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1. Furlani, F. (2006, Maggio). Dentro la relazione: L’Alleanza terapeutica dalla ricerca alla pratica clinica [In the report: The therapeutic alliance research into clinical practice]. Presentazione alla Conferenza Nazionale, Associazione per l'EMDR in Italia, Firenza, Italia.

Language: Italian

Format: Conference

Abstract:
Nella presentazione verrà esposta l’evoluzione di un protocollo di ricerca in psicoterapia che considera l’andamento dell’alleanza terapeutica e del clima emotivo tra paziente e terapeuta, confrontati con la situazione clinica del paziente. Verranno inoltre presentati i primi dati di una ricerca condotta con gli stessi criteri e che prevede l’osservazione di psicoterapie con approccio terapeutico EMDR e di psicoterapie con approccio cognitivo-costruttivista. Le indicazioni ottenute saranno discusse attraverso riflessioni e stimoli per la ricaduta pratica.

In the presentation will be outlined the evolution of a research protocol that considers the trend in psychotherapy and emotional climate of the therapeutic alliance between patient and therapist, compared with the clinical situation of the patient. Will also be presented the first data of a survey conducted by the same criteria and requiring compliance with therapeutic approach to psychotherapy and EMDR psychotherapy with cognitive-constructivist approach. The indications obtained will be discussed through reflections and stimuli for relapse practice.

Keywords: Cognitive-Constructivist Approach  Research Protocol  Therapeutic Alliance  

Accuracy Verified: Yes


2. 宋磊 王振英 [Song Lei & Wang Zhen-Ying]. (2007, November). 舍曲林联合EMDR治疗抑郁症对照研究 [Sertraline treatment of depression combined EMDR research: A control study of sertraline combined with the EMDR in the treatment of depression]. 临床心身疾病,13(4) [Journal of Clinical Psychosomatic Disease, 13(4)].

Language: Chinese

Format: Journal

Abstract:
目的 探讨舍曲林联合眼动脱敏和再加工治疗对抑郁症的临床疗效及安全性.方法 将64例抑郁症患者随机分为两组各32例,均给予舍曲林治疗,研究组联合眼动脱敏和再加工治疗,疗程均为6w.于治疗前及治疗第1 w、2 w、6 w末采用汉密顿抑郁量表、临床总体印象量表评定临床疗效,副反应量表评定不良反应.结果 治疗6 w末研究组有效率87.5%,对照组为84.4%,两组差异无显著性(χ2=0.129,P>0.05).汉密顿抑郁量表、临床总体印象量表评分,研究组治疗1 w末均较对照组下降显著(P均<0.05),2 w末均较对照组下降极显著(P均<0.01),6 w末差异均无显著性(P均>0.05).两组不良反应均轻微(P>0.05).结论 舍曲林联合眼动脱敏和再加工治疗治疗抑郁症疗效显著,起效更快,安全性高,依从性好.

Objective: To study the combined sertraline and reprocessing eye movement desensitization treatment for depression efficacy and safety. Methods 64 patients with depression were randomly divided into two groups, 32 cases were treated with sertraline treatment, the joint study group eyes Activity desensitization and reprocessing therapy, a course of 6w. in the first before treatment and 1 w, 2 w, 6 w end with Hamilton Depression Rating Scale, Clinical Global Impression Scale for assessment of clinical efficacy, adverse side effects rating scale reaction. Results 6 w end of study group and 87.5%, 84.4% of the control group, no significant difference between the two groups (χ2 = 0.129, P> 0.05). Hamilton Depression Rating Scale, Clinical Global Impression Scale scores 1 w at the end of treatment group was significantly decreased compared with the control group (P all <0.05), 2 w at the end than the control group decreased significantly (P all <0.01), 6 w at the end there was no significant difference (P all> 0.05) . two adverse reactions were mild (P> 0.05). Conclusion Joint eye sertraline desensitization and reprocessing therapy treatment of depression a significant effect, faster onset, high safety, good compliance.

Keywords: Control Study  Depression  Sertraline  

Accuracy Verified: Yes


3. Devilly, G. J. (2004, December). An approach to psychotherapy toleration: The Distress/Endorsement Toleration Scale (DEVS) clinical outcome studies. Journal of Behavior Therapy and Experimental Psychiatry, 35(4), 319-336. doi:10.1016/j.jbtep.2004.08.001.

