Francine Shapiro Library - EMDR Bibliography Links
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1. Fisher, J. A. (2000, November). Adapting EMDR techniques in the treatment of dysregulated or dissociative patients. Presentation at the International Society for the Study of Dissociation Annual Meeting, San Antonio, Texas.
Language: English
Format: Conference
Abstract:
Since its inception, EMDR [Eye Movement Desensitization and Reprocessing]
has been understood by both clinicians and patients as a powerful vehicle for processing
traumatic experience but one to be undertaken only when the patient has achieved some
degree of stabilization (Shapiro, 1992). In DID and DDNOS patients, that baseline
stability is also supposed to include a level of internal communication and consensus that
would permit cooperation between parts of self about how to tolerate the memory
processing and how to re-stabilize afterward. However, as any clinician who works with
this population knows, some dissociative disorder patients never achieve that degree of
internal coherence, and some have a long, rocky, tumultuous, exhausting road to travel
before they get there. Faced with the DID or DDNOS patient who cannot tolerate affect
or associations to traumatic memories; who cannot control switching, get grounded, or
resolve internal struggles over power and control; who is unable to manage selfdestructive
impulses; who cannot differentiate past and present experience; who is even
unable to tolerate Resource Development (Korn & Leeds, 2002) or create a Safe Place
insideis there any way that EMDR can be helpful?
Keywords: Dissociation Dysregulation
Accuracy Verified: Yes
2. Sinici, F., Erden, H. G., & Yurttas, Y. (2009, October). Akut stres bozuklu¤unda bir müdahale tekni¤inin uygulanabilirli¤i: Göz hareketleri ile duyarszlafltrma ve yeniden flleme (EMDR) [Applicability of an intervention technique in acute stress disorder: Eye movement desensitization and reprocessing (EMDR)]. Yeni Symposium Journal, 47(4), 178-186.
Language: Turkish
Format: Journal
Abstract:
Akut stres bozukluğu, Türkiye'de giderek artan ve kişinin hayat kalitesini oldukça bozabilen bir sorundur. Bu konuyla ilgili olarak yapılan çalışmalarda hangi tedavi şeklinin daha yararlı olduğu konusunda kesin bir karara varılamamıştır. Göz Hareketleri ile Duyarsızlaştırma ve Yeniden İşleme [Eye Movement Desensitization and Reprocessing: EMDR] tekniği, travmatik anıların birkaç uygulama oturumunda çözümlenebileceğini ifâde eden bir yaklaşımdır. EMDR oturumlarında hastadan yaşadığı bir travma sahnesi hayâl etmesini, olumsuz benlik imajı, travma ile ilgili olumsuz duyguları ve beden duyumlarını aklında tutması istenmektedir. Hastaya çift taraflı uyarı verilmektedir [gözün sağa sola hareketi, sağ ve sol kulağa verilen ses veya sağ ve sol ele verilen titreşim vb.]. Daha sonra danışana ortaya çıkan görüntü, duygu ve fiziksel duyumları anlatmaktadır. Bu tekrarlanan işlemler hastadaki olumsuz düşünce ve duygular duyarsızlaşıncaya kadar devam etmektedir. Olumsuz duygu ve düşüncelerin yerini olumlu duygu ve düşünceler almaktadır. Bu çalışmanın amacı hastaların hayat kalitelerini bozan ve travma sonrasındaki ilk 4 hafta içinde aşırı korku, çaresizlik veya duygusal tepkisizlikle beraber, diğer belirtilerin de görülebildiği akut stres bozukluğunun tedavisinde yeni bir yöntem olan ve 2 yıldır aktif olarak uyguladığımız göz hareketleri ile duyarsızlaştırma ve yeniden işleme [EMDR] tekniği konusunda yazılmış literatür bilgilerini gözden geçirerek bu konuda son yaklaşımların ortaya konulmasını sağlamaktır. Bununla birlikte EMDR tekniğinin yaygınlaştırılarak faâl olarak kullanılması hem hastalar hem de uygulayıcılar açısından büyük yararlar sağlayacağı düşünülmektedir.
Acute stress disorder is a syndrome that significantly disturbs the quality of life and has been increasingly observed in Turkey. Although there are many studies on this subject, there is no consensus about the best treatment choice. Eye Movements Desensitization and Reprocessing [EMDR] technique is a novel approach that helps to resolve traumatic memories in a few sessions. In EMDR sessions, patients are asked to think about the trauma scene that has occurred and keep the negative self image and negative feelings about the trauma and bodily feelings in mind. Bilateral stimulation is presented to the patient [right and left movement of the eye, sound to right and left ear and vibration to right and left hand etc]. Later arising images express the feelings and physical sensations. This procedure is repeated until desensitization to negative thought and feelings are achieved. Negative thought and feelings are replaced by positive thought and feelings. Purpose of this study is to review the studies in literature and describe the up-to-date approaches about EMDR technique which is a novel method in treatment of acute stress disorder that disturbs patient quality of life and presents with excessive fear, desperation, emotional desensitization and other symptoms within 4 weeks following the trauma and we have been using this treatment method frequently for more then 2 years. Nevertheless widespread and effective use of EMDR will provide considerable benefit for both patients and the performers.
Keywords: Acute Stress Disorder ASD: Behavior Therapy Emotional Disorder Eye Movement Fear Human Memory Disorder Psychologic Assessment Quality of Life Review Stimulation
Accuracy Verified: Yes
3. Phillips, M. (2008). Combining hypnosis with EMDR and ego state therapy for ego strengthening. In C. Forgash and M. Copeley, (Eds.) Healing the heart of trauma and dissociation with EMDR and ego state therapy (pp. 91-120). New York, NY: Springer Publishing Co.
