The main aim of the present investigation was (a) to establish a translation/adaptation of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol for Ongoing Traumatic Stress (EMDR-IGTP-OTS) for adolescents who have experienced childhood adverse experiences in the Pakistani context and (b) to demonstrate the fidelity, acceptability, feasibility, and efficacy of Urdu translated single-session EMDR-IGTP-OTS in reducing psychological distress among Pakistani adolescents. This study was premeditated to address the high vulnerability of adolescents to psychological distress after experiencing childhood trauma and the existing treatment gap. The study encompassed 2 phases; in phase I, EMDR-IGTP-OTS was translated/adapted into Urdu according to the Pakistani culture, whereas phase II consisted of a feasibility trial of the adapted protocol. A sample of 94 adolescents aged 11 to 16 years were selected from 2 government schools and randomized into the treatment group and control group with pre-treatment, post-treatment (immediately after the intervention), and follow-up assessments (after 3 months) through the Urdu version of the Depression, Anxiety, and Stress Scale (DASS-21). The single session of EMDR-IGTP-OTS was delivered in a group setting where bilateral stimulation was self-administered through the butterfly hug method and reprocessing was represented through an art therapy format, following the original EMDR-IGTP-OTS protocol. Findings provided evidence of the program's fidelity with good inter-rater reliability (r = 0.90**) along with high acceptability and feasibility through quantitative and qualitative measures. Additionally, results of mixed between-within-subjects' analysis of variance (ANOVA) depicted that psychological distress was significantly reduced at post-treatment and follow-up assessments through single-session EMDR-IGTP-OTS for the treatment group as compared to the control group (F = 56.54, P = 0.000, eta p2 = 0.161) with a notable decrease in subjective units of disturbance. The adapted version of EMDR-IGTP-OTS demonstrates fidelity, feasibility, acceptability, and efficacy in reducing psychological distress among adolescents and provides directions for an extensive randomized controlled trial on the efficacy of EMDR-IGTP-OTS within the context of Pakistan.
The prevalence of chronic pain is increasing, and conventional pain therapies often have limited efficacy in individuals with high levels of psychological distress and a history of trauma. In this context, the use of Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based psychotherapy approach for the treatment of posttraumatic stress disorder, is becoming increasingly important. EMDR shows promising results, particularly for patients with pain and high levels of emotional distress. Although group therapy is becoming increasingly popular in pain management, EMDR has mainly been studied as an individual treatment. However, a systematic review suggests that group therapy can be an effective tool for improving mental health outcomes, especially when trauma is addressed together. Based on these findings, an outpatient EMDR group program was developed for patients with chronic pain. The program consists of a total of four treatment days with 5–5.5 h therapy sessions each day and provides patients with a supportive environment in which they can learn effective pain management strategies and interact with other patients with similar experiences. Initial pilot evaluations indicate high efficacy and adequate safety for patients with chronic pain.
La thérapie de désensibilisation et de retraitement par les mouvements oculaires (EMDR) est considérée comme un traitement fondé sur des données probantes pour le traitement du trouble stress post-traumatique (TSPT) chez l’adulte, mais il y a des différences dans la façon dont les diverses directives internationales de traitement jugent la solidité de cette base de preuves. En outre, dans des domaines autres que le TSPT de l’adulte, les principales lignes directrices diffèrent encore davantage quant à la solidité de ces preuves et quant au moment où on utilisera l’EMDR. En 2019 a été lancée la Commission de chercheurs sur l’avenir de la thérapie EMDR ( Council of Scholars : The Future of EMDR Therapy Project ). Plusieurs groupes de travail ont été créés dans cette commission, l’un d’entre eux étant centré sur la recherche. Le présent article a été produit par ce groupe de travail. Le groupe a tout d’abord conclu qu’il y avait cinq domaines pour lesquels il existait une certaine base factuelle indiquant que l’EMDR était efficace, mais que davantage de données étaient nécessaires pour augmenter la probabilité qu’elle soit prise en compte dans les futures directives internationales de traitement. Ces domaines couvraient le TSPT chez les enfants et les adolescents, les interventions EMDR précoces, les TSPT liés aux conflits armés, la dépression unipolaire et la douleur chronique. Les recherches portant sur le rapport coût-efficacité de la thérapie EMDR ont été en outre identifiées comme l’une des priorités à aborder. Nous avons employé un système de hiérarchisation pour classer et évaluer les preuves dans les différents domaines abordés. Après avoir évalué les 120 études de résultats relatives à ces domaines, nous concluons ici que pour deux d’entre eux (le TSPT chez l’enfant et l’adolescent, et les recherches portant sur les interventions EMDR précoces), la force des preuves est évaluée au niveau le plus élevé, tandis que les autres domaines obtiennent le deuxième niveau le plus élevé. Nous formulons également quelques recommandations générales pour améliorer la qualité des futures recherches sur l’efficacité de la thérapie EMDR.