Language: English

Format: Journal

Abstract:
The issue of treatment tolerance within the field of psychotherapy is, at best, a nebulous construct and has been commonly evaluated via rates of subject attrition and homework compliance. This research presents the psychometric properties of a ten-item scale which endeavours to measure treatment distress and participant endorsement of therapy protocols used in clinical research. Two factors emerged and the subscales of Distress and Endorsement were derived. These subscales displayed good reliability with acceptable inter-item correlations within each subscale. The subscales were also able to differentiate the perspectives of male Vietnam veterans from their spouses on a lifestyle management course at the termination of intervention. However, this scale also displayed a cognitive behavioural trauma treatment protocol and eye movement desensitisation and reprocessing to be equivalent in treatment distress and participant endorsement in the treatment of PTSD. Preliminary findings suggest that the relationship between these two subscales and outcome may, to some extent, be population specific. First evidence suggests that intervention distress ratings may be influenced by severity of presentation, whilst endorsement ratings are more influenced by symptomatic improvement over time. Suggestions for future research are presented and the full questionnaire is attached as an appendix. [Author Abstract]

Keywords: Adults  Australians  Cognitive Therapy  Distress  Family Therapy  Endorsement  Females  Males  Outcome  Psychotherapeutic Processes  Questionnaire  Self Report Instruments  Spouses  Tolerance  Treatment  Treatment Effectiveness  Veterans  Vietnam War  

Accuracy Verified: Yes


4. Litt, B. (2007). The child as identified patient: Integrating contextual therapy and EMDR. In F. Shaprio, F. W. Kaslow, & L. Maxfield (Eds.), Handbook of EMDR and family therapy processes (pp. 306-324). Hoboken, NJ: John Wiley & Sons Inc.

Language: English

Format: Book Section

Abstract:
It is estimated that as many as 2% of children under age 12 and from 5% to 18% of adolescents suffer from a depressive disorder (Birmaher et al., 1996; Northey, Wells, Silverman, & Bailey, 2003) that will likely persist into adulthood (Northey et al., 2003; Wagner & Ambrosini, 2001). Contextual Therapy is a differentiation-based (e.g., Kerr & Bowen, 1988; Schnarch, 1991) approach in that it promotes self-determination in the face of family pressure for compliance, reliance on internal resources for self-validation rather than dependence on others for approval, and the overcoming of emotional discomfort in the interests of responsible action (Boszormenyi-Nagy & Krasner, 1986). Both the contextual approach and the Adaptive Information Processing (AIP) model predict that formative childhood experiences affect both psychological health and relational functioning. With its systemic paradigm and its ethical dimension of relationship, the contextual approach is complementary and additive to Shapiro's (2001) AIP model. The contextual approach shows the clinician where to look for the targets, and Eye Movement Desensitization and Reprocessing (EMDR) provides the potency to transform the experience. A general structure of phase-oriented therapy can be described that accounts for most, if not all, referrals for treatment. An assessment phase, a contracting phase, and an intervention phase characterize the main tasks of the therapist. In practice, these phases may overlap, coincide, or repeat themselves over the course of minutes, weeks, or months. This chapter describes only those practices that are unique to the integrated approach. (PsycINFO Database Record (c) 2008 APA, all rights reserved

Keywords: Adaptive Information Processing Model  Affective Disorders  Child Patients  Contextual Therapy  Depressive Disorder  Integrated Approach  Integrative Psychotherapy  Major Depression  Models  

Accuracy Verified: Yes


5. Adler-Tapia, R. L. (2012, June). Child psychotherapy: Integrating developmental theory into clinical practice. New York, NY: Spring Publishing.

Language: English

Format: Book

Abstract:
Children are often diagnosed and medicated without the consideration that their symptoms may actually be a healthy response to stressful life events. This integrative guide for mental health practitioners who work with children underscores the importance of considering the etiology of a child's symptoms within a developmental framework before making a diagnosis. By providing advanced training and skills for working with children, the book guides the therapist, step-by-step, through assessment, case conceptualization, and treatment with a focus on the tenets of child development and a consideration of the impact of distressing life events. The book first addresses child development and the evolution of child psychotherapy from the perspectives of numerous disciplines, including recent findings in neurodevelopment trauma, attachment, and neurobiology. It discusses assessment measures, the impact of divorce and the forensic/legal environment on clinical practice, recommendations for HIPAA compliance, evidence-based best practices for treating children, and the requirements for an integrated treatment approach. Woven throughout are indications for case conceptualization including consideration of a child's complete environment. This book provides an integrative approach to child psychotherapy from the perspective of healthy development through the lens of EMDR.

Keywords: Children  

Accuracy Verified: Yes


6. Jeffres, M. J. (2003). The efficacy of EMDR with traumatized children. Fielding Graduate Institute, Santa Barbara, CA. AAT 3100543.

