Addiction‐Focused Eye Movement Desensitization and Reprocessing Therapy as an Adjunct to Regular Outpatient Treatment for Alcohol Use Disorder: Results From a Randomized Clinical Trial

Abstract

BackgroundThis study examined the feasibility, safety, and efficacy of addiction‐focused eye movement desensitization and reprocessing (AF‐EMDR) treatment, as an add‐on intervention to treatment as usual (TAU).MethodsAdult outpatients with alcohol use disorder (AUD) (N = 109) who already received or had just started with TAU (Community Reinforcement Approach) were recruited at 6 outpatient addiction care facilities. They were randomly assigned to either TAU + 7 weekly 90‐minute sessions of AF‐EMDR (N = 55) or TAU‐only (N = 54). Assessments were made at baseline, after AF‐EMDR therapy (+ 8 weeks in the TAU‐only group), and at 1‐ and 6‐month follow‐up. The primary outcomes were changes in drinking behavior as reported by the participant and biomarker indices.ResultsData were analyzed as intent‐to‐treat with linear mixed models. Additionally, sensitivity analyses were performed. No group or interaction effects were found for any of the outcome variables. Only limited change over time was seen with regard to indices of personal and societal recovery and in some secondary indices of clinical recovery (craving, desire thinking, and rumination). Reliable Change Index calculations showed that more TAU‐only participants showed clinical improvement with regard to alcohol consumption while a somewhat higher proportion of participants in the TAU + AF‐EMDR group experienced less craving. The acceptability, safety, and feasibility of the treatments received in both groups were comparable.ConclusionsThere was no add‐on effect of AF‐EMDR on TAU with regard to drinking behavior in outpatients with an AUD. Possible explanations are discussed. Future studies should first establish proof of principle regarding the potential of AF‐EMDR therapy to disrupt operant learning and habits relevant in addiction.

EMDR as Treatment Option for Conditions Other Than PTSD: A Systematic Review

“…Eight RCT (out of 27), Two control-groups (out of 10) and three (out of 12) group studies reported that patients had stopped the EMDR sessions before completion of treatment. In particular, high levels of drop-out in a single study were reported in the treatment of addictions [number of dropouts, Addictions ( n = 19; Markus et al, 2020 )], OCD ( n = 17; Nazari et al, 2011 ), and Pain ( n = 12; Mazzola et al, 2009 ). Overall, the reasons for drop-out, when specified and explicitly related to the treatment, were usually because of how hard it is to reminisce past memories, or to EMDR being time-consuming (e.g., Markus et al, 2020 ).…”

“…A recent RCT tested the adjunction of EMDR in addition to TAU in a randomised group of adult patients with alcohol use disorder (Markus et al, 2020 ). The study failed to demonstrate any additive effects in the TAU+EMDR group; possibly due to the population tested being chronic poly-morbid patients with poor social support.…”

“…Of the studies with no improvement outcomes, four were randomised controlled trials (Carrigan and Levis, 1999;Ray and Page, 2002;Marsden et al, 2018;Markus et al, 2020) and one was a case report (Brennstuhl et al, 2017b). In the study by Markus et al (2020) on addiction, results not only did not show significant additive effects of AF-EMDR on TAU in drinking behaviour, but also reported that individuals in the control group had a more positive outcome than those with EMDR. In the study by Marsden et al (2018) on OCD, no significant differences between treatments at post-test were found and only 30% of patients improved in OCD symptoms.…”

Eye Movement Desensitization and Reprocessing desde la propuesta de valoración de Mario Bounge

“…Indicadores Evidencia** Científico "Este estudio se centra en el potencial de la terapia de desensibilización y reprocesamiento de los movimientos oculares (EMDR), como una intervención adicional al tratamiento regular de la adicción" (Markus et al, 2019). "Además de los numerosos estudios de control de casos, ahora también hay disponibles seis ensayos clínicos controlados aleatorios que demuestran la eficacia y la seguridad de la EMDR en el tratamiento de diferentes afecciones de dolor" (Tesarz, Wicking, Bernardy & Seidler, (2019).…”

“…Actualiza su información, la EMDR, desde su creación, ha sido objeto de experimentación (Cotter et al, 2017;Covers et al, 2019;Hegarty et al, 2016), a través de sus estudios, han actualizado la información de su eficacia y validez, lo que conlleva la modificación de datos, hipótesis y teorías, incluso con respecto a otros enfoques. Busca comentarios críticos de otros, no se opone a las críticas de otras corrientes o de sus detractores, al contrario, las toma en cuenta para sus estudios de validez y efectividad (Brennstuhl y Bassan, 2018;Jahanfar et al, 2020;Markus et al, 2019).…”