Language: English
Format: Book Section
Abstract:
This chapter will explore several uses of hypnosis and EMDR that can help to accomplish these objectives. Expert consensus is that trauma clients must move through an ordered process designed to strengthen and stabilize them before progressing to the uncovering, exploration, reworking, and integration of painful past experiences. The SARI model (Phillips 8c Frederick, 1995) is presented here as a framework for the recommended sequence of treatment. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Keywords: Ego State Therapy Ego Strenthening Hypnosis SARI Model
Accuracy Verified: Yes
4. Leeds, A. (2006, September). The consensus model. In criteria for assuring appropriate clinical use and avoiding misuse of resource development & installation when treating complex posttraumatic stress syndromes (A. Leeds). Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories. Resource Development and Installation (RDI) has been reported to be a potentially effective intervention for enhancing patient & stabilization. There are now several published descriptions and case reports of RDI including a summary in the standard reference text on EMDR. The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with posttraumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been offered RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for which patients and clinical situations the use of RDI is indicated; for which patients and clinical situations RDI should be offered cautiously, if at all, but alternate stabilization methods should be considered; and for which patients RDI should not be offered but where standard EMDR reprocessing should be offered without delay. An overview of RDI procedural steps will be presented to clarify its use. Strategies will be offered to address technical, clinical and countertransference issues that may be associated with misuse of RDI. Clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Complex PTSD Complex Posttraumatic Stress Disorder C-PSTD Consensus Model Resource Development & Installation RDI Treatment Criteria
Accuracy Verified: Yes
5. Leeds, A. (2006, September). Criteria for assuring appropriate clinical use and avoiding misuse of Resource Development & Installation when treating complex posttraumatic stress syndromes. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes
emphasizes assuring adequate stabilization before
and during uncovering and resolving of traumatic memories. Resource Development and Installation
(RDI) has been reported to be a potentially
effective intervention for enhancing patient & stabilization. There are now several published
descriptions and case reports of RDI including a
summary in the standard reference text on EMDR.
The growing use of RDI by EMDR trained
clinicians has been followed by reports indicating
that a significant number of patients with
posttraumatic stress syndromes who meet
standard EMDR readiness criteria for ego strength
and stability have been offered RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for which patients and clinical
situations the use of RDI is indicated; for which
patients and clinical situations RDI should be
offered cautiously, if at all, but alternate
stabilization methods should be considered; and
for which patients RDI should not be offered but
where standard EMDR reprocessing should be
offered without delay. An overview of RDI
procedural steps will be presented to clarify its
use. Strategies will be offered to address technical,
clinical and countertransference issues that may
be associated with misuse of RDI. Clinical
vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Consensus Model RDI Resource Development and Installation Treatment Criteria
Accuracy Verified: Yes
6. Leeds, A. M. (2007, June). Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories (Brown, Scheflin, & Hammond, 1998; Chu, 1998; Courtois, 1999; Hart, Nijenhius, Steele, 2006). Resource Development and Installation (RDI) has been described in a series of published case reports as an effective stabilizing intervention for adult survivors of adverse childhood experiences (Korn & Leeds, 2202; Leeds, 1997, 1998, 2001b; Leeds & Shapiro, 2000; Popky, 2005). These clinical case reports of RDI have been described observed decreases in intense shame, depersonalization, angry outbursts, self-injurious behaviors, compulsive eating, obsessive self-critical thoughts, persistent negative emotional states (misery), sexual acting out, and substance abuse. There are now several published procedural descriptions (Korn & Leeds, 2002; Leeds, 2001; Leeds & Shapiro, 2000) and a summary in the standard reference text on EMDR (Shapiro, 2001).
The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with post traumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been persistently offered RDI without being offered standard EMDR reprocessing. EMDR has been shown to produce stable, enduring treatment effects for symptoms of posttraumatic stress disorder. RDI has not. Until recently (Korn et al, 2004; Leeds, 2005, 2006; Shapiro, 2004) little attention has been given to assuring appropriate use and avoiding misuse of RDI. This presentation will describe serious clinical and professional issues in continuing to offer RDI over repeated treatment sessions to patients with posttraumatic stress syndromes who meet or achieve readiness criteria for standard EMDR reprocessing and in failing to offer or in excessively delaying EMDR reprocessing.
This presentation will clarify and review specific criteria for identifying: for which patients (1) and clinical situations (2) the use of RDI is indicated; for which patients and clinical situations (3) RDI should be offered cautiously, if at al, but alternate stabilization methods should be considered; and for which patients (4) RDI should not be offered but where standard EMDR processing should be offered without delay. An overview of RDI procedural steps will be presented (5) to clarify its clinical application. Strategies will be offered to address technical, clinical and countertransference issues that may b associated with misuse or excessive use of RDI. A series of ten clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD RDI Resource Development and Installation
Accuracy Verified: Yes
7. Leeds, A. (2010, July). Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate
stabilization before and during uncovering and resolving of traumatic memories. Resource Development and Installation
(RDI) has been reported to be a potentially effective intervention for enhancing patient stabilization. There are now several
published descriptions and case reports of RDI including a summary in the standard reference text on EMDR. The growing
use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with
posttraumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been offered
RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for
which patients (1) and clinical situations (3) the use of RDI is indicated; for which patients and clinical situations (4) RDI should
be offered cautiously, if at all, but alternate stabilization methods should be considered; and for which patients (2) RDI should
not be offered but where standard EMDR reprocessing should be offered without delay. An overview of RDI procedural steps
will be presented (5) to clarify its use. Strategies will be offered to address technical, clinical and countertransference issues
that may be associated with misuse of RDI. Clinical vignettes will be presented to illustrate appropriate clinical use, clinical
cautions and misuse of RDI.
