EMDR Therapy

The efficacy of online EMDR therapy

During the COVID-19 pandemic, online mental health treatments which are evidence-based are needed urgently. The social distancing measures that have been implemented around the world to reduce the spread of COVID-19 give clinicians no other choice but to deliver treatment via internet, audio/video call, or even e-mail. The continuation of distant-delivered treatment during this time is crucial, because clients and psychiatric patients seem to be more vulnerable.As a matter of fact, the COVID-19 outbreak has generated a worsening of symptoms in psychiatric patients compared with individuals without psychiatric complaints. Online EMDR clinic based in Melbourne is working to assist the delivering of online mental health services.

However, researchers started assessing the results of online EMDR sessions long before the pandemic started. For instance, a 2020 systematic review which identified one trial examining the effects of online EMDR therapy in treating PTSD in children and adults. The aforementioned uncontrolled trial was conducted in 2013 and it combined internet-delivered EMDR and CBT, both of which successfully diminished clinician-rated, but not self-rated PTSD symptom severity from pre treatment to post treatment,and both clinician-rated and self-rated PTSD from pre treatment to follow-up. Even so, this study was limited by the lack of a control group (consequently, it cannot be concluded that the improvements were determined by natural recovery), as well as bya small sample. Furthermore, due to the fact that EMDR and CBT were delivered together, the relative impact of the two forms of therapy is unknown. Also, no explicit description of the used web-based EMDR tool was provided, which makes the replication of this study impossible.After an introduction by a therapist, the EMDR tool was self-guided. This differs from the procedures used during the pandemic. When utilising a web based EMDR tool, eye movements are usually made by following the light ball of a light tube, with pulsators in both hands, and/or headphones with bilateral stimulation. Ideally,the therapist and the client have a synchronous video-connection. This would allow the therapist to tailor the working memory taxation through bilateral stimulation (e.g., the speed of the light ball) according to the patient’s needs. This procedure best mimics real-life EMDR. In this 2013 study, therapist involvement was minimal. Thus, it is still uncertain whether guided web-based EMDR sessions produce the same effects as face-to-face EMDR sessions.

Another 2020 study had more helpful results in terms of online EMDR efficacy. The study used a “mock name” and presented a new treatment without mentioning EMDR while utilising the working memory task as designed by Homer et al. in 2016. This task similarly induced horizontal eye movements, but it did so by making letters appear alternately on both sides of the screen and by having participants react whenever they saw a target letter. This task was unfamiliar for all participants, soit was more suitable to induce eye movements while recalling a memory without disclosing the real intention.The purpose of the study was twofold: the authors assessed whether an online analogue of EMDR is successful in diminishing the negative valence of autobiographical memories and whether manipulating outcome expectations impact the reduction in emotionality and vividness.Findings showed that a short online working memory task was effective in lowering both the emotionality and the vividness of unpleasantautobiographical memories. Therefore, the first hypothesis of the authors was confirmed. The results were consistent with earlier research supporting the 1997 and 2012 working memory theory of EMDR. The individuals in the positive information condition did not show a more significantreduction in emotionality and vividnessrelated to an autobiographical memory than did the individuals in the negative information condition. This disconfirmed their second hypothesis. Such results imply that EMDR is a robust therapy, and that the effects of outcome expectancy have too little of an impact to interfere with the particular components of this form of therapy.

The interest in online EMDR efficacy increased exponentially during the pandemic, so another study was conducted in 2021. This one aimed to compare the efficaciousness of two psychotherapeutic interventions for individuals and Italian health professionals who have been affected by the circumstances determined by the spread of COVID-19. In order to reach this goal, TF-CBT and EMDR sessions were provided online to treat the ongoing trauma related to isolation, quarantine, or work in COVID-19 hospital wards.The findings indicated that the EMDR and TF-CBT therapy sessions significantly improved the outcome measures and that they were equally effective. After the 7-session treatment, state anxiety was reduced by around 30%, while the depressive and the traumatic symptoms decreased by around 55%, in line with preceding investigations suggesting that PTSD treatments were also linked with reductions in depressive symptoms. These findings were confirmed at the 1-month follow-up, where traumatic symptoms decreased by an additional 11%.Even if they are not statistically significant, these follow-up data are very useful to the treatment target and its long-term stability.

While it is reassuring to see that online EMDR presently produces positive results, such results were also reached in a 2018 study, before the COVID-19 outbreak. In this case, the author utilized a remotely controlled software program that allowed the therapist to deliver EMDR treatment through telehealth. The results showed that online EMDR therapy sessions allowed the client to build and maintain a satisfactory rapport with the therapist just as they would have through face-to-face therapy. There was no relevant difference between the results obtained from each online EMDR therapy session and a face-to-face mode of treatment. The author of this study showed that an online EMDR tool can produce the same results as working face-to-face with a client. However, the preparation of the client is essential. If they engage with online therapy from an environment which does not allow them to focus (e.g., in the presence of their young children), the sessions cannot be very effective.

All things considered, online EMDR therapy seems to be efficacious. Online EMDR clinic in Melbourne will continue to deliver online services to clients.

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