countries is unusually commonplace, challenging to treat, and difficult to study.Postdisaster data gathered in 6-month intervals allowed the researchers in Norris et al. to observe the progress of PTSD symptoms. They noted that although the incidence of PTSD declined with time, this natural recovery continued for 18 months before leveling off, reflecting how natural healing can be painfully prolonged. Even by the 18-month leveling-off period, PTSD rates for the disaster victims remained higher than the PTSD base-rate in Mexico. These researchers concluded that their findings support a call for "early and ongoing interventions that provide mental health care to disaster victims in a way that is culturally appropriate and feasible for places . . . that have few mental health professionals to draw upon" (Norris et al., 2004, pp. 290-291). Eye Movement Desensitization and ReprocessingThe effectiveness of eye movement desensitization and reprocessing (EMDR) in the treatment of trauma survivors has been recognized by a variety of professional A lthough the literature on the effects of disasters has been accumulating for more than 2 decades, information on disaster-related symptomatology among victims in developing countries is proportionately sparse (Norris et al., 2002). One tentative conclusion is that natural disasters in the developing world are particularly complex. In a recent longitudinal study of the effects of floods and mudslides in Mexico, a team of international researchers found that disaster survivors reported a high prevalence of posttraumatic stress disorder (PTSD) (24% on average, ranging from 14% at one site to 47% in another) and a high incidence of major depressive disorder (Norris, Murphy, Baker, & Perilla, 2004). Interpretation of these data was complicated by the finding that residents of certain sites had experienced other potentially traumatic events during their lives and that their PTSD symptoms may have predated the disasters studied, lending support to the observation that trauma in developing Eye movement desensitization and reprocessing (EMDR) is recognized as an effective and efficient treatment for trauma-related issues. This article describes an integrated EMDR and group treatment for children and adults traumatized by natural disasters in several Latin American countries. This protocol combines the eight standard EMDR treatment phases with a group therapy model. The hypothesis is that the resulting hybrid offers more extensive reach than did the original EMDR model, which was intended for use with individuals, and takes treatment efficacy and efficiency well beyond that expected from traditional group process. To illustrate the application of the model, one formally measured field study and nine pilot projects are described. The promising results of this intervention suggest that EMDR is an effective means of providing treatment to large groups of people impacted by large-scale traumatic events (e.g., natural disasters). Controlled research is needed to clarify this issue.

Event Scale (IES) were then provided with the eye movement desensitization and reprocessing (EMDR) Protocol for Recent Critical Incidents (EMDR-PRECI), a single-session modified EMDR protocol for the treatment of recent trauma. Participants were randomly assigned to two groups: immediate treatment group and waitlist/delayed treatment group. There was no improvement in the waitlist/ delayed treatment group, and scores of the immediate treatment group participants were significantly improved, compared with waitlist/delayed treatment group paticipants. One session of EMDR-PRECI produced significant improvement on symptoms of posttraumatic stress for both the immediate-treatment and waitlist/delayed treatment groups, with results maintained at 12-week follow-up, even though frightening aftershocks continued to occur frequently. This study provides preliminary evidence in support of the protocol's efficacy in a disaster mental health continuum of care context. More controlled research is recommended to evaluate further the efficacy of this 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.

The eye movement desensitization and reprocessing (EMDR) individual protocol for paraprofessional use in acute trauma situations (EMDR-PROPARA) is part of a project developed at the initiative of Dr. Francine Shapiro. This randomized clinical trial examined the effectiveness of the protocol administered by experienced EMDR therapists. There were 39 traumatized first responders on active duty randomly assigned to receive two 90-min sessions of either EMDR-PROPARA or of supportive counseling. Participants in the EMDR-PROPARA group showed benefits immediately after treatment, with their scores on the Short PTSD Rating Interview (SPRINT) showing further decreases at 3-month follow-up. In comparison, supportive counseling participants experienced a nonsignificant decrease after treatment and an increase in the SPRINT scores at the second follow-up. The significant difference between the two treatments provides preliminary support for EMDR-PROPARA’s effectiveness in reducing severity of posttraumatic symptoms and subjective global improvement. More controlled research is recommended to evaluate further the efficacy of this intervention.

The EMDR Integrative Group Treatment protocol (EMDR-IGTP) has been used in different parts of the world since 1998 with both adults and children after natural or man-made disasters. This protocol combines the eight standard EMDR treatment phases with a group therapy model, thus providing more extensive reach than the individual application of EMDR. In this study the EMDR-IGTP was used with 16 bereaved children after a human provoked disaster in the Mexican State of Coahuila in 2006. Results showed a signifi cant decrease in scores on the Child's Reaction to Traumatic Events Scale that was main tained at 3-month follow-up. Although controlled research is needed to establish the effi cacy of this intervention, preliminary results suggest that EMDR-IGTP may be an effective means of providing treatment to large groups of people impacted by large-scale critical incidents (e.g., human-provoked disasters, terrorism, natural disasters).