Keywords: Posttraumatic Stress Disorder PTSD RDI Resource Development & Installation
Accuracy Verified: Yes
8. Errebo, N. (2010, July). A decade of EMDR humanitarian trainings in Asia. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
In 1999, EMDR Humanitarian Assistance Programs (HAP) began its work in Asia in Bangladesh. Since then HAP teams have
trained clinicians in India, Indonesia, China, Thailand, Sri Lanka. This presentation will summarize what has been learned
from ten years of experience in Asia. The EMDR HAP training in Sri Lanka following the 2004 tsunami will be presented in
detail. Issues addressed will include needs assessment, organization, collaboration among organizations, ethics, cultural
competence ,and program evaluation. Videotapes will show training and sessions of trainees with tsunami survivors. The
presentation will show how to train participants to think, write, and speak about EMDR as well as how to competently and
ethically utilize EMDR with clients.
An EMDR training program was conducted as a joint project of three organizations: EMDR Humanitarian Assistance Programs
(HAP), International Relief Teams (IRT), and the Sri Lankan National Counselors Association (SRILNAC). Between March and
December 2005, 30 Sri Lankan counselors were trained in EMDR. These counselors demonstrated competence in EMDR on
several measures, treated more than 1,000 children and more than 350 adult tsunami victims with EMDR in 2005, provided
narrative reports and outcome measures for most of their clients, and formed the Sri Lanka EMDR Association (SEA). The
crucial steps in establishing and implementing this training program are explained, with a summary of the subjective
impressions and learning experiences most valued by the training team, including an excerpt from a trainers journal. This
information may be useful to future cross-cultural humanitarian efforts following large-scale disasters.
This article summarizes the crucial steps in establishing and carrying out this training program as well. Previous HAP programs
in Bangladesh and Turkey (Konuk et al., 2006) had led to the development of a model of therapist training and service delivery
following large-scale natural disasters. Great need for mental health treatment in developing countries following a disaster
and the even greater challenge of delivering effective, culturally competent mental health treatment in these situations.
Silove and Bryant (2006) praised the rapid needs assessment after the tsunami as an important advancement in psychiatric
epidemiology that demonstrated the value of such assessment in guiding mental health interventions after disasters.They
pointed out that the controversy over whether to offer psychological treatment after disasters confuses funding agencies
and those planning mental health programs after disasters. Their concerns were echoed in Raphael and Stevenss (2006)
delineation of the emerging consensus about good mental health practice after disasters in an article that was not a part of
the Bangkok symposium. IRT directors, EMDR-HAP staff, and SRILNAC leaders discussed crucial political, ethical, economic,
and logistical decisions in conference calls and e-mails. They outlined a program that would be responsive to the culture and
needs of Sri Lanka, would provide world-class EMDR training and consultation, and would follow International Society for
Traumatic Stress Studies (ISTSS) guidelines for mental health programs in post disaster situations (Weine et al., 2002). Following
the funding mandate of IRT, the HAP team took responsibility for ensuring that services would in fact be delivered to tsunami
survivors and that those services would be clinically effective. Therefore, requirements for continuing participation were quite
specific, and trainees were more thoroughly evaluated than in previous HAP projects. These 30 counselors treated more than
1,350 tsunami survivors with EMDR between March and December 2005 and submitted outcome reports on these sessions
that show marked improvement in PTSD symptoms. We know from e-mail contact that a number of participants continue
to use EMDR effectively. As mentioned Important elements of the HAP training program in Sri Lanka included (a) adequate
funding, (b) selection of trainees, (c) negotiation of objectives among HAP,IRT, and SRILNAC, (d) the pre-EMDR training in
traumatology, (e) the consultation between trainings,(f ) the requirements for ongoing participation in the training, (g) a
variety of measures of competence in EMDR, (h) the continuing, ongoing consultation with trainees, and (i) dedication. A
project like this is expensive. IRT received.
Keywords: Asia HAP Humanitarian Assistance Programs Trainings
Accuracy Verified: Yes
9. van der Hart, O. (2011, March). Dissociation of the personality: The key to understanding chronic traumatisation and a guide to EMDR treatment. Preconference presentation at the 9th annual Conference of the EMDR UK & Ireland, Bristol.
Language: English
Format: Conference
Abstract:
There is currently consensus that the EMDR standard protocol needs to be modified
for chronically traumatized clients, such as clients with complex dissociative disorders, as it may
destabilize them. Therefore, therapists need to have a good understanding of the dissociative
personality structure that exists in these clients. Dissociation is an undue division of the personality
among two or more biopsychosocial systems or dissociative parts that comprise the survivors
personality. One or more of them function in daily life; others are fixated in traumatic experiences,
are living in trauma-time. The more severe the traumatisation, the more dissociative parts,
involving more complex trauma-related disorders, can be expected to exist. Dissociative parts have
psychobiological boundaries that are maintained, to a large degree, by different trauma-related
phobias, which are systematically resolved in phase-oriented treatment. Indeed, participants will
be able to describe structural dissociation of the personality as a specific form of integrative failure
that needs to be overcome in phase-oriented treatment, identify ways of relating dissociative
symptoms to the underlying dissociation of the personality, and identify targets such as the
dissociation-maintaining phobias, for EMDR interventions in the respective treatment phases. The
emphasis will be on the preparatory work, including how to work with dissociative parts living in
trauma-time and those perceived as being malevolent, necessary before focusing on the integration
of traumatic memories.
Keywords: Dissocation
Accuracy Verified: Yes
10. Korn, D. L. (2009). EMDR and the treatment of complex PTSD: A review. Journal of EMDR Practice and Research, 3(4), 264-278. doi:10.1891/1933-3196.3.4.264.
