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1. 生月 誠 , 田上 不二夫 [Ikezuki Makoto, and Tagami Fujio]. (2003年12月). 視線恐怖の治療メカニズム [Terror mechanism eye treatment]. 教育心理学研究, 51(4), 425-430 [Educational Psychology, 51 (4), 425-430].
Language: Japanese
Format: Journal
Abstract:
本研究では,視線恐怖を主訴とする被験者の,視線恐怖軽減のメカニズムを解明することが目的である。実験1では,言語反復を含むリラクゼーションによる脱感作の手続きを,実験2では,拮抗動作法による脱感作の手続きを用いた。いずれも,自己視線恐怖より,他者視線恐怖の軽減に効果的であり,distractionが視線恐怖軽減の重要な要因となることが示唆された。また,自己視線恐怖は自己の視線に関する独特の認知を伴っ …
In this study, the subjects complained of fear that someone, the goal is to elucidate the mechanism of reduced eye phobia. In Experiment 1, the relaxation process of desensitization by repetitive language, including, in the second experiment, using a desensitization procedure by antagonistic action. Both look over fear, self and others effectively to reduce eye phobia, distraction was suggested to be an important factor in reducing the look of fear. The look of fear on the unique self-awareness accompanied by their own eyes ...
Accuracy Verified: Yes
2. Koshal, A. (2012, June). The 4-fields-technique in the trauma therapy of complex traumatized and addicted patients [La técnica de 4-‐Campos en la terapia de trauma complejo y pacientes adictos, incluso en tratamiento de metadona]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
This
workshop
will
employ
lecture
and
demonstration
of
several
case
studies.
The
4-‐Field-‐Technique
is
a
special
method
of
EMDR
that
was
developed
by
Jarero
et
al.
1997
in
Mexico.
For
complex
traumatized
and
drug
addicted
people
this
method
is
very
helpful.
The
risk
to
trigger
other
trauma
clusters
is
quite
minor,
because
the
patient’s
concentration
is
focused
on
his
specific
picture
and
situation.
Several
international
studies
demonstrate
that
addicted
people
are
very
often
complex
traumatized.
(Felitti
et
al.,
2003;
Schmidt,
2000
etc.)
PTSD
and
other
trauma
symptoms
cause
a
lot
of
psychophysical
deregulation.
The
psychiatrist
Khantzian
realized
1985,
that
addicted
people
suffer
a
lot
from
different
symptoms
and
try
to
reduce
the
unbearable
inner
tension
in
using
drugs.
So
Khantzian
postulated
the
“self-‐medication
hypothesis
of
addictive
disorders”.
Janina
Fisher,
Trauma
Center
Boston,
2000,
interpreted
the
correlation
of
early
traumatization
and
drug-‐addiction
as
“compensatory
strategies
aimed
at
self-‐
regulation”.
20
years
of
psychotherapeutic
work
revealed,
a
high
percentage
of
addicted
patients
use
drugs
to
influence
their
emotional
states.
Drugs
and
alcohol
do
short
term
reduce
the
mentioned
symptoms.
Addicted
patients
need
to
learn
to
cope
in
another,
more
adaptive
way
to
get
a
better
functioning
self-‐regulation.
After
stabilization,
trauma-‐therapy
can
start.
So
the
patient
can
reduce
his
psycho-‐
physiological
deregulation.
Even
when
addicted
patients
are
still
in
a
methadone-‐
treatment
trauma-‐therapy
is
effective.
Practical
experiences
show
a
lot
of
successful
treatments.
Este
taller
empleará
la
presentación
y
demostración
de
muchos
estudios
de
caso.
La
técnica
de
4
campos
es
un
método
especial
de
EMDR
que
fue
desarrollado
por
Jarero
et
al.
1997
en
Méjico.
Para
gente
con
traumas
complejos
y
adictos
este
método
resulta
ser
muy
adecuado.
El
riesgo
de
disparar
grupos
de
traumas
es
menor,
debido
a
que
la
concentración
del
paciente
está
centrada
en
una
sola
imagen
y
situación.
Muchos
estudios
demuestran
que
los
adictos
son
muy
a
menudo
traumatizados
de
manera
compleja.
(Felitti
et
al.,
2003;
Schmidt,
2000
etc.)
El
TEPT
y
otros
síntomas
del
trauma
causan
muchas
desregulaciones
psicofisiológicas.
El
psiquiatra
Khantzian
se
dio
cuenta
en
1985,
que
la
gente
que
sufre
de
adicción
sufren
también
muchos
otros
síntomas
diferentes
e
intentan
reducir
su
tensión
interna
a
través
del
uso
de
sustancias.
Por
ello
Khantzian
postuló
“
La
hipótesis
de
la
automedicación
en
trastornos
adictivos”
Janina
Fisher,
Trauma
Center
Boston,
2000,
interpretó
la
correlación
de
la
traumatización
temprana
y
la
adicción
a
la
drogas
como
“
Estrategias
compensatorias
dirigidas
a
la
autorregulación”.
20
años
de
trabajo
psicoterapéutico
muestran
que
un
gran
porcentaje
de
pacientes
adictos
usan
drogas
para
modificar
sus
estados
emocionales.
Las
drogas
y
el
alcohol
reducen
a
corto
plazo
los
síntomas
mencionados.
Los
pacientes
adictos
necesitan
aprender
a
afrontar
de
manera
más
adaptativa
su
autorregulación.
Después
de
la
estabilización,
la
terapia
del
trauma
puede
empezar.
Por
ello
el
paciente
puede
reducir
su
desregulación
psicofisiológica.
Incluso
cuando
aún
están
sometidos
a
un
tratamiento
de
metadona
la
terapia
del
trauma
es
efectiva.
Las
experiencias
en
la
práctica
muestran
una
gran
cantidad
de
tratamientos
exitosos.
Keywords: 4-Fields-Technique Addiction
Accuracy Verified: Yes
3. Dellucci, H. (2010, July). A 6 gear mechanics for a safe journey through complex trauma therapy. Poster presented at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
Working with EMDR with people who suffer from complex trauma leads often to difficulties not only about case
conceptualization, but also desensitization and reprocessing, with a risk of destabilization or even decompensation.
Often many targets, especially those in early childhood can be located in the timeline before verbal abilities and thus stay
implicit. Should we then renounce to work with EMDR? Is it possible to use EMDR safely, by adapting to each client, and
their somehow chaotic life events without getting lost? The six gear mechanics relies on the metaphor about a car journey
through therapy with people who have complex trauma, and provides a structural hierarchy of treatment which allows
adaptation, by knowing what is done and why. It tries to integrate what is yet known in EMDR therapy with complex trauma,
and provides a dynamic and adaptive tool to navigate through therapy.
Keywords: 6 Gear Mechanics Complex Trauma
Accuracy Verified: Yes
4. Lucchese, D. (2000, Novembre). Aborto, EMDR e prevenzione della depressione post partum: un caso [Abortion, EMDR and prevention of postpartum depression: A case]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.
Language: Italian
Format: Conference
Abstract:
Viene descritto il caso di una giovane donna cui è stato diagnosticata una gravidanza a rischio per malformazione genetica del feto. Dopo un sofferto aborto terapeutico, la paziente ha subito un secondo aborto spontaneo, entrambi con caratteristiche traumatiche. Trattata con EMDR, comprese le complicanze e le sequele dal momento della diagnosi fino al future template, la paziente ha con successo riprocessato i vissuti di colpa e inadeguatezza, i pensieri irrazionali generati dal trauma, e soprattutto una serie di somatizzazioni e comportamenti rituali per lei finora inspiegabili. I target trattati sono stati sei, con cognizioni negative di inadeguatezza del suo ruolo materno e di colpa per le proprie decisioni. L’interesse del caso consiste nella elaborazione di vissuti corporei simbolici e di comportamenti disturbanti anche sul piano pratico e relazionale. Risulta evidente la funzionalità del EMDR nel trattamento dei ricordi delle vicende traumatiche vissute, sperimentate anche e soprattutto sul piano corporeo. L’utilizzo dell’EMDR ha permesso inoltre di evidenziare le possibilità di questo trattamento nella prevenzione della depressione post partum
Describes the case of a young woman whose pregnancy was diagnosed at risk for genetic malformation of the fetus. After suffering a therapeutic abortion, the patient underwent a second miscarriage, both with traumatic characteristics. Treated with EMDR, including complications and sequelae from the time of diagnosis until future templates, the patient with successfully reprocessed the feelings of guilt and inadequacy, irrational thoughts generated by the trauma, especially a series of somatization and conduct rituals for her so far unexplained. I six targets were treated with negative cognition of inadequacy of its role and the breast blame for their decisions. The interest in the case consists in the elaboration of bodily experience symbolic and disruptive behavior also at the practical and relational. The apparent functionality of EMDR in the treatment of memories of traumatic events experienced, tested also and especially on the body. Using EMDR experience has also highlighted the possibility of this treatment in the prevention of postpartum depression.
Keywords: Abortion Postpartum Depression
Accuracy Verified: Yes
5. Tarrier, N., Liversidge, T., & Gregg, L. (2006, November). The acceptability and preference for the psychological treatment for PTSD. Behaviour Research and Therapy, 44(11), 1643-1656. doi:10.1016/j.brat.2005.11.012.
Language: English
Format: Journal
Abstract:
The acceptability and preference of psychological treatments is important in understanding patient treatment seeking, choice, engagement and attrition and possibly treatment response in health care. The acceptability of, and preference for, 14 different types of psychological treatment for PTSD were investigated in a student population through invitation to participate in a web-based survey. Respondents were asked to rate each treatment on 10 scales and to rank the treatments in order of preference. Respondents were also asked whether they would seek treatment themselves, recommend treatment to friends and family, feel stigmatised by suffering from PTSD, had any prior knowledge of the treatments and if this had been positive or negative, and whether they had a history of psychological problems or treatment. A total of 330 respondents completed the survey. A past or current history of psychological problems and treatment was surprisingly high. Almost all respondents indicated that they would seek or recommend treatment in spite of high levels of stigmatisation. Factor analysis of the 10 scales indicated two factors: Endorsement and Discomfort. Rank ordering on preference and Endorsement scores was highly consistent. The highly preferred and endorsed treatments involved cognitive therapy, exposure, or psycho-education in spite of high levels of discomfort anticipated with exposure. Treatments involving new technologies, EMDR, and psychodynamic psychotherapy received the lowest Endorsement and preference. There was a modest influence of prior knowledge of a treatment. [Author Abstract]
Keywords: Cognitive-Behaviour Therapy Cognitive Therapy Exposure Therapy College Students Computer Assisted Psychotherapy Empirical Study Family Therapy Group Psychotherapy Posttraumatic Stress Disorder Preference Psychoanalytic Psychotherapy Psychological Treatment Psychotherapeutic Processes PTSD Quantitative Study Relaxation Therapy Treatment Acceptability Virtual Reality Exposure Web-Based Survey
Accuracy Verified: Yes
6. Crow, C., & Sause, E. (2007, June). Accessing preverbal trauma for effective adult EMDR. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Recent research (Moberg, 2003, The Oxytocin Factor) indicates the potential of early pre-verbal trauma to set up biochemical and neurological responses which activate certain triggers. Since the touchstone event is pre-verbal, it is difficult to identify, but crucial in the resolution of later traumas resistant to full EMDR processing (Those who remain stuck at a greater than 0 SUDs). The antedotal experience is that this model can activate the material more fully and facilitate more thorough competion of phases 4-8. "Once upon a Time" contains every element of the EMDR Protocol in the prescribed order, Incident, Image, NC, PC, VOC, Emotion, SUD, Body sensation. This experimental model is not a substitute for standard EMDR. It facilitates access tohese preverbal traumas and the resultant cognitions which may have formed around them. It allows for a return to the standard EMDR protocol after this early material has been effectively targeted and reprocessed. "Once Upon a Time" model allows for fuller connection with early material. History is collected through antedotal information from third party informants and family photographs and is used to create a metaphor; this technique can access the multiple modalities of pre-verbal experience previously intellectualized. Phase three begins with a short continuation of Phase 1 using an interview format to review and briefly discuss the various elements of the troubling material. A "sentence completion" format is used to obtain the TICES elements. Those spontaneous answers form the script for a "Once Upon a Time" (Crow, 2004, EMDRIA Montreal, Canada), a deviation from Phase 4 of the standard protocol. Pertinent examples of the application of this model will be discussed and demonstrated with video taped excerpts of actual clients. Video taped client reports of the long term effect of the shifts resulting from the "Once Upon a Time" experience will provide validation that this technique enables retur to the standard EMDR protocol and full processing of previously incompletely processed material. Participants will create their own "Once Upon a Time" script from a video example of client history as an experiential introduction to the intricacies of this model. Evidence indicates that this technique is effective on a "consultant" basis, where the "Once Upon a Time" can be conducted by a separate therapist skilled in the technique, and returned to their regular EMDR therapist to complete this treatment. Currently a study is underway utilizing a pre/post text design (N=10) and statistical analysis of the results to measure the quantitative change within the client.
Keywords: Model Poster Preverbal Trauma Theory
Accuracy Verified: Yes
7. de Roos, C., & Went, M. (2011, April). Als woorden tekort schieten: EMDR bij preverbaal trauma [When words fail: EMDR for pre-verbal trauma]. Presentatie op de 5e jaarlijkse conferentie van EMDR Vereniging, Nijmegen, Nederland.
Language: Dutch
Format: Conference
Abstract:
Infants (0-4 jarigen) kunnen allerlei traumatische gebeurtenissen meemaken zoals intrusieve medische handelingen, een ongeluk, seksueel misbruik en andere vormen van mishandeling. Daarnaast zijn er negatieve ervaringen die niet duidelijk identificeerbaar zijn zoals chronische oorpijn- of buikpijn. Ook deze ervaringen beinvloeden de ouder-kind interactie/ hechtingsrelatie en hebben daarmee hun weerslag op het vermogen tot emotieregulatie en het gedrag.
Herinneringen aan deze gebeurtenissen zijn preverbaal en dus niet op bewust nivo toegankelijk. Daardoor worden zij gemakkelijk over het hoofd gezien als mede-oorzaak of instandhoudende factor van emotionele of gedragsproblematiek in de basisschoolleeftijd. Na aanmelding bij de Geestelijke Gezondheidszorg wordt behandeling daarom vaak gericht op de aanpak van de huidige gedragsproblematiek (symptoombestrijding). Onze ervaring is dat EMDR hier een goede aanvulling biedt. Deze methode richt zich immers op de ‘onderlaag’ van de problematiek door negatieve ervaringen die hieraan gerelateerd zijn te verwerken. Daarna kan een inhaalslag gemaakt worden met betrekking tot de emotieregulatie waardoor zowel gedrag als de ouder-kind interactie verbeteren.
Aan de hand van casuïstiek van infants en schoolkinderen wordt de indicatiestelling en toepassing getoond van het EMDR protocol bij de behandeling van kinderen die in de eerste 4 levensjaren getraumatiseerd zijn. In de presentatie wordt geillustreerd hoe de ‘verhalenmethode’ geintegreerd kan worden in een breder behandelaanbod.
Werkvorm
In de presentatie worden theorie en praktijk gecombineerd. Videobeelden ondersteunen het verhaal.
Infants (0-4 years), all kinds of traumatic experience as intrusive medical procedures, accidents, sexual abuse and other forms ofof abuse . There are also negative experiences that are not clearly identifiable as chronic ear pain or abdominal pain. These experiences affect the parent-infant interaction / attachment relationship and thus have their impact on the capacity for emotion regulation and behavior.
Memories of these events are preverbal and not accessible on a conscious level. Thus they are easily overlooked as a cause or co-maintaining factor of emotional or behavioral problems in primary school. After reporting to the Mental Health Treatment is therefore often aimed at addressing the current behavioral problems (symptoms). Our experience here is that EMDR provides a good addition. This method is focused on the 'layer' of the problem by negative experiences related to this process. Then caught up with regard to both behavior and emotion regulation allowing the parent-child interactions improve.
Through case studies of infants and schoolchildren being shown the indication and application of the EMDR protocol in the treatment of children who are traumatized life on April 1. The presentation illustrated how the 'stories'method can be incorporated into a broader range of treatment.
Form
In the presentation combines theory and practice. Video images support the story.
Keywords: Infants Children Pre-Verbal Trauma
Accuracy Verified: Yes
8. Dexter, B.A. (2007, March). An angel. EMDRIA Newsletter, 12(1), 11.
Language: English
Format: Newsletter
Abstract:
“Just wanted to share something with you all. It is more than rewarding to see the wonderful things
people do for each other here. I wrote this short story the other day, as a way to honor these young
people who have sacrifi ced all. These are your incredibly brave young men and women, out doing
patrols and convoys at extreme risk of death. It is also amazing to see the wonderful work the medical
staff does here. I am so very thankful that we can provide this kind of medical care for our troops.
Surely God works through their hands!”
Accuracy Verified: Yes
9. de Jongh, A. (2005, November). Angstjes, angsten en fobieën: Hoe pak je het simpel aan met EMDR? [Anxiety, fears and phobias: How to go about it simple with EMDR?]. Presentatie op de eerste congres van de Vereniging EMDR Nederland, Ede, Nederland.
Language: Dutch
Format: Conference
Abstract:
EMDR is een gevalideerde behandelmethode voor psychisch trauma. Maar niet altijd leidt het meemaken van een vervelende gebeurtenis tot PTSS: angsten of fobieën zullen veel vaker het gevolg zijn. In veel gevallen is de behandeling van een fobische stoornis zelfs een stuk lastiger dan van een PTSS. Dit komt omdat er meer geheugenrepresentaties moeten worden bewerkt. Een complicerende factor in de behandeling kan verder zijn dat we te maken hebben lastig, ingesleten vermijdingsgedrag (bijv. bij sociale angst) of dat een bepaalde stimulussituatie objectief vervelende kantjes heeft (bijv. bij sommige medische angsten).
In deze workshop leren de deelnemers:
- een handige manier om angsten te diagnosticeren en casuïstiek te conceptualiseren in termen van EMDR
- te beslissen in welke gevallen EMDR is aangewezen, wanneer een cognitief gedragstherapeutische aanpak (of een combinatie) beter geschikt is en hoe deze behandeling eruit ziet
- gericht angsttargets te identificeren en snel tot de juiste NCs en PCs te komen
- cliënten voor te bereiden op moeilijke of relatief onveilige stimulussituaties
Het materiaal wordt gepresenteerd aan de hand van videobeelden, demonstraties en oefeningen. De workshop is geschikt voor ervaren en minder ervaren behandelaars, zowel op het terrein van volwassenen als kinderen en jeugd.
EMDR is a validated treatment for psychological trauma but does not require the experience of an unpleasant event for PTSD: fear or phobias are more often the result. In many cases, the treatment of a phobic disorder even more difficult than one PTSD. This is because more memory representations should be modified. A complicating factor in treatment may also be that we are facing difficult ingrained avoidance behavior (e.g. social anxiety) or that a certain objective stimulussituatie nasty lace has (e.g. some medical fears).
In this workshop participants learn:
- A convenient way to diagnose anxiety and case studies to conceptualize in terms of EMDR
- To decide cases in which EMDR is appropriate when a cognitive behavioral approach (or a combination) is more suitable and how this treatment looks
- Terror targets aimed to identify and quickly correct the NCS and PCs to come
- Clients to prepare for difficult or relatively unsafe stimulussituaties
The material is presented on the video footage, demonstrations and exercises. The workshop is suitable for experienced and less experienced practitioners, both in the field of adults and children and youth.
Keywords: Anxiety Fears Phobias
Accuracy Verified: Yes
10. Darker-Smith, S. (2008, June). Anorexia nervosa: CBT versus EMDR (A preliminary study). Presentation at the annual meeting of the EMDR Europe Association, London, England .
Language: English
Format: Conference
Abstract:
In treating clients with Anorexia Nervosa, what does appear to be consistent is the general view (e.g. Waller;
Treasure; Brewer) that recovery will take on average between 1 to 2 years with many clients suffering from this
disorder never making a full or complete recovery. 16 clients with a previous diagnosis of anorexia nervosa and
under medical supervision with a BMI of between 16.5 � 18 and still meeting criteria of Anorexia Nervosa (DSM
IV) were offered either EMDR (N.10) or CBT (N. 6). No therapeutic emphasis was placed directly on food in either
the CBT or the EMDR group (e.g. Fairburn). Those receiving EMDR recovered substantially quicker once the target
memory precipitating the Anorexic Onset was identified. Interestingly, food intake and weight increased
without needing to be targeted as a separate matter, once the �feeder-memory� had been adapted in 8 out of the
10 EMDR clients. Whilst the CBT group did improve, they continued to fluctuate in terms of active anorexic
patterns of behaviour and their weight or food intake did not appear to improve significantly. Although this is
only a preliminary study, the EMDR group reached �recovery� at around the 3 � 4 month mark, compared to the
CBT group, who still reported phobic reactions to both body-image and food at the 4 month mark. At the initial 1-
month follow-up post-study, the CBT group were still exhibiting symptoms of mental pre-occupation with diet /
weight compared to the EMDR group, who had reached normal BMI ranges (N. 9) and all reported little to no
pre-occupation with diet / weight. It would appear, on the basis of this preliminary study that the precipitators to
the development of Anorexia respond well to EMDR treatment targeting the precipitant memory. Furthermore, 6
of the EMDR group reported using the safe-space imagery to reduce their anxieties surrounding food and this
may have been a contributory factor in their recovery.
Keywords: Anorexia Nervosa CBT Cognitive Behavioral Therapy
Accuracy Verified: Yes
11. Darker-Smith, S. (2007, June). Application of mindfulness for impulse control and self harm. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Self harm presents a risk in using EMDR with emotionally vulnerable clients, due to the dangers of their immediate behaviours. However, often these behaviours are in response to deep-seated memories linked to traumas, which with the help of EMDR could safely be processed once the impulsive and risky behaviours are controlled. Mindfulness has been utilised by the Author as a stabilisation method of reducing dissociation in clients, prior to trauma processing (CEP conference – Darker-Smith, 2005). More recently, the author has discovered that the application of mindfulness and imagery techniques work more effectively for clients with tendencies for self-harm, compared to alternative behavioural techniques designed to distract from or substitute for impulsive desires to self-harm (e.g.., the use of ice cubes or elastic bans, to create a distraction from the impulse). Two groups were studied in the process of treating co-morbid symptoms for alternative conditions with EMDR, ranging from eating disorders, anxiety disorders, and trauma, prior to EMDR processing. For clinical reasons, clients with depression, personality disorders and other Axis 2 disorders were not included in this study due to contraindications in current research relating to Mindfulness. Participants self-harming behaviours related to superficial cutting, punching, and burning. Group 1 consisted of six clients who were offered alternative behavioural techniques (e.g., elastic bands or ice cubes) to distract or substitute for the desire for self-harm. Group 2 consisted of eight clients who were offered mindfulness techniques, including imagery meditations to distract or substitute for the desire to self harm. The groups were distributed as evenly as possible and no major emphasis was placed on the treatment of self-harming behaviours, instead being placed on the major problems (anxiety, eating disorder or trauma).
The Group (1)[consisted of 6 persons:(3 with Anxiety, 3 with Eating Disorders, 1 with Trauma)] who were offered suitable behavioural techniques utilised them effectively when their distress levels were mild (between 1-4 on a 0-8 behavioural scale), however, reverted back t self harming behaviours (e.g., cutting, burning, pinching) when distress levels reached 5 or higher. The Group (2)[consisted of 8 persons: (3 with Anxiety, 4 with Eating Disorders, 1 with Trauma)] who were offered aspects of Mindfulness training to facilitate tolerance of distressing emotions and being aware of the active moment did not tend (on average) to revert back to self-harming behaviours, choosing instead to utilise mindfulness methods (such as 3-minute breathing space).
Conclusion: Mindfulness is more effective as impulse control for self-harming behaviours than behavioural alternative strategies and can be utilised as a form of stabilisation in combination with controlling impulsive behaviours, prior to EMDR.
Keywords: Impulse Control Mindfulness Poster Self Harm
Accuracy Verified: Yes
12. De Divitiis, A. M. (2010, June). Application of resource development and installation (RDI) in delivery preparation in order to prevent post partum depression. In Female issues. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
According to the latest statistical evidence Post-Partum
Depression develops in approximately 13% of women
during the second -third month after childbirth with symptoms
lasting between few weeks and a year and risks of relapse.
Unlike the Baby Blues (affecting 70% of mothers, with onset in
the 3'd - 6" day after delivery and spontaneous recovery within
approximately two weeks), likely to be caused basically by hormone
modifications in the immediate aftermath of childbirth.
PPD development would seem to be solely determined by psychological
factors: the experience of childbirth, the surfacing of
unresolved problems in the relationships with attachment figures,
the change in the woman's role both in the social sphere and
within the couple relationship, the fear of being unable to adequately
attend to the new responsibilities (both in terms of skills
and of the ability to cope with the additional workioad), etc.
Consequently, women experiencing childbirth as a traumatic
experience are more destabilized by the event, and therefore.
at a higher risk of developing PPD.
Childbirth requires the deployment of many personal resources.
A woman in labor must be able to bear the pain, while having
to "push", 1.e. contrast the automatic antalgic reaction (which
would close the delivery channel) and "meeting the pain", during
the "expulsion" phase. Considering that "Peak Performances"
require moving out of a person's comfort zone and
stretching a person's boundaries, childbirth experience can be
rightfully considered a "Peak Performance".
This work describes RDI application times and modes during Delivery
Preparation in order to strengthen the different personal
resources needed by pregnant women to experience her childbirth
as an ego syntonic experience. In this sense, RDI associated
with EMDR can be considered an actual Primary Prevention intervention,
capable of teaching women something positive about
themselves, thus effectively offsetting the onset of PPD. Furthermore
the results of the application of this technique collected
during the Post-Partum phase on 48 women will be discussed.
Learning objectives:
1 identification of the specific issues predisposing the development
of PTSD due to Childbirth and of Post-Partum Depression.
2. Framing Childbirth as a Peak Performance.
3 Learning RDI (Resource Development and Installation) application
through Bilateral Stimuli during Delivery Preparation Courses.
Keywords: Delivery Preparation Female Issues Resource Development and Installation RDI Symposium
Accuracy Verified: Yes
13. De Divitiis, A. M. (2008, Novembre). Applicazione dello sviluppo e installazione delle risorse (RDI) nella psicoprofilassi al parto finalizzata alla prevenzione delle depressione post partum (DPP) [Application of resource development and installation (RDI) in psychoprophylaxis geared to the prevention of postpartum depression(DPP)]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.
Language: Italian
Format: Conference
Abstract:
Dagli ultimi dati statistici risulta che la Depressione Post Partum viene sviluppata da circa il 13% delle puerpere nel corso del secondo – terzo mese successivi al parto e la durata dei sintomi varia da qualche settimana ad un anno, con rischi di recidiva.
A differenza del Baby Blues (colpisce il 70% delle puerpere, insorge in III – VI giornata e si risolve spontaneamente nell’arco di un paio di settimane), imputabile essenzialmente alle fisiologiche modificazioni ormonali (calo degli estrogeni e progesterone) dell’im-mediato post partum, lo sviluppo della DPP sembrerebbe invece essere determinata da fattori di natura strettamente psicologica: l’esperienza del parto, il riemergere di problematiche irrisolte nelle relazioni con le figure di attaccamento, il cambiamento di ruolo della donna sia nell’ambito sociale che all’interno della coppia, il timore di non essere in grado di attendere adeguatamente alle nuove responsabilità (sia sul piano delle proprie capacità, che del nuovo carico di fatica fisica), ecc.
Le donne che hanno vissuto il parto come esperienza traumatica risultano essere maggiormente destabilizzate da tale evento e quindi maggiormente esposte allo sviluppo della DPP.
Il parto richiede alla donna il reclutamento di molteplici risorse personali. Nel corso del “travaglio” la donna deve riuscire a contenere il dolore, mentre nella fase dell’“espulsione” le viene richiesto inoltre di “spingere”, ossia di contrastare una reazione antalgica automatica (che chiuderebbe il canale da parto) per andare invece “incontro al dolore”. Se consideriamo che le “Prestazioni di Picco” si caratterizzano per essere “al di fuori” del proprio ambito di sicurezza, di agio e di conforto, nel tentativo di oltrepassare il limite estremo delle proprie capacità, l’esperienza del parto può essere inscritta a pieno titolo nelle “Prestazioni di Picco”.
Nel presente lavoro vengono descritte le modalità e i tempi di applicazione del RDI nel corso della Preparazione al Parto, finalizzata al rafforzamento delle diverse risorse personali di cui ogni gestante ha bisogno per poter vivere il parto come esperienza egosintonica. In tal senso l’RDI, tramite EMDR, è da considerarsi un vero e proprio Intervento di Prevenzione Primaria, in grado di insegnare alle donne qualcosa di positivo riguardo sé stesse, contrastando efficacemente l’insorgere della DPP. Verranno esposti, inoltre, i risultati dell’applicazione di tale tecnica su 48 gestanti, raccolti nella fase del Post Partum.
