing the STEP intervention on a larger scale and with other populations is needed.

Depuis 2001, les guerres en Irak et en Afghanistan exercent une pression considérable sur la médecine militaire pour gérer efficacement la demande croissante de soins en santé mentale du personnel déployé. Cet article examine la capacité du Ministère de la défense des Etats-Unis à fournir des services de santé mentale de qualité en fonction de la disponibilité (a) de la formation clinique, (b) des interventions en santé mentale et (c) de la recherche subventionnée portant sur les traitements de l’état de stress post-traumatique. Alors que des progrès notables ont été réalisés au niveau de l’accès au traitement cognitivo-comportemental et des études dans ce domaine, l’Intégration neuro-émotionnelle par les stimulations bilatérales alternées ou EMDR (Eye Movement Desensitization & Reprocessing) est beaucoup moins disponible – peut-être à cause de la controverse actuelle qui entoure la technique. Nous suggérons qu’une meilleure disponibilité des traitements comportementaux basés sur les données probantes, peut-être par le biais de la poursuite d’un récent programme régional de formation, serait bénéfique pour les vétérans qui y ont aujourd’hui peu accès.

This case study demonstrates the effective use of EMDR in helping a child manage fears triggered by a life-threatening chronic medical condition—congenital heart failure. It is well documented that childhood chronic illness creates ongoing stress and psychological problems for children and their families. Evidence suggests that interventions to enhance coping skills improve psychological functioning. EMDR has the potential to contribute to this end. Deconstructive analysis of a single EMDR session illustrates the working of Shapiro’s adaptive information processing (AIP) model. It demonstrates that the child can spontaneously open up channels of association to uncover, process, and resolve fears relating to the medical condition, as well as other concerns. A case is made for targeting whatever current, overt problem or symptom the child presents, because this inevitably serves as a portal to more covert, even unconscious core issues. Past, current, and future fears and traumatic experiences emerge and are processed to resolution. Also highlighted is the importance of integrating the individual EMDR treatment component into a family systems treatment approach for optimum outcome, because the illness impacts the whole family, ergo, the child. Recommendations for EMDR treatment planning and implementation with chronic illness are offered.

Le protocole “opaque pour le thérapeute” (blind-to-therapist) (Blore & Holmshaw, 2009a, 2009b) a été conçu pour contourner les réticences du patient à décrire le contenu de ses souvenirs traumatiques au cours de la désensibilisation et du retraitement par les mouvements oculaires (EMDR). Il a été utilisé auprès d'au moins six sortes de cas cliniques :

Cet article détaille l'historique, le développement et le statut actuel du protocole et illustre chacune de ces utilisations par des vignettes cliniques. Sont également abordées les difficultés rencontrées lors de l'utilisation du protocole et de la transition vers le protocole standard.

Bilateral stimulation (BLS) is of significant importance to eye movement desensitization and reprocessing (EMDR) therapy. Eye movements seem to be the most effective form of BLS in EMDR. A brief summary of the cultural applicability of EMDR is provided, and research which showed the value of incorporating religion and/or spirituality into psychotherapy is highlighted. Islamic Sufism, in common with other traditional religions, has long been known to have a psychotherapeutic perspective and has been used over time to help people to overcome trauma and stress. This article argues that the ritual movements associated with the Sufi Dhikr may involve a form of BLS and that this might underline some of the therapeutic effectiveness of Dhikr and Sufism. The authors recommend investigating if the Sufi Dhikr element could be incorporated into a modified EMDR protocol. We anticipate that this would give EMDR an even wider and more popular acceptance in the Middle East and the Muslim world.

This article provides excerpts from each chapter of An EMDR Primer: From Practicum to Practice (Hensley, 2009) to assist novice eye movement desensitization and reprocessing (EMDR) clinicians who are learning how to use this approach and to serve as a refresher for therapists who have not used EMDR consistently in their practices. Actual cases are presented that demonstrate various strategies that the therapist can use to help clients reach adaptive resolution of trauma. Tables and figures highlight important features to explain the obvious and subtle nuances of EMDR. Focal points are the following: (a) the adaptive information processing model; (b) the types of targets accessed during the EMDR process; (c) the 8 phases of EMDR; (d) the components of the standard EMDR protocol used during the assessment phase; (e) past, present, and future in terms of appropriate targeting and successful outcomes; and (f) strategies and techniques for dealing with challenging clients, high levels of abreaction, and blocked processing.