Language: English
Format: Journal
Abstract:
The diagnosis of posttraumatic stress disorder (PTSD) covers a wide range of conditions, ranging from patients
suffering from a one-time traumatic accident to those who have been exposed to chronic traumatization
and repeated assaults beginning at an early age. While EMDR and other trauma treatments have been
proven efficacious in the treatment of simpler cases of PTSD, the effectiveness of treatments for more
complex cases has been less widely studied. This article examines the body of literature on the treatment
of complex PTSD and chronically traumatized populations, with a focus on EMDR treatment and research.
Despite a still limited number of randomized controlled studies of any treatment for complex PTSD,
trauma treatment experts have come to a general consensus that work with survivors of childhood abuse
and other forms of chronic traumatization should be phase-oriented, multimodal, and titrated. A phaseoriented
EMDR model for working with these patients is presented, highlighting the role of resource development
and installation (RDI) and other strategies that address the needs of patients with compromised
affect tolerance and self-regulation. EMDR treatment goals, procedures, and adaptations for each of the
various treatment phases (stabilization, trauma processing, reconnection/development of self-identity) are
reviewed. Finally, reflections on the strengths and unique advantages of EMDR in treating complex PTSD
are offered along with suggestions for future investigations.
Keywords: Childhood Trauma Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD DESNOS Psychotherapy Research Review
Accuracy Verified: Yes
11. Peterson, G., Smyth, N., Greenwald, R., de Jongh, A., & Lee, C. (2000, October). EMDR for treatment of PTSD. Journal of Clinical Psychiatry, 61(10), 784-785.
Language: English
Format: Journal
Abstract:
Letters question the lack of representation of qualified EMDR clinicians in the Expert Consensus Guideline Series: Treatment of Posttraumatic Stress Disorder.
Two letters, one from Peterson and one from the EMDR International Association Research Committee (signed by Smyth, Greenwald, de Jongh, and Lee), commenting on: Foa, Davidson, and Frances, "Treatment of posttraumatic stress disorder (Expert consensus guideline series)," Journal of Clinical Psychiatry 60(Supplement 10) (1999) [14767], with a reply by Foa, Davidson, and Frances. [Pilots]
Keywords: Commentary Letter Posttraumatic Stress Disorder Practice Guideline Professional Criticism PTSD Professional Standards Reply
Accuracy Verified: Yes
12. Smyth N. J., Greenwald R., de Jongh A., & Lee, C. (2000, October). The expert consensus guideline series: Treatment of posttraumatic stress disorder: Commentary. Journal of Clinical Psychiatry, 61(Supplement 10), 784-785.
Language: English
Format: Journal
Abstract:
Comments on the article by E. B. Foa et al (see record 1999-11089-001) which presents expert consensus guideline recommendations for the treatment of posttraumatic stress disorder (PTSD). Even though the current authors conclude that the research design was carefully thought out, they state that the design features led to a marked under evaluation of eye movement desensitization and reprocessing in the guidelines on the treatment of PTSD. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Keywords: Commentary Letter Posttraumatic Stress Disorder PTSD Treatment
Accuracy Verified: Yes
13. Figley, C., Leeds, A., Tinker-Wilson, S., & van der Kolk, B. A. (2000). The expert consensus guideline series: Treatment of posttraumatic stress disorder: reply Commentary. Journal of Clinical Psychiatry, 61(10), 785-786.
Language: English
Format: Journal
Abstract:
No abstract available.
Keywords: Commentary Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
14. Foa, E. B., Davidson, J. R. T., & Frances, A., & Ross, R. (1999). Expert consensus treatment guidelines for posttraumatic stress disorder: A guide for families. Journal of Clinical Psychiatry, 60 (Supplement 16), 69-76.
Language: English
Format: Journal
Abstract:
No abstract available.
Keywords: Letter Posttraumatic Stress Disorder Practice Guidelines Professional Criticism Professional Criticism Reply Professional Standards PTSD
Accuracy Verified: Yes
15. Leeds, A. (2007, June). Improving self-regulation and social functioning for survivors of early emotional neglect and abuse with positive affect tolerance and integration protocol: A case series. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Survivors of early emotional neglect experience pervasive difficulties including vulnerability to adult psychiatric disorders and inability to regulate emotional states (Schore, 1996, 1997, 2000, 2001a, 2001b; Teicher, 2000, 2002; Teicher et al, 1993; Teicher et al., 1997). Their inability to regulate emotional states is not solely linked to effects of adverse events, but is significantly linked to insufficient exposure to normal, developmental attachment sequences that foster capacities for self-regulation.
A subset of adult survivors of early, pervasive, emotional neglect who meet full or partial criteria for posttraumatic stress disorder also present with comorbid Cluster C Axis II symptoms (Avoidant, Dependent, Obsessive-Compulsive) and meet criteria for dismissing (or fearful) insecure attachment (Cassidy & Shaver, 1999; Main, 1996).
Clinical assessment reveals these patients have low tolerance for positive interpersonal emotions and engage in defensive strategies to dismiss, minimize, deny or subtly avoid experiencing and assimilating this positive emotional states into their internal model of self. These strategies include overt and covert behavioral avoidance as well as dissociate defenses. Paradoxically, these patients may show superficial characteristics or competence, interpersonal skills, or emotional stability which on closer examination prove to be fragile or which collapse in the face of social stressors.
The general theoretical base for the Positive Affect Tolerance and Integration (PAT) protocol is related to McCulloughs (1996, 2003) model of affect phobia and recognizes McCulloughs emphasis on an anxiety regulating, titrated approach to developing tolerance for adaptive affect and associated coping behaviors. Putnams (1997) discrete behavioral states model provides an important conceptual framework for understanding these patients needs to gradually develop new discrete behavioral (psychophysiological and affective) states and new pathways (schemes and scripts) fostering access to these shared positive states often as a crucial early phase of treatment to help resolve their impairments in emotional self-regulation.