The latest statistics show that postpartum depression is developed by about 13% of mothers during the second to third months after delivery and the duration of symptoms varies from few weeks to a year, with risks of recurrence. Unlike the Baby Blues (affects 70% of mothers, occurs in III - VI day and resolves spontaneously within a couple of weeks), largely because of the physiological hormonal changes (decline in estrogen and progesterone) of IM-mediated post-partum, the development of the DPP seems to be determined by factors strictly psychological: the experience of childbirth, the resurgence of unresolved issues in relations with attachment figures, the changing role of women both in social the couple, the fear of not being able to wait adequately to new responsibility (both in terms of its ability, that the new burden of physical labor, etc.). Women who have experienced childbirth as a traumatic experience become more undermined by this event and, therefore, at greater risk of developing the DPP. The birth of the woman requires the recruitment of many personal resources. During the "Labor" the woman must be able to contain the pain, while in phase the 'expulsion' is the also required to "push", i.e. a reaction to counter analgesic automatic (which close the channel by birth) to go instead "to meet the pain." If we consider that "Peak Performance" are characterized by being "outside" the extent of its security, ease and comfort, in an attempt to go beyond the bounds of their abilities, experience delivery can be fully inscribed in the "peak performance". The present paper describes the methods and timing of application of RDI during the preparation for childbirth, which aims to reinforce the various personal resources which each pregnant woman needs to live the experience of childbirth as ego syntonic. In this sense, the RDI, through EMDR is considered true primary prevention interventions that can teach women something positive about themselves to effectively counter the rise DPP. Will be exposed, in addition, the results of applying this technique on 48 pregnant women, collected at the stage of post-partum.
Keywords: Postpartum Depression RDI Resource Development and Installation
Accuracy Verified: Yes
14. Royle, L., & Kerr, C. (2010, March). Are EMDR therapists at greater risk of developing secondary traumatic stress disorders?. Presentation at the 8th EMDR Association UK & Ireland Annual Conference & AGM, Dublin, Ireland.
Language: English
Format: Conference
Abstract:
Therapists who come
into contact with traumatised individuals are at risk of absorbing their distress resulting in
their own psychological injury. There is a variety of factors that increase the likelihood of
this happening and it can be argued that the EMDR therapist is exposed to many more of
these factors than the generic therapist or counsellor. The presenters hope to raise
awareness of these risks as the first step in addressing them and reducing the stigma in
admitting to secondary trauma.
As well as being provided with a theoretical overview of secondary trauma, participants in
this workshop will be encouraged to consider their own level of risk and practical steps
they can take to reduce this. The workshop will provide an overview of psychological
injury constructs including Compassion Fatigue, Vicarious Trauma and Burnout along with
a description of signs and symptoms of secondary trauma. Current recommendations for
treatment options are outlined and an example is given of how EMDR can be used to
successfully treat secondary trauma in the therapist.
Keywords: Burnout Compassion Fatigue Vicarious Trauma Secondary Traumtic Stress
Accuracy Verified: Yes
15. Haycock, R. D. (2009). Arming commanders to combat PTSD: A time for change – Attacking the stressors vice the symptoms. School of Advanced Military Studies, United States Army Command and General Staff College, Fort Leavenworth, Kansas.
Language: English
Format: Other
Abstract:
Arming Commanders to Combat Posttraumatic Stress Disorder by COL Robert D. Haycock, US Army, 53 pages.
Just as war is not a new phenomenon, neither are the issues associated with the mental and emotional scars combat brings to those who fight a nation’s wars. Historically, the United States has assumed a reactive vice proactive posture as it relates to coping with the fiscal, and humanistic challenges that manifest within a nation at war, and those who experience the trauma of combat. The Army has proven slow to respond to the need to train and educate its leaders and instead has devoted vast capital on the assessment and treatment of posttraumatic stress disorder (PTSD), attacking the symptoms as they arise, vice attacking the stressors which cause the affliction. The invasions of Iraq and Afghanistan and the deployment of forces throughout the world to combat terror, however, have created conditions whereby PTSD is again in the lime-light.
This monograph examines PTSD from a historical perspective reviewing the manner in which the Army viewed, assessed, and treated those afflicted with PTSD as well its methods for training and educating those honored with the opportunity to lead these warriors in battle. This monograph highlights existing shortfalls in assessment, training, doctrine, and education as it relates to those commanding at the battalion-level.
The Army does not properly prepare battalion commanders for the complexities of coping with PTSD in their units nor arm them with the tactics, techniques, and procedures necessary to mitigate the effects of PTSD on the combat effectiveness of their units and the soldiers that fill the ranks.
The Army should implement more rigorous assessment programs for units deployed to identify those at risk of PTSD or demonstrating stress-related symptoms before the mental well-being of the soldier is dramatically affected and treatment becomes more difficult. Further, the Army should review and update existing doctrine and training techniques (Battlemind training) to focus specifically on commanders at the battalion level. The Army must demonstrate a linkage between doctrine, training and education, enhance efforts to consolidate PTSD resources for ease of access, and revise strategic communications procedures to reduce stigmas associated with PTSD. The Army must arm its tactical commanders with the tools to address the stressors associated with PTSD in order to preserve the force and ensure its effectiveness in the ambiguous and complex environment which appears to best characterize the way ahead.
Keywords: Combat Military Monograph Posttraumatic Stress Disorder PTSD Stressors
Accuracy Verified: Yes
16. Liotti, G. (2012, June). Attachment, psychotherapy and EMDR [Apego, psicopatología y EMDR]. Keynote presented at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
The
defense
system
(freezing-‐fight-‐flight-‐feigned
death),
that
is
set
into
motion
in
every
individual
by
the
exposure
to
any
event
that
threatens
life
or
bodily
integrity
in
the
self
or
in
significant
others,
is
terminated
after
the
event
is
over
by
mental
and
interpersonal
processes
involving
the
soothing
and
security-‐
seeking
system
(attachment).
If
the
functions
of
the
attachment
system
are
hindered
by
memories
(internal
working
model,
IWM)
of
early
attachment
interactions
with
neglecting
or
abusive
caregivers,
the
defense
system
may
remain
active
for
long
periods
of
time
after
the
traumatic
event
is
over.
Insecure
and
especially
disorganized
IWMs
of
early
attachments,
together
with
the
unavailability
of
social
support
after
the
trauma,
are
thus
risk
factors
for
developing
the
symptoms
of
post-‐traumatic
stress
disorders.
This
lecture
dwells
on
the
main
features
of
attachment
disorganization,
on
the
negative
interference
of
attachment
disorganization
in
the
therapeutic
relationship,
and
on
the
reasons
why
the
characteristic
patient-‐therapist
relationship
in
EMDR
interventions
can
be
instrumental
in
by-‐passing
such
negative
interference.
El
sistema
de
defensa
(respuesta
de
inmovilización-‐lucha-‐huída-‐muerte
fingida)
que
se
pone
en
marcha
en
toda
persona
por
la
exposición
a
cualquier
incidente
que
amenaza
su
vida
o
la
integridad
física
o
las
de
sus
allegados
llega
a
su
fin
tras
el
incidente
mediante
procesos
mentales
e
interpersonales
implicados
en
el
sistema
de
tranquilizar
y
la
búsqueda
de
seguridad
(apego).
Si
las
funciones
del
sistema
de
apego
se
ven
impedidas
por
los
recuerdos
(el
modelo
del
funcionamiento
interno,
IWM,
por
sus
siglas
en
inglés)
de
interacciones
precoces
de
apego
con
cuidadores
negligentes
o
abusivos,
es
posible
que
el
sistema
de
defensa
permanezca
activo
durante
períodos
prolongados
después
de
que
el
evento
traumático
haya
terminado.
Así,
los
IWM
inseguros
y
especialmente
desorganizados
del
apego
temprano,
junto
con
la
falta
de
apoyo
social
tras
el
incidente
traumático,
se
convierten
en
factores
de
riesgo
para
el
desarrollo
de
síntomas
de
los
trastornos
postraumáticos.
Esta
conferencia
se
centra
en
los
rasgos
esenciales
de
la
desorganización
del
apego,
en
la
interferencia
negativa
de
la
desorganización
del
apego
en
la
relación
terapéutica
y
en
los
motivos
por
los
cuales
la
relación
característica
entre
paciente
y
terapeuta
en
las
intervenciones
con
EMDR
pueden
ser
instrumentales
para
puentear
dicha
interferencia
negativa.
Keywords: Attachment Keynote
Accuracy Verified: Yes
17. Aurora, R. N., Zak, R. S., Auerbach, S. H., Casey, K. R., Chowdhuri, S., Karippot, A., Maganti, R. K., Ramar, K., Kristo, D. A., Bista, S. R., Lamm, C. I., & Morgenthaler, T. I. (2010, August). Best practice guide for the treatment of nightmare disorder in adults. Journal of Clinical Sleep Medicine, 6(4), 389-401.
Language: English
Format: Journal
Abstract:
Prazosin is recommended for treatment of Posttraumatic Stress Disorder (PTSD)-associated nightmares. Level A. Image Rehearsal Therapy (IRT) is recommended for treatment of nightmare disorder. Level A. Systematic Desensitization and Progressive Deep Muscle Relaxation training are suggested for treatment of idiopathic nightmares. Level B. Venlafaxine is not suggested for treatment of PTSD-associated nightmares. Level B. Clonidine may be considered for treatment of PTSD-associated nightmares. Level C. The following medications may be considered for treatment of PTSD-associated nightmares, but the data are low grade and sparse: trazodone, atypical antipsychotic medications, topiramate, low dose cortisol, fluvoxamine, triazolam and nitrazepam, phenelzine, gabapentin, cyproheptadine, and tricyclic antidepressants. Nefazodone is not recommended as first line therapy for nightmare disorder because of the increased risk of hepatotoxicity. Level C. The following behavioral therapies may be considered for treatment of PTSD-associated nightmares based on low-grade evidence: Exposure, Relaxation, and Rescripting Therapy (ERRT); Sleep Dynamic Therapy; Hypnosis; Eye-Movement Desensitization and Reprocessing (EMDR); and the Testimony Method. Level C. The following behavioral therapies may be considered for treatment of nightmare disorder based on low-grade evidence: Lucid Dreaming Therapy and Self-Exposure Therapy. Level C No recommendation is made regarding clonazepam and individual psychotherapy because of sparse data.
Keywords: Nightmares Posttruamatic Stress Disorder PSTD
Accuracy Verified: Yes
18. Heide, K. M., & Solomon, E. P. (2006, May-June). Biology, childhood trauma, and murder: Rethinking justice. International Journal of Law and Psychiatry, 29(3), 220-233. doi:10.1016/j.ijlp.2005.10.001.
Language: English
Format: Journal
Abstract:
This article reviews recent findings in the developmental neurophysiology of children subjected to psychological trauma. Studies link extreme neglect and abuse with long-term changes in the nervous and endocrine systems. A growing body of research literature indicates that individuals with severe trauma histories are at higher risk of behaving violently than those without such histories. This article links these two research areas by discussing how severe and protracted child abuse and/or neglect can lead to biological changes, putting these individuals at greater risk for committing homicide and other forms of violence than those without child maltreatment histories. The implications of these biological findings for forensic evaluations are discussed. Based on new understanding of the effects of child maltreatment, the authors invite law and mental health professionals to rethink their notions of justice and offender accountability, and they challenge policymakers to allocate funds for research into effective treatment and for service delivery. [Author Abstract]
Keywords: Adolescents Attachment Brain Development Child Abuse Criminal Behavior Child Neglect Children Criminal Responsibility Forensic Evaluation Homicide Juvenile Offenders Literature Review Mitigating Factors Murder Neglect Neuroendocrinology Neurophysiology Posttraumatic Stress Disorder PTSD Sociopathy Survivors Trauma Violence
Accuracy Verified: Yes
19. Klaus, P. (2007, June). Birth trauma: Causes, effects, methods to heal with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Clinicians will gain an understanding of the types of
events that create psychological and physiological distress
and trauma both at birth and afterward. Many conditions
have their origin during this early period where generational
messages as well as traumatic events surrounding
birth and the early period of life can have negative effects.
Participants will learn methods to work within the infant
mind/body memory to retrieve early trauma and the subsequent
events that reinforced it as well as facilitate
healing through the life path of the individual. Clinicians
can benefit by recognizing the elements that influence
these situations, and with EMDR and other adjunctive
techniques learn to resolve these very early experiences to
help clients reach a higher level of adaptation for health.
Objectives:
1.Identify the characteristics of traumatic or negative birth
experiences.
2.Recognize the risk factors that affect the birth and can
be projected onto the infant.
3.Identify the effects of early trauma on parent-infant relationships,
bonding, the marital relationship, and on
the infant.
4.Learn about long-term psychological and somatic sequelae
of perinatal trauma on the adult individual.
5.Describe, demonstrate, and practice psychotherapeutic
methods with EMDR to help resolve and heal these experiences.
Keywords: Birth Trauma
Accuracy Verified: Yes
20. Reitz, S. (2008, September). Body-memories: A potential healing obstacle in trauma therapeutical and EMDR - Processes and a re-traumatization risk regarding body-based psychotherapies and other body work therapies. In H. Kanitschar (Chair), Trauma and Hypnosis. Symposium presented at the 11th Congress of the European Society of Hypnosis in Psychotherapy and Psychosomatic Medicine, Vienna, Austria.
Language: English
Format: Conference
Keywords: Body-Based Therapies Re-Traumatization Risk Symposium Trauma
Accuracy Verified: Yes
21. Spector, J., & Kremer, S. (2009). Can I use EMDR with clients who report suicidal ideation?. Journal of EMDR Practice and Research, 3(2), 107-108. doi:10.1891/1933-3196.3.2.107.
Language: English
Format: Journal
Abstract:
No abstract available.
Keywords: Risk Assessment Suicide Ideation
Accuracy Verified: Yes
22. Naccarato, C. (2001, December). The capsule adventure. EMDRIA Newsletter, 6(Special Edition), 12-14.
Language: English
Format: Newsletter
Abstract:
In EMDR, a client often cannot seem to move forward in processing a particular memory or scene, and continued attempts seem to worsen the client’s physical response, causing pain or other discomfort. This is a potentially damaging situation in that the discomfort may remain, the memory may not get processed to resolution, and the client may develop a negative view of EMDR and of therapy. Some years ago, I developed a low-risk imaginal invasive technique to encourage clients to explore what was happening in, and to, their bodies, I call it the “Capsule Adventure.” Having used this intervention more than 50 times, I have found it to be a reliable way of resolving this type of impasse and moving the session forward.
Keywords: Capsule Adventure
Accuracy Verified: Yes
23. Loris, M., & Johnson, D. R. (2001, December). Case study: Client treatment preference and imaginal exposure in three cognitive behavioral PTSD treatment. Poster presented at the 17th annual meeting of the International Society for Traumatic Stress Studies, New Orleans, LA.
Language: English
Format: Conference
Abstract: This case discussion will examine the intervention of EMDR (Shapiro, 1989), Prolonged Exposure (Foa, Rothbaum, Riggs & Murdock, 1990), and the Counting Method (Ochberg, 1996) on three adult female patients with PTSD symptoms. A recent treatment outcome study of 40 female trauma victims (Johnson and Lubin, 2001 in press) comparing these three treatments finds that the efficacy of the three treatments is supported and that the element of imaginal exposure may be the critical therapeutic factor. The presentation of these three cases focuses on the issue of client’s treatment preference and client personality traits as factors which may interface with imaginal exposure in treatment efficacy.
Keywords: Counting Method Prolonged Exposure Poster
Accuracy Verified: Yes
24. McFarlane, A. (2003, October-November). CBT vs. EMDR in the treatment of PTSD. In B. A. van der Kolk (Chair), Treatment outcome studies of PTSD. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL .
Language: English
Format: Conference
Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment
outcome studies using four different treatment modalities (CBT,
EMDR, psychopharmacology and Cognitive Processing) and presents
data on comparative efficacy, treatment responsiveness and
resistance, effects on comorbidity, quality of life, and biological
changes that accompany symptom improvement.
CBT vs. EMDR in the treatment of PTSD: 114 subjects were randomized into the study, but only 45 completed
up to week 10. The subjects in the study comprise 45 sufferers of
Post traumatic stress disorder as defined by the Clinician
Administered PTSD Scale (CAPS) (caps score > 50, and who satisfied
criteria A,B,C and D for PTSD diagnosis) and the PCL-C (PCL-C>50).
All subjects were victims of a traumatic experience and were
recruited through newspaper or radio advertisements, referrals from
private practitioners (18 subjects) or through the State Government
Insurance Commission (SGIC) (27 subjects). Subjects were randomised
into one of three treatments. Fourteen subjects received
EMDR, 21 received CBT and 10 were control subjects. The mean
age of the sample was 41.38 (SD=11.55) with the minimum age of
19 and the maximum age of 61. Sixteen of the subjects were male
and 29 were female. During the treatment period 17 of the subjects
were taking antidepressants and 6 were taking anxiolytics.
Approximately half of the sample was married (22 subjects 48.9%),
12 had never married, 4 were separated, 1 was defacto and 6 were
divorced. The mean number of treatment sessions for the entire
sample was 8.53 (SD 1.65). Out of the 45 participants in the study, 26
had suffered only one single trauma in their lives, 11 had experienced
several single traumas, 3 had suffered one ongoing trauma
and 5 individuals had suffered at least one ongoing and one specific
trauma. The following results were performed on the treatment
groups (total 35 subjects), with the control group being excluded
from all analyses. All subjects, were aged between 18 and 65, lived
in metropolitan Adelaide and had an adequate command of
English (reading and writing).All subjects gave informed consent to
the study and expressed their willingness to comply with the protocol.
Subjects with a history of adult seizure disorder, organic brain
disease or who were assessed to be at significant suicide risk (a
score of 3 or more on suicide question in HAM-D), were excluded
from the study, as were subjects taking psychotropic drugs (anticonvulsive/
antipsychotic) or sedatives more than 4 times a week. All
assessment and treatment sessions were conducted at the
University of Adelaide Department of Psychiatry at the Queen
Elizabeth Hospital. Assessment sessions were conducted by trained
research assistants and all therapy sessions were conducted by a
clinical psychologist, trained in both EMDR and CBT. Subjects were
assessed for suitability to enter the study via an initial screening
instrument (sent out to subjects in the post) and an initial screening
interview. Patients were further evaluated at week 0
(baseline/immediately prior to commencement of treatment), 3, 4,
6, 8 10, 20 (10 week followup).
Keywords: CBT Cognitive Behavioral Therapy Symposium
Accuracy Verified: Yes
25. Allen, J. G. (2003). Challenges in treating post-traumatic stress disorder and attachment trauma. Current Women’s Health Reports, 3, 213–220.
Language: English
Format: Journal
Abstract:
Treating women suffering from trauma poses significant
challenges. The diagnostic prototype of post-traumatic stress
disorder (PTSD) is based on single-event trauma, such as
sexual assault in adulthood. Several effective cognitivebehavioral
treatments for such traumas have been developed,
although many treated patients continue to experience
residual symptoms. Even more problematic is the complex
developmental psychopathology stemming from a lifetime
history of multiple traumas, often beginning with maltreatment
in early attachment relationships. A history of attachment
trauma undermines the development of capacities to
regulate emotional distress and thereby complicates the
treatment of acute trauma in adulthood. Such complex
trauma requires a multifaceted treatment approach that
must balance processing of traumatic memories with
strategies to contain the intense emotions this processing
evokes. Moreover, conducting such treatment places
therapists at risk for secondary trauma such that trauma
therapists also must process this stressful experience
and implement strategies to regulate their own distress.
Keywords: Attachment Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
26. Borrelli, S. (2002). Chaper 5: Into the new millennium: Child advocacy and EMDR. The EMDR Practitioner. Retrieved from http://www.emdr-practitioner.net on 12/27/2008.
Language: English
Format: Other
Abstract:
When planning treatment for a child, we must assess carefully the developmental issues
(internal press) that seem to be ascendant at different life stages, the context (external
press) in which these issues are being accomplished and probably frustrated, and
secondary gains issues. Especially for a child, the risks of change must be prepared for.
Family therapy theories remind us that as the child improves, the status quo of the family
"crisis" will also need to adapt. We’re all aware of the obvious and subtle resistances to
change offered by family members. all of whom might be vying for survival guarantees.
A sensitive assessment of the family context, then, is an essential aspect of the treatment
process. Which family members are most likely to be allies in the quest for change, and
who are the most at risk, and likely to challenge positive changes? [Excerpt]
Keywords: Children
Accuracy Verified: Yes
27. Knipe, J. (2008, June). The CIPOS method -- procedures to therapeutically reduce dissociative processes while preserving emotional safety. Presentation at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
It is well documented (Maxfield and Hyer, 2002) that the 8-phase EMDR model is highly effective for clients who
are troubled by disturbing memories. However, clients who are dissociative often have great difficulty in
maintaining present orientation and the "dual attention" that is a necessary condition for processing. Dissociative
clients are highly vulnerable, during the EMDR Preparation, Assessment and Dissociation Phases, to becoming
disoriented and overwhelmed by the surprising intrusion of dissociated parts that bring intensely disturbing
images and other information. Since, with these clients, there is a greater risk of non-therapeutic dissociative
abreaction, it is very important to counter this risk with an increased emphasis on safety and containment of
affect. In this presentation, I will describe two procedures that can be helpful in making the healing power of
EMDR available to clients who have this kind of vulnerability. One is the BHS (Back of the Head Scale), a
procedure that can be useful in assessing a client’s moment-to-moment level of dissociation during a traumafocused
EMDR session. The other is the CIPOS (Constant Installation of Positive Orientation and Safety)
procedure, which is a method of slowing down processing, and carefully containing and controlling the
emergence of potentially overwhelming post-traumatic material. These methods will be illustrated with video
segments of a therapy session.
Keywords: Back-of-the-Head Scale BHS CIPOS Method Contant Installation of Present Orientation and Safety Emotional Safety Psycholgical Defenses Targeting
Accuracy Verified: Yes
28. Munker-Kramer, E. (2007, June). CISD and EMDR. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Both EMDR and CISD have their positions in the treatment of PTSD and Acute Stress Disorders. They are parts of clear concepts of best practice in crisis and disaster and psychology (e.g., as one focused part CISD) in the immediate care and evaluated trauma therapy methods (with EMDR as a crucial example of well researched trauma therapy) for aftercare. It is very important for the best support of concerned persons and survivors to have good and vice versa supporting management of the interfaces on this continuum.
This lecture will emphasize the author’s opinion on the best possibilities to combine both parts and positions. This will be underlined by some actual research findings on the needs of concerned person and their perception on what they get.
The way of combining both specialized methods will be discussed out of a practitioner’s (in both methods) point of view and will be illustrated by some concrete cases. A senseful combination of EMDR and CISD and a precise consideration and screening for genuine and known risk factors and leading symptoms (e.g., hyperarousal) seem to be a good practice for those starting to suffer from stress disorders.
Keywords: CISD Critical Incident Stress Debriefing
Accuracy Verified: Yes
29. Loris, M., & Johnson, D. R. (2001, December). Client treatment preference and imaginal exposure in three cognitive behavioral PTSD treatments. Presentation at the 17th annual meeting of the International Society for Traumatic Stress Studies, New Orleans, LA .
Language: English
Format: Conference
Abstract:
This case discussion will examine the intervention of EMDR (Shapiro, 1989),
Prolonged Exposure (Foa, Rothbaum, Riggs & Murdock, 1990), and the Counting
Method (Ochberg, 1996) on three adult female patients with PTSD symptoms. A recent
treatment outcome study of 40 female trauma victims (Johnson and Lubin, 2001 in
press) comparing these three treatments finds that the efficacy of the three treatments
is supported and that the element of imaginal exposure may be the critical therapeutic
factor. The presentation of these three cases focuses on the issue of client’s treatment
preference and client personality traits as factors which may interface with imaginal
exposure in treatment efficacy.
Keywords: Imaginal Exposure Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
30. Opdyke, D. C. (1995, May). Clinical efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder. Georgia State University. AAT 9608510.
Language: English
Format: Dissertation/Thesis
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) has gained notoriety as a brief treatment for PTSD. In EMDR, clients repeatedly bring up traumatic events in memory and visually track stimuli moving back and forth in front of them. Previous group studies of EMDR have had methodological problems, however. The present study attempted to (1) assess EMDR's effectiveness compared to an Eye Focus treatment controlling for eye movement; (2) compare both treatments to a wait-list control; and (3) rate therapist characteristics to check experimenter bias.20 participants suffering from PTSD were randomly assigned to either EMDR or Eye Focus (EF) treatments, and immediate treatment or wait-list conditions. After two 90-minute treatment sessions, outcomes were assessed on subjective measures of anxiety (SUDs) and cognitive beliefs (VOCs). The mean SUDs pre-post differences on matched pairs t-tests indicated significant reduction of disturbance for both the EMDR group, p < .001, and the Eye Focus group, p < .001. VOC ratings showed similar treatment gains. Two-factor analyses assessed changes across groups (2 administrations x 2 treatment groups) on two standardized measures, the Impact of Event Scale (IES) and the Modified PTSD Symptom Scale (MPSS). The IES showed a main effect for treatment F (2, 18) = 16.45, p < .001, while wait-list remained unchanged F (2, 18) = 1.09, p > .05. A significant interaction F (2, 18) = 6.69, p < .05 supported treatment efficacy. EMDR and EF participants improved equally on the IES, i.e., no differences for type of treatment, F (2, 18) = 0.54, p > .05. The MPSS also showed a main effect for treatment, F (2, 18) = 6.46, p < .05, with wait-list unchanged, F (2, 18) = 0.27, p > .05. This interaction was not significant, p =.10. Further, both EMDR and EF groups demonstrated improvement on the MPSS. Results suggest that (1) EMDR and Eye Focus are both effective in reducing some self-reported PTSD symptoms; (2) EMDR and Eye Focus scores improved significantly compared to wait-list; and (3) ratings of experimenter bias suggested that the EMDR and Eye Focus participants were treated equally by the therapist. Future comparison studies should use larger samples, independent assessors, and equally-trained independent therapists. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 56(11-B), May 1996, pp. 6402
Keywords: Empirical Study Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
31. Landin-Romero, R., Novo, P., Santed, A., Vicens, V., McKenna, P. J., Pomarol-Clotet, E., Salgado-Pineda, P., Shapiro, F., & Amann, B. (2012, June). Clinical remission and functional modulation of the default mode network in a subsyndromal, traumatized bipolar patient after EMDR psychotherapy. Poster presented at the annual meeting of EMDR Europe, Madrid, Spain .
Language: English
Format: Conference
Abstract: Purpose of the study: Some patients with bipolar disorder do not show complete remission between episodes, but continue to exhibit subsyndromal mood symptoms [1]. One factor related may be comorbid posttraumatic stress disorder (PTSD), which has been found to be present in 16% to 39% of patients with bipolar disorder [2]. We describe the first case of an unstable bipolar II patient with history of various traumas that received Eye Movement Desensitization and Reprocessing (EMDR) psychotherapy and also underwent functional magnetic resonance imaging (fMRI) before and after the EMDR treatment to explore its effect on the brain’s neural networks.
Keywords: Bipolar Disorder
Accuracy Verified: Yes
32. Cusack, K. J., & Spates, C. R. (1999, January-April). The cognitive dismantling of eye movement desensitization and reprocessing (EMDR) treatment of posttraumatic stress disorder (PTSD): A case report. Journal of Anxiety Disorders, 13(1-2), 87-99. doi:10.1016/S0887-6185(98)00041-3 .
Language: English
Format: Journal
Abstract:
Twenty-seven subjects were exposed to standard Eye Movement Desensitization and Reprocessing (EMDR) treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest and two separate follow-up periods. Potential subjects met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A two-factor repeated measures analysis of variance revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables (ScienceDirect).
Keywords: Adults Americans Empirical Study Longitudinal Study Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Stressors Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
33. Oglesby, C., Foster, S., Sime, W., North, T. C., & Lendl, J. (1999). Collaborative partnerships in sport psychology applications of EMDR: High performance and trauma recovery. Symposium conducted at the annual conference of the Association of the Advancement of Applied Sport Psychology, Banff, Alberta, Canada.
Language: English
Format: Conference
Abstract:
Clinicians who have grown to accept and support Eye
Movement Desensitization Reprocessing (EMDR) have
begun to diversify the types of trauma populations in which
EMDR is applied. Psychology of injury researchers have
suggested, on the basis of their work, that an exciting new
direction in sport psychology is the implementation and
testing of new interventions aimed at modifying risk factors
for athletes. It has also been suggested that extant models of
athletic injury may reasonably be re-interpreted to account for
other traumatic stressors, additional to injury, in sport. EMDR
may reduce stress and trauma reactions in sport participants.
EMDR, however, has been developed as a clinical tool and
there are limitations on entrance to training in the approach.
There are myriad ways, however, in which valuable
partnerships may be formed, among psychologists, sport
psychologists, and educational sport psychology consultants
to use EMDR on behalf of clients. This symposium, within its
five sections, will report on many such collaborations. The
following are the objectives of the session: (a) provide a brief
overview of the research and theory base for EMDR and its
use in performance work; (b) describe case reports of
successful partnerships among EMDR-trained sport
psychologists and variably trained professionals from sport
performance.