Language: English

Format: Dissertation/Thesis

Abstract:
This study evaluated the effectiveness of up to five 60-minute sessions of eye movement desensitization and reprocessing (EMDR) for children (ages 8-12) who had suffered one or more traumas. Participants (N = 48) were randomly assigned to either an EMDR experimental group or a waiting list control. They were provided treatment by one of five therapists, all of whom were experienced, independent clinicians having received Level 2 training in the EMDR technique. The therapists followed Shapiro's protocol for children and were in 90% compliance with the protocol. The participants were carefully screened according to Shapiro criteria. This study was unique in that it included an integrated outcome measure (UCLA PTSD Index), consisting of an assessment of PTSD criteria and a rating of symptoms, reported by both parent and child. Analysis of pre-post changes consisted of two 2 x 3 ANCOVAs, one each for the child and adult report. The analysis of covariance revealed a main effect for the covariate (the pretest total PTSD Score), a main effect for group, and a significant group x time interaction effect, for both the child and adult report. Post hoc (Scheffe) analysis revealed that participants maintained the benefits of treatment at 1-month follow-up. [Author Abstract] Dissertation Abstracts International: Section B: The Sciences and Engineering. 64(8-B), 2004, pp. 4042.

Keywords: Emotional Trauma  Empirical Study  Eye Movements  Quantitative Study  

Accuracy Verified: Yes


7. Greenwald, R. (2002). EMDR and trauma-focused treatment for conduct problems. In J. Morris-Smith (Ed.), EMDR: Clinical applications with children, Occasional paper No. 19 (pp. 15-21) London: The Association for Child Psychology and Psychiatry.

Language: English

Format: Book Section

Abstract:
Trauma is proposed as a key to understanding the development and persistence of conduct problems, in conjunction with other contributing factors. Preliminary research on child/adolescent trauma treatment indicates that such treatment can successfully reduce post-traumatic symptoms as well as conduct problem symptoms. Eye movement desensitization and reprocessing (EMDR) has shown particular promise. However, it can be difficult to secure treatment compliance for trauma-focused work with this challenging population. A more comprehensive treatment approach is suggested which addresses trauma-related issues of motivation, safety, and self-efficacy as a foundation form which to introduce EMDR. Reductions in post-traumatic stress, related symptoms, and problem behaviours along with improved school performance, indicate the value of further study of this type of treatment approach.

Keywords: Children  Conduct Disorders  Occasional Paper  

Accuracy Verified: Yes


8. Balbo, M. (2003, May). EMDR and treatment of binge eating disorders. Symposium conducted at the annual meeting of the EMDR Europe Association, Rome, Italy.

Language: English

Format: Conference

Abstract:
The study shows use of EMDR therapeutic method in treatment of eating disorders with binge eating episodes with and without purging with clients treated with cognitive-behavioral psychotherapy. Dissatisfaction with the client’s own body and inadequacy stemming from the influence of cultural elements seem to be the highest maintenance factors of eating disorders associated with binge eating episodes. The study analyzes n.10 cases of clients with various dysfunctional ideas caused by distorted constructions with respect to their self-esteem, self-acceptance and personal value, as shown both in their EDI 2 (Eating Disorder Inventory – 2 by David M. Garner) scores and the analysis of their life histories. The SQ (Symptom Questionnaire by R. Keller) was also administered since it is particularly indicated for administration at short intervals. The EDI 2 and SQ tests have been administered after n.6 EMDR sessions. Results: Use of EMDR on the negative cognitions formulated, learnt and maintained by clients in their experience, as well as on alternatives to binge eating, has produced a considerable reduction of their dysfunctional ideas, and binge eating behaviors showing additionally an increase of the drive to change, leading to an increased compliance and autonomy in therapy progress. The results obtained shall be presented and discussed.

Keywords: Binge Eating  Eating Disorders  Symposium  

Accuracy Verified: Yes


9. Buckbee, R. (2012, October). EMDR to enhance the acceptance and treatment compliance of type 1 diabetes. Poster presented at the annual meeting of the EMDR International Association, Arlington, VA.

Language: English

Format: Conference

Keywords: Type 1 Diabetes  

Accuracy Verified: Yes


10. Gomory, T. (2001, January ). A fallibilistic response to Thyer’s theory of theory-free empirical research in social work practice. Journal of Social Work Education, 37(1), 26-50.

Language: English

Format: Journal

Abstract:
The author responses to the professor B.A. Thyer's theory of theory-free empirical research in social work practice. Thyer provides a number of examples in the present article, several apparently by his doctoral students. It is not quite clear what he means when he offers them in the spirit of these contemporary qualitative times as anecdotal examples of this distortion of the research process, except to suggest that these case examples are just personal reflections and are not therefore to be taken seriously. That would be most unempirical and to no point. It seems at least to this reviewer that a set of theoretical conjectures formalized in a treatment package was being tested, perhaps something to the effect that the provision of education about the consequence of compliance or noncompliance together with case management support and reminders will significantly improve maternal compliance. Thyer apparently doesn't recognize this as theory testing or using theory, but he would need to spell out specifically why, for example, case management is a theory-free intervention.[Author's abstract]

Keywords: Theory-Free Empirical Research  Thyer  

Accuracy Verified: Yes


11. Shapiro, E. (2009). Four elements exercise for stress management. In M. Luber (Ed.), Eye movement desensitization and reprocessing (EMDR) scripted protocols: Basics and special situations, (pp. 73-79). New York: Springer Publishing Co.