This presentation describes the use of standard EMDR procedural steps in a treatment plan that postpones the standard three pronged (past, present, future) PTSD protocol, but which is consistent with the consensus model for Complex PTSD (Brown, Scheflin & Hammond, 1998; Chu, 1998; Courtois, 1999; Hart, Nijenhuis, Steele, 2006) and other EMDR approaches focused initially on improving response to current stimuli (Hoffman, 2004; Leeds & Korn, 1998; Leeds & Shapiro, 2000) before attempting to target childhood traumatic memories. Targets for PAT are recent experiences in which the patient was exposed to positive, shared, interpersonal emotional states. The purposes for applying PAT to these targets are: to decrease defensive avoidance; dissociation and anxiety about shared positive emotional states; to increase capacity to tolerate and enjoy these shared positive emotional states; and to integrate these shared positive emotional states into positive schemas and self-concepts. Observed clinical gains following PAT included: improved mood and resilience, and decreased depersonalization during subsequent use of EMDR to reprocess traumatic memories.
The goal in presenting this Positive Affect Tolerance and Integration Protocol case series is to encourage research to evaluate the clinical effectiveness of this application of the standard EMDR procedures for a clinical subpopulation generally considered challenging to treat.
Keywords: Affect Tolerance Poster Self-Regulation Social Functioning
Accuracy Verified: Yes
16. Maxfield, L. (2002, June). The influence of methodological variables on outcome in psychotherapy research. Panel discussion (L. Beutler, Discussant, EMDR research and its future: Ecological validity, process research, outcome findings, and socio-political context) at the (SPR) Society for Psychotherapy Research, International Conference, Santa Barbara, CA.
Language: English
Format: Conference
Abstract:
Although there is consensus that EMDR is efficacious in the treatment of PTSD, different studies have achieved a range of results. This presentation reviews a methodological meta-analysis that found a significant positive correlation between effect size and ratings of methodological rigor. Specific client, therapist, and methodological factors were identified in the analysis as accounting for some of the disparities in outcome. These variables are examined, and include the over-all rigor of the study, qualities of the assessor, treatment fidelity, symptom severity, and appropriate course of treatment. Implications for interpreting research outcomes are discussed, and recommendations are made for future research. The scale for assessing methodological variables was adapted from Foa and Meadows (1997), and the analysis suggests modifications and additions to improve the measurement of methodology.
Keywords: Methodology Outcome Research
Accuracy Verified: Yes
17. Baldwin, D. (1997). Innovation, controversy, and consensus in traumatology. Traumatology, 3(1), 7-22. doi:10.1177/153476569700300103 .
Language: English
Format: Journal
Abstract:
Controversy follows innovation and threats to the status quo in many social domains, including the sciences. This article briefly summarizes information from the philosophy of science and data from studies of conflict in diverse fields. It then introduces two independent contemporary controversies in traumatology -- a new clinical method called EMDR and the Final Report of the APA Working Group on memories of childhood abuse -- and considers them within a broader context of the historical rift between psychological research and practice. The aim is to step outside the frame of specific conflicts and identify differences in philosophical orientation and values that contribute to communication difficulties and associated conflict between partisans. Approaches are offered toward building consensus within the field. [Author Abstract]
Keywords: Child Abuse Commentary False Memory Rape Scientific Research Survivors
Accuracy Verified: Yes
18. Leeds, A. (2006, September). Installation when treating complex posttraumatic stress syndromes. In Criteria for assuring appropriate clinical use and avoiding misuse of Resource Development & Installation when treating complex posttraumatic stress syndromes (A. Leeds. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories. Resource Development and Installation (RDI) has been reported to be a potentially effective intervention for enhancing patient & stabilization. There are now several published descriptions and case reports of RDI including a summary in the standard reference text on EMDR. The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with posttraumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been offered RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for which patients and clinical situations the use of RDI is indicated; for which patients and clinical situations RDI should be offered cautiously, if at all, but alternate stabilization methods should be considered; and for which patients RDI should not be offered but where standard EMDR reprocessing should be offered without delay. An overview of RDI procedural steps will be presented to clarify its use. Strategies will be offered to address technical, clinical and countertransference issues that may be associated with misuse of RDI. Clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD Consensus Model C-PTSD RDI Resource Development and Installation Treatment Criteria
Accuracy Verified: Yes
19. Hembree, E., & Foa, E. (2003, April). Interventions for trauma-related emotional disturbances in adult victims of crime. Journal of Traumatic Stress, 16(2), 187-199. doi:10.1023/A:1022803408114.
Language: English
Format: Journal
Abstract:
This paper provides an overview of several treatment interventions for trauma-related disturbances in adult victims of crime. Following a brief discussion of mental health service utilization among crime victims, we describe interventions for acute and chronic reactions to trauma. We present some controlled studies of psychosocial treatments for PTSD that have gained empirical support and are recommended as first line interventions by expert consensus including exposure therapy, cognitive therapy, and stress inoculation training, followed by a brief summary of selected studies examining the efficacy of pharmacological treatment for PTSD. Finally, we discuss multicultural issues, factors associated with treatment outcome, and challenges we have encountered in treating crime victims. [Author Abstract]
Keywords: Adults Crime Literature Review Posttraumatic Stress Disorder PTSD Survivors Treatment Treatment Effectiveness
Accuracy Verified: Yes
20. van Dijke, A., & Crijnen, A. A. M. (2011, April). The Netherlands centre for chronic early childhood traumatisation: Children and adolescents. Presentatie op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam.