Keywords: Performance Enhancement Sports Psychology Symposium
Accuracy Verified: Yes
34. van Ommeren, M. (1996, October). Comment on Greenwald (1996): The assessment of fidelity to the EMDR treatment protocol. Professional Psychology: Research & Practice, 27(5), 529. doi:10.1037/0735-7028.27.5.529.
Language: English
Format: Journal
Abstract:
Comments on R. Greenwald's (see record 83-27577) article in which he argues that fidelity to the eye movement desensitization and reprocessing (EMDR) protocol is the critical factor that determines whether a treatment outcome study will show that EMDR is effective. M. Van Ommeren recommends the formation of a panel that can make assessments as to whether or not the treatments used in EMDR outcome studies have fidelity. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Keywords: Letter Methodology Professional Criticism Treatment Effectiveness
Accuracy Verified: Yes
35. Davidson, M. M., Potter, A. E., & Wesselmann, R. D. (2010, September/October). Comparing dialectical behavior therapy to eye movement desensitization and reprocessing: A phase-based trauma treatment pilot project. Poster presented at the annual meeting of the EMDR Internation Association, Minneapolis, MN.
Language: English
Format: Conference
Abstract:
• More effective methods to treat adults affected by childhood trauma, disturbed attachments, and adulthood intimate partner violence are critically needed.
• Research utilizing Adult Attachment Interview (Hess, 1999) had found that when mothers hold unresolved memories of loss or childhood abuse, their children typically develop disorganized attachments and that when mothers are poorly or inconsistently responsive to their children’s cues, the children typically develop insecure attachments • A history of abuse by childhood attachment figures also increases the likelihood of becoming involved in domestic violence experiences in adulthood for both sexes (Gratz, 2009; Henderson et al, 2005) • Previous research has demonstrated that attachment experiences influence emotional functioning and vulnerability to emotion dysregulation (Critchheld et al, 2008). Numerous empirical works demonstrate the relationship between attachment style and aggression (e. g., Sockwaite et al, 2002; Henderson et al, 2005)
• Emotion dysregulation and problems with impulse control and unstable relationships are common symptoms associated with childhood abuse by attachment figures (Fonagy, 1997; Bhipman et al, 2005)
• Funding more effective treatment for problems in functioning related to childhood trauma and attachment issues is imperative. Dialectical Behavior Therapy (DBT) and Eye Movement Desensitization and Reprocessing (EMDR) are two approaches that have proven beneficial in treating individuals with borderline personality disorders and trauma, respectively, and thus, could prove beneficial as treatment modalities for childhood trauma and attachment problems
• The current investigation is a pilot study aimed at evaluating a treatment protocol aimed at effectively assisting adults with a history of childhood abuse and/or intimate partner violence to regulate emotions, resolve childhood trauma, move toward a healthier and more secure attachment status, and reduce the risk of repeating the cycle of violence and child abuse. More specifically, this pilot project evaluated a phase-based trauma treatment program that included (a) a year-long, initial emotion regulation skills-training phases utilizing DBT and (b) a second phase of either 10 individual sessions of EMDR or 10 individual session focused on further DBT skills training
Keywords: DBT Dialectical Behavior Therapy Poster
Accuracy Verified: Yes
36. Jaberghaderi, N., Dolatabadi, S., & Zand, S. O. (2002, Winter). A comparison of eye movement desensitzation and reprocessing and stress inoculation training (SIT) for sexually abused girls. Advances in Cognitive Science, 3(4), 16-26.
Language: English
Format: Journal
Abstract:
Fourteen sexually abused girls aged 12-13, were randomly assigned to receive either EMDR or SIT. Participants and their parents completed Child Report of Post Traumatic Symptoms (CROPS), and Parent Report of Post Traumatic Symptoms (PROPS), pre and post treatment.
Results indicated that there was significant influence only on the PROPS. But there was a significant impact on both these instrument (CROPS & PROPS), with EMDR. In evaluating CROPS and PROPS, factor analysis with SIT illustrated that, externalizing and internalizing symptoms in PROPS and avoidance thoughts and behaviors in CROPS were treated. Further the results gathered from factor analysis with EMDR, showed that internalizing and somatic symptoms in PROPS and self harm, depression feelings and also somatic symptoms in CROPS improved as well. Clinical findings also suggested that EMDR and SIT did not have any significant differences in treating posttraumatic symptoms. Factor analysis found that, EMDR was more effective than SIT in treating somatic symptoms of sexually abused girls.
Keywords: Iran Sexual Abuse SIT Stress Inocculation Training
Accuracy Verified: Yes
37. Merkies, Y. (2012, March). Complexe PTSS: Evaluatie van een behandeling door cliënt en therapeut - "Je moet niet typen tijdens de EMDR" [Complex PTSD: Evaluation of treatment by patient and therapist - "You need not type during EMDR."]. Presentatie op de 6e congres van de Vereniging EMDR Nederland, Arnhem, Nederland.
Language: Dutch
Format: Conference
Abstract:
Inhoud Presentatie: Het behandelen van complexe PTSS gaat met ups en downs. Tevreden zijn over een behaald succes kan afgewisseld worden met een periode van wanhoop. Het is voor de behandeling van belang dat de therapeut steeds een helikopterview houdt. Vragen die de therapeut daarbij zichzelf onder andere stelt zijn: waar zitten we in het proces, ben ik als therapeut te voortvarend of neem ik te weinig risico. De patiënt kan indien mogelijk gestimuleerd worden van een afstand naar zijn eigen behandeling te kijken en te leren analyseren: waardoor krijg ik nu een terugval of hoe gaat het nu met me? De verantwoordelijkheid en de regie liggen uiteraard bij de therapeut. Hoe kijkt de patiënt achteraf terug op zijn behandeling en de verschillende fasen hierin? Wat heeft hem in moeilijke periodes geholpen? Welk gedrag van de therapeut heeft hem echt geholpen en wat was juist storend (zie titel)? In hoeverre was humor helpend? Hoe kijkt de patiënt terug op de mate van inspraak. In deze presentatie wordt aan de hand van videobeelden en een interview met een patiënt teruggekeken op het therapieproces.
De patiënt is een ernstig getraumatiseerde man, die na een periode van stabilisatie zijn traumatische ervaringen op papier tekende. De tekeningen zijn in het begin gebruikt bij de ordening en bij bepaling van de werkvolgorde van de EMDR- behandeling. Tijdens de behandeling kon hij zelf goed aangeven wat hem hielp en wat niet. Na een forse terugval was hij in staat om te analyseren waardoor dit kwam en wat er voor nodig was om hier weer uit te komen. Deelnemers krijgen mee wat de do’s en don’ts zijn vanuit patiënt perspectief. Het belang van het nadenken over de therapeutische houding wordt gestimuleerd. De mogelijke angst om blunders te maken is hierna verminderd.
"You need not type during the EMDR" Content Presentation: The treatment of complex PTSD goes with ups and downs. Satisfied with a success achieved can be varied with a period of despair. It is important that the treatment the therapist still keeps a helicopter view. Questions that the therapist himself, among other states are: where we are in the process, I as a therapist to energetically or I take too little risk. The patient may be encouraged where possible from a distance to his own treatment to look and learn to analyze: how do I get a relapse or how is it going with me? The responsibility and control are of course with the therapist. How does the patient subsequently returned to his treatment and the different phases in this? What has helped him in difficult times? What behavior of the therapist has really helped him and what was just annoying (see title)? To what extent humor was helpful? How does the patient back on the degree of involvement. In this presentation, using video footage and an interview with a patient look back on the therapy process.
The patient is a severely traumatized man, who after a period of stabilization are traumatic experiences on paper signed. The drawings are in the beginning when used in the arrangement, and determining the operating sequence of the EMDR-treatment. During treatment, he could well indicate what helped him and what not. After a sharp decline, he was able to analyze and so this was what it took to come here again. Participants will take what the do's and don'ts are from patient perspective. The importance of thinking about the therapeutic attitude is encouraged. The possible fear of making mistakes is reduced below.
Keywords: Complex Posttraumatic Stress Disorder C-PTSD Complex PTSD
Accuracy Verified: Yes
38. Waayer, M., & Feijtel, M. (2006, November). Context en timing bij EMDR behandelingen met adolescenten [Context and timing of EMDR treatment with adolescents]. Workshop gepresenteerd aan de tweede congres van de Vereniging EMDR Nederland, Arnhem, The Netherlands.
Language: Dutch
Format: Conference
Abstract:
Pubers en adolescenten, leeftijd tussen 12 en 18 jaar kennen intensieve, snel wisselende ontwikkelingsfasen waarbij het veel afstemming van de therapeut vraagt hoe hij of zij contact kan aangaan met de jongere en zijn ouders.
Deze jongeren komen slechts zelden met een eigen hulpvraag bij de GGZ. Meestal trekken de ouders aan de bel, soms school, soms een andere hulpverlener.
Om met adolescenten te kunnen werken is het essentieel dat we aansluiting zoeken en vinden bij de jongere zelf en hoe die zijn probleem ervaart, ook al kan deze probleemdefinitie lijnrecht tegenover de aanmeldingsreden staan. Als er een hulpvraag is gevonden die erkent kan worden door de jonger zelf en door zijn ouders/opvoeders heeft de behandeling meer bodem om te kunnen starten.
Een indicatie voor EMDR-behandeling vraagt altijd om goede voorlichting en uitleg. Bij jongeren speelt vervolgens mee dat de identiteitsontwikkeling en de daarmee gepaard gaande onzekerheidsgevoelens er vaak aan bijdraagt dat EMDR als een “ vreemde gang van zaken” wordt beschouwd. De therapeut moet genoeg vertrouwen in zichzelf en de therapie hebben om de jongere ook het vertrouwen te geven om in proces te durven gaan. Soms gaat dit in golfbewegingen.
Het effect van de behandeling kan om dezelfde reden ontkend worden door de jongere zelf ( er zijn dingen veranderd maar dat kan natuurlijk nooit komen door dat rare gedoe, dat komt vast door die nieuwe verkering die nu zo gelukkig maakt) en belangrijk is dan om ook de context van de jongere erbij te betrekken. Ouders, brusjes of/en vrienden en school kunnen belangrijke informatiebronnen zijn om een goede inschatting te maken over het eventuele effect van de behandeling.
Timing wanneer een EMDR-behandeling kan starten zal rekening moeten houden met schoolvakanties, proefwerken, PTA’s, (examen)feesten…omdat het belangrijk is om niet teveel risico te nemen op verbreking van het verwerkingsproces.
Teenagers and adolescents, aged between 12 and 18 years have intense, rapidly varying stages of development where it is much matching the therapist asks how he or she can enter into contact with juveniles and their parents.
These young people are rare with an own demand for care in mental health. Usually the parents pull the bell, school sometimes, sometimes another helper.
To be able to work with adolescents is essential that we seek and find connections with the young people themselves and what they are experiencing problems, even though this problem definition are diametrically opposed to notification reason. If there is a demand for care is found to be acknowledge by the younger self and his parents / guardians, the more soil treatment to start.
One indication of EMDR therapy always requires good information and explanation. Among young people is then that the identity development and the associated uncertainty feelings that often contributes EMDR as a "foreign affairs" is seen. The therapist must have enough confidence in himself and the therapy to the young people the confidence to dare to go to trial. Sometimes this in waves.
The effect of the treatment can be denied for the same reason the young people themselves (there are some things changed but that can obviously never get through the crazy stuff that is established by the new traffic that is so happy) and also important is to the context of the younger involvement. Parents, siblings and / or friends and school information important to a good estimate on the possible effect of the treatment.
Timing when an EMDR treatment will have to start with school, papers, PTA's, (exam) parties ... because it's important not to take too much risk of breaking the process.
Keywords: Adolescents Juveniles
Accuracy Verified: Yes
39. Bauman, W., & Melnyk, W. (1994, Mar). A controlled comparison of eye movements and finger tapping in the treatment of test anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 25(1), 29-33. doi:10.1016/0005-7916(94)90060-4.
Language: English
Format: Journal
Abstract:
15 pairs of introductory statistics students, matched on initial test anxiety, were randomly assigned to eye movement desensitization (EMD) or control (finger tapping) conditions to test whether EMD effectively treats test anxiety and, if so, whether eye movement is the critical factor. Both groups had significant decreases in subjective units of disturbance during treatment, suggesting that another source of attenuation of elicited anxiety may be as effective as eye movement in reducing anxiety. There was a significant decrease in Test Anxiety Inventory Emotionality Scale scores from pretest to follow up for both groups, but mixed results on the Worry Scale and total anxiety scores. [Author Abstract]
Keywords: Adults Anxiety Disorders College Students EMD Life Experiences Survivor Treatment Effectiveness
Accuracy Verified: Yes
40. Johnson, D. R., & Lubin, H. (2006). The counting method: Applying the rule of parsimony to the treatment of posttraumatic stress disorder. Traumatology, 12(1), 83-99. doi:10.1177/153476560601200106.
Language: English
Format: Journal
Abstract:
A study is described comparing Prolonged Exposure, Eye Movement Desensitization and Reprocessing, and the Counting Method with 51 multiply-traumatized women. Measures of PTSD were significantly reduced by all three methods, but differences among the methods were negligible. Because the Counting Method utilizes only imaginal exposure as a therapeutic element, support is given to the more parsimonious conclusion that imaginal exposure may be both the necessary and sufficient factor in therapeutic effect, countering a trend in the field toward more complex, multi-faceted treatment packages. [Author Abstract]
Keywords: Adults Counting Method Exposure Therapy Females Imaginal Exposure Multiple Traumatic Events Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Survivors Treatment Effectiveness Women
Accuracy Verified: Yes
41. Hillman, J. L. (2002). Crisis intervention and trauma, New approaches to evidence-based practice. New York, NY: Kluwer Academic/Plenum Publishers.
Language: English
Format: Book
Abstract: R
ecent findings from an American Psychological Association task force suggest that one in four therapists will experience patient suicide, and that one in eight will feel threatened by patient violence during their career. Experts from this task force have also noted that clinicians receive virtually no formal training or coursework in crisis intervention. Despite the increasing need for professional services among members of the general population, current practitioners have few texts available that provide step-by-step, detailed information about how to engage in crisis intervention, and how to integrate recent, empirical research findings into theory and practice. This volume helps bridge this critical gap by providing a theoretically advanced, yet practical guide to crisis intervention.
Particular attention is given to the role of violence within our culture, patient suicide, school and workplace violence, long-term sequelae of trauma, clinical assessment and risk management, professional boundaries and burn-out, domestic violence, and the neurophysiology of trauma, as well as the needs of typically underserved patient populations including minority group members, older adults, gays and lesbians, and children. The text also features critical reviews of controversial topics, including EMDR, critical incident stress debriefing, recovered memories, dissociative identity disorder, and alternative medicine. [Springer]
Keywords: Crisis Intervention Trauma
Accuracy Verified: Yes
42. Feldner, M. T., Monson, C. M., & Friedman, M. J. (2007, January). A critical analysis of approaches to targeted PTSD prevention: Current status and theoretically derived future directions. Behavior Modification, 31(1), 80-116. doi:10.1177/0145445506295057.
Language: English
Format: Journal
Abstract:
Although efforts to prevent posttraumatic stress disorder (PTSD) have met
with relatively limited success, theoretically driven preventive approaches
with promising efficacy are emerging. The current article critically reviews
investigations of PTSD prevention programs that target persons at risk for
being exposed to a traumatic event or who have been exposed to a traumatic
event. This review uniquely extends prior reviews in this area by using theories
of PTSD to suggest future directions in the area of PTSD prevention. The
authors first discuss the primary mechanisms of action believed to account
for the failure for PTSD symptoms to remit among a substantial minority of
traumatic event–exposed individuals. Second, empirical progress in PTSD
prevention efforts is reviewed. Third, the authors consider how existing prevention
programs target these mechanisms of action. Finally, the authors consider
directions for future research in the area of targeted PTSD prevention.
Keywords: Posttraumatic Stress Disorder Prevention PTSD Risk Trauma
Accuracy Verified: Yes
43. Jensma, J. (1999, Summer). Critical incident intervention with missionaries: A comprehensive approach. Journal of Psychology and Theology, 27(2), 130-138.
Language: English
Format: Journal
Abstract:
When people are exposed to, or involved in, traumatic occurrences, they are at risk for PTSD to follow in the wake. This involves more than psychological discomfort; it involves a host of physiological, mental, emotional, and spiritual sequelae. The results of trauma can be so debilitating that a missionary might be unable to continue to minister. The effects can last a lifetime. Given the relatively high level of risk for missionaries to experience critical incidents and the possible aftereffects, it is important for churches and mission boards to have an adequate and comprehensive approach to member care in ministering to missionaries when they encounter critical incidents. A comprehensive plan would include critical incident stress debriefing as soon as possible after an incident, one-to-one counseling -- preferably with a therapist trained in eye movement desensitization and reprocessing (EMDR) -- for those individuals experiencing complex PTSD, debriefing for the debriefers, and a post-critical incident seminar at least 3 months after the incident. [Author Abstract]
Keywords: Complex PTSD Literature Review Missionaries Posttraumatic Stress Disorder Psychological Debriefing PTSD Recent Events Stressors Survivors
Accuracy Verified: Yes
44. Jongedijk, R. A., Gersons, B. P. R., & ter Heide, F. J. J. (2011, Het Voorjaar). De behandeling van complexe ptss-patiënten: Traumagerichte therapieën [The treatment of complex PTSD patients: Trauma-focused therapies]. Presentatie op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam .
Language: Dutch
Format: Conference
Abstract:
Bij de behandeling van
complexe ptss-patiënten wordt niet altijd de evidence-
based behandeling toegepast, zoals die wordt
beschreven in de richtlijnen. Doorgaans is de
mening, dat stabilisatie het enige mogelijke is
vanwege gevaar voor psychische decompensatie.
Inmiddels is voldoende evidentie, dat traumagerichte
therapieën ook bij complexe ptsspatiënten
mogelijk en effectief zijn.
Doel: In deze bijblijfsessie zal worden
betoogd, dat evidence-based traumagerichte behandeling
bij complexe ptss-patiënten mogelijk en
wenselijk is. Aandacht zal worden besteed aan
moeilijkheden en mogelijkheden bij deze groep
patiënten.
Methoden: Na een algemene inleiding
over de richtlijnen voor psychotherapeutische
behandeling van ptss en over complexe ptss (R.
Jongedijk), zullen vervolgens presentaties worden
gegeven over drie evidence-based behandelvormen
voor ptss, te weten het Kort Eclectisch Protocol
voor ptss (kep; B. Gersons), narratieve exposure
therapy (net; R. Jongedijk) en eye movement desensitisation
and reprocessing (emdr; J. ter Heide).
Expliciet zal worden ingegaan op de moeilijkheden
en mogelijkheden van deze therapievormen
bij complexe ptss-patiënten. De aanpassingen in
de behandeling voor deze groep patiënten zal worden besproken. Na de voordrachten zal er tijd zijn voor vragen
en discussie.
Resultaten: Er is een duidelijk overzicht
gegeven van drie evidence-based psychotherapievormen
voor ptss. Voor de complexe groep
ptss-patiënten zijn de eventuele aanpassingen
aan de standaardprocedures van de behandeling
aan bod gekomen.
Aangetoond is dat deze behandelvormen
goed toepasbaar zijn bij complexe ptss-patiënten.
Conclusie: Evidence-based behandeling
van complexe ptss-patiënten door middel van
traumagerichte psychotherapie heeft doorgaans
de voorkeur. De deelnemer van de bijblijfsessie
heeft kennis genomen van drie evidence-based
behandelvormen voor ptss en kent de moeilijkheden
en mogelijkheden om deze toe te passen bij
complexe ptss-patiënten.
In the treatment of complex PTSD patients is not always evidence-based treatment applied as described in the guidelines. Typically, the view that stabilization is the only possible because of risk of psychological decompensation. Meanwhile, sufficient evidence that trauma-focused therapies even for complex ptsspatiënten possible and effective. Purpose: This bijblijfsessie will be argued that evidence-based trauma-focused treatment for complex PTSD patients is possible and desirable. Consideration will be given to problems and opportunities in this patient group. Methods: After a general introduction about the guidelines for psychotherapeutic treatment of PTSD and complex PTSD (R. Jongedijk) will then presentations are given on three evidence-based treatments for PTSD, namely the short Eclectic Protocol for PTSD (kep; B . Gersons), narrative exposure therapy (net; R. Jongedijk) and Eye Movement Desensitisation and Reprocessing (EMDR, J. Heide). Will explicitly address the difficulties and possibilities of this therapy are patients with complex PTSD. The adjustments in the treatment of these patients will be discussed. After the presentations there will be time for questions and discussion. Results: There is a clear overview of three evidence-based forms of psychotherapy for PTSD. For the complex group of PTSD patients, the adjustments to the standard procedures of treatment addressed. It has been demonstrated that these therapies are well applicable for complex PTSD patients. Conclusion: Evidence-based treatment of complex PTSD patients by trauma-focused psychotherapy is usually preferred. The participant of bijblijfsessie has noted three evidence-based treatments for PTSD and knows the difficulties and possibilities to apply it in complex PTSD patients.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD
Accuracy Verified: Yes
45. van der Vleugel, B. (2013, April). De behandeling van PTSS bij mensen met een psychotische stoornis [The treatment of PTSD in people with a psychotic disorder]. In Onderzoek track 1 and 2. Presentatie op Het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.
Language: Dutch
Format: Conference
Abstract:
Trauma is een risicofactor voor het ontwikkelen van psychose. Het hebben van een ernstige psychiatrische aandoening verhoogt de kans op het ontwikkelen van een co-morbide posttraumatische stress stoornis. Desondanks wordt een co-morbide PTSS zelden gediagnostiseerd en wanneer dit wél gebeurt is behandeling van deze PTSS bepaald niet vanzelfsprekend. Behandelaren vrezen vaak dat het openlijk bespreken van traumatische levenservaringen zal leiden tot decompensatie, heropname, middelenmisbruik, zelfbeschadigend gedrag en / of suïcidaliteit. Ondertussen werken de PTSS klachten als olie op het vuur van de psychose.
Omdat mensen met psychotische klachten over het algemeen werden uitgesloten van deelname aan onderzoek naar de effecten van PTSS behandeling was lang niet bekend of psychologische behandeling conform de Richtlijn Angststoornissen ook bij deze populatie veilig en effectief is. Hier begint verandering in te komen.
In deze presentatie komen achtereenvolgens aan bod:
- De resultaten van een pilot onderzoek naar de effecten van EMDR bij mensen met een psychotische stoornis en een co-morbide PTSS (Van den Berg & Van der Gaag, 2012).
- De resultaten van een gecontroleerde multiple baseline study naar de effecten van EMDR en Prolonged Exposure bij mensen met een psychotische stoornis en een comorbide PTSS (De Bont, Van Minnen & De Jongh, submitted).
- De opzet en eerste bevindingen van het onderzoeksproject Treating Trauma in Psychosis (T.TIP), een multicenter RCT naar de behandeling van PTSS bij mensen met een psychotische Trauma is a risk factor for the development of psychosis. Having a severe psychiatric condition increases the chance of the development of a co-morbid post-traumatic stress disorder. Nevertheless, a co-morbid PTSD rarely diagnosed and when this happens, treatment of these PTSD determined not obvious. Clinicians often fear that openly discussing traumatic life experiences will lead to decompensation, reuptake, substance abuse, self-injurious behavior and / or suicidality. Meanwhile, the PTSD symptoms as fuel to the fire of the psychosis.
Because people with psychotic symptoms were generally excluded from research into the effects of PTSD treatment was long unknown or psychological treatment in accordance with Directive Anxiety disorders also in this population safely and effective. Here begins to be changing.
This presentation will subsequently be discussed:
- The results of a pilot study on the effects of EMDR in people with a psychotic disorder and comorbid PTSD (Van den Berg and Van der Gaag, 2012) .
- The results of a controlled multiple baseline study on the effects of EMDR and Prolonged Exposure to people with a psychotic disorder and comorbid PTSD (De Bont, Van Minnen & De Jongh, submitted).
- The design and initial findings of the research Treating Trauma in Psychosis (T.TIP), a multicenter RCT on the treatment of PTSD in people with a psychotic disorder (De Bont et al, submittedstoornis (De Bont et al., submitted).
Keywords: Posttraumatic Stress DIsorder PSTD Psychotic Disorders
Accuracy Verified: Yes
46. Dautovic, E. (2013, April). De toepassing van EMDR bij volwassenen met een complexe PTSS en een licht verstandelijke beperking: Practice en evidence based [The application of EMDR in adults with complex PTSD and mild intellectual disabilities: Evidence-based and practice]. In Onderzoek track 1 and 2. Presentatie op Het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.
Language: Dutch
Format: Conference
Abstract:
Mensen met een verstandelijke beperking hebben een verhoogde kans op het meemaken van, voor hen, ingrijpende life-events en in het verlengde hiervan een verhoogd risico op het ontwikkelen van een posttraumatische stressstoornis (PTSS). De prevalentie van PTSS blijkt significant hoger te zijn bij mensen met een verstandelijke beperking (VB) dan bij mensen zonder VB. Daarnaast valt in de praktijk, bij deze populatie, de hoge prevalentie van complexe PTSS op.
EMDR is een effectieve behandeling voor PTSS bij mensen zonder VB. Ook wordt EMDR al breed ingezet voor de behandeling van (complexe) PTSS bij mensen met een VB. Er is echter nog maar weinig onderzoek gedaan naar de effectiviteit van EMDR bij deze populatie.
Bij Kristal, centrum voor psychiatrie en verstandelijke beperking, wordt EMDR al een aantal jaar toegepast in de behandeling van volwassenen met een complex trauma en een (lichte) verstandelijke beperking. Hierbij wordt het EMDR-behandelprotocol voor jeugdigen, zoals door de VEN uitgegeven, trouw gevolgd. Dit, echter altijd in combinatie met een stabiliserende pre-treatment, welke onze doelgroep weerbaarder moet maken voor de spanning die een traumabehandeling kan opwekken.
Naast de praktische toepassing, welke deze benadering practice based maakte, heeft binnen Kristal tussen 2010 en 2013, synchroon aan de behandeling, een pilot-onderzoek naar de effectiviteit van deze behandeling gelopen. Dit met het doel deze benadering ook evidence based te maken.
People with intellectual disabilities have an increased chance of experiencing, for them, major life events and by extension an increased risk of developing post-traumatic stress disorder (PTSD). The prevalence of PTSD was significantly higher in people with intellectual disabilities (VB) than in those without VB. Furthermore falls in practice, in this population, the high prevalence of complex PTSD.
EMDR is an effective treatment for PTSD in people without VB. Even though EMDR is widely used for the treatment of (complex) PTSD in people with VB. However, there is little research on the effectiveness of EMDR in this population.
In Crystal, center for psychiatry and mental retardation, is EMDR for a number of years in the treatment of adults with complex trauma and a (mild) mental retardation . Here the EMDR treatment protocol for young people, as issued by the VEN, faithfully followed. This, however, always in combination with a stabilizing pre-treatment, which our audience resilient to make the stress of trauma treatment can generate.
Besides the practical application, which this approach practice based made, has within Crystal between 2010 and 2013, synchronously treatment, a pilot study on the effectiveness of this treatment occurred. This with the aim of this approach is to make evidence-based.
Keywords: Adults Intellectual Disabilities Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
47. Berendsen, S. & de Jongh, A. (2006, November). Debriefing of EMDR: Praten en afwachten, of verwerking versnellen? [Debriefing and EMDR: Talking and wait, or processing speed?]. Presentatie aan de tweede congres van de Vereniging EMDR Nederland, Arnhem, Netherland.
Language: Dutch
Format: Conference
Abstract:
In de afgelopen 20 jaar is het aanvankelijke enthousiasme over debriefing en andere vormen van opvang na schokkende gebeurtenissen onder invloed van wisselende onderzoeksresultaten behoorlijk getemperd doordat de effectiviteit steeds meer ter discussie kwam te staan.
De inleiders zullen een overzicht geven van de verschillende vormen van vroege hulp na schokkende gebeurtenissen en uiteenzetten hoe men hierbij geconfronteerd werd met het volgende dilemma:
• Aan de ene kant mogen interventies het natuurlijke verwerkingsproces niet belemmeren. Zo kan het stimuleren van slachtoffers om direct over hun gedachten en gevoelens te praten conform het CISD (Critical Incident Stress Debriefing) model van Mitchell (1983) het risico vergroten dat zij overweldigd worden door de ervaring, hetgeen contraproductief kan werken. Omdat de meeste mensen (70 à 80 %) op eigen kracht herstellen raden de invloedrijke NICE richtlijnen uit 2005 ‘watchfull waiting’ aan: het monitoren van het beloop van de posttraumatische stressreacties bij slachtoffers en het therapeutisch interveniëren wanneer een diagnosticeerbare stoornis tot ontwikkeling komt.