The aim of this randomized controlled trial with an intention-to-treat analysis was to evaluate the effectiveness, efficacy, and safety of the Acute Stress Syndrome Stabilization Individual (ASSYST-I) treatment intervention in reducing posttraumatic stress disorder (PTSD) symptoms in female children polytraumatized by adverse childhood experiences, neglect, and maltreatment. A total of 40 female children met the inclusion criteria and participated in the study. Participants’ ages ranged from 8 to 17 years old (M =14.67 years). A two-arm randomized controlled trial (RCT) design was applied. PTSD symptoms were measured in three-time points for all participants in the study. Results showed that the intervention had a significant effect for time on PTSD symptoms (F (2,76) = 36.92 p <.000, η² = .493). A significant effect for group was also found (F (1, 38 = 32.7, p<.005, η² = .896) with a large effect, and a significant interaction between time and group, (F (2, 76) = 56.00, p <.000, η² = .600). Means comparison using t test between groups showed significant differences between the Treatment Group (TG) and the Control Group (CG) in the three-time points comparisons showing a large effect on Time 2 (Post-treatment assessment) which was maintained on Time 3 (Follow-up assessment). Results on the Reliable Change Index (RCI) and the Clinically Significant Change (CSC) Margin showed that the ASSYST-I treatment intervention exhibited reliable change on PTSD symptom reduction and clinically significant change, indicating that the treatment group participants are more likely to belong to the non-PTSD population after the intervention. Conversely, the control group participants are more likely to belong to the PTSD population. No adverse effects or events were reported by the participants during the treatment procedure administration or at follow-up. None of the participants showed clinically significant worsening/exacerbation of symptoms after treatment. Participants in the control group received the intervention treatment after the follow-up assessment, fulfilling our ethical criteria.
While eye movement desensitization and reprocessing (EMDR) is considered an evidence-based treatment for posttraumatic stress disorder (PTSD) in adults, there are differences as to how various international treatment guidelines judge the strength of this evidence base. Furthermore, in areas other than adult PTSD, major guidelines differ even more as to the strength of the evidence base and when to use EMDR. In 2019, the Council of Scholars: The Future of EMDR Therapy Project was initiated. Several working groups were established, with one assigned to the focus area of research. This article is a product of that working group. Firstly the group concluded that there were five areas where there was some base that EMDR was effective, but more data were needed to increase the likelihood that it would be considered in future international treatment guidelines. These areas were PTSD in children and adolescents, early EMDR interventions, combat PTSD, unipolar depression, and chronic pain. In addition, research into cost-effectiveness of EMDR therapy was identified as one of the priorities. A hierarchical system was used for classifying and rating evidence in the focus areas. After assessing the 120 outcome studies pertaining to the focus areas, we conclude that for two of the areas (i.e., PTSD in children and adolescents and EMDR early interventions research) the strength of the evidence is rated at the highest level, whereas the other areas obtain the second highest level. Some general recommendations for improving the quality of future research on the effectiveness of EMDR therapy are formulated.
