Effective Treatment of Veterans With PTSD: Comparison Between Intensive Daily and Weekly EMDR Approaches

Abstract

The effectiveness of EMDR therapy in treating veterans diagnosed with PTSD was evaluated in this study using two treatment formats: intensive daily EMDR treatment provided twice a day during a 10-day period and a second format of one session each week. The study used archived outcome data previously collected and stored at Soldier Center. Both formats provided 18–20 treatment sessions of EMDR therapy to veterans diagnosed with PTSD that included dissociative exhibitions and moral injury issues. Questions addressed included: (1) does EMDR therapy administered twice daily ameliorate veterans’ PTSD symptoms; (2) does EMDR therapy administered twice daily provide equivalent outcome results as EMDR therapy administered weekly for 18–20 sessions; and (3) does the treatment outcome persist. The effectiveness of the weekly treatment group was also evaluated. Both groups’ results were assessed at pre-treatment, post-treatment and 1-year follow-up. The results indicated that both weekly treatment and intensive daily treatment groups produced statistically significant treatment effects (p < 0.001) that were maintained at 1-year follow-up. The10-day EMDR intensive daily treatment (EMDR therapy twice a day for 10 days) produced a similar outcome as to that of the weekly treatment with a 1-year follow-up. Results support the effectiveness of EMDR therapy when offered in both weekly treatment format as well as the intensive 10-day format on an outpatient basis. While recognizing the limitations of this study the results are significant to warrant additional research.

A Systematic Review of Intensive Empirically Supported Treatments for Posttraumatic Stress Disorder

“…The results of the random-effects modeling revealed a mean Cohen's d effect size 1.57, 95% CI [1.24, 1.91], which denotes a large impact of treatment on symptom reduction. Moreover, the findings from studies in which long-term follow-up assessments were conducted found that intensive treatments were associated with large improvements in PTSD symptoms at varying posttreatment intervals (Bryan et al, 2018;Ehlers et al, 2010Ehlers et al, , 2014Foa et al, 2018;Hendriks et al, 2018;Hurley, 2018;Van Woudenberg et al, 2018), Cohen's ds = 0.74-2.59.…”

“…These five studies varied in study design, population, location of services, and EST. Despite this variability, all studies with an available comparison group reported a lower or similar dropout rate from the intensive condition compared with the standard treatment condition (Ehlers et al, 2014;Foa et al, 2018;Hurley, 2018). Of note, the study that reported the highest dropout rate (n = 15, 13.6%) from an intensive treatment condition (i.e., daily PE; Foa et al, 2018) included participants who never initiated treatment; of the participants who initiated therapy, 3.6% (n = 4) did not complete treatment.…”

Exploring Moral Injury: Theory, Measurement, and Applications

“…Similar to the multitude of moral injury measures, we noted there are a plethora of treatments currently available for moral injury. Dr. Gray presented on Adaptive Disclosure, but other proposed treatment options include Prolonged Exposure (Foa et al, 2007), Cognitive Processing Therapy (Resick et al, 2017), Spiritually Integrated Cognitive Processing Therapy (Pearce et al, 2018), Impact of Killing (Maguen et al, 2017), Acceptance and Commitment Therapy (Nieuwsma et al, 2015), and Eye Movement Desensitization and Reprocessing therapy (Hurley, 2018). Yet, despite the impressive number of intervention options, there is a general lack of efficacy or effectiveness data supporting their utility for treating moral injury (Griffin et al, 2019).…”

Longitudinal Multisite Randomized Controlled Trial on the Provision of the EMDR-IGTP-OTS to Refugee Minors in Valencia, Spain

“…In this study, intensive EMDR therapy was provided [93][94]. Evidence suggests that more frequent scheduling of treatment sessions maximized PTSD treatment outcomes [95].…”