• Aan de andere kant zal zo vroeg mogelijk hulp geboden moeten worden aan zogenaamde ‘hoog-risico’ slachtoffers: dit zijn mensen waarvan direct duidelijk is dat ze niet zo maar op eigen kracht zullen herstellen. Vroege hulp is erop gericht om het lijden te bekorten en de ontwikkeling van secundaire problemen te voorkomen (zoals werkverzuim c.q.-verlies, relatieproblemen en middelenmisbruik).
De inleiders stellen dat niet afgewacht moet worden totdat na 4 weken een PTSS gediagnosticeerd kan worden en dan pas therapeutisch te interveniëren. Bediscussieerd zal worden hoe vroeg na een schokkende gebeurtenis (enkele dagen tot weken) bij indringende herbelevingen (nare beelden met hoge SUD nivo’s) EMDR effectief ingezet kan worden (dit zal geïllustreerd worden met casuïstiek en videobeelden). Het doel is om bij de ‘laag risico’ mensen het natuurlijke verwerkingsproces te versnellen en bij de ‘hoog risico’ mensen een verwerkingstoornis te voorkomen.
Over the past 20 years, the initial enthusiasm for debriefing and other forms of relief after shocking events under the influence of changing research properly tempered by the effectiveness is increasingly being called on them.
The speakers will give an overview of the various forms of early support after traumatic events and explain how this was confronted with the following dilemma:
• On the one hand, the interventions do not impede natural process. Thus, encouraging victims to direct their thoughts and feelings to talk according to the CISD (Critical Incident Stress Debriefing) model of Mitchell (1983) increase the risk that they are overwhelmed by the experience, which is counter-productive work. Because most people (70 to 80%) on its own restore suggest the influential NICE guidelines 2005 'watchful waiting' to: monitoring the course of posttraumatic stress reactions in victims and therapeutic intervention when a diagnosable disorder develops.
• On the other hand, as early as possible should be offered help in so-called high-risk victims, these are people whose right it is clear that not just on their own recovery. Early help is designed to minimize suffering and to the development of secondary problems occur (such as absenteeism or loss, relationship problems and substance abuse).
The speakers that should not wait until 4 weeks after a diagnosis of PTSD can be and then therapeutic intervention. Discussed will be how soon after a shocking event (several days to weeks) in penetrating reliving (unpleasant images with high levels SUD's) EMDR can be used effectively (this will be illustrated with case studies and video). The goal is to "low risk" people's natural process to speed up and at 'high risk' people to avoid a processing disorder.
Keywords: Debriefing
Accuracy Verified: Yes
48. Darker-Smith, S. (2012, October). Dissociative disorders and EMDR: Depersonalisation, derealisation and dissociation. Presentation at the at the 4th Autumn EMDR Workshop Conference, Sheffield, UK.
Language: English
Format: Conference
Abstract:
Within the field of dissociative disorders, EMDR clinicians are advised that there should be significant stabilisation in the preparation phase of the standard protocol. Indeed, where a client has been experiencing depersonalisation and / or derealisation for a significant period of time, there can be elements of heightened risk, such as suicidal intent caused by living in this ‘half-life’ or ‘dream-state’. For these clients, using a float-back technique to introduce body sensation as a mechanism of grounding can be, and is, highly effective in terms of stabilisation. This can enable a swifter progression to a place of stability in order to target the cause of dissociation, where it has been triggered by a natural, protective psychological avoidance to a traumatic event as well as reduce risk of suicide in clients who are experiencing significant distress at being ‘trapped’ in this ‘alternate reality’.
Keywords: Derealization Depersonalization Dissociation
Accuracy Verified: Yes
49. Spoormaker, V. I., & Montgomery, P. (2008, June). Disturbed sleep in post-traumatic stress disorder: Secondary symptom or core feature?. Sleep Medicine Reviews, 12(3), 169-184. doi:10.1016/j.smrv.2007.08.008 .
Language: English
Format: Journal
Abstract:
Sleep disturbances are often viewed as a secondary symptom of post-traumatic stress disorder (PTSD), thought to resolve once PTSD has been treated. Specific screening, diagnosis and treatment of sleep disturbances is therefore not commonly conducted in trauma centres. However, recent evidence shows that this view and consequent practices are as much unhelpful as incorrect. Several sleep disorders—nightmares, insomnia, sleep apnoea and periodic limb movements—are highly prevalent in PTSD, and several studies found disturbed sleep to be a risk factor for the subsequent development of PTSD. Moreover, sleep disturbances are a frequent residual complaint after successful PTSD treatment: a finding that applies both to psychological and pharmacological treatment. In contrast, treatment focusing on sleep does alleviate both sleep disturbances and PTSD symptom severity. A growing body of evidence shows that disturbed sleep is more than a secondary symptom of PTSD—it seems to be a core feature. Sleep-focused treatment can be incorporated into any standard PTSD treatment, and PTSD research needs to start including validated sleep measurements in longitudinal epidemiologic and treatment outcome studies. Further clinical and research implications are discussed, and possible mechanisms for the role of disturbed (REM) sleep in PTSD are described.
Keywords: Etiology Insomnia Nightmares Posttruamatic Stress Disorder PTSD REM Sleep Risk Factor Sleep Sleep Apnea Sleep Disorders Treatment
Accuracy Verified: Yes
50. Krafona, K. (2010). Does eye movement desensitization and reprocessing (EMDR) have any utility in intellectual disabilities? Two bereavement case reports. The Ghana International Journal of Mental Health, 2(1).
Language: English
Format: Journal
Abstract:
Individuals with intellectual disabilities (ID) are to some extent discriminated against when it comes to the psychotherapies. The long held belief that individuals with ID do not benefit from such interventions has been attributed in part to communication difficulties, lack of insight and lack of language
sophistication. Yet, it is well known that these individuals are about four-fold at risk of developing mental health problems. Cognitive behavior therapies (CBT) and other related therapies are becoming more recognized in the field of intellectual disabilities. Loss and bereavement is common among people with ID but their exposure to interventions such as Eye Movement Desensitization and Reprocessing
(EMDR) has been limited. EMDR is a psychological intervention that encompasses many aspects of
traditional therapies such as CBT and psychodynamic therapies. There is little research in this area for people with ID. This paper reports two cases in individuals with intellectual disabilities who were
struggling with bereavement. They appear to have benefited from EMDR sessions and there may be
scope for research to establish its efficacy in this field.
Keywords: Intellectual Disabilities
Accuracy Verified: Yes
51. Tate, K. (2003). Does naturally occurring EMDR-like phenomena in the work environment increase employment risk for survivors of violent crimes?. Mental Health Santuary. Retrieved from http://www.naturalhealthweb.com/articles/tate1.html on 3/29/2013.
Language: English
Format: Other
Abstract:
EMDR (Eye Movement Desensitization and Reprocessing) is a controversial yet exciting therapy that assists many, including survivors of violent crimes to process their experiences so that they can move forward in their healing. The therapist deliberately stimulates left-right brain processing while facilitating an environment similar to that experienced while dreaming. It is particularly effective in treating people with post traumatic stress disorder.
While this carefully constructed set of circumstances is beneficial in the hands of a qualified EMDR practitioner and in a safe environment, is it possible that the very factors which lead to healing in EMDR therapy present themselves unawares outside the clinical environment causing post-traumatic stress episodes? The actual triggers leading to a post traumatic stress episode vary, but perhaps upon inspection a naturally occurring commonality mimicking the EMDR phenomenon is present.
Although eye movements are the most commonly used external stimulus employed by EMDR therapists, they also use auditory tones, tapping, or other types of tactile stimulation. Are there naturally occurring corollaries in the everyday environment which would make it difficult for a survivor of violent crime to function in their day to day duties? Are work tasks unknowingly triggering the beginnings of an EMDR session without the presence of an EMDR practitioner to facilitate the information processing? Is a post-traumatic stress response the result? Survivors of violent crimes are at high risk for employment. Does Naturally Occurring EMDR-Like Phenomena in the Work Environment Increase Employment Risk for Survivors of Violent Crimes?
Keywords: Posttraumatic Stress Disorder PSTD Survivors Violent Crimes
Accuracy Verified: Yes
52. Connell-Jones, G. (2011). Drug modulated EMDR Treatment for borderline personality disorder. Presentation at the 12th European Conference on Traumatic Stress (ECOTS), Vienna, Austria. European Journal of Psychotraumatology, Supplement 1, 189. doi:10.3402/ejpt.v2i0.7237189.
Language: English
Format: Journal
Abstract:
From my clinical work over the past 4 years a case series of 15 women patients, all detained in a secure hospital for
periods of up to 30 years discharged after EMDR therapy. Some cases discussed in depth, others factor analysed as
case series. Drug modulation permitted intensive therapy. The factors of complex stress disorder are beeing
discussed and its simlarity to borderline personality disorder. The effects of long term instititutionalisation after
detention in security. The responsible clinician as ‘‘goaler and therapist’’ as well as therapeutic pitfalls are being
explored. The psychopathology of the flashback is contrasted with the psychpathology of the alter (dissociative
identity). Prognostic factors and outcomes are being presented. The implications for personality disorder as a
diagnosis contrasted with complex PTSD will be evaluated.
Keywords: Borderline Personality Disorder BPD Drug Modulation
Accuracy Verified: Yes
53. Lueger-Schuster, B., & Olff, M. (2008, June). Early intervention following traumatic events. Presentation at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
On successful completion of the workshop, participants will be able to:
· Describe the commonly used approaches to early intervention following
traumatic events and the rationale behind them including blanket
intervention, targeted interventions and the timing of them. Describe specific interventions including critical incident stress debriefing,
psychological debriefing, psychological first aid, critical incident stress
management, trauma risk management, supportive counselling and trauma
focused cognitive behavioural therapy.
Discuss the current evidence base for the effectiveness of early interventions
following traumatic events.
Keywords: Early Intervention
Accuracy Verified: Yes
54. Dyregrov, A. (2006, March). Early interventions following disasters – A place for EMDR and trauma therapy?. Presentation at the 4th annual Conference of the EMDR UK & Ireland Association, London, UK.
Language: English
Format: Conference
Abstract:
Considerable professional debate exists regarding the role of mental health
professionals in the early intervention following disasters. Emotional first aid is a
natural part of disaster response in western countries, while the active
involvement of mental health professionals is debated. The current paradigm is
to screen to find those at risk after a period of time (usually > 1 month) and then
refer those in need to more active traumatherapeutic assistance based on the
screening results. Dr. Dyregrov will argue for an active role for mental health
professionals in the early response, but will discuss and question whether EMDR
or other specific trauma therapy should be offered within the first few weeks
following a disaster.
Keywords: Disasters Early Interventions
Accuracy Verified: Yes
55. Kutz, I., Dekel, R., Schreiber, S., Resnick, V., Dolberg, O. T., Barkai, G., Leor, A., Rapoport, E., & Bloch, M. (2008, November). The effect of a single session of EMDR on intrusive distress in acute stress syndromes. Symposium/panel conducted at the 24th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.
Language: English
Format: Conference
Abstract:
Early diagnosis and intervention in mass
casualty events: Since September 2000, Israeli and Palestinian societies suffered
great losses. on the Israeli side, civilians of all ages, and ethnic
groups, have been exposed to various types of terrorist attacks.
This symposium examines issues of diagnosis and interventions
The effect of a single session of EMDR on intrusive distress in acute stress syndromes: Purpose: To examine the efficacy of a single session of a modified
abridged EMDR protocol in reducing Acute Stress Syndromes
(ASS) following accidents and terrorist bombing attacks.
Methods: Treatment was provided, in a general hospital inpatient
and out-patient setting to 86 patients with ASS.
Friday: 11:00 a.m. – 12:15 p.m.
Presenters are underlined and discussants are italicized.
If serving in both roles, they are both underlined and italicized. Findings: Fifty percent reported immediate fading of their intrusive
symptoms and general alleviation of their distress, 27% described
partial alleviation of their symptoms, while 23% reported no
improvement. Four week and six month follow-up, in the terror
victims group only, showed that the immediate responders
remained symptom free, while half of the non-responders, who
also received subsequent additional interventions modalities, were
still symptomatic.
Conclusions: The difference in response may be attributed, in part,
to the fact that immediate responders tended to have an
uncomplicated ASS with fewer risk factors for PTSD, while the
non-responders had higher exposure to former traumas and
endorsed more risk factors for PTSD. These results support other
anecdotal reports on the rapid effects of brief EMDR intervention in
uncomplicated cases and offer a psycho-physiological hypothesis
for immediate response. While additional controlled studies are
essential, this immediate symptomatic relief may be a potential
addition for focused interventions in acute trauma victims.
Keywords: Acute Stress Disorder ASD Bombings Israel Palenstine Panel Symposium Terrorists
Accuracy Verified: Yes
56. Rooijmans, J., Rosenkamp, N. H. G., Vernholt, P., & Visscher, R. A. (2012). The effect of eye movements on craving, pleasantness and vividness in smokers. Social Cosmos, 3(2), 200-214.
Language: English
Format: Journal
Abstract:
The presence of craving is an important factor in continuing smoking. Following the
Elaborated Intrusion (EI) theory of Desire, craving is effective through the formation of
smoking-related mental images. In the current study, craving was generated through the use of
a future personal smoking-related image. Eye movements were observed in accordance with
the Eye Movement Desensitization Reprocessing (EMDR) intervention. The effect of these
eye movements on craving was investigated. In addition, the effect of eye movements on the
pleasantness and vividness of the image was examined. 36 participants took part in a withinsubjects
design with repeated measures. In line with expectations, perceived craving
decreased immediately after the experimental condition (eye movements) was experienced.
This decrease was not found in the control condition (fixation on a plain wall). After recall of
the smoking-related image, the extra measurement showed that the decrease was temporary.
Contrary to expectations, the degree of pleasantness and vividness did not decrease after eye
movements. In conclusion, the eye movements were found to have only a temporary effect on
craving for cigarettes, and did not result in desensitization of the pleasantness and vividness of
the personal smoking-related images.
Keywords: Craving EI-Theory Eye Movement Smoking
Accuracy Verified: Yes
57. Kutz, I., Resnik, V., & Dekel, R. (2008). The effect of single-session modified EMDR on acute stress syndromes. Journal of EMDR Practice and Research, 2(3), 190-200. doi:10.1891/1933-3196.2.3.190.
Language: English
Format: Journal
Abstract:
A single session of a modified, abridged EMDR protocol was provided in a general hospital inpatient and outpatient setting to 86 patients with acute stress (AS) syndrome suffering from intrusion distress following accidents and terrorist bombing attacks. Fifty percent reported immediate fading of intrusive symptoms and general alleviation of distress, 27% described partial alleviation of their symptoms and distress, while 23% reported no improvement. Partial and nonresponders were provided with or referred for more comprehensive treatment. At 4-week and 6-month follow-up, the immediate responders in the terror victims group remained symptom free. The immediate responders tended to have uncomplicated AS symptoms with fewer risk factors for posttraumatic stress disorder (PTSD), while the nonresponders had higher exposure to former traumas and endorsed more risk factors for PTSD. These results support other anecdotal reports on the rapid effects of brief EMDR intervention on intrusive symptoms in early uncomplicated posttraumatic cases. Although more controlled studies are essential, this immediate method for symptomatic relief may be a potential addition for focused interventions in acute trauma victims.
Keywords: Acute Stress Disorder ASD Intrusions Mass Casualty Event MCE Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
58. Becich, H. A. (1995). The effect of varying the rate of the eye movements in eye movement desensitization reprocessing (EMDR) with battered women. California School of Professional Psychology, Los Angeles, CA. AAT 9531596.
Language: English
Format: Dissertation/Thesis
Abstract:
The rapid saccades used in eye movement desensitization reprocessing (EMDR) have been reputed to be critical to its efficacy. To evaluate this hypothesis, the rate of the eye movements was varied in this study. Subjects included 27 battered women who were rated PTSD-positive by a modified version of the Symptom Checklist (MSC). Participants were randomly assigned to one of three groups: EMDR Fast, EMDR Slow or Control.Prior to treatment, subjects completed the Revised Impact of Events Scale (IES). Treatment involved one experimental session lasting up to 90 minutes. Dependent variables included the Subjective Units of Distress (SUDs) (derived from the Subjective Units of Disturbance Scale), the Validity of Cognition (VOC) and the Vividness of Traumatic Image (VTI) Scales as well as the Intrusion subscales of the MSC and the IES. At post-treatment one week later, subjects again provided responses to the five dependent variables and, for ethical reasons, were provided another session of treatment at the EMDR Fast rate if their SUDs were 2 or greater. Results of the mixed, two factor analyses indicated no differences between the groups. Hence, the outcomes showed that the rapid eye movements did not provide a differential treatment effect as hypothesized. All groups experienced improvement on the SUDs and VTI Scales and the MSC Intrusion subscale, supporting occurrence of an exposure effect. This investigation was the first controlled EMDR study conducted with battered women, as well as the first experiment on this procedure using a clinical population in which the rate of the eye movements was varied. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 56(5-B), Nov 1995, pp. 2854
Keywords: Adults Americans Battery Empirical Study Follow-up Study Females Posttraumatic Stress DIsorder PTSD Spouse Abuse Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
59. Manfield, P. (2006, September). Effective EMDR targeting with couples. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The workshop begins with a discussion of which clients this technique is appropriate for. The
technique is not recommended for couples in which
either or both partners do not have adequate affect
tolerance, observing ego, or trust of each other's
integrety. Other risk factors for using EMDR in
couples therapy that have been highlighted in other
presentations and literature will be briefly reviewed.
Participants will learn to differentiate between
clients' statements that represent present experience
and those that represent concepts of present
experience or reporting of past experiences.
Participants will be taught specific interventions
which they will practice in guided exercise that
will enable them to facilitate both individuals and
couples to stay in their present experience during
EMDR targeting. Irrational emotional responses
to daily interactions and conflicts are often the result
of unresolved issues resulting from underlying
feeder memories. Participants will learn a simple
method for identifying underlying issues of each
individual partner related to a given conflict. The
final and most substantial portion of this
presentation will be focused on using a refined
"affect bridge" technique to identify the feeder
memories associated with those issues so that they
can be targeted with the standard EMDR protocol.
Specific methods will be taught to overcome
clients' resistance and difficulties with accessing
memories; these methods include use of accessing
cues (re: Neurolinguistic Programming) and
developing eidetics (re: Eidetic Psychotherapy)
These methods will be illustrated using a case
transcript, guided participant experiential exercise, and live demonstration.
Keywords: Couples Couples Therapy Targeting
Accuracy Verified: Yes
60. Farkas, L. (2008, December). The effects of motivation-adaptive skills-trauma resolution (MASTR) - Eye movement desensitization and reprocessing (EMDR) on traumatized adolescents with conduct problems. Universite de Montreal, Canada. AAT NR55659.
Language: English
Format: Dissertation/Thesis
Abstract:
Objective.- This dissertation explored the effectiveness of a treatment package, Motivation-Adaptive Skills-Trauma Resolution (MASTR) in combination with Eye Movement Desensitization and Reprocessing (EMDR). This intervention was assessed in a sample of traumatized adolescents manifesting conduct problems (CPs) admitted to youth protective services. CP adolescents have been found to be particularly treatment-resistant and the treatments used with them often neglect to target the trauma that many of these youths have faced. Therefore, it seemed promising to implement a trauma-focused treatment with these youths that accounts for their resistance to treatment. MASTR-EMDR was studied with this population due to the favorable findings in the few studies assessing its use with high-risk populations. In addition to examining the effects of this treatment with CP youth exposed to various types of trauma, a particular focus was given to victims of sexual abuse (SA). This type of trauma seemed particularly suited for EMDR due to its circumscribed nature, which may be more easily worked through in this treatment that targets one trauma at a time.
Method.- Participants in the first study were 40 adolescents (ages 13-17) exhibiting CPs and exposed to trauma in youth protective services. A subsample (n = 30), consisting of victims of SA, was included in the second study. Participants in both studies were randomly assigned to MASTR-EMDR treatment or to a wait list condition where they were offered routine care. Self-report questionnaires and semi- structured interviews were administered to participants and one of their parents or caregivers by independent evaluators at three points in time: pre-treatment, post-treatment (12 weeks later) and follow-up (12 weeks after post-treatment). These measures evaluated trauma history, trauma-related sequelae, CPs, social competence and internalizing problems. The MASTR-EMDR sessions were administered once a week over a 12 week period, with each session lasting a maximum of 1.5 hours.
Results.- ANCOVAs and repeated measures ANCOVAs were used to assess treatment effects and the maintenance of gains at a 3-month follow-up. As predicted, MASTR-EMDR led to significant gains in outcome measures compared to routine treatment with both samples. In addition, gains were maintained at follow-up.
Conclusions.- This dissertation supports the use of MASTR-EMDR in populations exposed to general trauma and SA who exhibit CPs. This research was innovative in its implementation of a novel treatment-approach in youth protective services, where empirically-supported treatments are necessary and sometimes lacking. Therefore, the results have both clinical and scientific value and can help pave the way toward more trauma-focused treatments for CP youth, more evidence-based practices in youth protective services as well as enrich current understanding of the effects of this treatment approach.[Author Abstract]
Keywords: Conduct Problems Protective Services Psychotherapeutic Techniques Trauma Treatment Outcome Youth
Accuracy Verified: Yes
61. Sack, M., Lempa, W., & Lamprecht, F. (1999). Eine neue psychotherapeutische behandlungsmethode für patienten mit posttraumatischer belastungsstörung: EMDR. Behandlungsdurchführung und ergebnisse einer pilotstudie [A new psychotherapy treatment for patients with Post-Traumatic Stress Disorder: EMDR. Treatment implementation and results of a pilot study]. Psychomed, 11, 164-169 .
Language: German
Format: Journal
Abstract:
Nicht erst seit dem Zugunglück von Eschede und den damit im Zusammenhang stehenden Medienberichten wird zunehmend auch in der Öffentlichkeit bekannt, daß psychische Traumatisierungen zu einer tiefen und anhaltenden Verletzung des Gefühls der persönlichen Sicherheit und Unverletzbarkeit führen können. Dies wird oft wie ein Riß im Selbstverständnis oder wie ein Zusammenbruch des persönlichen Weltbildes beschrieben. Plötzlich wird die Welt als bedrohlich erlebt. Der Betroffene fühlt sich schutzlos und ausgeliefert. Typische Symptome, die in der Folge von belastenden Ereignissen auftreten, sind Schlafstörungen und Alpträume, quälende Wiedererinnerungen, Ängste und situationsbezogenes Vermeidungsverhalten sowie erhöhte Schreckhaftigkeit und Konzentrationsstörungen. Normalerweise bilden sich diese Symptome innerhalb einiger Tage bis einiger Wochen zurück. Bleiben diese psychischen und psychosomatischen Beeinträchtigungen jedoch bestehen, so ist bei einem Vorliegen von länger als 3 Monaten eine Posttraumatische Belastungsstörung zu diagnostizieren.
In den letzten Jahren wurde die Forschung über Traumafolgen erheblich intensiviert. Es wurden neue Erkenntnisse gewonnen, die dazu beigetragen haben, daß die psychotherapeutischen Verfahren zur Behandlung traumatisierter Menschen erheblich verbessert werden konnten. Seit vier Jahren behandelt die Abteilung Psychosomatik und Psychotherapie der MHH Menschen mit Posttraumatischen Belastungsstörungen im Rahmen einer Traumasprechstunde und erforscht die psychischen und biologischen Auswirkungen von Traumatisierungen.
Epidemiologie
Nach Ergebnissen einer Vielzahl von epidemiologischen Studien, ist die Posttraumatische Belastungsstörung (Posttraumatic stress disorder, kurz PTSD) infolge von Traumatisierungen in der Kindheit oder im späterem Leben, eine in ihrer Häufigkeit und sozioökonomischen Bedeutung lange unterschätzte Erkrankung. Unter Zugrundelegen der Diagnosekriterien der Posttraumatischen Belastungsstörung nach DSM-III-R liegt die Lebenszeitprävalenz in den USA für beide Geschlechter bei 7,8 Prozent bis 12,3 Prozent, wobei etwa doppelt so viele Frauen betroffen sind wie Männer (5). Für die deutsche Bevölkerung gib es noch keine epidemiologisch gesicherten Prävalenzzahlen, aber die Bedeutung von "Traumatisierungen" für die Entstehung oder für die erhebliche Verschlechterung psychischer Störungen wird immer deutlicher. Ein Beispiel hierfür ist die lebhafte Diskussion in den Medien über die psychischen Folgen von Traumatisierungen für Unfallopfer und Rettungskräfte in der letzten Zeit.
Die empirischen und klinischen Befunde zu Traumatisierungen in der Kindheit haben Egle, Hoffmann & Joraschky jüngst in einer Monographie zusammengestellt (1). Danach ist die Rolle von Vernachlässigung, Mißbrauch und Mißhandlung für eine Reihe von psychischen Störungen wie Selbstverletzendem Verhalten, Borderline-Störungen und Dissoziativen Störungen mittlerweile unstrittig und scheint auch für Subgruppen von Patienten mit Eßstörungen, Angststörungen, Persönlichkeitsstörungen und Somatisierungsstörungen von erheblicher Relevanz zu sein.
Weit unterschätzt ist zudem die Häufigkeit von Posttraumatischen Belastungsstörungen infolge von Unfällen oder Einsätzen in Krisengebieten. 20 Jahre nach dem Vietnamkrieg leiden noch immer ca. 15 Prozent aller Vietnamkriegsveteranen an einer PTSD. Opfer von Gewaltverbrechen und Überfällen sowie auch Zeugen von Gewalttaten, wie z.B. Rettungspersonal und Feuerwehrangehörige, stellen eine weitere Risikogruppe für die Entwicklung einer PTSD dar.
Not since the train wreck of Eschede and the related media reports, is increasingly known to the public that psychological trauma can lead to a deep and persistent breach of the feeling of personal safety and invulnerability. This is often described as a crack in the self or as a breakdown of the personal worldview. Suddenly the world is experienced as threatening. The person concerned feels defenseless and delivered. Typical symptoms that occur as a result of stressful events are insomnia and nightmares, distressing recollections, fears and situational avoidance behavior and increased nervousness and difficulty concentrating. Usually these symptoms are back within a few days to a few weeks. But they remain psychological and psychosomatic disturbances exist, so with a presence of more than 3 months is a post-traumatic stress disorder to diagnose.
In recent years, research on consequences of trauma was significantly intensified. It gained new insights that have contributed to the psychotherapeutic method for the treatment of traumatized people could be greatly improved. For four years, the Department of Psychosomatic Medicine and Psychotherapy, MHH treats people with post-traumatic stress disorder in a trauma clinic and explores the psychological and biological effects of trauma.
Epidemiology
According to results of a large number of epidemiological studies, post-traumatic stress disorder (Post Traumatic Stress Disorder, PTSD short) as a result of trauma in childhood or in later life, a decrease in frequency and socio-economic importance of long underestimated disease. Inter alia with the diagnostic criteria of posttraumatic stress disorder according to DSM-III-R lifetime prevalence in the U.S. is for both sexes at 7.8 percent to 12.3 percent, with about twice as many women are affected as men (5). For the German people give it no epidemiological prevalence data secure, but the meaning of "trauma" in the development or for the serious deterioration of mental disorders is increasingly clear. An example is the lively discussion in the media about the psychological consequences of trauma for victims and rescue workers in recent times.
The empirical and clinical findings concerning traumatic experiences in childhood have Egle, Hoffmann & Joraschky recently compiled in a monograph (1). Then disorders the role of neglect, abuse and mistreatment for a number of mental disorders such as self-injurious behavior, borderline disorders and dissociative now undisputed, and appears to be for subgroups of patients with eating disorders, anxiety disorders, personality disorders and somatization disorders is of considerable relevance.
Also greatly underestimated the incidence of post-traumatic stress disorder as a result of accidents or operations in critical areas. 20 years after the Vietnam War still suffer about 15 percent of Vietnam War veterans in a PTSD. Victims of violent crimes and robberies, as well as witnesses of violence, such as Rescue workers and firefighters, are another risk group for the development of PTSD dar.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
62. Hofmann, A., & Hase, M. (2012, June). EMDR to treat chronic depression [EMDR en el tratamiento de la depresión]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Depression is an often debilitating disease with a high prevalence. Not only is depression associated with other diseases, often leads into disability but shows a high risk of suicides. Relapse is seen often and every relapse increases the risk of chronicity. Research shows that there is no strong correlation with genetic factors but with stressful life-‐events. There is growing evidence of the efficacy of EMDR in the treatment of chronic depression. Two pilot studies show promising data. A European multicenter study is running since 2010. As EMDR is often well tolerated and accepted there is hope to gain another option in the treatment of chronic depression. The EMDR depression protocol aims to achieving more complete remissions of a depressive episode and prevent later relapse. In this workshop the presenters will explain the depression protocol, regarding treatment planning, targeting sequence and techniques. Video demonstration will outline the teaching points and will enable the participant to integrate this approach into clinical practice.
La
depresión
es
a
menudo
una
enfermedad
debilitante
con
una
alta
prevalencia.
No
sólo
se
asocia
a
otras
enfermedades,
en
muchas
ocasiones
puede
derivar
en
una
invalidez
y
muestra
un
alto
riesgo
de
suicidios.
