The EMDR Recent Traumatic Episode Protocol With an Intensive Care Survivor: A Case Study

Abstract

The intensive care survivor population is increasing. Critical illness can lead to long term psychological distress for a significant proportion of intensive care survivors. This situation has been brought into even starker focus with the impact of COVID-19. Critical illness can lead to long term psychological distress for a significant proportion of intensive care survivors. Risk factors for post-intensive care psychological distress include delirium experiences. This single case study describes the therapeutic process and utility of the Recent-Traumatic Episode Protocol (R-TEP), an eye movement Desensitization and reprocessing (EMDR) therapy protocol for early intervention, with an ICU survivor where therapy was conducted remotely. The treatment provision is unusual in terms of the use of the R-TEP protocol and therapy not being in person. Treatment response was assessed using three standardized measures pre-treatment, post-treatment and at 4-month follow-up, and through qualitative feedback. The advantages of the R-TEP structure are discussed and the need for further research with the ICU survivor population considered.

Eye Movement Desensitization and Reprocessing (EMDR) Treatment in the Medical Setting: A Systematic Review

“…One case study described a positive effect, lasting up to four months after treatment, of online performed EMDR on depression, anxiety and QoL in a patient who survived ICU admission and suffered from PTSD afterwards: 105 see Supplementary Table 4O.…”

A randomised pilot feasibility study of eye movement desensitisation and reprocessing recent traumatic episode protocol, to improve psychological recovery following intensive care admission for COVID-19

“…Two recent case studies describe positive treatment effect following ICU admission. 29,30 The Recent Traumatic Episode Protocol, (R-TEP) 31 is an EMDR intervention, adapted for early delivery, that allows for processing of fragmented, traumatic memories; frequently reported by ICU survivors and associated with post-ICU PTSD development. 32 EMDR R-TEP has reduced PTSD symptoms following missile attacks, 33,34 and life-threatening medical events.…”

“…32 EMDR R-TEP has reduced PTSD symptoms following missile attacks, 33,34 and life-threatening medical events. 35,36 The aforementioned, case study 30 described a positive treatment response to EMDR R-TEP, following ICU admission.…”

Mixed-methods randomised study exploring the feasibility and acceptability of eye-movement desensitisation and reprocessing for improving the mental health of traumatised survivors of intensive care following hospital discharge: protocol

“…Recent investigations of EMDR’s effectiveness in treating medical event-induced trauma, following cancer, stroke, cardiac events and multiple sclerosis have yielded promising but inconclusive findings 25. Case studies with ICU survivors26 27 and our own novel work with survivors of COVID-19-related critical illness28 also show promise, underscoring the need for systematic evaluation in this population. However, definitive evidence of benefit is not available.…”