The aim of this longitudinal multisite randomized controlled trial (RCT), using a treatment as usual (TAU) control group design, was to evaluate the effectiveness of the Acute Stress Syndrome Stabilization Remote for Groups (ASSYST-RG) procedure in reducing posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the general population during the COVID-19 pandemic lockdown in Mexico. A total of 63 adults (60 females and 3 males) met the inclusion criteria. Participants’ ages ranged from 21 to 73 years old (M =43.09 years). Significant differences between groups were found in all variables. Differences between groups were maintained at follow up assessment. ANOVA for repeated-measures (pre-treatment, post-treatment and follow-up) showed that the ASSYST-RG had a significant effect to reduce Posttraumatic Stress Disorder (F (2, 122) = 22.40 p <.000, η P2 = .269). Anxiety and depression showed a significant interaction effect for time and group (F (1, 61) = 8.89, p <.00, η P2 = .127) and (F (2, 122) = 35.04, p <.001, η P2 = .365) respectively. No adverse effects or events were reported by the participants during the procedure administration or at three months follow-up while all participants were still in lockdown. None of the participants showed clinically significant worsening/exacerbation of symptoms after the procedure. This randomized controlled trial provides evidence for the effectiveness, efficacy, feasibility, and safety of the ASSYST-RG in reducing posttraumatic stress, anxiety, and depression symptoms in the general population during the COVID-19 pandemic lockdown.
This longitudinal multicenter randomized controlled trial has three objectives 1) to evaluate the EMDR-PRECI in the remission of the PTSD Diagnosis on female minors who were victims of sexual and/or physical violence compared to treatment as usual (TAU), 2) to evaluate the effectiveness of the EMDR-PRECI in the reduction of the PTSD, anxiety, and depression symptoms of the participants compared with TAU, and 3) to expand the knowledge on the existing correlation between the PCL-5 core criteria for PTSD provisional diagnosis and the CAPS-5 PTSD clinical diagnosis on this population. The study was conducted in 2019 in the cities of Puebla, Mexico, and Mexico City, in three sites of a non-profit organization who provide services to women in vulnerable situations. A total of 32 minors met the inclusion criteria. Participants' ages ranged from 12 to 17 years old (M =15.35 years old). Participation was voluntary with the participant's and their legal guardian's consent. It is relevant to mention that 31 of the 32 participants were pregnant during treatment with an average of 24.63 weeks (6.15 months) of pregnancy. All patients in the EMDR treatment group did not meet PTSD diagnostic criteria after treatment and at 90-days-follow-up assessments, while all patients in the TAU group maintained their PTSD baseline clinical diagnosis after treatment and at 90-days-follow-up assessments. Analyses of variance (ANOVA) for repeated measurements were used for PTSD, Anxiety and Depression; t test and Cohen´s d effect size were calculated using within and between designs for the different measurements. ANOVA revealed a significant effect for time (F (2, 52) = 149.53 p <.001, ηP2 =.852), for group (F (1, 26 = 140.71, p<.001, ηP2 =.844) and Anxiety scores showed a significant effect for time (F (1, 26) = 32.89, p <.001, ηP2 =.559) and a significant interaction effect between time and group (F (1, 26) = 17.37, p <.001, ηP2=.401) showed the decrease for the treatment group. For the depression scores significant effects were found for time (F (1, 26) = 21.77, p <. 001, ηP2 =.456. Results also showed significant interaction effects between time and group. (F (1, 26) = 6.17, p <.05, ηP2 =.192). No significant effects for TAU group were founded. The study results indicate that the administration of the EMDR-PRECI could be a feasible, cost-effective, and time-efficient therapy to address PTSD diagnosis, and PTSD, anxiety and depression symptoms in this population.