Language: English

Format: Book Section

Abstract:
The rationale behind the creation of "The Four Elements Exercise for Stress Management" is to address the cumulative effect of external and internal triggers that occur over the course of the day. Since we know that people cope better with stress when they stay within their arousal "window of tolerance," ways to lower stress—especially when under stress—are essential. The heart of the exercise consists of four, brief, self-calming and self-control activities. The sequence of the four elements—Earth-Air-Water-Fire—is designed to follow the body up from the feet to the stomach and chest, to the throat and mouth, and up through the head. It begins with the ground to signify safety in the present reality and moves up to the imagination of recalled safety. By checking in with stress levels at random times throughout the day and also when stressful events are occurring, the exercise can aid in preventing the accumulation of stress and enables clients to stay within their window of tolerance. The modest goal is to reduce the stress level by 1 or 2 units each time the exercise is performed. The original conceptualization of the Four Elements Exercise was that the first three elements could be a preparation for the Safe Place (or other resource exercise such as the Resource Connection), especially when there is an ongoing emergency situation or when it is difficult to find a Safe Place. Often, the fourth element is introduced at the following meeting, as the first three elements are enough to remember and practice in the beginning for clients. Working on the Safe Place separately during the following session gives it more space and impact. It is advisable to follow up on how the client practiced the four elements at the beginning of the next session and to ask them to show you how they do it. If necessary, demonstrate it again at the beginning of the first few sessions. This is a way of checking for compliance and readiness for EMDR as well as present level of stress and sense of safety with you in the room. [PsycINFO Database]

Keywords: Four Elements Exercise  Protocol  Stress Management  

Accuracy Verified: Yes


12. Engel, L. (1998). Imaginary crimes: Resolving survivor guilt and writer's block. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, 1st ed. (pp. 138-163). New York: W. W. Norton.

Language: English

Format: Book Section

Abstract:
A 45-year old female professor of creative writing complained of depression, obsessing about an ex-boyfriend, and a writing block. She is in ongoing but episodic treatment within the framework of a psychodymanic model, specifically Control Mastery Theory, utilizing EMDR as an exploratory tool and treatment method. Issues of survivor guilt toward her murdered sister, identification with her anxious, unhappy mother, and compliance with her critical and rejecting father were addressed and at least partially worked through in the first 11 sessions (reported here). Her depression has lifted, she has been able to write freely for the first time in ten years, and has stopped obsessing about her ex-boyfriend. The therapist was able to combine CMT and EMDR to create a rapid but deep exploration and amelioration of the client's major, longstanding life problems. [Text, p. 162]

Keywords: Adults  Americans  Case Report  Cognitive Therapy  Depressive Disorders  Females  Guilt  Life Experiences  Psychotherapeutic Processes  Survivors  

Accuracy Verified: Yes


13. Bruno, T. (2006, Maggio). Le emozioni dei terapeuti nel lavoro con persone vittime di traumi interpersonali [The emotions of therapists working with victims of interpersonal trauma]. Presentazione alla Conferenza Nazionale, Associazione per l'EMDR in Italia, Firenza, Italia.

Language: Italian

Format: Conference

Abstract:
Quando ascoltiamo storie di devastazione, terrore, impotenza e di tradimento della fiducia, come naturale conseguenza, le nostre sicurezze più profonde possono essere messe in crisi. Applicando l’EMDR, a volte, possiamo essere messi di fronte alla “realtà del trauma” inaspettatamente, senza parole: il/la paziente “torna là” rivive l’esperienza col corpo e noi assistiamo e “viviamo il suo trauma”. Le emozioni (paura, schifo, terrore, rabbia, senso di paralisi ecc.) possono irrompere nello spazio sicuro della stanza di terapia e sfidare il nostro senso di “invulnerabilità” e prevedibilità. Rispetto all’impatto del materiale traumatico sul terapeuta quando si trova come testimone di eventi terribili e delle loro conseguenze ci possono essere risposte quali senso di paralisi, paura, desideri sadici e di vendetta, fino a “violazioni del setting”. Nel lavoro sul trauma possiamo agire in un continuum che va da risposte di evitamento con sentimenti di rifiuto e rabbia verso risposte di iper identificazione con la vittima. Esiste un rapporto circolare fra aspetti controtransferali e traumatizzazione secondaria negli operatori. Possono emergere problemi esistenziali e spirituali, sentimenti aggressivi e di giudizio, orrore, rabbia, senso di vulnerabilità, dolore-pena e sintomi classici del Disturbo da Stress Post Traumatico. La conoscenza, la consapevolezza e la gestione di questo processo all’interno della relazione terapeutica è fondante rispetto alla riparazione del danno nelle vittime e alla salute mentale dei terapeuti. Nel corso della presentazione ci sarà una focalizzazione sugli aspetti del ciclo del controtranfert e della traumatizzazione secondaria nel terapeuta e si forniranno elementi di protezione per i terapeuti.

