Two Method Approach: A Case Conceptualization Model in the Context of EMDR

Abstract

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.

The impact of eye movements and tones on disturbing memories involving PTSD and other mental disorders

“…To this end, the results have important clinical implications as these suggest that such procedures could potentially be applied to resolve a much broader array of memories than those of PTSD alone. With regard to EMDR therapy, it is an already established clinical practice for this therapy to be deployed in a broad range of psychological conditions, in which memories of earlier life events are deemed to play a pivotal role in the acquisition and maintenance of these conditions, ranging from the spectrum of anxiety disorders (De Jongh & ten Broeke, 2010) to somatoform disorders (van Rood & de Roos, 2009), and psychotic disorders (van der Berg & van der Gaag, 2011). Yet, it should be noted that, compared to the wealth of evidence favoring EMDR therapy for PTSD, treatment outcome studies on these conditions are still scarce.…”

“…This was done in a standardized manner (De Jongh et al, 2010). Next, the full EMDR protocol (Shapiro 2001;De Jongh and Ten Broeke, 2003) was used.…”

“…To this end, EMDR is increasingly applied as a treatment for other (anxiety) disorders (De Jongh & Ten Broeke, 2009), such as driving phobias (De Jongh, Holmshaw, Carswell, & van Wijk, 2011), and other conditions and symptoms that developed following an adverse event (see for instance De Jongh & Ten Broeke, 2010;Maxfield & Melnyk, 2000). If the working memory model is a valid explanation for what occurs during EMDR, it would mean that taxing working memory is effective in resolving negative memories that play a role in, or underlie, a broad variety of psychological symptoms and conditions.…”

Treating trauma in psychosis with EMDR: A pilot study

“…The EMDR was primarily focussed on the trauma that caused the current PTSD. We used the 'first method' approach to identify targets for desensitization (De Jongh, Ten Broeke, & Meijer, 2010). This means the starting point for the case conceptualization was an inventory of the PTSD re-experiencing symptoms that caused most of the burden in the previous weeks.…”

EMDR in Psychosis: Guidelines for Conceptualization and Treatment

“…Preliminary results show that working on imagery might reduce psychotic symptoms (Morrison, 2004). Table 1 shows the possible indications and conceptualizations for the application of EMDR in psychosis using the Two Method Approach (De Jongh, Ten Broeke, & Meijer, 2010). The therapist can follow the standard EMDR protocol, yet must be aware of some possible specific obstacles that may appear in clients with psychosis.…”