The aim of this longitudinal multisite randomized controlled trial (RCT), using a waitlist/delayed treatment control group design, was to evaluate the effectiveness of the Eye Movement Desensitization and Reprocessing-Integrative Group Treatment Protocol for Ongoing Traumatic Stress Remote (EMDR-IGTP-OTS-R) in reducing posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in healthcare professionals working in hospitals during the Covid-19 pandemic in Puebla, Mexico. The study was conducted in 2020 in the city of Puebla, Mexico with healthcare professionals (nurses and medical doctors) working in ten hospitals who received Covid-19 patients. A total of 80 healthcare professionals met the inclusion criteria. Participants’ ages ranged from 21 to 51 years old (M =33.24 years). In this study, the early EMDR online group therapy intervention was initiated seven weeks after the first Covid-19 patients died in the hospitals. Intensive EMDR group treatment was provided. Data analysis by repeated measures ANOVA, showed that the EMDR-IGTP-OT-R had a significant effect on the explored variables (PTSD, Anxiety, and Depression) in time, group, and interaction time by group. Comparisons within means of the different pairs of longitudinal measurements were also useful to observe the consistency of the data. Results showed a large effect size (Cohen´s d, from 1.93 to 1.25) between the pretest and the first posttreatment assessment, being able to attribute these effects to the EMDR-IGTP-OTS-R treatment. Results were confirmed with the between-group mean comparisons since the waitlist/delayed treatment act as a control group. In this case, the effect size (Cohen´s d) varied from 3.95 to 1.92 showing a large effect of the difference between groups, attributed to the start time of the treatment. Results also showed an overall subjective global improvement in the study participants. No adverse effects (e.g., symptoms of dissociation, fear, panic, freeze, shut down, collapse, fainting), or events (e.g., suicide ideation, suicide attempts, self-harm, homicidal ideation) were reported by the participants during treatment or at three months post-treatment follow-up while all participants were still working in their hospitals receiving COVID-19 patients. None of the participants showed clinically significant worsening/exacerbation of symptoms on the PCL-5 or HADS after treatment. To the best of our knowledge, this is the first RCT on early intervention with an evidence-based trauma-focus (TF) therapy (e.g., EMDR, TF-CBT) provided online in a group format and intensive treatment modality to healthcare professionals working in hospitals during the COVID-19 pandemic. This randomized controlled trial provides evidence for the effectiveness, efficacy, feasibility, and safety of the EMDR-IGTP-OTS-R in reducing posttraumatic stress, anxiety, and depression symptoms for healthcare professionals working in hospitals during the Covid-19 pandemic, expanding the EMDR therapy frontiers.
EMDR therapy administered to patients with cancer has proven to be effective in the reduction of posttraumatic stress disorder (PTSD) symptoms and PTSD diagnosis remission. The main objective of this study was to measure the PTSD scores and diagnosis changes before and after the provision of the EMDR-Protocol for Recent Critical Incidents and Ongoing Traumatic Stress (EMDR-PRECI) to female patients with cancer-related PTSD diagnosis. A secondary objective was to observe the immunoglobulins and the cortisol changes pre and post-treatment. Seven female patients with different types of cancer (5 breast, 1 colon, and 1 lymphatic cancer), different cancer treatments (radiation, chemotherapy, radiation, and chemotherapy), and PTSD diagnosis related to their diagnosis and cancer treatment met the inclusion criteria. Participants’ age ranged from 40 to 57 years old (M = 52.28 years old). For PTSD diagnosis and total scores, we used the Global Assessment of Posttraumatic Stress Questionnaire validated for the Mexican population. Biomarkers (cortisol and immunoglobulins) were measured before and after EMDR treatment. For the neuroendocrine measure, we used the cortisol levels in the participant’s blood. For the immunological measure, we used the Nephelometry technique. We measured the changes in the following types of antibodies (immunoglobulins): a) Immunoglobulin A (IgA), b) Immunoglobulin G (IgG), and c) Immunoglobulin M (IgM). EMDR-PRECI was provided by three licensed EMDR clinicians formally trained in the protocol administration. Each EMDR-PRECI session lasted 50-60 minutes. The minimum number of sessions was three and the maximum ten with an average of five. Treatment focused only on the distressing memories related to diagnosis and cancer treatment. No adverse effects were reported during treatment or at six months post-treatment assessment. Results showed a full PTSD diagnosis remission in all participants with significant differences for PTSD scores, t (6) = 2.44, p < .05. These results are in concordance with Carletto et al., study in which all patients treated with EMDR no longer met criteria for PTSD [12]. No significant differences were found for immunoglobulins or cortisol. We believe that the administration of the EMDR-PRECI could be an efficient and effective component of a psychosocial approach to reduce or eliminate cancer-related PTSD symptoms and diagnosis.
