EMDR Therapy for Trauma-Related Disorders

Shapiro, Francine; Laliotis, Deany

doi:10.1007/978-3-319-07109-1_11

Cited by 40 publications

(23 citation statements)

References 25 publications

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“…The duration of a typical 3MDR session is 90 min, of which a patient walks on the platform for 45–60 min. This timeframe is in accordance with other trauma-focused therapies ( 27 , 63 ) and allows for addressing 7 pictures. In the first proof of concept study ( 69 ) patients received 4 sessions of 3MDR.…”

Section: The 3mdr Interventionsupporting

confidence: 54%

“…In this task patients are asked to follow a horizontally moving ball across the screen with their eyes and call out numbers aloud that are displayed on this ball. The working mechanism of the dual-attention task used in EMDR (most often eye movements, which bears similarities with the task applied in 3MDR) has recently been argued to rely on reconsolidation and the learning of new information which can be added to the original memory trace ( 63 ). Several studies ( 64 , 65 ) have provided support for this theory as they found that reconsolidation can indeed be disrupted in an adaptive manner by a distractor stimulus or task.…”

Section: The 3mdr Interventionmentioning

confidence: 99%

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An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy

2018

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Despite an array of evidence-based psychological treatments for patients with a posttraumatic stress disorder (PTSD), a majority of patients do not fully benefit from the potential of these therapies. In veterans with PTSD, up to two-thirds retain their diagnosis after psychotherapy and often their disorder is treatment-resistant, which calls for improvement of therapeutic approaches for this population. One of the factors hypothesized to underlie low response in PTSD treatment is high behavioral and cognitive avoidance to traumatic reminders. In the current paper we explore if a combination of personalized virtual reality, multi-sensory input, and walking during exposure can enhance treatment engagement, overcome avoidance, and thereby optimize treatment effectiveness. Virtual reality holds potential to increase presence and in-session attention and to facilitate memory retrieval. Multi-sensory input such as pictures and music can personalize this experience. Evidence for the positive effect of physical activity on fear extinction and associative thinking, as well as embodied cognition theories, provide a rationale for decreased avoidance by literally approaching cues of the traumatic memories. A dual-attention task further facilitates new learning and reconsolidation. These strategies have been combined in an innovative framework for trauma-focused psychotherapy, named Multi-modular Motion-assisted Memory Desensitization and Reconsolidation (3MDR). In this innovative treatment the therapeutic setting is changed from the face-to-face sedentary position to a side-by-side activating context in which patients walk toward trauma-related images in a virtual environment. The framework of 3MDR has been designed as a boost for patients with treatment-resistant PTSD, which is illustrated by three case examples. The intervention is discussed in context of other advancements in treatment for treatment-resistant PTSD. Novel elements of this approach are activation, personalization and empowerment. While developed for veterans with PTSD who do not optimally respond to standardized treatments, this innovative framework holds potential to also be used for other patient populations and earlier stages of treatment for patients with PTSD.

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Section: The 3mdr Interventionsupporting

confidence: 54%

Section: The 3mdr Interventionmentioning

confidence: 99%

An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy

2018

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“…A rank ordering of the effect sizes for the eight studies indicated that three of the four largest effect sizes (top half) were from the sequenced, multicomponent therapies. The use of EMDR therapy which includes a focus on traumatic memories as well as a preparation phase and multiple supporting interventions (e.g., positive images) (see Shapiro & Laliotis, 2015 ) was reported to substantially benefit childhood sexual abuse participants, yielding large pre-post effect sizes for PTSD symptoms ranging from 1.93 to 1.46 (Ehring et al, 2014 ).…”

Section: Optimal Treatment Outcomes: Are We There Yet?mentioning

confidence: 99%

The “one size fits all” approach to trauma treatment: should we be satisfied?

Cloitre

2015

European Journal of Psychotraumatology

145

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There have been significant advances in the treatment of posttraumatic stress disorder in the last two decades. Further improvements in outcomes will be supported by recognition of the heterogeneity of symptoms in trauma populations and the development of treatments that promote the tailoring of interventions according to patient needs. Collaboration with patients regarding preferences about treatment structure, process, and outcomes is critical and will benefit the effectiveness and quality of treatments as well as the speed of their dissemination. New research methodologies are required that can incorporate important variables such as patient preferences and symptom heterogeneity without necessarily extending already lengthy study times or further complicating study designs. An example of alternative methodology is proposed.

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“…Research has also found that other forms of BLS, such as bilateral tactile taps or auditory tones, are also effective methods of reducing vividness in trauma (van den Hout et al, 2011b ; de Jongh et al, 2013 ). This evidence led Shapiro to conclude that dual attention may be the mechanism responsible for the treatment gains rather than any effect unique to the EMs (Shapiro and Laliotis, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action

et al. 2018

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Background: Eye movement desensitization and reprocessing [EMDR] is an innovative, evidence-based and effective psychotherapy for post-traumatic stress disorder [PTSD]. As with other psychotherapies, the effectiveness of EMDR contrasts with a limited knowledge of its underlying mechanism of action. In its relatively short life as a therapeutic option, EMDR has not been without controversy, in particular regarding the role of the bilateral stimulation as an active component of the therapy. The high prevalence of EMDR in clinical practice and the dramatic increase in EMDR research in recent years, with more than 26 randomized controlled trials published to date, highlight the need for a better understanding of its mechanism of action.Methods: We conducted a thorough systematic search of studies published until January 2018, using PubMed, ScienceDirect, Web of Knowledge and Scopus databases that examined the mechanism of action of EMDR or provided conclusions within the framework of current theoretical models of EMDR functioning.Results: Eighty-seven studies were selected for review and classified into three overarching models; (i) psychological models (ii) psychophysiological models and (iii) neurobiological models. The evidence available from each study was analyzed and discussed. Results demonstrated a reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy. Recently, more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy.Discussion: Despite the increasing number of studies that published in recent years, the research into the mechanisms underlying EMDR therapy is still in its infancy. Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions.

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EMDR Therapy for Trauma-Related Disorders

Cited by 40 publications

References 25 publications

An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy

An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy

The “one size fits all” approach to trauma treatment: should we be satisfied?

How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action

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