Las
recaídas
son
muy
comunes
y
cada
recaída
incrementa
el
riesgo
de
la
cronicidad.
Las
investigaciones
muestran
que
no
existe
una
fuerte
correlación
entre
los
factores
genéticos,
pero
sí
con
eventos
vitales
estresantes.
Existe
una
creciente
evidencia
de
la
eficacia
del
EMDR
para
el
tratamiento
de
la
depresión
crónica.
Dos
estudios
piloto
muestran
datos
prometedores
en
un
centro
multidisciplinar
que
lleva
funcionando
desde
2010.
Como
la
terapia
con
EMDR
normalmente
es
bien
tolerada
y
aceptada,
existe
la
esperanza
de
contar
con
otra
opción
para
el
tratamiento
de
depresión
crónica.
El
protocolo
de
depresión
crónica
EMDR,
tiene
como
objetivo
conseguir
una
más
completa
remisión
de
los
episodios
depresivos
y
prevenir
las
recaídas.
En
este
taller
los
ponentes
explicarán
el
protocolo
de
depresión
referente
a
la
planificación
del
tratamiento,
detección
de
secuencias
y
técnicas.
Una
demostración
en
vídeo
resumirá
las
pautas
de
actuación
y
permitirá
al
profesional
integrar
este
enfoque
en
la
práctica
clínica.
Keywords: Depression
Accuracy Verified: Yes
63. Darker-Smith, S. (2011, October). EMDR and borderline personality disorder and use of B2T protocol. Presentation at the 3rd annual EMDR Autumn Workshop Conference, Durham, England.
Language: English
Format: Conference
Abstract:
The adaptation of the order of the EMDR 8-phase standard protocol to target specific abandonment issues first and primarily limits the therapy interfering behaviours which lengthens overall therapeutic intervention duration and acts as a road-block (Leahy etc.) to therapy. Specifically, using a blind-to-therapist protocol for this client group once fears of abandonment (often acted out in the therapeutic dynamic) is addressed, then the risk of empathy-enhancing exaggerations is reduced. (Author abstract)
Keywords: Borderline Personality Disorder
Accuracy Verified: Yes
64. Hofmann, A. (2001, May). EMDR and dissociation. Presentation at the EMDR Europe Association annual meeting, London, UK .
Language: English
Format: Conference
Abstract:
Patients with dissociative disorders usually are a complex traumatised population that has an
increased risk of complications during their treatment course. In treating these patients
EMDR can be one of the key treatment approaches in a therapy setting that usually needs to
include a number of other treatment modalities and an overall comprehensive treatment plan.
The objective of this presentation is to give an overview of the opportunities that EMDR
offers and to reduce risks in the course of treatment.
Keywords: Dissociation
Accuracy Verified: Yes
65. Ostacoli:, L., Bertino, G., & Faretta, E. (2013, June). EMDR and health: EMDR brief treatment in medical conditions with a high emotional charge: A possible challenge. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland.
Language: English
Format: Conference
Abstract:
Stress and high emotional situations such as complex traumas have a negative influence on the psycho – physiologic adaptive process to illness. If these experiences are not elaborated, they could be stored as dysfunctional memories causing psychophysical vulnerability. EMDR treatment requires a proper detection and reprocessing of stressing memories in present and past events and in future templates, handling worries and fears.
Treatment protocol for serious medical diseases will be presented, focusing in the domains of Multiple Sclerosis and Oncology. Starting from the person and his system (biopsychosocial model), the main interest will be placed on case conceptualization and preparation of the project with EMDR, and then the identification of targets for further processing. From here, through the exposure of specific cases treated, we will work on bodily symptoms (the feeling perceived) through floatback to promote the connection of memories. The presentation of the research project and the first data obtained will follow.
The design helps the person to relate themselves to the traumatic material as something that they can see, represent, touch, by sharing and by exploring their resonances with the therapist; the design provides an emotional containment that allows the processing of intense emotions, reduces significantly the risk of dissociations, and allows the recovery of creative resources.
The fundamental aim of the model is to facilitate the building of a constructive relationship with themselves and with the “sick body”, by elaborating the traumatic events that have led to a dysfunctional self-image and explored, strengthened their resources with the aim of building the “navigation tools” and an effective “first-aid kit” for times of crisis. It will be presented the model of the intervention and the strategies proposed and used, through the presentation of clinical cases.
The analysis of the success factors and of the difficulties encountered will allow us to define a possible direction for future brief interventions with patients affected by complex organic diseases.
Learning objectives:
To learn EMDR protocols adapted to deal with serious medical illnesses such as Cancer and Multiple Sclerosis;
To analyse the therapeutic process by narrative and graphic material; and
To learn specific features to deal with fears of loss and impairment
Keywords: Disease Medical Illness Multiple Sclerosis Oncology
Accuracy Verified: Yes
66. Spierings, J. J. (1999). EMDR and mourning. New Hope, PA: EMDR Humanitarian Assistance Programs.
Language: English
Format: Book
Abstract:
This manual is based on presentations given by Dr. Spierings. Specific topics are covered, such as the definitions, phases and tasks of handling the normal mourning process. Also included are topics based on clinical indicators, high risk factors and protocols for the complicated mourning process. [EMDR-HAP]
Accuracy Verified: Yes
67. Spierings, J. (2000, May 6). EMDR and mourning. Presentation at the annual meeting of the EMDR Europe Association, Utrecht, Netherlands.
Language: English
Format: Conference
Abstract:
This presentation consists of the following two parts:
I. The normal mourning process:
Defintions, phases, mourning tasks and characteristics
General treatment principles, EMDR and other treatment techniques
Therapeutic attitude and your own grief reactions as a therapist
II. The complicated mourning process:
Definitions, high-risk factors, diagnostic criteria and clinical indicators
Patterns of complicated mourning
For each pattern: specialized treatment techniques, EMDR protocols and treatment plans
Keywords: Complicated Grief Grief Mourning Protocol
Accuracy Verified: Yes
68. Nickerson, M. (2008, June). EMDR and the treatment for angry and violent behaviours. Presentation at the annual meeting of the EMDR Europe Association, London, England .
Language: English
Format: Conference
Abstract:
This workshop will assist the EMDR clinician to more effectively treat angry and violent behaviour. It will include
an initial review of the prevalence, impact and dynamics of the problem. The common cyclical nature of violent
acting out will be depicted as well as other characteristics in a spectrum of hostile behaviours including
perpetrator state and trait issues. Current non-EMDR clinical approaches and the evolving field of domestic
violence will be reviewed to aid the EMDR clinician in skilfully integrating into existing clinical contexts and to appreciate the unique capacities of EMDR. The primary focus of the workshop will be on special considerations
in the successfully tailored use of the 8-Phase Treatment approach. Clients with problematic anger or violent
behaviour present many challenges for the often undertrained clinician and commonly avoid, resist and
manipulate treatment or drop out prematurely. Keys to successful clinical engagement, risk assessment and case
formulation will be highlighted as critical to early phases of treatment. A metaphor based guide to case
formulation will be presented and a decision-tree style flow chart will be offered to inform treatment planning
including determining client readiness for trauma processing. EMDR offers the potential for desensitizing the
trauma that often drives violent behaviour. Considerations in the identification, prioritization and sequencing of
targets for processing will be outlined. This will include use of the cycle of violence model for target
identification. Multiple clinical examples will be offered to illuminate points including video taped case material.
Accuracy Verified: Yes
69. Donovan, L. (2002, June). EMDR and traumatized children/adolescents: Systemic affect regulation. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.
Language: English
Format: Conference
Abstract:
Developmental and systemic perspectives support incorporating the caregiver/family in EMDR treatment of children and adolescents to
maximize efficacy and minimize risks. Participants will learn to: 1)
identify multiple options, risk factors, and guidelines (eg, for timing,
sequencing, identifying the need for EMDR/RDI in the traumatized parent/caregiver as well as the child); 2) identify strategies to maximize vicarious
processing, and promote resource development and affect regulation in
the caregiver/family; 3) define with the family ways to provide safety,
take rerponsibility and guide choices; and 4) utilize the nartural relational
context to develop affect regulation in the child/adolescent.
Keywords: Adolescents Affect Regulation Children
Accuracy Verified: Yes
70. Nickerson, M. (2008, September). EMDR and treatment for angry and violent behaviors. Presentation at the annual meeting of the EMDR International Assocation, Phoenix, AZ.
Language: English
Format: Conference
Abstract:
EMDR offers unique potential in the treatment of clients with angry and violent behaviors. This workshop will include an initial review of the issue’s prevalence, common dynamics, and historic intervention strategies. The underaddressed role of trauma often driving these tendencies will be illuminated. Primary focus will be on the tailored implementation of the 8-Phase Treatment approach. Keys to successful clinical engagement, risk assessment and a metaphor based guide to case formulation will be highlighted. Considerations in the identification, prioritization and sequencing of targets for processing will be outlined. Clinical examples will be offered to illuminate points, including video taped case material.
Keywords: Angry Behaviors Violent Behaviors
Accuracy Verified: Yes
71. Lackie, B. (2004). EMDR as an early itervention in trauma and disaster mental health. Presentation at the annual meeting of the American Psychological Association, Honolulu, HI.
Language: English
Format: Conference
Abstract:
Summarizes a presentation discussing EMDR as an early intervention in trauma and disaster mental health. EMDR is one of the more effective preventative approaches to the effects of disaster and trauma which has emerged over the past ten years. This part of the presentation will review the research findings for effectiveness of this particular approach to reducing the risks of future PTSD, comparing and contrasting it to the alternative approaches presented by the panel. Please see the attached author submitted abstract for more detailed informatoin on EMDR.
Keywords: Disasters Intervention Mental Health Posttraumatic Stress Disorder Prevention Risk Factors Trauma Treatment Effectiveness Evaluation
Accuracy Verified: No
72. Braun, P., & van Og, A. (2005, November). EMDR bij klinisch opgenomen TBS-gestelden: ”Elk voordeel heb z’n nadeel” [EMDR clinical TBS recorded as such: "Any benefit me his disadvantage"]. Presentatie op het Eerste Congres van de Vereniging EMDR Nederland, Ede, Nederland.
Language: Dutch
Format: Conference
Abstract:
Deze lezing gaat over het implementeren van EMDR
in een zeer complexe (TBS) instelling, waarbij beveiliging en onlosmakelijk behandeling verweven zijn, met een diagnostisch zwaar belaste doelgroep:
• Meervoudige persoonlijkheidsstoornissen
• Meervoudig ernstig getraumatiseerd
• Verslavingsproblematiek
• Specifieke psychiatrische problematiek
• Forensische problematiek
• Combinaties
Het TBS systeem van behandelen (met beveiliging als belangrijk punt) verhoudt zich soms moeilijk tot de behandeling met EMDR van de individuele patiënt. Angst voor de beheersbaarheid van een patiënt gedurende de behandeling kan als een contra-indicatie worden gezien voor EMDR-behandeling. Het is de vraag of EMDR gecontraïndiceerd is in een TBS-kliniek vanwege de veiligheid. De inbedding van de behandeling in de TBS-kliniek alsmede het toepassen van zelfcontroletechnieken zijn hierbij belangrijke factoren.
Complicerende factor is dat veel TBS-patiënten zowel zelf getraumatiseerd zijn als wel ernstige delicten hebben gepleegd waarmee ze anderen hebben getraumatiseerd.
In deze lezing willen wij vooral aan de orde stellen hoe de behandeling van het daderschap zich verhoudt tot de behandeling van het slachtofferschap van de patiënt. We willen hiervan zowel de inhoudelijke als de ethische kant belichten. Van belang hierbij is ook de discussie rondom de indicatiestelling: richt men zich eerst op het daderschap of juist op het slachtofferschap? Verder willen we de gelaagdheid van de behandeling benoemen: de behandelaar heeft niet alleen te maken met de problematiek van de patiënt maar ook te maken met de gesloten kliniek en verschillende functionarissen daarin. Die gelaagdheid heeft direct gevolgen voor de vorm en inhoud van de behandeling.
Als hypothese willen we naar voren brengen dat de behandeling van trauma’s essentieel kan zijn voor de behandeling van persoonlijkheidsproblematiek. Schemagerichte Cognitieve Therapie (J. Young), sluit in onze ogen naadloos aan op EMDR. Beide stromingen richten zich op dezelfde type existentiële “Ik ben ….“ opvattingen.
This lecture is about the implementation of EMDR
In a very complex (TBS) of institution, and security are inextricably intertwined treatment, with a heavily loaded diagnostic target:
• Multiple personality disorder
• Multiple severely traumatized
• Addiction Problems
• Specific psychiatric problems
• Forensic issues
• Combinations
The TBS system of treatment (with security as an important point) does sometimes difficult to EMDR treatment of individual patients. Fear of the manageability of a patient during treatment as may be considered a contraindication for EMDR treatment. The question is whether EMDR is contraindicated in a TBS clinic for security reasons. The embedding of treatment in the TBS clinic and the use of self-control techniques are important factors.
Complicating factor is that many TBS patients, both self-traumatized as well have committed serious crimes with which they have traumatized others.
In this talk we mainly discussed how the treatment of the perpetrator is related to the treatment of the victimization of the patient. We wish them both the substantive and ethical angles. Of importance here is the discussion surrounding the needs assessment: the focus is first on the perpetrator or at the very victimization? We also want to appoint the stratification of treatment: the therapist has not only faced with the problem of the patient but also to do with the clinic closed and several officers therein. Such layering has direct implications for the form and content of treatment.
As a hypothesis we want to highlight that the treatment of trauma may be essential for the treatment of personality problems. Schema-Focused Cognitive Therapy (J. Young), close our eyes seamlessly with EMDR. Both schools focus on the same existential type "I am ...." opinions.
Keywords: TBS System of Treatment
Accuracy Verified: Yes
73. Dautovic, E., Aldenkamp, E., & Rodenburg, R. (2012, June). EMDR effectiveness in adults with PTSD and an intellectual disability: A case series [La efectividad del EMDR en adultos con una discapacidad intelectual y TEPT: Series de casos]. Presentation at the annual meeting of the EMDR Europe Assocation, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Background People with an intellectual disability (ID) have an increased
vulnerability for abuse and assault, and subsequently an increased risk of developing
post-traumatic stress disorder (PTSD). The prevalence of PTSD is found to be
significantly higher in people with intellectual disabilities than in people without
disabilities. Eye movement Desensitization and Reprocessing (EMDR) has proved to be
an effective PTSD treatment in people without ID. EMDR is widely used in treating
people with ID, while research into the effectiveness of EMDR in individuals with an ID
is very scarce. Therefore more research is necessary to speak of EMDR being an
evidence-based trauma treatment for this specific population.
Objective The objective of this study was to investigate the efficacy of eye movement
desensitization and reprocessing (EMDR) in treating PTSD in adults with an ID. The
effects of the treatment on anxiety, symptoms of depression, and quality of life were
also investigated.
Methods From September 2010 till december 2012, adults with an ID, diagnosed with
PTSD and treated with EMDR, were included in the study. Before and after treatment
questionnaires were completed by the participants. Normative deviation scores (NDS)
were calculated to estimate the condition of the participant before and after
treatment compared to the non-disabled population. The Reliable Change Index (RCI)
was used to establish statistically significant change due to treatment.
Preliminary results Primarily, a significant change in PTSD symptoms, from clinical to
non-clinical levels, is found. Secondarily, co-morbid anxiety and depression complaints
are detected, which decline after treatment with EMDR. In addition, an increase in
wellbeing in the participants is found.
Conclusion From the preliminary results EMDR seems an effective treatment for PTSD
in adults with an ID. However, for calculations are still being conducted, the final
results and conclusions will be presented at the conference
La
población
con
una
discapacidad
intelectual,
tiene
un
riesgo
mayor
de
vulnerabilidad
para
el
abuso
y
el
asalto,
y
por
tanto
un
aumento
en
el
riesgo
de
desarrollar
un
trastorno
de
estrés
post-‐traumático
(TEPT).
La
prevalencia
del
TEPT
es
significativamente
mayor
en
personas
con
retraso
mental
que
en
personas
sin
este
tipo
de
discapacidad.
El
EMDR
ha
sido
mostrado
como
efectivo
en
el
tratamiento
del
TEPT
en
personas
sin
discapacidad
intelectual.
EDMR
es
ampliamente
usado
en
el
tratamiento
de
personas
con
discapacidad
intelectual,
mientras
tanto
la
investigación
en
la
efectividad
del
EMDR
en
personas
con
discapacidad
intelectual
es
muy
escasa.
Consecuentemente
mas
investigaciones
son
necesarias
para
hablar
de
EMDR
siendo
un
tratamiento
valido
para
el
trauma
en
esta
población
especifica.
El
objetivo
de
este
estudio
fue
investigar
la
eficacia
del
reprocesamiento
por
movimiento
oculares
(EMDR)
en
el
tratamiento
del
TEPT
en
adultos
con
una
deficiencia
mental.
Los
efectos
de
este
tratamiento
en
ansiedad,
síntomas
de
depresión
y
calidad
de
vida
fueron
también
investigados.
Desde
Septiembre
de
2010
hasta
diciembre
de
2012,
los
adultos
con
una
deficiencia
mental,
fueron
diagnosticados
de
TEPT
y
tratados
con
EMDR,
fueron
incluidos
en
este
estudio.
Se
pasaron
cuestionarios
pre
y
post
tratamiento
a
los
participantes.
Las
puntuaciones
de
desviación
típica
fueron
calculadas
para
estimar
la
condición
del
participante
antes
y
después
del
tratamiento
comparada
con
la
población
sin
discapacidad.
El
índice
de
cambio
real
(RCI)
fue
utilizado
para
establecer
de
manera
estadísticamente
significativa
el
cambio
debido
al
tratamiento.
Los
resultados
preliminares,
muestran
un
cambio
significativo
en
el
los
síntomas
del
TEPT,
en
niveles
clínicos
y
no
clínicos.
De
manera
secundaria,
quejas
de
comorbilidad
con
ansiedad
y
depresión
fueron
detectadas
que
disminuyeron
tras
el
tratamiento
con
EMDR.
Además,
un
incremento
en
el
bienestar
de
los
participantes
fue
encontrado.
La
conclusión
de
estos
datos
preliminares
es
que
el
EMDR
parece
ser
un
tratamiento
efectivo
para
el
TEPT
en
adultos
con
una
discapacidad
intelectual.
Sin
embargo,
los
cálculos
aún
están
siendo
analizados,
los
resultados
finales
y
las
conclusiones
serán
presentadas
en
la
conferencia.
Keywords: Adults Intellectual Disability Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
74. Hase, M. (2001, May). EMDR in a critical incident in Germany (prison riot). Presentation at the EMDR Europe Association annual meeting, London, UK.
Language: English
Format: Conference
Abstract:
The prison system serves, among many others, one important goal: to separate those members
of society, who are dangerous to others, from the more peaceful and law-abiding majority. As
a consequence one could assume that the inmates of a prison from a, subgroup of human
beings, distinct by their aggressive potential. Though this is not true for all of the prisoners, it may be true for many of them. It is a well known fact, at least in Germany, that procedures
for controlling the safety in a prison, can't eliminate criminal behaviour or dealing with drugs
in a prison. One could assume, that even if an adequate standard of safety is upheld, a prison
would be a dangerous place to work in and that prison staff would be at a considerable risk of
being traumatised at work. In the prison system in Lower Saxony, Germany, between 5 and
10 recently traumatised staff are invited to participate in a group consultation each year. The
number of unrecorded cases is certainly much higher. In contrast there is not much literature about traumatisation of prison staff. On the other hand
prison staff are regarded as a population often reluctant to engage in psychotherapy and
leaving psychotherapy prematurely, without a significant treatment effect.
On 13th of August 1999 a prisoner attacked prison staff at Uelzen prison in Lower Saxony,
Germany. The perpetrator killed two members of staff, wounded two others severely and
committed suicide immediately afterwards. More members of staff suffered from the
psychological effects of the violence. The Critical Incident Team within the Ministry of
Justice provided intensive care and counselling. 15 members of staff were identified as a
high risk group to develop PTSD. 10 members of staff began psychotherapy. 7 qualified for
a diagnosis of PTSD, 3 for related diagnoses, according to ICD-10 criteria None of them left
therapy prematurely. One member of staff suffered from the effects of a civil war situation
experienced 15 years before, with a late onset PTSD triggered by vicarious traumatisation.
Only one remains out of work, but does not qualify for a diagnosis of PTSD at present. Three
are still in therapy. 7 patents ended therapy with a complete recovery. EMDR was applied to
great extent in 9 of the 10 cases. EMDR was tolerated well and proved to be fast and
efficient. Treatment effects seem to last over time. Setting the focus on the trauma and using
EMDR as a specific psychotherapeutic method seems to provide an accepted strategy with
significant gains for this population.
Keywords: Critical Incident Prison Recent Events Riot
Accuracy Verified: Yes
75. Beer, R. (2006). EMDR in de behandeling van jongeren met een eetstoornis [EMDR in the treatment of adolescents with an eating disorder]. Kinder- & Jeugdpsychotherapie, 33(3), 54-64.
Language: Dutch
Format: Journal
Abstract:
Eetstoornissen zijn ernstige ziektebeelden met een grote kans op een chronisch
beloop, hoge morbiditeitcijfers en veel co-morbiditeit (van Elburg & Rijken,
2004). In de DSM IV worden verschillende eetstoornissen onderscheiden:
Anorexia Nervosa, Boulimia Nervosa en Eetstoornis Niet Anders Omschreven.
Eetstoornissen komen meestal tot bloei tijdens de adolescentie. Bij Anorexia
Nervosa ligt de piek van het ontstaan tussen veertien en achttien jaar, Boulimia
Nervosa begint doorgaans pas na het zestiende jaar (Robbe e.a., 1999;
Fleminger, 2002; Vandereyken & Noordenbos, 2002). Anorexia Nervosa (AN)
heeft het hoogste mortaliteitspercentage van alle psychiatrische stoornissen en
bij adolescenten staat het op de derde plaats in de rij van meest voorkomende
stoornissen. Behandelingsresultaten zijn weinig bemoedigend (Vandereyken &
Noordenbos, 2002). Voor AN is nog geen ‘evidence based’ behandeling
voorhanden. Zie: National Institute of Clinical Excellence (2004) en de
Multidisciplinaire Richtlijn Eetstoornissen (2006). Behandelaars zijn daarom
nog steeds op zoek naar nieuwe invalshoeken.
Op de afdeling jeugdpsychiatrie van het Universitair Medisch Centrum Utrecht
is een zorgprogramma eetstoornissen ontwikkeld, waarmee jongeren met AN en
met een Eetstoornis NAO worden behandeld door een multidisciplinair team2.
Zie voor een beschrijving van dit programma: van Elburg & Rijken (2004).
Tijdens mijn werkzaamheden voor deze afdeling (2000-2005) heb ik hieraan
mogen bijdragen door het implementeren van cognitieve gedragstherapie en
EMDR als potentiële onderdelen van een breed-spectrum behandeling. Een
beschrijving van een protocol voor cognitieve gedragstherapie is in
voorbereiding ( Beer & Tobias).
In dit artikel wordt beschreven hoe EMDR kan worden ingezet bij de
behandeling van jongeren met een eetstoornis. De hier beschreven experimentele status. De voorgestelde mogelijkheden zijn weliswaar
uitgeprobeerd door meerdere psychotherapeuten, maar van systematische
toetsing is nog geen sprake geweest. Een gedetailleerde beschrijving en
theoretische onderbouwing van de voorgestelde toepassing van EMDR is
eveneens in voorbereiding (Beer & Hornsveld). In dit artikel wordt besproken
waarom (theoretisch kader), hoe (aangrijpingspunten) en wanneer (timing)
EMDR kan worden ingezet. Na een aantal illustratieve behandelfragmenten
wordt besproken waarom het juist voor jongeren een waardevolle module kan
zijn in een multidisciplinaire behandeling (toegevoegde waarde). Afgesloten
wordt met een conclusie.
Eating disorders are serious illnesses with a high risk of chronic
course, high morbidity rates and many co-morbidity (Elburg & Rich,
2004). The DSM IV eating disorders several distinguished:
Anorexia Nervosa, Bulimia Nervosa and Eating Disorder Not Otherwise Specified.
Eating disorders usually come to fruition during adolescence. In Anorexia
Nervosa is the peak of emergence between fourteen and eighteen, Bulimia
Nervosa usually begins after the age of sixteen (Robbe et al, 1999;
Fleminger, 2002; Vander Eyken & Noorden, 2002). Anorexia Nervosa (AN)
has the highest mortality rate of all psychiatric disorders and
among adolescents is on the third row of the most common
disorders. Treatment results are very encouraging (Vander Eyken &
Noorden, 2002). AN is no "evidence based treatment
available. See: National Institute of Clinical Excellence (2004) and
Multidisciplinary Directive Eating Disorders (2006). Clinicians are therefore
still looking for new angles.
The adolescent psychiatry department at the University Medical Center Utrecht
is an eating disorder care program developed for young people with AN and
with an ED-NOS treated by a multidisciplinary team2.
For a description of this program from Elburg & Rich (2004).
During my work on this section (2000-2005) I have this
may contribute by implementing cognitive behavioral therapy and
EMDR as potential components of a broad-spectrum treatment. A
description of a protocol for CBT in
preparation (Beer & Tobias).
This article describes how EMDR can be used in the
treatment of adolescents with eating disorders. The described experimental state. The options proposed are indeed
tested by several therapists, but systematic
review has not been a case. A detailed description and
theoretical underpinning of the proposed use of EMDR is
also in preparation (Beer & Horn Field). This article discusses
why (theoretical framework), how (targets) and when (timing)
EMDR can be used. After several treatments illustrative excerpts
discuss why it is a valuable youth module
in a multidisciplinary treatment (value added). Completed
with a conclusion.
Keywords: Adolscents Eating Disorders
Accuracy Verified: Yes
76. Steeghs, M., & Gerrits, G. (2011, December). EMDR in de kindergeneeskunde [EMDR in paediatrics]. Tijdschrift voor Kindergeneeskunde, 79(6), 199-202, doi:10.1007/s12456-011-0039-2.
Language: Dutch
Format: Journal
Abstract:
Dit artikel beschrijft het belang van het inzetten van eye movement desensitization and reprocessing (EMDR) om traumatisering te voorkomen of te behandelen bij kinderen en adolescenten. Paediatric medical traumatic stress en posttraumatische stressstoornis worden besproken om de relevantie van EMDR voor de kindergeneeskunde toe te lichten. Er volgt een korte beschrijving van het behandelprotocol en twee verklaringsmodellen voor het effect van EMDR. Ter illustratie worden er in het artikel twee casussen beschreven. Er wordt gepleit voor vroege risicosignalering en tijdige doorverwijzing door kinderartsen en medische teams. Geconcludeerd wordt dat EMDR een kindvriendelijke en breed toepasbare methode is om de negatieve gevolgen van traumatische ervaringen die kinderen in een medische setting opdoen te behandelen of te voorkomen.
This article describes the importance of the use of Eye Movement Desensitization and Reprocessing (EMDR) for trauma to prevent or treat in children and adolescents. Paediatric medical traumatic stress and posttraumatic stress disorder are discussed the relevance of EMDR for pediatrics to explain. There follows a brief description of the treatment protocol and two explanatory models for the effect of EMDR. For illustration, there are two cases described in the article. There are calls for early risk detection and timely referral by pediatricians and medical teams. It is concluded that EMDR is a child-friendly and widely applicable method is to reduce the negative effects of traumatic experiences that children experience in a medical setting to treat or prevent.
Keywords: Pediatrics
Accuracy Verified: Yes
77. Hofmann, A., & Solomon, R. (2009). EMDR in der behandlung akut traumatisierter [EMDR in the treatment of acutely traumatized]. In A. Hofmann, N. Galley, & R. A. Solomon, EMDR – Therapie psychotraumatischer Belastungssyndrome, 2 Tabellen, (4., unveränd. Aufl.) (pp 107-114 ) Stuttgart: Georg Thieme Verlag KG.
Language: German
Format: Book Section
Abstract:
Mit den zunehmenden Erfahrungen und Forschungsergebnissen
im Bereich psychotraumatischer
Reaktionen gelangte in den Jahren nach
der Entwicklung der Konzepte über die chronischen
traumatischen Störungen auch der Bereich
der akuten Traumatisierungen in das Blickfeld
systematischer Studien und Interventionsversuche.
So wurden zunehmend diagnostische und
therapeutische Konzepte entwickelt, in denen versucht
wird, Opfern von z. B. krimineller Gewalt,
schweren Unfällen oder kritischen Zwischenfällen
im polizeilich/militärischen Bereich bereits kurz
nach den traumatischen Ereignissen hilfreich zur
Seite zu stehen und – wenn möglich – sogar die
Entwicklung schwerer Störungen zu verhindern.
Als günstig erwies sich dabei, dass sich die
Mehrzahl der Opfer akuter Traumatisierungen innerhalb
einer Zeit von mehreren Wochen bis Monaten
ohne äußeres therapeutisches Eingreifen
spontan erholen und das Ereignis seelisch bewältigen
können (Rothbaum u. Foa 1993).