This randomized controlled trial aimed to evaluate the effectiveness of the Eye Movement Desensitization and Reprocessing Protocol for Recent Critical Incidents and Ongoing Traumatic Stress (EMDR-PRECI) in reducing posttraumatic stress disorder (PTSD), anxiety, and depression symptoms related to the work of first responders on active duty. Participants were randomly assigned to two 60-minute individual treatment sessions ( N = 30) or to a no-treatment control condition ( N = 30). They completed pre-, post-, and follow-up measurements using the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders , fifth edition ( DSM-5 ) (PCL-5) and the Hospital Anxiety and Depression Scale (HADS). Data analysis by repeated measures analysis of variance (ANOVA) showed clear effects of the EMDR-PRECI in reducing PTSD work-related symptoms in the treatment group with symptom reduction maintained at 90-day follow-up with a large effect size ( d = 3.99), while participants continued to experience direct exposure to potentially traumatic work-related events during the follow-up period. Data analysis by repeated measures ANOVA revealed a significant interaction between time and group, F (2,116) = 153.83, p < .001, η P 2 = .726 for PTSD, and for anxiety F (1,58) = 37.40, p < .005, ηP2 = .090, but not for depression. A t-test showed a clear decrease for depression symptoms for the treatment group with statistically significant results. The study results suggest that the EMDR-PRECI could be an efficient and effective way to address first responders' work-related PTSD, anxiety and depression symptoms. Future research is recommended to replicate these results and to investigate if symptom improvement also results in the reduction of physical health symptoms and early retirement for PTSD-related reasons among first responders.
The aim of this longitudinal multisite randomized controlled trial (RCT) was to evaluate the effectiveness of the EMDR-Integrative Group Treatment Protocol for Ongoing Traumatic Stress (EMDR-IGTP-OTS) in reducing severe posttraumatic stress disorder, depression, and anxiety symptoms in refugee minors living in Valencia, Spain. The study was conducted in 2019 in the city of Valencia, Spain, in six sites for refugees (homes or residences). A total of 184 minors (all males) met the inclusion criteria. Participants' ages ranged from 13 to 17 years old (M =16.36 years). Participants' time since the arrival to the sites in Valencia varied from January 2018 to March 2019. Participation was voluntary with the participants and their legal guardian's consent. In this study, intensive EMDR therapy was provided. This intensive format allowed the participants to complete the full course of treatment in a short period. Treatment was provided simultaneously by eighteen licensed EMDR clinicians formally trained in the protocol administration divided into six teams. Each of the treatment group participants received an average of eight hours of treatment, provided during nine group-treatment sessions, three times daily during three consecutive days in a setting inside the six refugee sites. EMDR-IGTP-OTS treatment focused only on the distressing memories related to their life as refugees and did not address any other memories. No adverse effects were reported during treatment or at three-month post-treatment assessment. Data analysis by repeated measures ANOVA showed that the EMDR-IGTP-OTS was effective in reducing PTSD symptoms in the treatment group (F (2, 122) = 43.17p <.001, ηP 2=.414). A significant effect for group (F (1, 61 = 5.52, p<.05, ηP 2 =.898) and a significant interaction between time and group for this variable, (F (2, 122) = 11.10, p <.001, ηP 2=.154) confirmed the effects of the treatment. Significant effects for time (F (1, 61) = 7.46, p <.001, ηP 2 =.109) and for interaction between time and group (F (1, 61) = 6.13, p <.01, ηP 2=.091) were found for both, anxiety and depression, (F (1, 61) = 7.02, p <. 01, ηP 2 =.104) and (F (1, 61) = 7.92, p <.001, ηP 2=.116). The study results indicate that the intensive administration of the EMDR-IGTP-OTS could be a feasible, cost-effective, time-efficient, culturally sensitive, and effective component of a multidisciplinary psycho-social group-based program to address PTSD, depression, and anxiety symptoms among refugee minors.
L’expérience du cancer est un facteur de stress particulier au sein de l’infrastructure de l’état de stress post-traumatique (ESPT) car cette maladie débilitante implique des facteurs de stress permanents, et elle est à la fois aiguë et potentiellement chronique. Le cancer peut s’accompagner d’un large éventail d’effets négatifs connexes, tels que la détection d’une tumeur, le diagnostic, la gravité de la maladie et le pronostic, l’agressivité des traitements, la mutilation et le dysfonctionnement physique, les effets secondaires du traitement, les perturbations du fonctionnement physique, social et professionnel et, parfois, la récidive et un diagnostic de maladie terminale. Cet article fournit une description détaillée de l’application clinique du protocole intégratif de traitement de groupe de désensibilisation et de retraitement par les mouvements oculaires (EMDR-IGTP) adapté aux patients adolescents et adultes atteints de cancer et vivant avec un stress traumatique continu. Ce protocole administre les huit phases du traitement EMDR individuel à un groupe de patients en utilisant une composante de l’art-thérapie (c’est-à-dire des dessins) et le « butterfly hug » (BH – le « câlin de papillon », une méthode de stimulation bilatérale autoadministrée utilisée pour traiter le matériel traumatique). Une étude antérieure (Jarero et coll., 2015) avait montré qu’après six séances d’EMDR-IGTP, on observait une diminution significative des symptômes d’ESPT liés au diagnostic et au traitement de différents types de cancer chez des femmes adultes. Les effets se maintenaient lors de la séance de suivi, 90 jours plus tard. Dans le présent article, nous discutons de la manière dont on peut se servir de ce protocole pour fournir efficacement un traitement EMDR intensif à de grands groupes de patients, et nous donnons des instructions détaillées pour son utilisation, afin d’aborder l’une des principales dimensions psychologiques du cancer : les réactions de stress traumatique permanentes que connaissent les patients. Un exemple clinique illustre le processus de traitement.