When we hear stories of devastation, terror, helplessness and betrayal of trust, as a natural result, our securities may be made deeper into crisis. Applying EMDR, sometimes, we may be confronted with the "reality of trauma" unexpectedly, without words, it/the patient "back there" relive the experience with the body and we are seeing and "live her trauma." Emotions (fear, disgust, fear, anger, sense of paralysis, etc.) can break into the safe space of the therapy room and challenge our sense of "invulnerability" and predictability. Compared to the impact of traumatic material when the therapist is as a witness to terrible events and their consequences there may be responses such as sense of paralysis, fear, desires and sadistic revenge, to "violations of the setting." In work on trauma, we can act on a continuum ranging from avoidance responses with feelings of rejection and anger responses of hyper identification with the victim. There is a circular relationship between trauma and countertransference issues in the secondary players. Existential and spiritual problems can arise, aggressive feelings and judgments, horror, anger, sense of vulnerability, pain and pain-classic symptoms of Post Traumatic Stress Disorder. Knowledge, awareness and management of this process within the relationship Therapeutic compliance is fundamental to repairing the damage in the victims and mental health therapists. During the presentation there will be a focus on aspects of the cycle controtranfert and secondary traumatization in the therapist and will give protection elements for therapists.

Keywords: Interpersonal Trauma  

Accuracy Verified: Yes


14. Neunuebel, C. L. (2010, July). Making EMDR user friendly for Asians. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
Making EMDR User Friendly For Asians: 1. Training Asians in EMDR • Issues of confidentiality • Fears of being judged by colleagues • School systems in Asia being shame based • Shame in speaking about personal issues • Poor knowledge of own emotions • Issues of fate and karma • Need for Asian facilitators to be assertive with authority figures • Hesitancy of Asian trainees to ask questions • Western facilitators receive more compliance but need for Asian facilitators • Need for translated material to be in colloquial language • Need for Asian vignettes. 2. Practicing EMDR by Asian practitioners and for Asian clients: • Problems with extremes – SUD’s and VOC, • Clients struggle with emphasis on individual not family, • Loss of face for practitioner to use manual, • Most Asian clients have poor imaginative or visualization skills, • Physical sensations are more available than emotions, • Lack of anger at abusive family members and authority figures, • Issues of ghosts and superstitions. 3. Supervision of Asian EMD, • Provide supervisees of own mistakes, • Providing supervision in countries where there are no consultants or facilitators, • Can provide Western supervisors-but best might be co-leading supervision with a local practitioner. My material for this presentation has been developed over 13 years of using EMDR with Asian clients and from 10 years of providing facilitation and supervision for EMDR trainees. Also my many years in Asia, speaking the languages and having been partly raised by Chinese nannies, have given me an understanding of Asian values, family organization and taboos. I would like this workshop to provide a springboard for discussions with the attendees in collecting other ides for making EMDR Asian friendly.

Keywords: Asians  Practice  Theory  

Accuracy Verified: Yes


15. ten Broeke, E., Korrelboom, K., & de Jongh, A. (1998, December). Over de noodzaak van herhaalde en langdurige blootstelling aan traumatische herinneringen bij de behandeling van posttraumatische stress stoornis (PTSS)? [Is prolonged exposure to traumatic memories necessary in PTSD?]. Gedragstherapie, 31(4), 273-290.

Language: Dutch

Format: Magazine

Abstract:
Langdurige blootstelling aan traumatische herinneringen wordt door velen beschouwd als een noodzakelijk element in de behandeling van posttramatic stress-stoornis (PTSS). Deze bewering wordt ondersteund door de doeltreffendheid van de directe therapeutische blootstelling (DTE), zoals blijkt uit gecontroleerde studies. Omgekeerd is er aanwijzingen dat andere behandelmethoden die geen gebruik maken van langdurige blootstelling wijzen verschijnt even effectief. Bovendien is de effectiviteit van de DTE bemoeilijkt door zowel psychiatrische complicaties en de beperkte compliance van de patiënt als gevolg van problemen met de blootstelling huiswerkopdrachten. In deze paper wordt geconcludeerd dat de DTE is een levensvatbare behandeling voor PTSS, maar het is twijfelachtig of DTE moet worden beschouwd als de 'voorkeursbehandeling' voor PTSS. Steekwoorden: langdurige blootstelling, PTSS, te herzien.