Language: English
Format: Conference
Abstract: Contents of the workshop: Adequate treatment in the mental health care system is not available for a large group of children and adults suffering from the consequences of chronic early childhood traumatisation. The Netherlands centre for chronic early childhood traumatisation (LCVT) aims to enhance treatment services by offering a nationwide network of tertiary referral trauma centres (TRTC) providing psychotherapy, innovation and research, as well as education. In 2008 LCVT was formed with eleven trtc affiliated with Mental Health Services. lcvt affiliated services use a unique client-monitoring system as sampling frame in order to monitor the progress and results of all trtc treatments. Information is gathered systematically and at regular intervals on all patients of the trtc on clinical symptoms, personality, day-to-day functioning, quality of life, use of health care services and social functioning. Evaluation diagnostics provide answers to which degree treatment goals are realised. Format: Workshop Aim: To provide the participants with information on: Management and implementation of TRTC in mental health services for children; Efficacy of eye movement desensitisation and reprocessing (EMDR) in children; The development of a consensus-based treatment monitoring system.
Keywords: Adolescents Childhood Traumatization Children
Accuracy Verified: Yes
21. Leeds, A. M. (2001, December). Principals and procedures for enhancing current functioning in complex posttraumatic stress disorder with EMDR resource development and installation. EMDRIA Newsletter, 6(Special Edition), 4-11 .
Language: English
Format: Newsletter
Abstract:
When developing a treatment plan, clinicians need to be able to recognize not only the specific effects of trauma but to consider symptoms reflecting limited capacities for emotional self regulation. Such problems are often found when client histories included significant childhood neglect or other disruptions of each childhood attachment (Damasio, 1999; Schore, 2000; Sigel, 1999). Clients with a history of secure attachment appear to be more vulnerable to PTSD (Alexander, et al., 1998; Muller, Sicoli, & Kemieux, 2000) and initially need to be addressed with procedures different from those for trauma specific symptoms. Therefore in the consensus model of posttraumatic treatment (Browm Scheflin, & Hammond, 1998; Chu, 1998; Courtois, 1999) clinicians are urged to focus on clients personal safety, stabilization, and the development of client capacities for tolerating and modulating strong affect in the early phases of treatment.
Keywords: DESNOS RDI Resource Development and Installation Posttraumatic Stress Disorder PTSD Stabalization
Accuracy Verified: Yes
22. Matthess, H. (2007, June). Profits from the benefit of structural dissociation on the application with EMDR for complex-traumatized clients. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Clients with chronic and complex Posttraumatic Stress
Disorder (PTSD) caused by severe traumata in childhood,
are often still treated inadequately, especially when they
developed additional dissociative symptoms or a Dissociative
Disorder.
There is a current consensus about the need tomodify the
EMDR standard protocol in the treatment of complex
traumatized and dissociative clients. From the theoretical
background of structural dissociation theory and Janets
system of action systems, the therapist has not only to recognize
clients deficits but also to address action tendencies
in the clients inner system that could ameliorate
coping strategies in solving problems in daily life.
With the help of bilateral stimulation, blending of parts
of the personality containing different information can
be promoted often resulting in remarkable changes in the
behavior and resource activation. The main principles
that need to be regarded treating complex and dissociative
clients with bilateral stimulation will be explained
and basic rules for treatment plans including the use of
EMDR will be developed.
English subtitled video examples demonstrate the proposed modification
of the EMDR standard protocol and will
be discussed in detail. I will present shortly recent research
findings on autonomic nervous system alterations
during EMDR. These results help to define special
working mechanisms of our modified EMDR protocol in
clients with dissociative disorders.
Keywords: Complex Trauma Dissociation
Accuracy Verified: Yes
23. Gillies, D., Taylor, F., Gray, C., OBrien, L., & DAbrew, N. (2012). Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (Review). Cochrane Database of Systematic Reviews (Online), 12, CD006726. doi:10.1002/14651858.CD006726.pub2.
Language: English
Format: Journal
Abstract:
Background:
Post-traumatic stress disorder (PTSD) is highly prevalent in children and adolescents who have experienced trauma and has high
personal and health costs. Although a wide range of psychological therapies have been used in the treatment of PTSD there are no
systematic reviews of these therapies in children and adolescents.
Objectives:
To examine the effectiveness of psychological therapies in treating children and adolescents who have been diagnosed with PTSD.
Search methods:
We searched the Cochrane Depression, Anxiety and Neurosis Review Groups Specialised Register (CCDANCTR) to December 2011.
The CCDANCTR includes relevant randomised controlled trials fromthe following bibliographic databases: CENTRAL (the Cochrane
Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We also checked
reference lists of relevant studies and reviews. We applied no date or language restrictions.
Selection criteria:
All randomised controlled trials of psychological therapies compared to a control, pharmacological therapy or other treatments in
children or adolescents exposed to a traumatic event or diagnosed with PTSD.
Data collection and analysis:
Two members of the review group independently extracted data. If differences were identified, they were resolved by consensus, or
referral to the review team.
We calculated the odds ratio (OR) for binary outcomes, the standardised mean difference (SMD) for continuous outcomes, and 95%
confidence intervals (CI) for both, using a fixed-effect model. If heterogeneity was found we used a random-effects model. Main results
Fourteen studies including 758 participants were included in this review. The types of trauma participants had been exposed to included
sexual abuse, civil violence, natural disaster, domestic violence and motor vehicle accidents. Most participants were clients of a traumarelated
support service.
The psychological therapies used in these studies were cognitive behavioural therapy (CBT), exposure-based, psychodynamic, narrative,
supportive counselling, and eye movement desensitisation and reprocessing (EMDR). Most compared a psychological therapy to a
control group. No study compared psychological therapies to pharmacological therapies alone or as an adjunct to a psychological
therapy.
Across all psychological therapies, improvement was significantly better (three studies, n = 80, OR 4.21, 95% CI 1.12 to 15.85) and
symptoms of PTSD (seven studies, n = 271, SMD -0.90, 95% CI -1.24 to -0.42), anxiety (three studies, n = 91, SMD -0.57, 95% CI
-1.00 to -0.13) and depression (five studies, n = 156, SMD -0.74, 95% CI -1.11 to -0.36) were significantly lower within a month of
completing psychological therapy compared to a control group.