This randomized controlled trial extended the investigation previously conducted by Jarero et al. (2015) which found that the eye movement desensitization and reprocessing Integrative Group Treatment Protocol adapted for ongoing traumatic stress (EMDR-IGTP-OTS) was effective in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. The current study sought to determine if the results could be replicated and if the treatment would also be effective in reducing symptoms of anxiety and depression. Participants in treatment (N = 35) and no-treatment control (N = 30) groups completed pre, post, and follow-up measurements using the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (PCL-5) and the Hospital Anxiety and Depression Scale (HADS). Data analysis by repeated measures analysis of variance (ANOVA) showed that the EMDR-IGTP-OTS was effective in significantly reducing symptoms of PTSD, anxiety, and depression, with symptoms maintained at 90-day follow-up and with large effect sizes (e.g., d = 1.80). A comparison of the treatment and no-treatment control groups showed significantly greater decreases for the treatment group on symptoms of PTSD, anxiety, and depression. No significant correlation was found when exploring the relationship between scores on the Adverse Life Experiences scale and scores indicating pretreatment severity of PTSD, anxiety, and depression. This study suggests that EMDR-IGTP-OTS may be an efficient and effective way to address cancer-related posttraumatic, depressive, and anxious symptoms.
The aim of this preliminary study was to evaluate the effectiveness of specially trained and supervised paraprofessionals in administering the eye movement desensitization and reprocessing Integrative Group Treatment Protocol (EMDR-IGTP) to reduce work-related posttraumatic stress disorder (PTSD) symptoms. The 2 paraprofessionals in this study were specially selected and trained in the application of the EMDR-IGTP and then provided treatment in an uncontrolled clinical trial to 37 clients from 3 non-governmental organizations in Bolivia. The participants were adult staff members (protective services workers, caregivers, psychologist, lawyers, and social workers) who provided care to children and adolescents with severe interpersonal trauma. Four EMDR-IGTP sessions within a parallel 2-week period were administered for each randomly assigned group. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) was administered at pretreatment and 30 and 90 days’ posttreatment. A repeated measures analysis of variance (ANOVA) determined that PCL-5 score means differed statistically significantly between time points F (2, 72) = 574.53, p < .001, η P 2 = .94. The study presents preliminary evidence scaling up EMDR therapy in a low- and middle-income country, making it possible to reach larger numbers of people in a shorter time, thereby offering an operational advantage. The study has limitations specially related to the size of the sample, the use of only one measure, and the lack of comparison with a control group or treatment. Further studies are required to present large samples with more measures and comparison of results with another therapy or control group.
Experiencing cancer is a peculiar stressor within the infrastructure of posttraumatic stress disorder (PTSD) because this debilitating disease involves ongoing stressors and is both acute and potentially chronic. The experience can include a wide range of associated adverse events, such as tumor detection, diagnosis, severity of disease, and prognosis; aggressive treatment; disfigurement and bodily dysfunction; side effects of treatment; impaired physical, social, and occupational functioning; and sometimes, recurrence and diagnosis of terminal illness. This article provides a detailed description of the clinical application of the Eye Movement Desensitization and Reprocessing (EMDR) Integrative Group Treatment Protocol (EMDR-IGTP) Adapted for Adolescents and Adults Living with Ongoing Traumatic Stress for the patients with cancer. This protocol administers the eight phases of EMDR individual treatment to a group of patients using an art therapy format (i.e., drawings) and the butterfly hug (a self-administered bilateral stimulation method to process traumatic material). A previous study (Jarero et al., 2015) showed that after 6 sessions of EMDR-IGTP, there was a significant decrease in PTSD symptoms related to the diagnosis and treatment of different types of cancer in adult women. Effects were maintained at 90-day follow-up. In this article, we discuss how this protocol can be used to effectively provide intensive EMDR treatment to large groups of patients, and we provide detailed instructions for its provision to address one of the major psychological dimensions of cancer: the ongoing traumatic stress responses experienced by patients with cancer. A clinical example illustrates the treatment process.