Als problematisch zeigte sich aber einerseits die
Vielfalt möglicher Symptome direkt nach einem
traumatischen Ereignis, andererseits der zunehmende
Übergang in eine posttraumatische Symptomatik
(aber auch andere) bei einer meist
kleineren Gruppe der Traumatisierten (Orner u.
Schnyder 2003).
Forscherische und therapeutische Bemühungen
versuchen derzeit, die Gruppe der Traumaopfer,
die ein erhöhtes Risiko haben könnten, später eine
posttraumatische Störung zu entwickeln, zu identifizieren
und ihnen – wenn möglich – schon frühzeitig
gezielt Hilfe zukommen zu lassen.
Auf der anderen Seite wird so versucht, die
Traumaopfer, bei denen eine Bewältigung des
traumatischen Ereignisses ohne spezifische therapeutische
Hilfe erwartet werden kann, nicht unnötig
zu pathologisieren, ihnen aber ausreichend
Unterstützung und Hilfe zu gewähren, sodass sie
den Verarbeitungsvorgang ohne äußere Irritationen
abschließen können (Fischer et al. 1998).
Diese diagnostischen und therapeutischen Forschungen
sind derzeit noch in vollem Gange, gesicherte
Forschungsergebnisse liegen bisher nur in
wenigen Bereichen der Behandlung akuter Traumatisierungen
vor (Barre u. Biesold 2002, Orner u.
Schnyder 2003, Yehuda 1998). Dennoch liegen bereits
Modellrechnungen der Kostenträger vor, die
belegen, dass frühe, fundierte Interventionsansätze
bei akut Traumatisierten (z. B. Überfallopfern)
erhebliche Kosteneinsparungen der Kostenträger
bewirken (Wiessmann 2002).
Angesichts der großen Zahl der täglich bei
schweren Unfällen oder Verbrechen akut traumatisierten
Menschen, die derzeit mit einer Vielzahl
empirisch wenig validierter Konzepte behandelt
werden müssen, wird der hohe Handlungsdruck
einerseits, die Einschränkung vieler der folgenden
Anhaltspunkte für therapeutische Intervention andererseits,
deutlich.
Auch Hinweise und Empfehlungen bezüglich
eines Einsatzes der EMDR-Methode bei diesen Patienten
sollten mit diesen Einschränkungen verstanden
werden. Auch wenn es einige erste Hinweise
auf einen erfolgversprechenden Einsatz der
EMDR-Methode bei akut Traumatisierten gibt, so
sollte eine Therapie mittels EMDR in einen umfassenden,
z. B. dynamisch-behavioralen, Behandlungsplan
dieser Patienten eingebettet werden
(Bisson 2003, McNally u. Solomon 1999). Weiterhin
sollte der systematische Einsatz der EMDR-Methode
derzeit – wenn irgend möglich – an hohen
Qualitätsstandards orientiert und forschungsmäßig
evaluiert werden, um die Nutzen-Risiko-Abwägung
bezüglich bestimmter Patientengruppen
sowie den optimalen Einsatzzeitpunkt konfrontierender
Verfahren systematisch verbessern zu können.
With increasing experience and research results
in the field of psycho-traumatic
Responses came in the years after
the development of concepts about the chronic
traumatic disorders, the area
of acute trauma in the field of view
systematic studies and intervention trials.
Thus, more diagnostic and
therapeutic concepts developed in which attempts are
is, for example, victims of criminal violence,
serious accidents or critical incidents
the police / military shortly
after the traumatic events to help
Page is available and - if possible - even the
to prevent development of severe disorders.
Proved to be favorable, that the
Most of the victims of acute trauma in
a period of several weeks to months
without an external therapeutic intervention
spontaneously recover and cope with the emotional event
can (Rothbaum and Foa 1993).
One problem was but one part of the
Variety of possible symptoms immediately after a
traumatic event, on the other hand, the increasing
Transition to a post-traumatic symptoms
(And others) usually at a
smaller group of traumatized (and Orner
Schnyder 2003).
Research and therapeutic efforts
currently trying the group of trauma victims,
an increased risk could later
to develop post-traumatic disorder to identify
them and - if possible - early
to be targeted to come help.
On the other hand, will attempt to
Trauma victims, where a managing
traumatic event without specific therapeutic
Assistance can be expected not unnecessarily
pathologization them but enough
to provide support and assistance so that they
the processing operation without external irritation
can conclude (Fischer et al. 1998).
These diagnostic and therapeutic research
are still in full swing, secured
Research results are presently available in
few areas of acute trauma
and before (Barre and Biesold 2002, Orner
Schnyder 2003, Yehuda 1998). Nevertheless, there are already
Model calculations of the cost modes, in the
Demonstrating that early, in-depth intervention approaches
in acute trauma (such as assault victims)
significant cost savings for payers
cause (Wiesmann 2002).
Given the high volume of daily at
serious accidents or crimes acutely traumatized
People currently with a variety
empirically validated concepts treated less
must be the high pressure to act
one hand, the restriction of many of the following
Indications for therapeutic intervention on the other,
significantly.
Also advice and recommendations regarding
of using the EMDR method in these patients
should understand these limitations
be. Although there are some initial indications
a promising application of
EMDR method in acutely traumatized people are so
should be a therapy using EMDR in a comprehensive,
such as dynamically-behavioral, treatment plan
these patients are embedded
(Bisson 2003, McNally and Solomon 1999). Furthermore,
should be the systematic use of the EMDR method
now - if possible - to high
Quality standards and research-oriented terms
is assessed to the benefit / risk ratio
with respect to specific patient groups
and the optimal use time of confrontational
Method to improve systematically.
Keywords: Trauma
Accuracy Verified: Yes
78. Sack, M., Lempa, W., & Lamprecht, F. (2003). EMDR in der behandlung dissoziativer störungen [EMDR in the treatment of dissociative disorders]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, 1 (3), 25-33.
Language: German
Format: Journal
Abstract: Keywords: Dissociative Disorders, Psychotherapeutic Processes Accuracy Verified: Yes 79. Zobel, M.
(2006). EMDR in der behandlung von suchtpatienten mit posttraumatischer belas tungsstörung [EMDR in the treatment of addicted patients with post-traumatic stress disorder]. In Schriftenreihe des Fachverbandes Sucht, e.V. Band 29 "’Integrierte Versorgung’: Chancen und Risiken für die Suchtrehabilitation"
Beiträge des 18. Heidelberger Kongresses 2005, Geesthacht: Neuland.. Language: English Format: Other Abstract: Keywords: Addictions Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 80. Gonzalez, A., Mosquera, D., & Moskowitz, A. (2012, June). EMDR in psychosis and severe mental disorders [EMDR
en
psicosis
y
trastorno
mental
severo]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Psychosis Severe Mental Disorders Accuracy Verified: Yes 81. Hofmann, A. (2000, May 6). EMDR in the treatment of dissociative disorders. Presentation at the annual meeting of the EMDR Europe Association, Utrecht, Netherlands. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Accuracy Verified: Yes 82. Marich, J. (2011). EMDR made simple: 4 approaches to using EMDR with every client. Eau Claire, WI: Premier Publishing & Media . Language: English Format: Book Abstract: Accuracy Verified: Yes 83. Amato, M. (2008, Novembre). EMDR nel servizio screening post-partum [EMDR in the post-partum screening service]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia. Language: Italian Format: Conference Abstract: Keywords: Post-Partum Depression Accuracy Verified: Yes 84. Darker-Smith, S. (2007, June). EMDR vs CBT in the treatment of anorexia nervosa: A preliminary study. Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Anorexia Nervosa CBT Cognitive Behavioral Therapy Accuracy Verified: Yes 85. Solomon, R. M. (2008, June). EMDR with grief and mourning. Presentation at the annual meeting of the EMDR Europe Association, London, England. Language: English Format: Conference Abstract: Keywords: Bereavement Grief Mourning Psychotherapeutic Processes Survivors Accuracy Verified: Yes 86. Bertolotti, G. (2008, June). EMDR: Should be appropriate in a rehabilitation multidisciplinary programme?. Poster session presented at the annual meeting of the EMDR Europe Association, London, England. Language: English Format: Conference Abstract: Keywords: Rehabilitation Multidisciplinarian Program Accuracy Verified: Yes 87. Shapiro, F. (1991, August). EMDR: A cautionary note. EMDR Network Newsletter, 1(1), 3-4. Language: English Format: Newsletter Abstract: Keywords: Cautions Accuracy Verified: Yes 88. Bower, B. (1995, October 21). EMDR: Promise and dissent. Science News, 148(17), 270-271. Language: English Format: Magazine Abstract: Keywords: Research Accuracy Verified: Yes 89. Corrigan, F. M. (2005, June). Emoting mindfullness drives reprocessing: Clinical and functional MRI observations. In Research issues. Symposium conducted at the annual meeting of the EMDR Europe Association, Brussels, Belgium. Language: English Format: Conference Abstract: Accuracy Verified: Yes 90. Seliga, M. (2009, Fall). Empirically supported treatment interventions for clients with posttraumatic stress disorder and comorbid borderline personality
disorder: A critical review. Praxis, 9, 61-69. Language: English Format: Journal Abstract: Keywords: Borderline Personality Disorder Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 91. Ernst, E. (2004, August). Ephedra alkaloids and brief relapse in EMDR-treated obsessive compulsive disorder, Reply. Acta Psychiatrica Scandinavica, 110(2), 159. doi:10.1111/j.1600-0047.2004.00369.x. Language: English Format: Journal Abstract: Keywords: Comment Ephedra alkaloids Letter Obsessive Compulsive Disorder OCD Relapse Reply Accuracy Verified: Yes 92. Yehuda, R. (2012, October). Epigenetics: What does it explain about trauma survivors?. Plenary presented at the annual meeting of the EMDR International Association, Arlington, VA
. Language: English Format: Conference Abstract: Keywords: Epigenetics Plenary Survivors Trauma Accuracy Verified: Yes 93. Reamer, F. G. (2004, September). Ethical issues in EMDR: Risk-management implications. Presentation at the annual meeting of the EMDR International Association, Montreal, Ontario Canada. Language: English Format: Conference Abstract: Keywords: Ethics Risk Management Accuracy Verified: Yes 94. Boyer, W. R. (2007). An exploratory study of the effects of EMDR on state/trait anxiety and anger in adult male sex offenders. Argosy University, San Francisco, CA. ATT 3286571. Language: English Format: Dissertation/Thesis Abstract: Keywords: Anger Anxiety Criminals Developmental Disabilities Empirical Study Qualitative Study Outpatients Quantitative Study Sex Offenders Sex Offenses Trauma Treatment Accuracy Verified: Yes 95. Jumelet, C. (2011, April). Eye movement desensitisation and reprocessing
(EMDR) bij kinderen met een verstandelijke beperking [Eye Movement Desensitisation and Reprocessing (EMDR) in children with intellectual disabilities]. Symposia op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam. Language: Dutch Format: Conference Abstract: Achtergrond: Eye movement desensitisation
and reprocessing (EMDR) is een evidence-based
behandelmethode voor zowel kinderen als volwassenen
die blijvende psychische of lichamelijke
klachten overhouden aan een of meer ingrijpende
gebeurtenissen. Er is nog nauwelijks effectonderzoek
verricht bij kinderen met een verstandelijke
beperking (VB). Deze doelgroep heeft meer risico
op traumatische ervaringen vanwege beperkte
cognitieve en verbale vaardigheden en geringere
draagkracht (Mevissen 2010). EMDR doet weinig
beroep op verbale mogelijkheden, is een concrete
en directieve methode en lijkt daarom in het bijzonder
geschikt voor kinderen met een VB.
Doel: emdr beschikbaar maken voor
getraumatiseerde kinderen met een VB.
Methoden: Bestaande EMDR-protocollen
worden aangepast door elementen aan te brengen
als: visualiseren middels pictogrammen;
ouders meer betrekken, bijvoorbeeld door hen het
verhaal te laten vertellen; effectevaluatie via
ouders en belangrijke derden (leerkracht), meer
herhaling en meer sessies. Resultaten: In een caseserie van 10 patiënten met een iq tussen 50-85 was er in 70% een goed resultaat. Alle patiënten maakten de
behandeling af. Het aantal sessies varieerde tussen
2 en 10. Conclusie: emdr is een veelbelovende
behandelmethode bij kinderen met een VB. Keywords: Children Intellectual Disabilities Accuracy Verified: Yes 96. Soberman, G. B. (1998). Eye movement desensitization and reprocessing (EMDR) in the treatment of conduct disorder with preadolescents and adolescents. Walden University, Minneapolis, MN. AAT 9910218. Language: English Format: Dissertation/Thesis Abstract: Keywords: Adolescents Conduct Disorder Emotional Trauma Empirical Study Preadolescents Symptoms Trauma Treatment Outcomes Accuracy Verified: Yes 97. Vyas, K. J. (2008, April). Eye movement desensitization and reprocessing (EMDR) to decrease human immunodefiency virus (HIV) risk behaviors among Latino men who have sex with men (MSM). Presentation at the National Conference on Undergraduate Research, Salisbury University, MD. Language: English Format: Conference Abstract: Accuracy Verified: No 98. Rodenburg, R., Benjamin, A., Meijer, A. M., & Jongeneel, R. (2009, September). Eye movement desensitization and reprocessing in an adolescent with epilepsy and mild intellectual disability. Epilepsy & Behavior, 16(1), 175-180. doi:10.1016/j.yebeh.2009.07.015. Language: English Format: Journal Abstract: Keywords: Case Report Children Epilepsy Intellectual Disability Reliable Change Index Trauma Symptoms Accuracy Verified: Yes 99. Hudson, J., Chase, E., & Pope, H. (1998, January). Eye movement desensitization and reprocessing in eating disorders: Caution against premature acceptance. International Journal of Eating Disorders, 23(1), 1-5. Language: English Format: Journal Abstract: Keywords: Eating Disorders Literature Review Accuracy Verified: Yes 100. Gosselin, P. W. (1994). Eye movement desensitization and reprocessing in the treatment of test anxiety: A study of the effects of eye movement and expectancy on the procedure's results. University of Massachusetts Amherst. AAT 9420630. Language: English Format: Dissertation/Thesis Abstract: Keywords: Test Anxiety Accuracy Verified: Yes 101. Foley, T. (1996). Eye movement desensitization and reprocessing treatment of communication anxiety: A closer look. Western Michigan University. AAT 9640073. Language: English Format: Dissertation/Thesis Abstract: Keywords: Assessment Speeches College Students With Communication Anxiety Effectiveness Evaluation Empirical Study Oral Communication Speech Anxiety Treatment Treatment Effectiveness Accuracy Verified: Yes 102. Tootell, E. (2004). Eye movement desensitization and reprocessing: A comprehensive literature review. Argosy University, San Francisco, CA. AAT 3118435. Language: English Format: Dissertation/Thesis Abstract: Keywords: Literature Review Treatment Effectiveness Accuracy Verified: Yes 103. Vanhoeck, K., & Gykiere, K. (2010). Fantasiemanagement bij seksuele delinquenten [Fantasy management in sexual offenders]. Tijdschrift voor Seksuologie, 34, 224-235. Language: Dutch Format: Journal Abstract: Keywords: Fantasy Management Sex Offenders Accuracy Verified: Yes 104. Dellucci, H. (2012, June). The Gear Box. A structured protocol for a safe EMDR process with complex trauma [“Gearbox”
(Caja
de
cambios):
un
protocolo
estructurado
para
un
proceso
[terapéutico]
seguro
con
EMDR
[en
pacientes]
con
trauma
complejo]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Gear Box Accuracy Verified: Yes 105. Leeds, A. M. (2012, November). Guía de protocolos estándar de EMDR para terapeutas, supervisores y consultores [A guide to the standard EMDR protocols for clinicians, supervisors, and consultants]. Bilbao ESPAÑA: Desclée De Brouwer. Language: Spanish Format: Book Abstract: Keywords: Prtactice Protocols Theory Accuracy Verified: Yes 106. Leeds, A. M. (2009). A guide to the standard EMDR protocols for clinicians, supervisors, and consultants. New York, NY: Springer Publishing Co. Language: English Format: Book Abstract: Keywords: Protocols Accuracy Verified: Yes 107. van den Hout, M. A., & Engelhard, I. M.
(2011, March). Hoe het komt dat EMDR werkt [How it is that EMDR works]. Directieve Therapie en Hypnose, 31(1), 5-23. doi:10.1007/s12433-011-0002-5. Language: Dutch Format: Journal Abstract: Accuracy Verified: Yes 108. Brivio, R., & Bergamaschi, L. (2008, January). Human and organizational aspects affecting the
wellbeing in rescue-working activity: EMDR (Eye
movement desensitization and reprocessing),
Mirror Neuron and Stress Inoculation: The role of
training methods, practice and simulation for
psychological risks prevention and management in
emergency workers.. International Workshop Reinforce Rescuers' Resilience by Empowering a well-being Demension Workshop, Turin, Italy . Language: English Format: Conference Abstract: Keywords: Emergency Workers Mirror Neuron and Stress Inoculation Rescue-Working Activity Risk Prevention and Management Accuracy Verified: Yes 109. Fernandez, I. (2002, Dicembre). I disturbi post-traumatici da stress, fattori di rischio, aspetti diagnostici e trattamento con l'EMDR [The post-traumatic stress disorder factors of risk, diagnostic aspects and treatment with EMDR]. Rivista Scientifica di Psicologia, Sommario 01, 15-24. Language: Italian Format: Journal Abstract: Keywords: PTSD Emergency Treatment Therapy Accuracy Verified: Yes 110. Fernandez, I. (2009, Marzo). Il trauma della sterilita: Applicazioni cliniche dell'EMDR [The trauma of infertility: Clinical Applications of EMDR]. Presentazione presso il soma Convegno Infertilita ARM e Psiche: Riflessioni, professinalita, Esperienza a confronto, Milano, Italia. Language: Italian Format: Conference Abstract: Keywords: Infertility Accuracy Verified: Yes 111. Woodward, V. (2000, December). Incorporating EMDR and psychodrama into therapy. EMDRIA Newsletter, 5(Special Edition), 16-18. Language: English Format: Newsletter Abstract: Keywords: Psychodrama Accuracy Verified: Yes 112. Greenwald, R. (1996, February). The information gap in the EMDR controversy. Professional Psychology: Research & Practice, 27(1), 67-72. doi:10.1037/0735-7028.27.1.67 . Language: English Format: Journal Abstract: Keywords: Literature Review Professional Training Treatment Effectiveness Accuracy Verified: Yes 113. Lyhus, K. E. (2003, April). Integration of EMDR with other therapeutic approaches: A survey investigation. Catholic University of America, Washington, DC. AAT 3067496. Language: English Format: Dissertation/Thesis Abstract: Keywords: Assimulative Integration Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Traumatic Memories Accuracy Verified: Yes 114. Munder, T., Fluckiger, C., Gerger, H., Wampold, B. E., & Barth, J.
(2012, October). Is the allegiance effect an epiphenomenon of true efficacy differences between treatments? A meta-analysis. Journal of Counseling Psychology, 59(4), 631-637. doi:10.1037/a0029571. Language: English Format: Journal Abstract: Keywords: Comparative Outcome Research Meta-Analyses Researcher Allegiance Accuracy Verified: Yes 115. Bardot, E. (2009). L 'EMDR (Eye movement desensitization and reprocessing). In A. Deneux, F.-X. Poudat, & T. Servillat (Eds.) Les psychothérapies: Approche plurielle (pp. 375-386) Paris: Masson. Language: French Format: Book Section Abstract: Accuracy Verified: Yes 116. Riberto, S., Fernandez, I., Furlani, F., & Vigorelli, M.
(2010). L'alleanza terapéutica nel trattamento cognitivo-costruttivista e nell' eye movement desensitization and reprocessing (EMDR) [Therapeutic alliance in cognitive-constructivist treatment and in eye movement desensitization and reprocessing (EMDR).]. Psicoterapia Cognitiva E Comportamentale, 16(1), 85-101. Language: Italian Format: Journal Abstract: Keywords: Cognitive Constructivist Treatment Therapeutic Alliance Accuracy Verified: Yes 117. Lazzari, D. (2008, Novembre). L'EMDR in ottica PNEI (interazione corpo-mente) [EMDR in optical PNEI (interaction body-mind)]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia. Language: Italian Format: Conference Abstract: Keywords: Body-Mind Interaction PNEI Accuracy Verified: Yes 118. Dellucci, H. (2010, Novembre). La boîte de vitesses - Naviguer de manière sécurisée dans la thérapie avec des personnes souffrant de traumatismes complexes [The gearbox - Navigate safely in therapy with people suffering complex trauma]. A l'Approfondissement Psychotherapeutique en EMDR. Moderateur, EMDRRevue, Theorie et Clinique therapeutiques. Language: French Format: Other Abstract: Keywords: Gearbox Accuracy Verified: Yes 119. Navas-Torrejano, D. S. (2011, Enereo-Junio). La desensibilización y reprocesamiento del movimiento (EMDR): El tratamiento para el trastorno de estrés postraumático [Eye movement desensitization and reprocessing (EMDR): Treatment for posttraumatic stress disorder]. Revista Ciencias Biomédicas, 2(1), 158-162. Language: Spanish Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 120. Bossini, L., Tavanti, M., Calossi, S., Marino, G., Pieraccini, F., Vatti, G., & Castrogiovanni, P. (2008, Novembre). Le modificazioni del volume hippocampale dopo una terapia con EMDR nel PTSD [EMDR treatment for PTSD: effect on hippocampal volume]. Plenaria presentato le applicazioni cliniche di EMDR Congresso Nazionale, Milano, Italia. Language: Italian Format: Conference Abstract: Keywords: Hippocampal Volume Plenary Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 121. Gamba, M. (2005). L’integrazione dell'EMDR nella
psicoterapia dei disturbi del
comportamento alimentare [EMDR integration into the psychotherapy of eating disorders]. Universita Degli Studi Padova, Italia. Language: Italian Format: Dissertation/Thesis Abstract: Keywords: Eating Disorders Accuracy Verified: Yes 122. Lapp, L. K., Agbokou, C., Peretti, C. S., & Ferreri, F. (2010, September). Management of post traumatic stress disorder after childbirth: A review. Journal of Psychosomatic Obstetrics & Gynecology,
31(3), 113-122. doi:10.3109/0167482X.2010.503330. Language: English Format: Journal Abstract: Keywords: Childbirth Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 123. Litt, B. K. (2006, September). The marriage of EMDR and ego state theory in couples therapy. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA. Language: English Format: Conference Abstract: Keywords: Couples Therapy Ego State Therapy Accuracy Verified: Yes 124. Bodill, B. (2007, March). Measuring outcomes: Using EMDR in the NHS. Symposium at the 5th annual Conference of the EMDR UK & Ireland Association, Glasgow, Scotland. Language: English Format: Conference Abstract: Keywords: NHS Outcomes Symposium Accuracy Verified: Yes 125. Chang, S. H. (2005). Mechanism of EM in EMDR: Change strength of semantic associations. Presentation at the American Psychological Association Annual Convention, Washington, DC. Language: English Format: Conference Abstract: Keywords: EMDR REM REM-Sleep Dependent Memory Reprocessing Model Posttraumatic Stress Disorder PTSD Saccadic Eye movement Semantic Association Accuracy Verified: Yes 126. Mosquera, D. (2012, March). Met behulp van EMDR bij de behandeling van borderline-stoornis bersonality [Using EMDR in the management of borderline personality disorder]. Preconference presentatie op de 6e congres van de Vereniging EMDR Nederland, Arnhem, Nederland . Language: Dutch Format: Conference Abstract: Keywords: Borderline Personality Disorder Accuracy Verified: Yes 127. Kehle, S., Polusny, M., & Meis, L. (2009, November). A meta-analytic review of exposure
therapy and EMDR in the treatment of
adult PTSD. Presentation at the 25th Annual Meeting of the International Society for Traumatic Stress Studies, Atlanta, GA. Language: English Format: Conference Abstract: Keywords: Exposure Therapy Meta-analysis Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 128. Kehle, S., Polusny, M., & Meis, L. (2009, November). A meta-analytic review of exposure therapy and EMDR in the treatment of adult PTSD. Presentation at the 25th annual meeting of the International Society for Traumatic Stress Studies, Atlanta, GA. Language: English Format: Conference Abstract: Keywords: Adult Exposure Therapy Meta-Analytic Review Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 129. Uram, S. (2012, October). The neurobiology of trauma made simple. Presentation at the annual meeting of the EMDR International Association, Arlington, VA. Language: English Format: Conference Abstract: Keywords: Neurobiology Trauma Accuracy Verified: Yes 130. Bossini, L., Poliziotto, N., Tavanti, M., Calossi, S., Lombardelli, A., Vatti, G., & Castrogiovanni, P. (2006, Febbraio). Neuroimaging e PTSD: Dati morfovolumetrici e loro variazioni dopo trattamento [Neuroimaging and PTSD: Facts morfovolumetrici and their changes after treatment]. Presentazione al Congresso XI SOPSI (Società Italiana di Psicopatologia), Roma, Italia. Language: Italian Format: Conference Abstract: Keywords: Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 131. Lohr, J. M., Hooke, W., Gist, R., & Tolin, D. F. (2003). Novel and controversial treatments for trauma-related stress disorders. In S. O Lilienfeld, S. J. Lynn, J. M. Lohr, (Eds.), Science and pseudoscience in clinical psychology (pp. 243-272). New York: Guilford Press. Language: English Format: Book Section Abstract: Keywords: Critical Incident Stress Debriefing Posttraumatic Stress Disorder PTSD Stressors Survivors TFT Thought Field Therapy Treatment Effectiveness Accuracy Verified: Yes 132. Lilieblad, B. (1996, October 9). Ogonrorelser vid bearbetning av traumatisk stress [Eye movements when coping with traumatic stress]. Läkartidningen, 93(41), 3553. Language: Swedish Format: Newsletter Abstract: Keywords: Letter Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 133. Jaspers, J. (2011, March). Over behandeleffectiviteit en verandermechanismen [About treatment effectiveness and change mechanisms]. Psychologie & Gezondheid, 39(1), 3-4. Language: Dutch Format: Journal Abstract: In het vorige nummer van Psychologie & Gezondheid schreef Remco Havermans een kritische forumbijdrage over mindfulness. Zijn stelling, dat de werkzaamheid van mindfulnessmeditatie nog onvoldoende is aangetoond om de toepassing ervan in de gezondheidszorg te rechtvaardigen, wordt in dit nummer beargumenteerd tegengesproken door Maya Schroevers en haar collega’s en door Ivan Nyklíček. Zijmenen dat het effectonderzoek naar mindfulness weliswaar nog uitgebreider en beter kan, maar dat het onderzoek tot nu toe voldoende evidentie heeft opgeleverd om toepassing te rechtvaardigen. Nyklíčekmerkt hierbij op dat in de psychologie een nieuwe therapie meestal eerst in de klinische praktijk jarenlang wordt toegepast voordat wetenschappelijk deugdelijk wordt onderzocht of de therapie wel werkt. Havermans blijkt verre van overtuigd en fileert de aangedragen evidentie genadeloos. Deze interessante discussie roept de vraag op wanneer we een behandeling evidence based mogen noemen. Het standpunt dat hiervan pas sprake kan zijn als gecontroleerd onderzoek de effectiviteit van de behandeling heeft aangetoond, zal door de meeste vakgenoten worden onderschreven. Maar wat is ‘gecontroleerd onderzoek’? Volstaat een wachtlijstcontrolegroep of moet de (nieuwe) behandeling worden vergeleken met andere actieve interventies, waarvan al eerder de effectiviteit is aangetoond?
Ook de relatie tussen praktijk en theorie is interessant. Afgezien van de vraag of de opmerking van Nyklíček nog steeds hout snijdt in deze tijd van evidence based interventies, is het wel verantwoord om op grote schaal een nieuwe psychologische interventie toe te passen als de effectiviteit of specifieke werkzaamheid nog niet is aangetoond? Havermans meent dat men een nieuwe gedragstherapeutische interventie ontwikkelt op basis van veelbelovende klinische observaties en gedragswetenschap, met andere woorden er moet ook een theoretische onderbouwing van de interventie zijn. Voor dit laatste is inderdaad veel te zeggen, maar de geschiedenis leert dat de theorieën die aanvankelijk als verklaring voor de werkzaamheid van de interventie werden geformuleerd, meestal bij nader inzien de toets van de wetenschappelijke kritiek niet konden doorstaan. Onderzoek in de traditie van de experimentele psychopathologie (Jansen, Van den Hout & Merckelbach, 2010) heeft al heel wat reinigend werk verricht op theoretisch gebied.
