A Clinician's Guide to the Efficacy of EMDR Therapy

Abstract

Thirty years after its introduction in 1989, eye movement desensitization and reprocessing (EMDR) therapy has evolved to become a comprehensive psychotherapy, guided by Shapiro's adaptive information processing model. Her model views most mental health disorders as stemming from unprocessed earlier disturbing events. This understanding of the etiological role of trauma has opened the door for EMDR treatment of multiple types of presentations. There are now more than 44 randomized controlled trials that have investigated EMDR treatment of posttraumatic stress disorder (PTSD), early traumatic stress, and traumatized children. In addition, there are 28 randomized controlled trials which have evaluated its use with major depressive disorder, bipolar disorder, psychosis, anxiety disorders, obsessive compulsive disorder, substance use disorder, and pain. Seventy-five percent of these studies provided Shapiro's standardized procedure, while others tested modifications developed for specific populations. The focus of treatment varied across the studies, with various targets being processed to achieve good outcomes. The research demonstrates EMDR's effectiveness in reducing/eliminating PTSD and trauma-related symptoms, and in improving symptoms related to presenting problems and disorders. EMDR can be considered to have well-established efficacy for the treatment of PTSD. The emerging evidence for EMDR's efficacy with disorders other than PTSD must be considered preliminary and in need of replication conducted with randomized controlled trials using rigorous methodology. EMDR's position in various treatment guidelines is discussed, and the needs for future research are elaborated.

The Potential for Computerized Eye Tracking Technology to Improve Bilateral Stimulation Methodology and Assessment

“…EMDR has long been utilized to decrease the symptoms associated with PTSD and has also been found to enhance clinical outcomes for other mental health diagnoses including depression, bipolar, psychosis, panic disorder, anxiety disorder, OCD, substance abuse disorder, and pain 4 Open Access bilateral stimulation (BLS) while processing (thinking, talking) a traumatic memory. Bilateral stimulation can involve any motion that crosses the midpoint of the body, but the earliest, and most common method, is eye movements.…”

“…While EMDR has support as an efficacious technique for treating PTSD, it is not universally accepted as the gold standard for treatment of that diagnosis. Both the American Psychological Association (APA) and UK National Institute for Health and Care Excellence (NICE) only conditionally recommend EMDR for the clinical treatment of PTSD 4 . The technique draws criticism due to the fact that the specific mechanism of change has yet to be identified 7 .…”

EMDR for Survivors of Sexual and Intimate Partner Violence at a Nonprofit Counseling Agency

“…Over 70 randomized control trials have established EMDR as an effective treatment for PTSD (Maxfield, 2019) across numerous populations, including disaster-bereaved individuals (Lenferink et al, 2017), individuals with bipolar disorder (Moreno-Alcázar et al, 2017), and survivors of sexual violence (Allon, 2015;Edmond et al, 1999;Rothbaum et al, 2005), domestic violence (Ehring et al, 2014;Jaberghaderi et al, 2019), and IPV (Mosquera & Knipe, 2017). Other therapies that have shown effective results in addressing PTSD among survivors of sexual violence, domestic violence, and IPV include prolonged exposure (Rothbaum et al, 2005), cognitive processing theory (Chard, 2005;Krupnick, 2009), STAIR/Exposure (Cloitre et al, 2010), STAIR-NST (Cloitre et al, 2012), andCBT (McDonagh et al, 2005).…”

“…Additionally, group interpersonal therapy was assessed specifically in the context of low-income female participants with PTSD related to interpersonal trauma (Krupnick et al, 2008). In comparing EMDR with TF-CBT, EMDR has shown similar impact to TF-CBT on PTSD symptoms, and similar or greater impact than TF-CBT with comorbid disorders, such as depression and anxiety (Maxfield, 2019). However, each treatment does not come at an equal cost of time to survivors, with EMDR requiring less treatment time and a lower mean cost than TF-CBT to effectively treat PTSD among adults (Mavranezouli et al, 2020).…”

EMDR therapy for misophonia: a pilot study of case series

“…In the last decades, the insight that unprocessed traumatic memories (not only criterion A events) play an important role in the development and maintenance of a variety of mental health conditions led to the use of EMDR therapy as a trauma-focused treatment for a broader spectrum of disorders (Shapiro, 2018 ). Evidence for its effectiveness for disorders beyond PTSD is growing, such as for major depressive disorder, bipolar disorder, psychosis, anxiety disorders, obsessive compulsive disorder, substance use disorder, and pain (Matthijssen et al, 2020 ; Maxfield, 2019 ). In a recent meta-analysis of RCTs (Cuijpers, Veen, Sijbrandij, Yoder, & Cristea, 2020 ), significant results were found for EMDR in phobias and test anxiety, but with a high risk of bias.…”