This research evaluated the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) Protocol for Recent Critical Incidents (EMDR-PRECI) in reducing posttraumatic stress symptoms related to the explosion in an explosives manufacturing factory north of Mexico City that killed 7 employees. The EMDR-PRECI was administered on 2 consecutive days to 25 survivors who had posttraumatic stress symptoms related to the critical incident. Participants’ mean score on the Short PTSD Rating Interview (SPRINT) was 22, well above the clinical cutoff of 14. They were randomly assigned to immediate and waitlist/delayed treatment conditions and therapy was provided within 15 days of the explosion. Results showed significant main effects for the condition factor, F (1, 80) = 67.04, p < .000. SPRINT scores were significantly different across time showing the effects of the EMDR therapy through time, F (3, 80) = 150.69, p < .000. There was also a significant interaction effect, condition by time, F (2, 80) = 55.45, p < .001. There were significant differences between the two treatment conditions at Time 2 (post-immediate treatment vs. post-waitlist/delayed), t (11) = −10.08, p < .000. Treatment effects were maintained at 90-day follow-up. Results also showed an overall subjective improvement in the participants. This randomized controlled trial provides evidence for the efficacy of EMDR-PRECI in reducing posttraumatic stress symptoms after a technological disaster.
Le protocole EMDR (désensibilisation et retraitement par les mouvements oculaires) individuel pour une utilisation paraprofessionnelle dans les situations de traumatisme aigu (EMDR-PROPARA) fait partie d'un projet développé à l'initiative du Dr Francine Shapiro. Cet essai clinique randomisé a examiné l'efficacité de ce protocole, administré par des thérapeutes EMDR expérimentés. Trente-neuf premiers intervenants en service actif ayant subi des traumatismes ont été répartis de manière aléatoire en deux groupes et ont reçu des séances de quatre-vingt-dix minutes, soit d'EMDR-PROPARA, soit de thérapie de soutien. Les participants du groupe EMDR-PROPARA ont montré une amélioration immédiatement après le traitement, et leurs scores au Short PTSD Rating Interview (SPRINT), lors d'un suivi à trois mois, avaient encore baissé. Comparativement, les participants du groupe ayant bénéficié de la thérapie de soutien présentaient une amélioration non significative après le traitement et une augmentation des scores au SPRINT lors du second suivi. La différence significative entre les deux traitements donne un support préliminaire à l'hypothèse de l'efficacité de l'EMDR-PROPARA pour réduire la gravité des symptômes post-traumatiques et favoriser une amélioration subjective globale. Les auteurs recommandent que des études mieux contrôlées soient menées afin d'évaluer plus précisément l'efficacité de cette intervention.
The purpose of this research is to evaluate the effectiveness of the eye movement desensitization and reprocessing (EMDR) Integrative Group Treatment Protocol (EMDR-IGTP) in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. EMDR-IGTP intensive therapy was administered for 3 consecutive days, twice daily, to 24 adult women diagnosed with different types of cancer (cervical, breast, colon, bladder, and skin) who had PTSD symptoms related to their diagnosis and treatment. The data was analyzed using factorial ANOVA with the effects of the EMDR-IGTP evaluated with the Short PTSD Rating Interview as dependent variable and group (two groups of patients: active phase and follow-up phase of cancer treatment) and time (four time points) as independent variables. Post hoc analyses were carried out. Results showed significant main effects for time and group. No significant interaction was found. Results also showed an overall subjective improvement in the participants. This pilot study suggests that intensive administration of the EMDR-IGTP can be a valuable support for cancer patients with PTSD symptoms related to their diagnosis and treatment. Further research with randomized controlled studies is needed to demonstrate the effectiveness of EMDR-IGTP in this population.