Op de keper beschouwd is van heel wat evidence based interventies aangetoond dat deze effectief zijn, maar hoe deze werken is veelal nog onduidelijk of voor de theoretische onderbouwing ervan is nog onvoldoende steun gevonden. Het laatste Najaarscongres van de Vereniging voor Gedragstherapie en Cognitieve Therapie (VGCT) had als thema ‘Change. Verandermechanismen en cognitieve gedragstherapie’. Tijdens het congres werd duidelijk dat over de verandermechanismen van evidence based interventies nog veel onduidelijkheid bestaat en dat het onderzoek hiernaar soms verrassende resultaten laat zien (Jaspers, 2011). Het is bepaald niet alleen EMDR (eye movement desensitization and reprocessing), waarover de theoretische inzichten zijn veranderd, ook al bestaat over de werkzaamheid van de interventie geen twijfel. In het volgend nummer van Psychologie & Gezondheid leest u hier meer over.
In dit nummer vindt u nog een forumbijdrage, waarin de spreekwoordelijke knuppel in het hoenderhok wordt gegooid. De prikkelende titel ‘Huidige behandeling depressie is weggegooid geld’ nodigt op zijn minst uit tot lezing. Hoezo weggegooid geld? Als er een probleem is waarvoor evidence based behandelingen bestaan, is het immers depressie. Kok en collega’s laten echter zien dat ondanks de enorme bedragen die jaarlijks in Nederland worden uitgegeven aan de behandeling van depressie, in de huidige financiering van de gezondheidszorg nog onvoldoende rekening wordt gehouden met het hoge risico op terugval bij depressie. Het door velen, om uiteenlopende redenen verfoeide DBC-systeem (Diagnose Behandel Combinatie) ontmoedigt om langdurig met behandelingen door te gaan. Bestaande effectieve interventies om het risico op terugval te verminderen worden nauwelijks toegepast, terwijl deze bij de behandeling van een vaak chronische aandoening als depressie uitdrukkelijk zijn aangewezen. Hiermee wijzen de auteurs impliciet op een belangrijke tekortkoming van het bestaande effectonderzoek: het gebrek aan evaluatie van de langetermijneffecten van de onderzochte interventie. Ook voor psychologische interventies bij depressie is duidelijk dat deze werkzaam zijn. En al geldt ook voor depressie dat we nog lang niet weten wat de specifieke werkingsmechanismen zijn (hoe deze werken), de noodzaak van implementatie van evidence based interventies om terugval te vermijden of uit te stellen kan niet genoeg worden benadrukt. Het recidiverend karakter maakt depressie immers tot een aandoening met zowel hoge maatschappelijke kosten als een zeer hoge ziektelast, lijdensdruk en risico op suïcide. Keywords: Change Mechanisms Accuracy Verified: Yes 134. Agius, M., Middleton, E., & Zaman, R. (2011, January). P02-466 - Audit and re-audit of patients with PTSD in a community team in Bedfordshire, UK. European Psychiatry, 26(1), 1062. doi:10.1016/S0924-9338(11)72767-5. Language: English Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 135. Park, S.-C., Park, Y.-C., Lee, M.-S., & Chang, H. S. (2012, March). Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: A pilot study. Acta Neuropsychiatrica. doi:10.1111/j.1601-5215.2011.00623.x. Language: English Format: Journal Abstract: Keywords: Pilot Study Plasma Brain-Derived Neurotrophic Factor Level Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 136. Ellis, T. L. (1999). Play therapy versus eye movement desensitization and reprocessing (EMDR): A comparative study examining the treatment effects with school-age children, Homan Elementary School, Fresno, California. California State University, Fresno. AAT 1401332. Language: English Format: Dissertation/Thesis Abstract: Keywords: Counseling in Elementary Education Play Therapy Accuracy Verified: Yes 137. Strom, I., & Christie, H. (2001, May). Possible EMDR targets when working with children diagnosed with OCD: A case history. Poster presented at the EMDR Europe Association annual meeting, London, UK . Language: English Format: Conference Abstract: Keywords: Children Obsessive Compulsive Disorder OCD Poster Accuracy Verified: Yes 138. Tryon, W. W. (2005, January). Possible mechanisms for why desensitization and exposure therapy work. Clinical Psychology Review, 25(1), 67-95. doi:10.1016/j.cpr.2004.08.005. Language: English Format: Journal Abstract: Keywords: Systematic Desensitization Exposure Therapy Learning-Memory Mechanism Accuracy Verified: Yes 139. Winkel, F. W. (2007, October 17). Post traumatic anger: Missing link in the wheel of misfortune. Lecture delivered on the official acceptance of the INTERVICT office of professor of Psychological Victimology at Tilburg University, Netherlands. Language: English Format: Other Abstract: Keywords: Anger Posttraumatic Stress Disorder PSTD Accuracy Verified: Yes 140. Creamer, M., & O'Donnell, M. (2002). Post-traumatic stress disorder. Current Opinion in Psychiatry, 15(2), 163-168. Language: English Format: Journal Abstract: Keywords: Cognitive Therapies Drug Therapy Exposure Therapies Posttraumatic Stress Disorder Prevention Primary Prevention PTSD Risk Factors Secondary Prevention Susceptibility (Disorders) Treatment Vulnerability Factors Accuracy Verified: Yes 141. Qain, M. (2010, July). Posttraumatic growth and its impact factos among earthquake victims in Sichuan. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia. Language: English Format: Conference Abstract: Keywords: Earthquake Sichaun Victims Accuracy Verified: Yes 142. van der Kolk, B. A. (2000). Posttraumatic stress disorder and the nature of trauma. Dialogues in Clinical Neuroscience, 2(1), 7-22. Language: English Format: Journal Abstract: Keywords: Etiology Historical Account Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 143. Stramrood, C., Paarlberg, K. M., Vingerhoets, A. J., van den Berg, P. P., & van Pampus, M. G. (2012, March). Posttraumatic stress following childbirth:
Diagnosis, treatment and prevention. Poster presented at the 70th annual scientific meeting of the American Psychomatic Society, Athens, Greece. Language: English Format: Conference Abstract: Keywords: Childbirth Accuracy Verified: Yes 144. Hasto, J., & Vojtova, H. (2012). Posttraumatická stresová porucha, bio-psycho-sociálne aspekty EMDR a autogénny tréning pri pretrvávajúcom ohrození: Prípadová stúdia [Post-traumatic stress disorder, bio-psycho-social aspects of EMDR and autogenic training with ongoing risk: A case study]. (1.vyd) Olomouc: Univerzita Palackého v Olomouci. Language: Slovak Format: Book Abstract: Keywords: Autonomic Nervous System Bilateral Stimulation Neurobiology Posttraumatic Stress Disorder PTSD REM Sleep Accuracy Verified: Yes 145. Aasen, B. (2010, July). Practical work with dissociated parts with EMDR. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia. Language: English Format: Conference Abstract: Keywords: Dissociation Accuracy Verified: Yes 146. Ehntholt, K. A., & Yule, W. (2006, December). Practitioner review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology & Psychiatry, 47(12), 1197-1210. doi:10.1111/j.1469-7610.2006.01638.x. Language: English Format: Journal Abstract: Keywords: CBT Children Cognitive Behaviorial Therapy Literature Review Narrative Exposure Therapy NET Posttraumatic Stress Disorder PTSD War Refugees Accuracy Verified: Yes 147. Hopchet, M., & Detournay, F. (2012, June). Preliminary study on the effects of simultaneous application of two types of
stimulations (eye movements and tactile stimuli) on psychophysiological autoreported
symptoms in the treatment of negative autobiographical memories [Estudios
preliminares
sobre
los
efectos
de
la
aplicación
simultanea
de
dos
tipos
de
estimulación
(movimientos
oculares
y
táctiles)
en
sintomatología
psicofisiológica
autoinformada
en
el
tratamiento
de
recuerdos
autobiográficos
negativos]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Autobiographical Memories Bilateral Stimulation Eye Movements Tactile Stimulation Accuracy Verified: Yes 148. Cantelmi, T. (2010, Novembre). Prevalenza, incidenza e diagnosi differenziale dei disturbi da stress post-traumatici in oncologia [Prevalence, incidence and differential diagnosis of post-traumatic stress disorder in oncology]. Presentazione al "Convegno La psicotraumatologia Oncologica, Roma, Italia. Language: Italian Format: Conference Abstract: Keywords: Cancer Posttraumatic Stress Disorder PSTD Accuracy Verified: Yes 149. Guettler, K. (2004, June). A preverbal trauma mastered by dynamic psycho-therapy and EMDR. In psychodynamics and EMDR (B. Lilieblad, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden. Language: English Format: Conference Abstract: Keywords: Preverbal Trauma Primary Repression Repetition-Compulsion Symposium Trauma Accuracy Verified: Yes 150. Giannantonio, M. (2002, Settembre). Psicoterapia ipnotica e eye movement desensitization and reprocessing (EMDR): Sinergie e integrazioni nella psicoterapia dei disturbi post-traumatici e dell'attaccamento (EMDR) [Hypnotic psychotherapy and eye movement desensitization and reprocessing (EMDR): Synergies and integration in psychotherapy with post-traumatic stress and attachment]. IX Congresso della Società Europea di Ipnosi: L'ipnosi e gli altri modelli terapeutici nel nuovo millennio, Roma, Italia. Language: Italian Format: Conference Abstract: Keywords: Attachment Posttraumatic Stress Accuracy Verified: Yes 151. Lennmarken, C., & Sydsjo, G. (2007, September). Psychological consequences of awareness and their treatment. Best Practice & Research: Clinical Anaesthesiology, 21(3), 357-367. doi:10.1016/j.bpa.2007.04.005. Language: English Format: Journal Abstract: Keywords: Anesthesia Awareness CBT Cognitive Behaviorial Therapy Consciousness Memory Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 152. Ilic, Z. (2004). Psychological preparation of torture victims as witnesses toward the prevention of retraumatisation. In Ž. Špiric, G. Kneževic, V. Jovic, & G. Opacic (Eds.), Torture in war: Consequences and rehabilitation of victims – Yugoslav experience. (pp. 377-387) Belgrade, Serbia: International Aid Network. Language: English Format: Book Section Abstract: Accuracy Verified: Yes 153. Gillies, D., Taylor, F., Gray, C., O’Brien, L., & D’Abrew, 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: Keywords: Adolescents Children Posttraumatic Stress Disorder PTSD Review Accuracy Verified: Yes 154. Kitchiner, N. J. (2004, August). Psychological treatment of three urban fire fighters with post-traumatic stress disorder using eye movement desensitisation reprocessing (EMDR) therapy. Complementary Therapies in Nursing and Midwifery, 10(3), 186-193. doi:10.1016/j.ctnm.2004.01.004. Language: English Format: Journal Abstract: Keywords: British Case Report Fire Fighters Males Middle Aged Posttraumatic Stress Disorder PTSD Stressors Survivors Accuracy Verified: Yes 155. Hughes, J. H. (2006, July). Psychology and cognitive processing in post-traumatic disorders. Psychiatry, 5(7), 228-230. doi:10.1053/j.mppsy.2006.04.002. Language: English Format: Journal Abstract: Keywords: CBT Cognitive Behaviorial Therapy Cognitive Therapy Posttraumatic Stress Disorder PTSD Stress-Related Disorders Trauma Accuracy Verified: Yes 156. Devilly, G. J., & Borkovec, T. D. (2000, June). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31(2), 73-86. doi:10.1016/S0005-7916(00)00012-4. Language: English Format: Journal Abstract: Keywords: Adults Australians Cognitive Therapy Postttraumatic Stress Disorder PTSD Self Report Instruments Stressors Survivors Accuracy Verified: Yes 157. van Loey, N. E. E., & van Son, M. J. M. (2003). Psychopathology and psychological problems in patients with burn scars: Epidemiology and management. American Journal of Clinical Dermatology, 4(4), 245-272. Language: English Format: Journal Abstract: Keywords: Burns Comorbidity Epidemiology Literature Review Posttraumatic Stress Disorder Predisposition PTSD Survivors Treatment Accuracy Verified: Yes 158. Pham, T., & Willocq, L. (2005, June). Psychopathy and traumatic stress in a forensic hospital. In Research Issues. Symposium conducted at the annual meeting of the EMDR Europe Association, Brussels, Belgium. Language: English Format: Conference Abstract: Keywords: Forensic Hospital Research Symposium Accuracy Verified: Yes 159. Peñalba, V., McGuire, H., & Leite, J. R. (2009). Psychosocial interventions for prevention of psychological disorders in law enforcement officers. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005601. doi:10.1002/14651858.CD005601.pub2. Language: English Format: Other Abstract: Keywords: Law Enforcement, Officers Review Accuracy Verified: Yes 160. Teegen, F. (2000). Psychotherapie der posttraumatischen belastungsstörung [Psychotherapy of post-traumatic stress disorder]. Psychotherapeut, 45(6), 341-349. doi:10.1007/PL00006723. Language: German Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 161. Corrigan, F. M. (2004). Psychotherapy as assisted homeostasis: Activation of emotional processing mediated by the anterior cingulate cortex. Medical Hypotheses, 63(6), 968-973. Language: English Format: Journal Abstract: Keywords: Cognitive Processes Cognitive Therapy Neurobiology Accuracy Verified: Yes 162. Farrell, D., & Keenan, P. (2010, July). A Q-Methodology evaluation of EMDR HAP facilitators training in Pakistan. Poster presented at the 1st EMDR Asia Conference, Bali, Indonesia. Language: English Format: Conference Abstract: Keywords: Facilitators Q-Methodology Evaluation Pakistan Poster Accuracy Verified: Yes 163. Blore, D. C. (2009, March). The range and diversity of post traumatic growth following EMDR for involvement in a road traffic accident. Symposium conducted at the 7th annual Conference of the EMDR UK & Ireland Association, Manchester, UK. Language: English Format: Conference Abstract: Keywords: Diversity Motor Vehicle Accident Symposium Accuracy Verified: Yes 164. Koppel, R. H. (2009, May). Rapid eye movement effects on traumatic memories: A test of the working memory hypothesis. The College of William and Mary, Williamsburg, VA. Language: English Format: Dissertation/Thesis Abstract: Keywords: Hypotheses Rapid Eye Movements REM Traumatic Memories Accuracy Verified: Yes 165. Todder, D., & Kaplan, Z. (2007, August). Rapid eye movements for acute stress disorder using video conference communication. Telemedicine and e-Health, 13(4), 461-464. doi:10.1089/tmj.2006.0058. Language: English Format: Journal Abstract:
Keywords: Telemedicine Telepsychiatry Trauma Treatment Accuracy Verified: Yes 166. Benish, S. G., Imel, Z. E., & Wampold, B. E. (2008 June). The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons. Clinical Psychology Review, 28(5), 746–758. doi:10.1016/j.cpr.2007.10.005.. Language: English Format: Journal Abstract: Keywords: Comparison Meta-analysis Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 167. Weisensee, K. (2002). Resiliency through EMDR self-administration: A proposal for a protocol. The EMDR Practitioner. Retrieved from http://www.emdr-practitioner.net on 12/27/2008. Language: English Format: Other Abstract: Keywords: Self-Administration Accuracy Verified: No 168. Greenwald, R. (2008, November). Resolving early memories reduces the distress of
later related memories. Poster presented at 24th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL. Language: English Format: Conference Abstract: Keywords: Early Memories Later Memories Accuracy Verified: Yes 169. Greenwald, R. (2008, June). Resolving early memories reduces the level of distress associated with later memories. Presentation at the annual meeting of the EMDR Europe Association, London, England. Language: English Format: Conference Abstract: Keywords: Memories Accuracy Verified: Yes 170. Schmidt, S. J. (1999, March). Resource-focused EMDR: Integration of ego state therapy, alternating bilateral stimulation, and art therapy. EMDRIA Newsletter, 4(1), 8, 10-13, 25-28. Language: English Format: Newsletter Abstract: Keywords: Art Therapy Bilateral Stimulation BLS Ego State Therapy Resource-Focused EMDR Accuracy Verified: Yes 171. Hase, M., & Hofmann, A. (2005, März). Risiken und nebenwirkungen beim einsatz der EMDR-Methode [Risks and adverse effects in treatment with EMDR]. PTT: Persönlichkeitsstörungen Theorie und Therapie, 9(1), 16-21. Language: German Format: Journal Abstract: Keywords: Adverse Effects Posttraumatic Stress Disorder PTSD Risk Factors Side Effects (Treatment) Stress Accuracy Verified: Yes 172. Dietrich, A. M. (2001, April). Risk factors in PTSD and related disorders: Theoretical, treatment, and research implications. Traumatology, 7(1), 23-50. doi:10.1177/153476560100700103. Language: English Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PSTD Risk Factors Accuracy Verified: Yes 173. Sharp, I. R. (2003, August). The role of critical thinking skills in practicing psychologists' theoretical orientation and choice of intervention techniques. Drexel University. Language: English Format: Dissertation/Thesis Abstract: Accuracy Verified: Yes 174. Chang, S. H. (2007, September). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. Presentation at the annual meeting of the EMDR International Association Conference, Dallas, Texas. (NSC
93-2413-H-002-002-). Language: English Format: Conference Abstract: Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Semantic Association Accuracy Verified: Yes 175. Chang, S. H. (2009). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. National Taiwan University, Taipei, Taiwan. Language: English Format: Dissertation/Thesis Abstract: Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Sematic Association Accuracy Verified: Yes 176. Lilienfeld, S. O., & Landfield, K. (2008, October). Science and pseudoscience in law enforcement: A user-friendly primer. Criminal Justice and Behavior, 35(10), 1215-1230. doi:10.1177/0093854808321526. Language: English Format: Journal Abstract: Keywords: Confirmation Bias Falsifiability Law Enforcement Peer Review Police Pseudoscience Accuracy Verified: Yes 177. Scheck, M. M., Schaeffer, J. A., Gillette, C. S., & van der Kolk, B. A. (1996, June). Scientific investigations into EMDR (Part I) - Brief psychological intervention with young high-risk females: A comparison of eye movement desensitization and reprocessing with active reflective listening. Presentation at the annual meeting of the EMDR International Association, Denver, CO. Language: English Format: Conference Keywords: Americans Battery Child Abuse Effects Emotional Abuse Females Incest Posttraumatic Stress Disorder PTSD Random Clinical Trial Rape RCT Stressors Survivors Treatment Effectiveness Young Adults Accuracy Verified: Yes 178. Leserman, J. (2005). Sexual abuse history: Prevalence, health effects, mediators, and psychological treatment. Psychosomatic Medicine, 67(6), 906-915. doi:10.1097/01.psy.0000188405.54425.20. Language: English Format: Journal Abstract: Keywords: HMO Health Maintenance Organization HPA Hypothalamic-Pituitaryadrenocortical Review Posttraumatic Stress DIsorder PTSD Sexual Abuse Trauma Accuracy Verified: Yes 179. Dodgson, P. W. (2007, June). Shame: The adaptive information processing model and introduction of the "protocol interweave" in EMDR with victims of torture, rape and organised violence. Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Adaptive Information Processing AIP Organised Violence Protocol Interweave Rape Shame Torture Accuracy Verified: Yes 180. Brink, A. (2006). Spiritualität in der traumatherapie mit EMDR [Spirituality in trauma therapy with EMDR]. Institut für Traumatherapie. Retrieved from http://www.traumatherapie.de/users/brink/Spirituelle%20Aspekte.html on 11/16/2011. Language: German Format: Other Abstract: Keywords: Spirituality Trauma Therapy Accuracy Verified: Yes 181. Kitchur, M. (2005). The strategic developmental model for EMDR. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 8-56). New York: W W Norton & Co. Language: English Format: Book Section Abstract: Keywords: Patient History Hypnotherapy Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Stressors Survivors Accuracy Verified: Yes 182. Kitchur, M. (2000, December). The strategic developmental model for EMDR: A sequential treatment strategy for diverse populations, facilitative of developmental recapitulation, with implications for neurobiological maturation. EMDRIA Newsletter, 5(Special Edition), 4-10. Language: English Format: Newsletter Abstract: Keywords: Strategic Developmental Model Accuracy Verified: Yes 183. Hann, G. R. (2001, Fall). Students: For your eyes only!. Psychotherapy Bulletin, 36(4) . Language: English Format: Newsletter Abstract: Keywords: Albert Ellis Alvin R. Mahler Don Lusterman Francine Shapiro Gary DeNelsky Hanna Levinson James Bray James F.T. Bugental Norman Ables Psychology Psychotherapy Rachel Hare-Mustin Accuracy Verified: Yes 184. Tofani, L. R. (2003, May). Systemic family therapy and EMDR: Theoretical and practical considerations for their intergration. Symposium conducted at the annual meeting of the EMDR Europe Association, Rome, Italy. Language: English Format: Conference Abstract: Keywords: Symposium Systemic Family Therapy Accuracy Verified: Yes 185. Puliatti, M., & Giannantonio, M. (2008, April). T08-O-15 Childhood sexual abuse and vulvodynia: Hypnotic psychotherapy and eye movement desensitization and reprocessing (EMDR) – An integrated approach. Revue Europeènne de Sexologie et de Santè Sexuelle, 17(Supplement 1), S109-S110. doi:10.1016/S1158-1360(08)72816-0 . Language: English Format: Journal Abstract: Keywords: Dyspareunia Dysesthetic Vulvodynia Sexual Pain Sexological Techniques Accuracy Verified: Yes 186. Dieffenbach, I. (2010, June). TAFO study II (Task force) long-term evaluation of specific therapeutic early interventions following acute strain among children and adolescents with multiple trauma experience. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Acute Stress Adolescents Children Early Intervention Multiple Trauma Incidents Symposium TAFO Accuracy Verified: Yes 187. Paulsen, S. L., & Golston, J. (2005, September). Taming the storm: 43 secrets to successful stabilization. Presentation at the annual meeting of the EMDR Interational Association, Seattle, WA. Language: English Format: Conference Abstract: Keywords: Affect Dysregulation Bridging Theory Stabilization Accuracy Verified: Yes 188. Lovett, J. (2012, October). Targeting confusion to facilitate trauma resolution and promote attachment. Presentation at the annual meeting of the EMDR International Association, Arlington, VA. Language: English Format: Conference Abstract: Keywords: Attachment Confusion Accuracy Verified: Yes 189. Knipe, J. (2002, June). A tool for working with dissociative clients. EMDRIA Newsletter, 7(2), 14-15. Language: English Format: Newsletter Abstract: Keywords: Dissociation Accuracy Verified: Yes 190. Aduriz, M. E. (2007, Novembro). Trabajando creativamente con EMDR en niños y familia - Como motivar al niño a usar EMDR [Working creatively with EMDR children and family - How to motivate the child to use EMDR]. Presentación en el Primer Congreso Iberoamericano de EMDR, Brasilia, Brasil. Language: Spanish Format: Conference Abstract: Accuracy Verified: Yes 191. González-Brignardello, M. P., & Vázquez, A. M. M (2004). Tratamiento de un caso de trastorno por estrés postraumático con EMDR dentro de un marco cognitivo-conductual [Intervention in a case of post-traumatic stress disorder with EMDR within a cognitive behavioral setting]. Cliníca y Salud, 15(3), 337-354. Language: Spanish Format: Journal Abstract: Keywords: Clinical Case Study Empirical Study Intervention Major Depression Posttraumatic Stress Disorder Psychotherapeutic Techniques PTSD Terrorism Victimization Accuracy Verified: Yes 192. Siracusano, A., & Niolu, C. (2006, Settembre-Dicembre). Trattamento farmacologico del - Disturbo post-traumatico da stress [Drug treatment of - post-traumatic stress disorder]. NÓOς, 12(3), 243-276. Language: Italian Format: Journal Abstract: Keywords: Acute Stress Disorder ASD Cognitive-Behavioral Therapy Comorbidity Hypnosis Peritraumatic Dissociation Psychological Debriefing Trauma Accuracy Verified: Yes 193. Mevissen, L., & Lievegoed, R. (2010, June). Trauma and institutionalization -
EMDR: A tool to cure, relieve or prevent. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Institutionalization Accuracy Verified: Yes 194. Mevissen-Renckens, L. (2008, August). Trauma and trauma therapy (EMDR) in people with ID. Symposium presented at the 13th World Congress of the International Association for the Scientific Study of Intellectual Disabilities, Cape Town, South Africa. Language: English Format: Conference Abstract: Keywords: ID Intellectual Difficulties Posttraumatic Stress Disorder PTSD Symposium Accuracy Verified: Yes 195. Schleyer, M. A. (2000, July). The trauma client's experience of eye movement desensitization and reprocessing: A heuristic analysis. Union Institute and University, Cincinnati, OH. AAT 9958854 . Language: English Format: Dissertation/Thesis Abstract: Keywords: Adults Americans Empirical Study Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Stressors Survivors Treatment Effectiveness Accuracy Verified: Yes 196. Scharloo, A., & Coppens, L. (2010, Apirl). Trauma treatment after sexual abuse for people with developmental disabilities. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociaion Conference, Belfast, Northern Ireland. Language: English Format: Conference Abstract: Keywords: Developmental Disabilities Sexual Abuse Accuracy Verified: Yes 197. Urtz, A. (2010, June). Trauma treatment via EMDR after heart attack.
A psychologist´s report from a rehabilitation
hospital for heart and cardiovascular diseases. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Heart Attack Medical Issues Symposium Accuracy Verified: Yes 198. van der Vleugel, B. M., van den Berg, D. P. G, & Staring, A. B. P.
(2012, March-April). Trauma, psicosi, disturbo da stress post-traumatico e l’utilizzo dell’EMDR [Trauma, psychosis, post-traumatic stress disorder and the application of EMDR]. Rivista di Psichiatria, 47(2 Suppl. 1), 33S-38S. doi:10.1708/1071.11737. Language: Italian Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PTSD Psychosis Schizophrenia Trauma Accuracy Verified: Yes 199. van den Berg, D., & van der Vleugel, B. (2011, June). Trauma, psychosis and EMDR. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria
. Language: English Format: Conference Abstract: Accuracy Verified: Yes 200. Tinker, R., Wilson, S., & Becker, L. A. (1999, June). Trauma-based diagnosis: A framework to predict treatment parameters for EMDR with children and adults. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV. Language: English Format: Conference Abstract: Keywords: Adults Children Trauma-Based Diagonsis Risk Factors in PTSD Treatment Length Treatment Parameters Accuracy Verified: Yes 201. Diseth, T. H., & Christie, H. J. (2005, September). Trauma-related dissociative (conversion) disorders in children and adolescents – An overview of assessment tools and treatment principles. Nordic Journal of Psychiatry, 59(4), 278-292. doi:10.1080/08039480500213683. Language: English Format: Journal Abstract: Keywords: Adolescents Children Conversion Disorders Empirical Study Quantitative Study Accuracy Verified: Yes 202. Tufnell, G. (2008, June). Traumatised parents of traumatised children: A brief EMDR intervention. Presentation at the annual mmeting of the EMDR Europe Association, London, England. Language: English Format: Conference Abstract: Keywords: Children Accuracy Verified: Yes 203. Russell, M. C. (2008, April). Treating traumatic amputation-related phantom limb pain: A case study utilizing eye movement desensitization and reprocessing within the Armed Services. Clinical Case Studies, 7(2), 136-153. doi:10.1177/1534650107306292. Language: English Format: Journal Abstract: Keywords: Clinical Case Study Military Pain Phantom Limb Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 204. 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: Keywords: Military Misconduct Violence Accuracy Verified: Yes 205. Dohrmann, M. (2009). Treatment effects of EMDR on risk to re-offend by sexual offenders traumatized as children. Colorado School of Professional Psychology, The University of the Rockies, Colorado Springs. AAT 3344547. Language: English Format: Dissertation/Thesis Abstract: Keywords: Good Lives Model Recidivism Sex Offenders Sexual Deviance Trauma Treatment Accuracy Verified: Yes 206. de Jongh, A. (2012). Treatment of a woman with emetophobia: A trauma focused approach. Mental Illness, 4(1), 10-14. doi:10.4081/mi.2012.e3. Language: English Format: Journal Abstract: Keywords: Emetophobia Specific Phobia Vomiting Phobia Accuracy Verified: Yes 207. Klaff, F. R. (1995, June). Treatment of children's fears with EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA. Language: English Format: Conference Abstract: Accuracy Verified: Yes 208. Mevissen, L. (2011, June). Treatment of people with developmental disabilities. How far can we go?. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria. Language: English Format: Conference Abstract: Keywords: Developmental Disabilities Treatment Accuracy Verified: Yes 209. de Jongh, A. (2001, May). Treatment of phobias with EMDR. Presentation at the EMDR Europe Association annual meeting, London, UK . Language: English Format: Conference Abstract: Keywords: Phobias Accuracy Verified: Yes 210. Grant, M. (2001). Understanding and treating chronic pain as trauma, with EMDR. Author. Language: English Format: Other Abstract: Keywords: Chronic Pain Trauma Accuracy Verified: Yes 211. McFarlane, A. (2010, June). Understanding traumatic stress reactions - The linking of phenomenology, aetiology and treatment plan. Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Posttraumatic Stress Disorder PTSD Traumatic Stress Accuracy Verified: Yes 212. Marotta, S. A. (2003, Winter). Unflinching empathy: Counselors and tortured refugees. Journal of Counseling and Development, 81(1), 111-114. doi:10.1002/j.1556-6678.2003.tb00232.x. Language: English Format: Journal Abstract: Keywords: Counselors Empathy Refugees Torture Accuracy Verified: Yes 213. Kutz, I. (2007, June). The use of single session EMDR protocol in acute stress syndromes (ASS). Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Acute Stress Syndrome Early Intervention Accuracy Verified: Yes 214. Wesselmann, D. (2013, April). Using EMDR to treat attachment trauma in adults and children. Preconference presentation at the Congress EMDR Vereniging EMDR Nederland, Nijmegen, the Netherlands. Language: English Format: Conference Abstract: Keywords: Adults Children Trauma Attachment Accuracy Verified: Yes 215. Zantvoord, J. B., Diehle, J., & Lindauer, R. J. (2013, March). Using neurobiological measures to predict and assess treatment outcome of psychotherapy in posttraumatic stress disorder: Systematic review. Psychotherapy and Psychosomatics, 82, 142-151. doi:10.1159/000343258. Language: English Format: Journal Abstract: Accuracy Verified: Yes 216. Donneau, D., Barry, S., Heteau, C., Hamrioui, M., Journniac, K., Ferric, O., Heron, A., & Paris, P. (2012, Decembre). Utilisation de l'outil EMDR pour améliorer la prise en charge des psycho-traumatismes
dans un service d'urgence psychiatrique [Using EMDR tool to improve the management of psychological trauma
in a psychiatric emergency service ]. Poster présenté au 40ème Congrès annuel de l'Association Française de Thérapie comportementale cognitive de et), Paris, France. Language: French Format: Conference Abstract: Keywords: Emergency Service Trauma Accuracy Verified: Yes 217. Beer, R., & van der Meijden, H. (2013, April). Why EMDR in the treatment of an eating disorder? How? So ...: ideas, hypotheses and findings with respect EMDR aimed at influencing a negative body image [Hoezo EMDR bij behandeling van een eetstoornis?
