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EMDR for Posttraumatic Stress Disorder (PTSD)

EMDR is the most thoroughly researched psychotherapy method for the treatment of symptoms of Posttraumatic Stress Disorder (PTSD). Below is the logic that supports the position that EMDR is the best psychotherapy for the treatment of symptoms of PTSD.

1. Numerous controlled studies show EMDR is as effective as cognitive-behavior therapy.
Marcus, S. V., Marquis, P., & Sakai, C. (1997). Controlled study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy, 34, 307-315.
Lee, C., Gavriel, H., Drummond, P., Richards, J. & Greenwald, R. (2002). Treatment of post-traumatic stress disorder: A comparison of stress inoculation training with prolonged exposure and eye movement desensitization and reprocessing. Journal of Clinical Psychology, 58, 1071-1089.
Power, K. G., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., Swanson, V., & Karatzias, A. (in press). A controlled comparison of eye movement desensitisation and reprocessing versus exposure plus cognitive restructuring, versus waiting list in the treatment of posttraumatic stress disorder. Journal of Clinical Psychology and Psychotherapy.
Ironson, G., B. Freund, B., Strauss, J. L. & Williams J. (2002). Comparison of two treatments for traumatic stress: A community-based study of EMDR and prolonged exposure. Journal of Clinical Psychology. 58(1): 113-128.
Sprang, G. (2001). The use of eye movement desensitization and reprocessing (EMDR) in the treatment of traumatic stress and complicated mourning: Psychological and behavioral outcomes. Research on Social Work Practice, 11, 300-320.

2. The only published outlier is Devilly.
Devilly, G. J., & Spence, S. H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive behavioral trauma treatment protocol in the amelioration of post traumatic stress disorder. Journal of Anxiety Disorders, 13 (1-2), 131-157.
3. The Maxfield & Hyer meta-analysis shows the importance of study rigor --which disqualifies Devilly's study.
Maxfield, L. & Hyer, L. (2002). The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD. Journal of Clinical Psychology. 58(1): 23-41.
4. Van Etten & Taylor meta-analysis assesses exposure and EMDR equally effective, but EMDR as more efficient.
Van Etten, M. L. & Taylor, S. (1998) Comparative efficacy of treatments for posttraumatic stress disorder: A meta-analysis. Clinical Psychology & Psychotherapy, 5, 126-144.
5. Chemtob et al found that EMDR reduces disturbance in children.
Chemtob, C. M., Nakashima, J. & Carlson, J. G. (2002). Brief treatment for elementary school children with disaster-related posttraumatic stress disorder: A field study. Journal of Clinical Psychology. 58(1): 99-112.
6. The International Society for Traumatic Stress Studies guidelines assess EMDR as effective with a A/B rating. The additional studies that would now bring it up to an A rating (See Lee; Ironson; Power).
Chemtob, C. M., Tolin, D. F., van der Kolk, B. A., & Pitman, R. K. (2000) Eye movement desensitization and reprocessing in E. A. Foa, T. M. Keane & M. J. Friedman (Eds.) Effective treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press.
7. As noted in Keane and Barlow, exposure/CBT and EMDR are equivalently effective. However, EMDR has been found to be more efficient (Lee; Ironson; Power; van Etten).
Keane, T. M. & Barlow, D. H. Posttraumatic stress disorder. In: Barlow, D. H. (Ed.) (2001). Anxiety and its disorders: the nature and treatment of anxiety and panic. New York: Guilford Publications.
8. Wilson et al. study and follow-up indicates that the benefits of EMDR are substantial and long lasting.
Wilson, S. A., Becker, L. A., & Tinker, R. H. (1995). Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals. Journal of Consulting and Clinical Psychology, 63, 928-937
Wilson, S. A., Becker, L. A., & Tinker, R. H. (1997). 15-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for psychological trauma. Journal of Consulting and Clinical Psychology, 65 (6), 1047-1056.

9. There are numerous instances in the literature in which misconceptions about EMDR have been developed and maintained. Perkins & Rouanzoin have attempted to sort out the confusion.
Perkins, B. R. & Rouanzoin, C. C. (2002). A critical evaluation of current views regarding eye movement desensitization and reprocessing (EMDR): Clarifying points of confusion. Journal of Clinical Psychology. 58(1): 77-97.
10. The American Psychological Association has approved the EMDR Institute as a CEU provider because EMDR has been shown to be effective for trauma--as noted in the ISTSS guidelines.
11. The United Kingdom Department of Health (2001) has also listed EMDR as an efficacious treatment for PTSD.
United Kingdom Department of Health. (2001). Treatment choice in psychological therapies and counselling evidence based clinical practice guideline. London: Author. WEB: http://www.doh.gov.uk/mentalhealth/treatmentguideline

 
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