Prolonged exposure to traumatic memories is considered by many as a necessary element in the treatment of posttramatic stress disorder (PTSD). This claim is supported by the effectiveness of direct therapeutic exposure (DTE), as is evident from controlled outcome studies. Conversely, there is evidence to suggest that other treatment approaches that do not use prolonged exposure appear equally effective. Furthermore, the effectiveness of DTE is complicated by both psychiatric complications and limited patient compliance as a result of difficulties with exposure homework assignments. In this paper, it is concluded that DTE is a viable treatment for PTSD, but it is questionable whether DTE should be considered the 'treatment of choice' for PTSD. Key words: prolonged exposure, PTSD, review.

Keywords: Cognitive Therapy  Episodic Memory  Implosive Therapy  Posttraumatic Stress Disorder  PTSD  Prolonged Exposure  Review  Treatment  

Accuracy Verified: Yes


16. Giovannozzi, G. (2012, June). Regulated eye contact activation and installation protocol [Regulación de la activación del contacto ocular y protocolo de instalación]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Porges’ polyvagal theory provides a plausible explanation for the covariation between psychiatric and behavioral disorders and the atypical regulation of the Autonomic Nervous System (ANS). Porges himself associated this phenomenon with the failed maturation of the ventrovagal circuit, as well as with the child’s failure to learn the ability to modulate the so-­‐called “vagal break” which keeps the heart-­‐rate low and inhibits the influence of the SNS, allowing the modulation of the facial and head muscles and, therefore, the social engagement function, often impaired in psychiatric pathologies. From a psychotherapy standpoint, Porges’ finding that the maturation of the ventrovagal circuit and of its associated braking function occurs ontogenetically later than that of other ANS branches (last months of pregnancy and first year of life) and that a good relation with the caregiver is essential for its development is of significant importance. In this dyad – with the cortical-­‐bulbar pathway, sufficiently myelinated at birth, regulating face and head muscles and allowing signals exchange with the caregiver – children learn to confront their internal states and the environment as well as regulate their emotions, regulating an adaptive neuroception with the consequent possibility of a good social involvement. This focus on the first year of life and the caregiver – child dyad, in terms of time and place for the construction of biologically based behaviors common to all human beings, paves the way, as anticipated by Porges himself, for new possible intervention models in psychotherapy directly acting on the missed or impaired steps in this first phase of the psycho-­‐physiological development process, without disregarding its psychobiological quality. Clinical Application Since I believe that the inter-­‐brain perspective is the most efficient not only for the etiological explanation but especially for the restoration of relational impairments occurred during brain-­‐brain interactions, I chose eye contact (EC), because, according to several scholars, it is a privileged communication channel, in particular between mother and child. Several scholars agree that all forms of psychopathology share a failure in emotional regulation, which can be mostly traced back to the failure in the child-­‐ caregiver adaptive tuning and therefore to the impairment of their inter-­‐brain communication. An intervention on the EC shifts the therapy focus on this dysregulation to restore its functions. The EMDR AIP approach relies on the brain adaptive processing ability. EMDR has proved, in appropriate conditions (good therapeutic alliance, client stabilization, compliance with the EMDR protocol), our brain can repair traumatic injuries, i.e., reacquire and use information dysfunctionally stored after a trauma. Successful use of EMDR on target not directly traceable to a traumatic event (e.g., defenses, chronic pain, etc.) allows for the possibility to use this processing tool in increasingly broad fields and refines its resources. Thanks to its three-­‐pronged approach to dysfunctionally stored information in the brain (EMDR works on the cognitive, emotional and somatic level), the inter-­‐brain quality of its scope (the therapeutic alliance is part of the healing process) and for its focus on the present (EMDR works on the present, i.e., on the current and active components of the pathogenetic memory, bypassing all mediations and interpretation), EMDR seemed the most appropriate therapeutic tool to intervene on the EC dysregulation found in several psychiatric pathologies. Conclusion An EMDR protocol for the exploration and modulation of the EC is proposed. This protocol proved particularly useful with depressed or severely dissociative clients. After making clients aware of their difficulty in maintaining the EC, they are retrained to use this contact first on objects, then on animals (excellent mediators of a primitive form of social contact) until they are able to achieve eye contact with the therapist. During this training, clients are encouraged to become aware of their body sensations, emotions and beliefs, and the positive ones are installed with BLS. Memories of relational situations where clients identify an impaired EC are identified and these are targeted with the standard protocol. The focus then shifts to present and future situations. The regulation purpose of this protocol affects the application mode: interventions must never be dysregulating, therapists must proceed slowly. Clients must be rigorously kept within their window of tolerance, must be trained to recognize it and able of staying within its boundaries with respect to the microregulation of the EC.