The psychological therapy for which there was the best evidence of effectiveness was CBT. Improvement was significantly better for
up to a year following treatment (up to one month: two studies, n = 49, OR 8.64, 95% CI 2.01 to 37.14; up to one year: one study,
n = 25, OR 8.00, 95% CI 1.21 to 52.69). PTSD symptom scores were also significantly lower for up to one year (up to one month:
three studies, n = 98, SMD -1.34, 95% CI -1.79 to -0.89; up to one year: one study, n = 36, SMD -0.73, 95% CI -1.44 to -0.01),
and depression scores were lower for up to a month (three studies, n = 98, SMD -0.80, 95% CI -1.47 to -0.13) in the CBT group
compared to a control. No adverse effects were identified.
No study was rated as a high risk for selection or detection bias but a minority were rated as a high risk for attrition, reporting and
other bias. Most included studies were rated as an unclear risk for selection, detection and attrition bias.
Authors conclusions:
There is evidence for the effectiveness of psychological therapies, particularly CBT, for treating PTSD in children and adolescents for
up to a month following treatment. At this stage, there is no clear evidence for the effectiveness of one psychological therapy compared
to others. There is also not enough evidence to conclude that children and adolescents with particular types of trauma are more or less
likely to respond to psychological therapies than others.
The findings of this review are limited by the potential for methodological biases, and the small number and generally small size
of identified studies. In addition, there was evidence of substantial heterogeneity in some analyses which could not be explained by
subgroup or sensitivity analyses.
More evidence is required for the effectiveness of all psychological therapiesmore than one month after treatment.Much more evidence
is needed to demonstrate the relative effectiveness of different psychological therapies or the effectiveness of psychological therapies
compared to other treatments. More details are required in future trials in regards to the types of trauma that preceded the diagnosis
of PTSD and whether the traumas are single event or ongoing. Future studies should also aim to identify the most valid and reliable
measures of PTSD symptoms and ensure that all scores, total and sub-scores, are consistently reported.
Keywords: Adolescents Children Posttraumatic Stress Disorder PTSD Review
Accuracy Verified: Yes
24. Graca, J., Palmer, G. A., & Occhietti, K. (2010, September/October). Psychotherapeutic interventions for symptom reduction in veterans with PTSD: A nonrandomized study in a residential clinical setting. Poster presented at the annual meeting of the EMDR International Association, Minneapolis, MN.
Language: English
Format: Conference
Abstract:
Posttraumatic stress dlsorder (PTSD) is the most serious and prevalent of the
mental disorders among returning United States combat veterans. As veterans who
have sewed in Iraq and Afghanistan join the ranks of combat veterans from prior
conflicts the need and availability of evidence-based treatments tor PTSD is
increasing. Three psychotherapies for PTSD consistently have been identified in
recent meta-analyses as evidence-based treatments for PTSD. Results of the
analyses indicate that trauma-focused cognitive behavior therapy (CPT), exposurebased
therapy (PE) and eye movement desensitization and reprocessing (EMDR) are
effective. International treatment guidelines for PTSD have the same consensus
regarding EMDR, PE and CPT as treatments of choice for PTSD (e.g., APA, 2004;
Department of Veterans Affairs and Department of Defense (DoD). 2004).
Keywords: Nonrandomized Study Poster Posttraumatic Stress Disorer PTSD Residential Clinical Setting Symptom Reduction Veterans
Accuracy Verified: Yes
25. Schottenbauer, M. A., Arnkoff, D. B., Glass, C. R., & Gray, S. H. (2006). Psychotherapists in the community: Reported prototypical psychodynamic treatments of trauma. Journal of the American Psychoanalytic Association, 54(4), 1347-1353. doi:doi:10.1177/00030651060540040111.
Language: English
Format: Journal
Abstract:
The effort to categorize psychotherapeutic treatments according to their efficacy has in the past decade led to a number of lists of empirically supported treatments (ESTs; Chambless and Ollendick 2001). With regard to trauma, the primary treatments that have undergone the rigorous empirical testing necessary to be included in lists of ESTs (e.g., Nathan and Gorman 1998; Roth and Fonagy 2005) are largely cognitivebehavioral treatments and eye movement desensitization and reprocessing (EMDR; Shapiro 1995). Nevertheless, there are many indications that clinicians in the community use psychodynamic psychotherapy for treating trauma. A recent guideline for psychiatrists on the treatment of PTSD notes clinical consensus on the usefulness of psychodynamic psychotherapy in treating certain types of trauma, particularly in cases where interpersonal functioning is substantially impacted (APA 2004). Empirical research reveals that many clinicians in the community employ psychodyna
Keywords: Poster Psychodynamic Treatments Trauma
Accuracy Verified: Yes
26. Easton, S., & Ost, J. (2006). Should EMDR really be recommended as equivalent to CBT for post trauma difficulties?. BABCP Magazine, 19. Retrieved from http://www.port.ac.uk/departments/academic/psychology/staff/downloads/filetodownload,62618,en.pdf 8/21/2012.
Language: English
Format: Magazine
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) has been recommended
for individuals who have experienced difficulties following a traumatic experience in
the National Institute for Clinical Excellence (NICE, 2005) report on treatments for
Post Traumatic Stress Disorder (PTSD). Cognitive Behavioural Therapy (CBT) is
also singled out for recommendation, apparently indicating some degree of
equivalence of these two approaches. The NICE guidelines are intended to give an
indication of expert consensus on best practice and, as such, are already affecting
perceptions, beliefs and preferences of both the wider public and service providers.
