Evidence on EMDR2

The efficacy of eye movement desensitisation and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) has been shown by a comprehensive body of literature. Ever since its introduction, EMDR’s effects have been achieved through the interaction of numerous processes, such as free association, somatic awareness, and cognitive restructuring. The research which has been conducted on bilateral stimulation involved in EMDR treatment shows that it has the potential to alleviate symptoms of other disorders besides PTSD. Because it can produce positive therapeutic results in a short amount of time, without requiring homework or an extensive exposure to the painful memory, the majority of allied health regard EMDR as an efficient and effective approach. The following article was written by an EMDR psychologist in Melbourne

The potential of EMDR therapy has been explored extensively, and the curiosity it generated has led to highly rewarding results. Out of five controlled studies conducted during 1998-2002, four of them showed that 77-100% of the single-trauma clients from civilian populations no longer met PTSD criteria after only 3-6 hours of treatment. Several multiple-trauma client studies on EMDR which were conducted using mixed samples (for instance, Marcus, Marquis, & Sakai, 1997) found a 77-83% remission rate of PTSD in up to 10 treatment hours. Five of the six civilian controlled studies conducted during 1995-2002 showed that EMDR treatment effects have either maintained or increased at the follow-up. As a matter of fact, the 1995 study found that 84% of the participants who had been previously diagnosed with PTSD continued to benefit from the positive results of EMDR therapy even at the 15-month follow-up.

In the past 30 years, countless meta-analyses have been conducted in order to assess the efficacy of EMDR. In this paper, we will refer to the findings of five meta-analyses conducted during 1998-2006. All of them reached the conclusion that EMDR therapy is just as efficacious as other forms of PTSD treatment, and that it produces such results without involving the use of homework. However, it remains unclear whether EMDR therapy is superior to certain forms of psychotherapy, and it is yet to be concluded which trauma clients are more likely to benefit from it. And EMDR online therapy is another delivery framework that needs further research.

In spite of not reaching an explicit conclusion, there are numerous studies which compare EMDR therapy with psychotherapies such as cognitive behavioral therapy (CBT). For instance, a 2004 randomised study showed that both CBT and EMDR were highly effective in reducing PTSD symptoms and behavioural problems. The participants were fourteen Iranian girls aged 12-13, all of whom had experienced sexual abuse. Although the EMDR therapy sessions were favored by a non-significant trend related to self-reported PTSD symptoms, both forms of psychotherapy were considered successful. EMDR and CBT were also compared in a 2006 meta-analysis involving 7 studies and 209 participants, of whom 65% were women.  It is worth mentioning that the participants completed all therapy sessions. Although the meta-analysis reinforced the fact that both forms of psychotherapy are efficacious in the treatment of PTSD, it could not establish which of the two were superior.

In 2014, Francine Shapiro published a review article in which she discusses 25 randomised controlled trials (RCTs) that emphasise the positive effects of EMDR. 7 out of 10 RCTs showed that the EMDR treatment was more effective and/or more rapid than trauma-focused cognitive behavioral therapy (TF-CBT). One of the 10 RCTs found that CBT was superior on certain measures. The EMDR therapy consisted of no homework and 8 standard sessions, while the CBT therapy involved 4 imaginal exposure sessions, 4 therapist-assisted in vivo exposure sessions, as well as 50 hours of homework entailing a combination of imaginal exposure and in vivo exposure. Generally speaking, patients may find EMDR therapy more appealing because it can produce results faster than CBT. Since it doesn’t require any homework, EMDR can be used on consecutive days. Thus, the treatment is completed rapidly and the costs are lower.

In spite of the extensive research which has been conducted in the past 30 years, the full potential of EMDR therapy is yet to be discovered. However, more recent studies help us understand why and how this form of therapy could be better than CBT in alleviating PTSD symptoms. A 2018 systematic review and meta-analysis of RCTs discussed 14 eligible studies in order to reach a conclusion on this matter. The meta-analysis conducted using 11 out of 14 studies showed that EMDR is superior to CBT in PTSD symptom reduction, but the one conducted using 4 studies found no statistically relevant distinctions between the results of the two forms of psychotherapy at the 3-month follow-up. Further research showed that, while EMDR is superior to CBT also when it comes to alleviating anxiety, it is not better in treating depression. These findings are incompatible with the 2001 meta-analytic study conducted by Günter H Seidler and Frank E. Wagner, who showed that EMDR therapy was more efficacious than CBT in reducing symptoms of depression. Similarly, a meta-analytic study conducted in 2012 indicated a considerable advantage for EMDR over TF-CBT in reducing depression.

From a clinical standpoint, such findings should be neither overlooked, nor taken for granted and trials looking at EMDR online need to be considered. For instance, the previously mentioned 2018 meta-analysis has some limitations – the numbers of participants included in the RCTs are rather low, the subgroup meta-analysis of PTSD and depression at the 3-month follow-up involved a small number of studies, and a meta-regression of numerous variables (for instance, age) was not conducted. In order to obtain conclusive evidence and to confirm the findings of this meta-analysis, large population RCTs with longer follow-ups are certainly needed. Clients located in Melbourne may benefit from EMDR therapy online.

Contradictory results regarding the superiority of one form of psychotherapy over the other do not invalidate the efficacy of both EMDR and CBT in treating numerous disorders. It is remarkable that EMDR generates positive effects which are so similar to the ones produced by CBT, given the fact that the latter was introduced almost 30 years earlier. EMDR is a new therapeutic approach, and yet it is already supported by comprehensive evidence. This only emphasises how fruitful EMDR therapy can become, and how much it can expand beyond the treatment of PTSD.

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