La teoría polivagal de Porges proporciona una explicación plausible para la covariación entre los trastornos psiquiátricos comportamentales y la regulación atípica del sistema nervioso autónomo (ANS). El propio Porgues asoció este fenómeno con el fallo de maduración del circuito ventrovagal, por tanto el niño falla al aprender una habilidad también llamada “bloqueo vagal”, que mantiene la tasa cardiaca baja e inhibe la influencia del SNS, permitiendo la modulación de los músculos faciales y la cabeza, y por tanto, la función optima del compromiso social, a menudo emparejada con patologías psiquíatricas. Partiendo desde un punto de vista psicoterapéutico, Porges encontró que la maduración del circuito ventrovagal y su asociación con la función de frenado ocurre ontogenéticamente después que otras ramas del sistema nervioso autónomo (Los últimos meses del embarazo y los primeros años de vida) y que una buena relación con el cuidador es esencial para su desarrollo es significativamente importante. En esta línea – con vía córtico-­‐bulbar, lo suficientemente mielinizada en el nacimiento, regulando los músculos de la cara y la cabeza y permitiendo señales de intercambio con el cuidador-­‐ Los niños aprenden a estar cómodos con sus estados internos y con un ambiente que también regula sus emociones, regular una neurorecepción con la consecuente posibilidad de una buena integración social. Centrándonos en el primer año de vida del niño y el cuidador – La pareja de niños, en términos de tiempo y lugar para la construcción biológica fundamentada y basada en todos los seres humanos, allana el camino, como anticipó Porges, para nuevos modelos de intervención en psicoterapia, actuando directamente con el paso perdido o afectado de esta primera fase del proceso de desarrollo psicofisiológico, sin tener en cuenta su calidad psicobiológica. Aplicación Clínica. Desde que creó que la perspectiva del cerebro interior, continúa siendo la más eficiente no solo para desarrollar explicaciones etiológicas, también para la restauración de los desajustes relacionados ocurridos durante las interacciones cerebro-­‐cerebro. Escogí contacto visual (ECE), porque, de acuerdo con numerosos investigadores, es un privilegiado canal de comunicación, particularmente eficaz entre una madre y su hijo. Numerosos profesionales afirman que todas las formas de psicopatología comparten una fallo en la regulación emocional, que solo puede crear un error en el la comunicación interna del cerebro. Esta intervención en el EC modifica la terapia y la centra en la desregulación y la restauración de funciones. El enfoque EMDR SPIA está basado en la habilidad de procesamiento de la información relevante, EMDR ha sido probado en condiciones idóneas (buena alianza terapéutica, estabilización de la queja del cliente disgustado con el EMDR.).

Keywords: Installation Protocol  Regulated Eye Contact Activation  

Accuracy Verified: Yes


17. Holmshaw, M., Hodder, K. I., & Carswell, J. W. (2009, April). The relative efficacy of trauma-focused cognitive behavioural therapy and EMDR in treating psychological trauma resulting from road traffic accidents. Presentation at the annual British Psychological Society Conference, Brighton, UK.

Language: English

Format: Conference

Abstract:
Objectives: Following road traffic accidents (RTAs) psychological problems are common and can cause long-term disability. Whilst both trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR) have proved successful in treating such problems there is currently no clear evidence supporting one treatment over the other. Previous comparisons of these treatments have been based on small samples. The present research aimed to explore the relative efficacy of CBT and EMDR in treating psychological trauma resulting from RTAs in a large sample. Design: Patients who had previously been involved in an RTA were referred to a psychological rehabilitation provider and received treatment with either CBT or EMDR by accredited therapists. The treatments were compared on drop-out rate number of sessions required for completion of treatment therapist rating of success and a number of widely used psychometric measures which were administered at assessment and again at the end of treatment. Methods: A total of 1179 referrals were made of which 435 met the inclusion criteria and proceeded to treatment. These patients presented with a range of psychological trauma symptoms resulting from RTAs which had occurred an average of 21 months previously. Posttraumatic stress disorder (PTSD) was diagnosed in 51 per cent of patients with the remaining patients presenting with travel anxiety depression general anxiety and other psychological conditions. Outcomes were assessed in the whole sample and separately for those with a diagnosis of PTSD. Results: No differences emerged between the treatments on any outcome measure both for patients diagnosed with PTSD and for those with other trauma-related symptoms. Both CBT and EMDR resulted in large improvements in self-rated symptoms as assessed using the psychometric measures and in both groups over 80 per cent of cases were rated by the therapist as successful or having made good progress by the end of treatment. The CBT group required an average of 9.1 sessions and the EMDR group required an average of 9.9 sessions. Reliable change indices showed that over 80 per cent of patients made clinically significant improvements in both treatment groups. Conclusions: In conclusion both CBT and EMDR proved to be effective treatments for psychological trauma resulting from RTAs but no differences emerged between them in terms of efficacy patient compliance and number of sessions required. Psychological trauma following RTAs is eminently treatable in the community when treatment is offered by trained CBT or EMDR therapists.