Keywords: CBT Cognitive Behaviorial Therapy
Accuracy Verified: Yes
27. van der Hart, O., Solomon, R., & Gonzalez, A. (2010, September/October). The theory of structural dissociation as a guide for EMDR treatment of chronically traumatized clients. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN.
Language: English
Format: Conference
Abstract:
Chronically traumatized clients with complex dissociative disorders need careful preparation. There is currently consensus that the EMDR standard protocol needs to be modified for chronically traumatized clients, as it may destabilize them. Thus, the therapist needs to have a good understanding of the dissociative personality structure that exists in their clients, the dissociative parts, their strengths and deficits, and their interrelationships. Using the framework of phase-oriented treatment and the theory of structural dissociation of the personality, this workshop will help participants understand the preparatory work necessary before integrating traumatic memories and discuss important procedural considerations for each phase of EMDR.
Keywords: Chronic Traumatization Structural Dissociation
Accuracy Verified: Yes
28. Foa, E., Davidson, J., Frances, A., Culpepper, L., Ross, R., & Ross, D. (1999). Treatment of posttraumatic stress disorder. Journal of Clinical Psychiatry, 60 (Supplement 16), 4-76.
Language: English
Format: Journal
Abstract:
No abstract available.
Keywords: Consensus Panels Posttraumatic Stress Disorder PTSD Treatment Guidelines
Accuracy Verified: Yes
29. Cohena, J. A., Mannarino, A. P., & Rogal, S. (2001, January). Treatment practices for childhood posttraumatic stress disorder. Child Abuse and Neglect, 25(1), 123-135. doi:10.1016/S0145-2134(00)00226-X.
Language: English
Format: Journal
Abstract:
Objective: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. Method: An anonymous survey was mailed to 207 child psychiatrists ("medical") [members of the American Academy of Child and Adolescent Psychiatry] and 460 nonphysician ("non-medical") therapists [members of the International Society for Traumatic Stress Studies] inquiring about current interventions used to treat children with PTSD. Results: 247 responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. 95% of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. Conclusions: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR. [Author Abstract]
Keywords: Adolescents Arousal Avoidance Children Drug Therapy Mental Health Personnel Reexperiencing Posttraumatic Stress Disorder PTSD Treatment Effectiveness
Accuracy Verified: Yes
30. Dellucci, H. (2011, December). The use of EMDR in the treatment of patients with complex dissociative disorders related to trauma. Presentation at the First European Society for Trauma and Dissociation, Paris, France .
Language: English
Format: Conference
Abstract:
Today EMDR is widely recognized as one of the most effective therapies for simple trauma. But if people
suffer from complex trauma, with dissociative disorder, EMDR, as it has been invented originally,
becomes problematic. The therapist has then to develop his/her art in order to keep the therapeutic
process ongoing. Numerous authors conceptualized many different ways of adapting the EMDR standard
protocol for those apparently difficult clients. Here also, there is no consensus between therapists who
are extremely cautious and take a lot of time before coming to the trauma confronting phase, and those
who go earlier to desensitization and do further adaptations. Which are the risks ? How to adapt therapy
to the sometimes chaotic life style of the person ? In which ways EMDR could be adapted to overcome
this dilemma and be more efficient, even with those clients known as being difficult ?
Keywords: Dissociative Disorders
Accuracy Verified: Yes
31. Hummel, H., & Matthess, H. (2005, June). What to teach beside EMDR in trauma-centered psychotherapy. In Teaching EMDR. Symposium conducted at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
The objective of this workshop is to encourage the participants to develop
and carry out a comprehensive course for diagnostics and treatment of
trauma-related disorders.
The trauma-curricula in Schaffhausen and Sinzig were created
independently as training courses for psycho-traumatology. They are taken
as examples to clarify basic ideas on how to organize curricular-structured
seminars in the field of psycho-traumatology and trauma-therapy. The
EMDR-trainings are very well established as basic for trauma confrontation
therapy but "around EMDR" there is much more to teach that can only be
learnt over a longer period of time.
The curricular structure as a means to teach the knowledge and skills
improves the motivation of colleagues to attend the seminars. Consensus,
cooperation, and mutual recognition between other institutes and international organizations in the field of psycho-traumatology committed to
a general draft makes the acceptance even stronger.
There is consensus about the knowledge of anamnesis, diagnostics,
treatment planning, stabilization techniques, and the working through of
traumatic material. In both curricula more than one method for trauma confrontation
is taught. The more tools and skills the therapist is able to use
the easier it is to find the appropriate method for each client. So therapists
can avoid what is meant by the proverb: "if you only have a hammer you
will treat everything like a nail" (Maslow).
The first evaluation of the participants in both curricula in Schaffhausen and
Sinzig will be presented including questions about relevance. satisfaction
with structure and content as well as suggestions for improvement.
Accuracy Verified: Yes
32. Bisson, J. (2008, June). Evidence, treatment guidelines, consensus & harmony. Plenary presented at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
Disagreements regarding the efficacy and effectiveness of interventions to
prevent and treat post traumatic disorders have caused divisions within
the traumatic stress field and had a negative impact on its image to the
outside world. The emergence of an evidence based approach to
management has been considered threatening by some but, in fact, has
helped regulate and improve clinical provision. Its detractors have fairly
criticised over-reliance on and over-generalisation of the results from
some randomised controlled trials but used sensibly an evidence based
approach has many advantages. For example, it has allowed effective
interventions that have not been widely supported in the past to become
accepted. The emergence of EMDR as a first-line treatment for chronic
PTSD is an excellent example of this. The use of evidence to determine
treatment guidelines for PTSD will be used to illustrate how an evidence
based approach can be effectively adopted.
Keywords: Plenary Treatment Guidelines
Accuracy Verified: Yes