According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused treatment. The purpose of this paper is to critically evaluate the research underlying these treatment guidelines for cPTSD, and to specifically address the question as to whether a phase-based approach is needed. As reviewed in this paper, the research supporting the need for phase-based treatment for individuals with cPTSD is methodologically limited. Further, there is no rigorous research to support the views that: (1) a phase-based approach is necessary for positive treatment outcomes for adults with cPTSD, (2) front-line trauma-focused treatments have unacceptable risks or that adults with cPTSD do not respond to them, and (3) adults with cPTSD profit significantly more from trauma-focused treatments when preceded by a stabilization phase. The current treatment guidelines for cPTSD may therefore be too conservative, risking that patients are denied or delayed in receiving conventional evidence-based treatments from which they might profit.

A series of single-case experiments was used to evaluate the application of Eye Movement Desensitization and Reprocessing (EMDR) to traumatically induced dental phobia. Following two to three sessions of EMDR treatment, three of the four patients demonstrated substantially reduced self-reported and observer-rated anxiety, reduced credibility of dysfunctional beliefs concerning dental treatment, and significant behavior changes. These gains were maintained at six weeks follow-up. In all four cases, the clinical diagnosis present at pretreatment was not present at posttreatment at a clinical level. All patients actually underwent the dental treatment they feared most within three weeks following EMDR treatment. The findings support the notion that EMDR can be an effective treatment alternative for phobic conditions with a trauma-related etiology.

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Eye Movement Desensitization and Reprocessing (EMDR ) is een relatief nieuwe procedure op het terrein van de psychotherapie. Ervaringen met EMDR geven aanleiding tot hoopvolle verwachtingen van de behandeling van diverse aan trauma gerelateerde angststoornissen, met name post-traumatische stress-stoornis (PTSS). Onderdeel van deze procedure is dat de therapeut bij de clie¨nt een aantal snelle en ritmische oogbewegingen uitlokt door te vragen zijn of haar vinger te volgen, terwijl de clie¨nt een beeld van de traumatische herinnering in gedachten houdt. In dit artikel worden de achtergronden en de principes van EMDR belicht en wordt de stapsgewijze procedure uitvoerig beschreven. Een gevalsbeschrijving van een clie¨nt met een paniekstoornis en een tandartsfobie laat zien dat EMDR kan leiden tot een langdurige vermindering van angstklachten. Tevens wordt ingegaan op de huidige stand van zaken van de wetenschappelijke ondersteuning van EMDR . Het toepassen van EMDR bij PTSSwordt door wetenschappelijk onderzoek gesteund, maar empirische ondersteuning voor de therapeutische effectiviteit van EMDR bij andere angststoornissen ontbreekt.

This article outlines a comprehensive model that helps to identify crucial target memories for EMDR treatment. The "Two Method Approach" can be used for conceptualization and treatment implementation for a broad spectrum of symptoms and problems, other than those related to PTSD per se. The model consists of two types of case conceptualizations. The First Method deals with symptoms whereby memories of the etiological and/or aggravating events can be meaningfully specifi ed on a time line. It is primarily aimed at the conceptualization and treatment of DSM-IV-TR Axis I disorders. The Second Method is used to identify memories that underlie patients' so-called dysfunctional core beliefs. This method is primarily used to treat more severe forms of pathology, such as severe social phobia, complex PTSD, and/or personality disorders. The two methods of case conceptualization are explained step by step in detail and are illustrated by case examples.