Keywords: CBT  Cognitive Behavior Therapy  Road Traffic Accidents  

Accuracy Verified: Yes


18. Shapiro, F. (1993, Winter). Stray thoughts:  Issues of compliance in EMDR. EMDR Network Newsletter, 3(3), 1-2.

Language: English

Format: Newsletter

Abstract:
Too often the limitations of the therapist's model, repertoire of interventions, or ability to interact with the client are dismissed as due to client "resistance." While client resistance and non-compliance may certainly be issues that need to be overcome, the interaction between the client and the clinician should not be discounted as possibly contributing to the lack of the therapeutic effect.

Keywords: Compliance  Resistance  

Accuracy Verified: Yes


19. Mendes, D. D., Mello, M. F., Ventura, P., Passarela, Cde. M., Mari, J. de J. (2008). A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder. International Journal of Psychiatry Medicine, 38(3), 241-259. doi:10.2190/PM.38.3.b.

Language: English

Format: Journal

Abstract:
Objective: Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy were unable to detect differences between CBT and other psychotherapies. The purpose of this study was to conduct systematic review on the efficacy of CBT in comparison with studies that used other psychotherapy techniques. Method: Databases were searched using the following terms: posttraumatic stress disorder/stress disorder, treatment/psychotherapy/behavior cognitive therapy, randomized trials, and adults. Randomized clinical trials published between 1980 and 2005 and that compared CBT with other treatments for PTSD was included. The main outcomes were remission, clinical improvement, dropout rates and changes in symptoms. Results: The 23 clinical trials included in the review comprised 1,923 patients: 898 in the treatment group and 1,025 in the control group. CBT had better remission rates than EMDR (RR = 0.35; 95%CI: 0.16; 0.79; p = 0.01) or supportive therapies (RR = 0.43; 95%CI: 0.25; 0.74; p = 0.002, completer analysis). CBT was comparable to Exposure Therapy (ET) (RR = 0.90; 95%CI: 0.58; 1.40; p = 0.64), and cognitive therapy (CT) (RR = 1.01; 95%CI: 0.67; 1.51; p = 0.98) in terms of efficacy and compliance. Conclusions: These findings suggest that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.

Keywords: CBT  Cognitive Behavioral Therapy  Comparative Study  Posttraumatic Stress Disorder  PTSD  Systematic Review  

Accuracy Verified: Yes


20. Wright, S. A., & Russell, M. C. (2013, April). Treating violent impulses: A case study utilizing eye movement desensitization and reprocessing with a military client. Clinical Case Studies, 12(2), 128-144, doi:10.1177/1534650112469461.

Language: English

Format: Journal

Abstract:
The growing attention to acts of interpersonal violence and misconduct among military members has accompanied a host of research investigating the nature and causes associated with these behaviors. As such, a robust body of literature exists lending insight into risk factors and clinical presentations associated with anger and aggression; however, such factors are multidimensional and complex, particularly for those suffering with war stress injuries. Furthermore, mental health stigma and treatment compliance with exposure and cognitive-based models, particularly in clients with aggressive presentations, can impact successful outcomes. One active-duty marine was referred to an outpatient mental health clinic for the treatment of posttraumatic stress disorder (PTSD). Four sessions of eye movement desensitization and reprocessing (EMDR) were used to significantly reduce obsessive violent impulses, traumatic grief, and depression. The benefit of EMDR therapy as a treatment for violent impulses is explored. The results are promising, but more research is needed.

Keywords: Military  Misconduct  Violence  

Accuracy Verified: Yes


21. Carbone, D. J. (2008). Treatment of gay men for post-traumatic stress disorder resulting from social ostracism and ridicule: Cognitive behavior therapy and eye movement desensitization and reprocessing approaches. Archives of Sexual Behavior, 37(2), 305-316. doi:10.1007/s10508-007-9239-3.

Language: English

Format: Journal

Abstract:
This report describes the clinical treatment of a sample of 4 gay men suffering from PTSD attributed to their repeated experiences with peer ridicule and ostracism throughout childhood and adolescence, caused by their gender variant appearance and behavior. All of the men in the sample shared the following features: (1) a childhood history of ridicule and ostracism from both peers and adults focused on their gender variant presentation designed to elicit gender norm compliance; (2) a lack of social support networks to assist them in coping with the stress; (3) self-destructive coping responses that began in childhood and continued into adulthood in an attempt to lessen the experience of shame; and (4) symptoms of PTSD. A treatment model utilizing cognitive-behavioral therapy and eye movement desensitization and reprocessing was discussed. [Author Abstract]

Keywords: Adults  Americans  Case Report  CBT  Cognitive Behavior Therapy  Cognitive Therapy  Gay Men  Homosexuals  Males  Persecution  Posttraumatic Stress Disorder  Psychotherapeutic Processes  PTSD  Survivors  

Accuracy Verified: Yes