Hoe? … Zo: ideeën, hypothesen en bevindingen t.a.v. EMDR gericht op beïnvloeding van een negatieve lichaamsbeleving]. Presentatie op het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland. Language: Dutch Format: Conference Abstract: Keywords: Eating Disorders Negative Body Image Accuracy Verified: Yes 218. Greene, M. (2004, February). The wild bunch: EMDR and angry boys. Presentation at the 2nd annual Conference of the EMDR UK & Ireland Association, Birmingham, UK. Language: English Format: Conference Abstract: Keywords: Affect Regulation Anger School-Setting Students Accuracy Verified: Yes 219. Vazquez, A. G. (2008, June). Work with parts in DID & EMDR. Presentation at the annual meeting of the EMDR International Association, London, England. Language: English Format: Conference Abstract: Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 220. Gonzalez, A. (2008, June). Work with parts in DID & EMDR. Presentation at the annual meeting of EMDR Europe Association, London, UK. Language: English Format: Conference Abstract: Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 221. Shapiro, F. (1991, August). Worth repeating. EMDR Network Newsletter, 1(1), 1-2. Language: English Format: Newsletter Abstract: Accuracy Verified: Yes
Psychologische Behandlung von traumatischen Belastungsstörungen mit EMDR. Die EMDR-Behandlung ist nach unserer Erfahrung eine sehr effektive Technik zur Behandlung von traumatischen Erinnerungen bei Patienten mit dissoziativen Störungen. Das Ziel der Traumabehandlung bei dissoziativen Patienten zusätzlich zu der Verringerung der Belastung von posttraumatischen Symptomen, Aussetzen der zuvor abgespaltenen Erinnerungen im Sinne einer Integration von dissoziierten Erfahrung liegt. Die EMDR-Behandlung dissoziativer Patienten brauchen, wenn nötig. durch Ändern der Standard-Protokoll auf den einzelnen Elastizität eingestellt werden. Da dissoziative Speicher Barrieren durch eine EMDRBehandlung sehr schnell untergraben werden kann, kombiniert mit dem Risiko der Übererflutung durch aversive Reize, sollte dies nur von entsprechend erfahrenen Therapeuten und mit Sorgfalt im Rahmen einer umfassenden Traumatherapie eingesetzt werden.
Psychological treatment of traumatic stress disorders with EMDR. The EMDR treatment is, in our experience a very effective technique for the treatment of traumatic memories in patients with dissociative disorders. The aim of trauma treatment in dissociative patients in addition to reducing the burden of post-traumatic symptoms, exposing the previously split-off memories in the sense of an integration of dissociated experience content. The EMDR treatment of dissociative patients need, if necessary. be adjusted by modifying the standard protocol on the individual resilience. Since dissociative memory barriers through a EMDRBehandlung may be undermined very quickly, combined with the risk of Übererflutung by aversive stimuli, this should only be used by suitably experienced therapists and with care in the context of a comprehensive trauma therapy.
Die Wahrscheinlichkeit, dass wir im Laufe unseres Lebens einem oder mehreren
traumatisierenden Ereignissen ausgesetzt sind, ist relativ hoch: Die Lebenszeitprävalenzen
von traumatischen Ereignissen und einer posttraumatischen Belastungsstörung
betragen in internationalen epidemiologischen Studien für Frauen 17,7 – 74,2
Prozent (PTBS: 1,3 - 12,3 Prozent) und für Männer 25,2 - 81,3 Prozent (PTBS: 0,4 -
6,0 Prozent) (Kuhn, 2004). Menschen mit Suchtproblemen berichten dabei überzufällig
häufig von Gewalt- und Missbrauchserfahrungen in Kindheit, Jugend und im Erwachsenenalter.
In vielen Fällen kann ein Zusammenhang zwischen dem traumatischen
Ereignis, der Entwicklung einer posttraumatischen Belastungsstörung und Alkoholmissbrauch
und –abhängigkeit abgeleitet werden (Perkonigg et al., 2000; Zobel,
2006). Bei Vorliegen einer PTBS íst das Risiko einer Suchterkrankung oder anderer
komorbider Störungen um das 4-5fache erhöht (Breslau, 2002).
The probability that we are in the course of our lives one or more
traumatic events are exposed, is relatively high: the lifetime prevalence
of traumatic events and posttraumatic stress disorder
be in international epidemiological studies for women from 17.7 to 74.2
Percent (PTSD: 1.3 - 12.3 percent) for men and from 25.2 to 81.3 percent (PTSD: 0.4 -
6.0 percent) (Kuhn, 2004). People with addiction problems to report here than chance
often violence and abuse experiences in childhood, adolescence and adulthood.
In many cases, a connection between the traumatic
Event, the development of post traumatic stress disorder and alcohol abuse
and are derived dependence (Perkonigg et al., 2000; Zobel,
2006). In the event of a PTSD is a risk of addiction or other
comorbid disorders at the 4-5-fold increased (Breslau, 2002).
Interactions between trauma and biology, dissociation and psychosis are
complex. Some cases could be more biologically based, and traumatic events may
trigger a psychotic episode or contribute to the low-response to usual
interventions. But traumatic experiences could also influence neurodevelopment
and brain structure. In some cases past adverse events may be a main factor in the
development of psychotic psychopathology. The treatment of psychotic disorders
with a specifically trauma-oriented therapy as EMDR, can help us to evaluate the
relative contribution of these different factors from clinical results. The empirical
research about the application of EMDR will be also reviewed.
A relevant point for EMDR therapy in psychotic disorders is the complex
relationship between dissociation and psychosis. Patients presenting with the
belief of being controlled by an external force, intrusive thoughts and hallucinatory
voices that comment on one's thoughts or actions or that have a conversation with
other hallucinated voices, are easily diagnosed as schizophrenic or psychotic but
can often be best understood and approached as dissociative symptoms. These
patients can be treated with EMDR, but the procedures present relevant
modifications in relation with the standard EMDR procedure for PTSD.
In this workshop we will briefly describe how EMDR can be applied in different
examples of psychotic patients, and based on these clinical examples (presented a case-descriptions or videos, we will reflect on the previously described aspects.
Las
interacciones
entre
trauma
y
biología,
disociación
y
psicosis
son
complejas.
Algunos
casos
pueden
estar
más
basados
en
el
ámbito
biológico,
y
los
eventos
traumáticos
pueden
ser
disparadores
de
un
episodio
psicótico
o
contribuir
a
la
baja
respuesta
ante
las
intervenciones
usuales.
Pero
las
experiencias
traumáticas
pueden
también
influenciar
el
neurodesarrollo
y
la
estructura
cerebral.
En
Algunos
casos
eventos
adversos
del
pasado
pueden
ser
el
principal
factor
para
desarrollar
psicosis
o
una
psicopatología.
El
tratamiento
de
los
trastornos
psicóticos
con
un
terapia
orientada
al
trauma
como
el
EMDR
nos
ayudan
a
evaluar
la
contribución
relativa
de
distintos
factores
a
los
resultados
clínicos.
La
investigación
empírica
acerca
de
la
aplicación
del
EMDR
también
será
revisada.
Un
punto
relevante
de
la
Terapia
EMDR
en
trastornos
psicóticos
es
el
resultado
complejo
de
la
relación
entre
disociación
y
psicosis.
Los
pacientes
que
presentan
creencias
de
control
por
fuerzas
externas,
pensamientos
intrusivos
y
voces
alucinatorias
que
comentan
las
acciones
o
pensamientos
o
tienen
una
conversación
con
otras
voces
alucinatorias,
normalmente
son
diagnosticadas
como
esquizofrenia
y
psicosis
pero
en
algunas
ocasiones
estarían
mejor
entendidas
desde
un
enfoque
que
las
considerara
síntomas
disociativos.
Estos
pacientes
pueden
ser
tratados
con
EMDR,
pero
los
procedimientos
presentan
modificaciones
referentes
al
procedimiento
estándar
de
EMDR
para
el
TEPT.
Patients with dissociative disorders are a complex patient population in which EMDR can be one of the key treatment approaches in a therapy setting that usually needs to enclose a number of other treatment modalities and an overall comprehensive treatment plan. If undiagnosed, dissociative patients are, on the other hand, at increased risk of developing complications during the treatment with EMDR. In this workshop, participants will learn how to: (1) develop a comprehensive treatment plan that includes trauma work with EMDR, (2) integrate the 8 phases of EMDR with the three general phases of trauma treatment according to Janet (stabilization, trauma work, integration), (3) find a good balance to interchange in therapy between stabilization phases, trauma work with EMDR and work within the therapeutic relationship, and (4) recognize and possibly counter treatment complications.
Eye Movement Desensitization and Reprocessing (EMDR) has established itself as an evidence-based psychotherapy for the treatment of trauma and other related mental health disorders. Despite the numerous studies touting EMDR’s efficacy, it is still largely regarded as too complicated to understand, a major factor in why many who have been trained in EMDR no longer use it. EMDR Made Simple: 4 Approaches to Using EMDR with Every Client offers a fresh approach to understanding, conceptualizing, and ultimately implementing EMDR into clinical settings.
Dr. Jamie Marich brings in her clinical experience from other modalities and disciplines to show that EMDR is more than just a series of protocols that need to be mastered in order for it to be effective. Using common sense language, clinical cases, and practical examples, EMDR Made Simple will give you the tools to build on your existing clinical knowledge and make EMDR work for you and your clients.
L’attività è stata svolta presso l’U.O. di ginecologia-ostetricia di Lamezia Terme nella quale è stato attivato uno Screening sulla “Depressione in gravidanza e nel puerperio” che ha come obiettivo primario di individuare i soggetti vulnerabili alla depressione o PN- PTSD e di rilevare i fattori di rischio: vulnerabilità e/o scatenanti e i fattori protettivi. La gravidanza e il parto sono eventi fisiologici che segnano un periodo determinato del ciclo di vita di una donna. Sono eventi che attivano vissuti emotivi intensi e predispongono la donna ad una eccessiva sensibilità e vulnerabilità. In questo periodo la donna contatta e fa proprie una serie di processi identificativi assunti nell’infanzia che possono, se non bene rielaborati, bloccare il comportamento responsivo della futura madre con comportamenti non idonei e convizioni target inadeguate. Anche la presenza di eventi di vita stressanti possono sovraccaricare la donna a livello emotivo tale da strutturare comportamenti poco adattivi da provocare serie difficoltà nella gestione del bambino.
Nel sistematizzare tale screening si è adoperato il metodo EMDR sia nell’ambito dell’assessment nella raccolta delle informazioni dal punto degli aspetti diagnostici con riferimenti alla mappa dei traumi, che nella cura nell’uso dei tices, taping, posto al sicuro in soggetti particolarmente vulnerabili.
Tale metodologia si è dimostata efficace in quanto:
• individua in brevissimo tempo il target delle difficoltà con i possibili traumi,
• attiva i fattori di protezione con istallazione delle risorse positive,
• desensibilizza e fluidifica gli stati emotivi intensi,
• velocizza la risoluzione dei comportamenti disadattavi in comportamenti adattivi adeguati al maternage, al ben-essere della donna e della genitorialità.
The activity was held at the U. O. gynecology-obstetrics Lamezia Terme in which it was activated a screening on "Depression in pregnancy and childbirth" which has as main objective to identify those vulnerable to depression or PN-PTSD and to detect risk factors: vulnerability and / and protective factors or triggers. Pregnancy and childbirth are physiological events that mark a given period of the life cycle of a woman. They are events that trigger intense emotional experiences and predispose women to an excessive sensitivity and vulnerability. During this time she makes contact, and their identification processes undertaken a series of childhood that can, if not well elaborated, lock the responsive behavior of the mother with inappropriate behavior and inappropriate convictions target. The presence of stressful life events can overload the woman on an emotional level that structuring behavior just to cause serious problems in adaptive management of the child.
In systematizing this screening method was used in EMDR is of the Assessment in collecting information from the diagnostic aspects with reference to the map of trauma care in the use of which tices, taping, safe place particularly in subjects vulnerable.
This methodology is effective because it can show:
• identify the target in the shortest time possible difficulty with trauma,
• active protection factors with installation of positive resources,
• desensitizes and liquify the intense emotional states,
• speeds up the resolution of maladaptive behavior in adaptive behaviors adapted to mothering, the well-being of women and parenting.
In working with clients with anorexia nervosa for the past 18 months, it has become apparent that while many clinicians continue to utilise a variety of treatment means, CBT or systemic family therapy are often treatments most frequently offered to the sufferer. However, what does appear to be consistent is the general view (e.g., Waller; Treasure; Brewer) that ‘recovery’ will take an average between 1 to 2 years with many clients suffering from this disorder never making a full or complete recovery.
With this in mind, sixteen clients with a previous diagnosis of anorexia nervosa and under medical supervision with a BMI of 16.5 – 18 and still meeting the mental criteria of anorexia nervosa (DSM IV) were offered either EMDR (N.10) or CBT (N.6). Starting with the premise that most sufferers of anorexia nervosa argued that simply ‘eating’ is not the answer – but rather the mechanism by which control is maintained – it was agreed that regular weigh-ins and the use of food journals would form part of the study – however, no therapeutic emphasis would be placed directly on food in either the CBT or the EMDR group.
Those receiving EMDR recovered substantially quicker and with less food-related exposure, once the target memory precipitating the anorexic onset was identified. Interestingly, food intake and weight increased without needing to be targeted as a separate matter, once the ‘feeder’ memory had been adapted in 8 out of the 10 EMDR clients. In the remaining two clients, behavioural experiments targeting the “practice of behaving (and eating) normally’ one day a week in order to reduce the fear of ‘normality’ was used with good effect.
Whilst the CBT group did improve, they continued to fluctuate in terms of active anorexic patterns of behaviour and their weight or food intake did not appear to improve significantly.
Although the trial lasted for 6 months duration, on average, the EMDR group reached ‘recovery’ at around 3-4 month mark, compared to the CBT group of which five noticed ‘improvement,’ however, did not appear to have increased weight and still reported phobic reactions to both body-mage and food at the 4 month mark. One in the CBT group did make a significant improvement based on cognitive restructuring alone and this client did increase weight and intake significantly at the same ratio as the EMDR group.
At the initial 1-month follow-up post-study, the CBT group were still exhibiting symptoms of mental pre-occupation with diet/weight compared to the EMDR group who had reached normal BMI ranges (N.9) and all reported little to no pre-occupation with diet/eight.
Although this study is still pending follow-ups of all clients, there would appear, on the basis of this preliminary study that anorexia nervosa appears to respond better to EMDR in shorter treatment duration than CBT.
Furthermore, six of the EMDR group reposed using safe-space imagery to reduce their anxieties surrounding food and this may have been a contributory factor.
The death of a loved one confronts people with particularly complicated challenges at
a time of often unparalleled distress. This workshop will focus on integrating EMDR
into the treatment of grief and mourning. Understanding grief and mourning in terms
of the Adaptive Information Processing model will be presented and illustrated by case
presentations and videos of EMDR sessions. EMDR does not shorten the phases the
mourner has to go through for adaptive assimilation and accommodation of the loss,
but processes the factors that can complicate the mourning. The processes the
mourner has to go through for assimilation and accommodation of the loss, and how
EMDR facilitates movement through them, will be presented. Particular attention will
be paid to how EMDR facilitates the emergence of adaptive inner representations. We
do not lose attachments to loved ones that die, they are transformed. We move from
loving in presence to loving in absence. Memories of the deceased often emerge
during EMDR treatment. It is the emergence of memories of the deceased that let us
know and acknowledge the meaning of the relationship, the person’s role in our lives
and identity, and enable us to carry the basic security of having loved and been loved
into the future. We can go forward in a world without the deceased, because we have
an adaptive inner representation to take with us.
Content includes:
· Overview of AIP model and how it applies to grief and mourning
· Acute grief as a form of traumatic stress
· Common responses to loss
· The six “R” processes of mourning
· High-risk factors predisposing to complicated mourning
· General principles of EMDR treatment in grief and mourning
Because EMDR is a powerful short-term therapy effective for confronting and overcoming stress, anxiety, and
trauma which could be its role in an intensive rehabilitation multidisciplinary programme? As well-known PTSD is
the most common diagnostic category used to describe symptoms arising from emotionally traumatic
experience.This disorder presumes that the person experienced a traumatic event involving actual or threatened
death or injury to themselves or others. Some research shows that EMDR is rapid, safe and effective in helping
those who suffer from anxiety, distressing memories, nightmares, insomnia, as consequences from traumatic
events. Several recent reviews have looked at the relationship between medical illness and subsequent PTSD.
Moreover Spindler(2005) published a review with focal point on subjects after cardiovascular disease and mainly
with a focus on prevalence rates, risk factors, and future. Should be possible catch a trauma event right through
in-hospital and use the EMDR when appropriate? Hence how should be tailored an appropriate assessment
procedures during the rehabilitation in-hospital? Anxiety (using a the STAI) and Depression (measured with
Depression Questionnaire) with clinical cut-off score might be useful in screening and an adequately structured
interview could complete in-hospital screening. In a more wide assessment screening a device for
psychophysiological assessment measuring electrodermal activity and heart rate/pulse wave. An elevated
cardiovascular and electrodermal activity during the interview should be an index for selecting a clinical simple of
patients where carry out a deeper assessment in search for a trauma connect to the pre-rehabilitation period or
older. The aforementioned could be a wished-for screen subjects with trauma events both at short or long term
insurgence.
The responses to my article, "Eye Movement
Desensitization & Reprocessing:
From EMD to EMDR -- A New Treatment
Model for Anxiety and Related
Traumata" in the May 1991 (Vol. 14, No.
5) issue of the Behavior Therapist, have been both gratifying and, at times, disturbing.
After receiving numerous requests
for a "description of the revised
procedure," and upon rereading the article,
I can see that I did not make sufticiently clear
the fact that clients are at risk
if untrained clinicians attempt to use
EMDR.
Scientists rarely sound as apologetic as Charles R. Figley did after discussing his latest investigation at the American Psychological Association's annual meeting in New York City this August. "I'm taking a major risk in presenting such odd and unusual techniques to you," Figley told the assembled clinicians. "But these are potentially revolutionary treatments for traumatic stress reactions."
It is proposed that enhanced mindfulness of emotions is a key factor in
successful reprocessing of traumatic memories with EMDR. Clinical
experience of utilising this focus will be presented. An attempt to study the
hypothesis using functional magnetic resonance imaging will be described.
The overall stigma- and gender-related controversies
that surround the diagnosis of Borderline Personality
Disorder (BPD) present a unique ethical mandate to the
practitioner. The relationship between trauma and the
BPD diagnosis strengthens the need for carefully
designed treatment interventions in order to secure the
benefits of trauma-focused work, while minimizing the
risk of undue regression. The complexity and risk of
harm introduced by a diagnosis of comorbid BPD and
PTSD urges the need for clarification of optimal
treatment interventions to guide practitioners. The use
of adjunctive treatment modalities alongside traumafocused
interventions emerges as an empirically
supported technique in the treatment of severely
comorbid patients.
Reply by the current author to the comments made by E.M. Corrigan and J. Jennett (see record 2004-16054-010) on the original article (see record 2003-05653-002). They describe a 29-year-old woman with an obsessive compulsive disorder relapse following ingestion of herbal products containing ephedra alkaloids. This case report highlights a number of points which can be important for psychiatric practice: our patients often see herbal remedies as risk-free additions to their conventional treatments; in reality, however, they can contain powerful ingredients with potential to harm. One may love or hate complementary medicine, but vis-à-vis its popularity with our patients it seems an ethical imperative to know the essentials about it. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Most persons who develop PTSD in the aftermath of exposure recover from trauma-related symptoms, but remain at risk for a recrudescence of symptoms. This suggests that there are aspects of the response to high magnitude trauma that are long-lasting, despite variations in symptom intensity over time. Current bio-behavioral models of PTSD fall short of explaining the apparent paradox of an enduring response on the one hand and symptom change over time on the other. However, this phenomenon can potentially be explained by epigenetic mechanisms. Epigenetics (literally: “epi” meaning “in addition to” genetics) refers to a heritable change in the genome that can be induced by environmental events and does not involve an alteration of DNA sequence. Such modifications reflect enduring changes in the function of the DNA that are caused by environmental exposures. These changes can alter gene function influencing its biological activity. This presentation will discuss evidence for such changes in PTSD, and will explain how such mechanisms explain many of the salient features of PTSD, including individual variation in responses to events of similar intensity (e.g., combat exposures), and the relative permanence of biological and psychological alterations associated with the disorder. Current models of stress, or even gene-environment interactions, only partially address the influence of prior exposure(s) on PTSD vulnerability and the long-lasting biological and psychological effects of trauma exposure. In addition, epigenetic modifications can be transmitted intergenerationally, both through the maternal and paternal lines. The implications of such changes as PTSD vulnerability factors will also be discussed.
This workshop will provide participants with a comprehensive overview of ethical, malpractice, and risk-management issues encountered in EMDR. Using extensive case material, participants will learn how to handle complex practice-based ethical dilemmas, prevent professional malpractice, and avoid liablity. Emphasis will be on practical strategies designed to protect clients, professionals, and employers. Key topics will include the limits to clients' rights to confidentiality and self-determination, privileged communications, informed consent procedures, the use of high-risk treatment techniques, boundary issues and dual relationships, conflicts of interest, defamation of character, consultation and referral, supervision, termination of services, documentation, and the problem of impaired colleagues. Participants will be provided with a typology of compelling ethical dilemmas and "high risk" areas, and acquainted with practical decision-making strategies.
The purpose of this exploratory study was to investigate the effects of EMDR
on state and trait anxiety and anger levels associated with developmental
traumas of sexual offenders in outpatient sex offender treatment. A
qualitative component explored the participants' perceptions of their
therapy experiences as helpful in resolving problematic reactive behaviors
linked with the developmental traumas and other negative life experiences.
The male participants ranged in age from 20 to 49 and were self-selected
from a purposive sample of clients receiving treatment in an outpatient sex
offender program in Southwest Florida. From this sample group, N = 17, the
study participants were randomly assigned to one of two treatment
modalities, EMDR or CBT. This exploratory study utilized a
quasi-experimental, mixed methods format to analyze the effects of EMDR on
state/trait anxiety and anger levels. The study utilized both quantitative
and qualitative research strategies to acquire what Webster and Marshall
(2004) described as "the clearest, fullest picture of behavior" (p. 118).
The quantitative analysis of data obtained from the pre and post-testing
found no significant differences between the treatment groups in reducing
state/trait anxiety and anger levels. The analysis of the qualitative
interview data revealed four core themes: Treatment Efficacy, Emotional
Processing, Therapeutic Alliance, and Empowerment. The emergent themes of
emotional processing and the therapeutic alliance have not been fully
explored in sex offender therapy and may warrant further scrutiny.
Additionally, processing of developmental traumas and past victimization has
been avoided or minimized in standard cognitive-behavioral sex offender
treatment contrary to more recent research findings that identify attachment
problems and intimacy deficits as key dynamic risk factors associated with
sexual recidivism (Adams, 2003). The field of sex offender therapy may
benefit from future research that investigates the role of trauma resolution
in mitigating dynamic risk factors that are linked with recidivistic sexual
violence. EMDR may serve as an adjunctive therapy to assist sexual offenders
to effectively process developmental wounds and in so doing target dynamic
risk factors by improving their ability to emotionally self-regulate and
enhance their ability to more fully experience victim empathy and improve
interpersonal relationships. Future sex offender research may benefit from
more expanded investigations of EMDR and other limbic therapies. Dissertation Abstracts International: Section B: The Sciences and Engineering. 68(10-B), 2008, pp. 6951.
Background: Eye Movement Desensitisation
and reprocessing (EMDR) is an evidence-based
treatment for both children and adults
that permanent mental or physical
complaints about holding one or more major
events. There is little outcome research
performed in children with intellectual
restriction (VB). This group has more risk
limited due to traumatic experiences
cognitive and verbal skills and lower
capacity (Mevissen 2010). EMDR does little
rely on verbal abilities, is a concrete
and directive method and therefore seems particularly
for children with a VB.
Purpose: EMDR available to
traumatized children with a VB.
Methods: Existing EMDR protocols
be modified by elements to
as: visualization using icons;
parents more involved, by for instance the
story to tell, through impact assessment
parents and significant others (teacher), more
repetition and more sessions. Results: In a case series of 10 patients with an IQ between 50-85, there was 70% a good result. All the patients were
treatment. The number of sessions varied between
2 and 10. Conclusion: EMDR is a promising
treatment for children with VB.
The purpose of this study was determine the efficacy of Eye Movement Desensitization Reprocessing (EMDR) with traumatized adolescents primarily diagnosed with conduct disorder (CD). The effect of exposure to domestic violence and other forms of human initiated violence puts children at risk of developing significant mental health problems including CD and other childhood disorders that can have a profound effect on the community. In order to test the null hypotheses that the EMDR treatment protocol would not lead to any significant reduction in posttraumatic or behavioral symptoms with this population, a repeated measures MANOVA was utilized for four of the five dependent variables. These variables were the Impact of Event Scale (IES), the Child Report of Posttraumatic Symptoms (CROPS), the Parent Report of Posttraumatic Symptoms (PROPS), and the Problem Rating Scale (PRS). A simple two-group independent t-test analysis was used to analyze the fifth independent variable (reward points) and the 2-month follow-up data. All of the 5 null hypotheses were supported by an inferential analysis (MANOVA; t-test) of the dependent variables of this study. EMDR treatment was not found to be statistically significant on any of the dependent variables. Despite these findings, future research should continue to focus on the efficacy of EMDR with childhood trauma. Future research should also continue to focus on the emotional needs of children in residential treatment, the benefits of therapeutic as opposed to punitive intervention with delinquent youths, and the role that EMDR can play in breaking the cycle of violence in our society. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 59(10-B), April 1999, pp. 5587.
Among Latino MSM, those who have reported early childhood sexual abuse continually report high levels of HIV risk behaviors. The objective of this study was to test if EMDR can be more effective as an HIV risk reduction behavioral intervention than a non-trauma based comparison, the Explore Study intervention. At a university-based outpatient clinic, 35 Latino MSM were randomized into Explore (n=13) and EMDR (n=22). The main outcome measure was a self-report questionnaire assessing unprotected anal sex, number of sexual partners, and use of substances before or during sexual activity during the previous month. Sexual risk behaviors were assessed at baseline, before randomization, and at one week post-intervention. Compared to baseline rates, participants who didn’t report unprotected receptive anal intercourse increased by 11% in Explore and decreased by 12% in EMDR. The corresponding comparisons for number of sexual partners were a 4% increase for Explore and a 41% decrease in EMDR. Explore and EMDR participants showed an increment of 25% and 9%, respectively, in those who denied having used alcohol or drugs before or during sexual activity. Follow-up data at 2 and 6 months post-intervention are being collected. This preliminary analysis suggests that certain HIV risk behaviors can be reduced by EMDR, while others can be equally reduced by more conventional interventions.
Intellectual disability is a comorbid condition in epilepsy. People with epilepsy and intellectual disability are at high risk of developing behavioral problems. Among the many contributors to behavioral problems in people with epilepsy and intellectual disability are those of traumatic experiences. As such, behavioral problems can be seen as a reflection of these traumatic experiences. Among established trauma therapies, eye movement desensitization and reprocessing (EMDR) is an emerging treatment that is effective in adults and also seems to be effective in children. This article is a case report of EMDR in an adolescent with epilepsy and mild intellectual disability, in whom the EMDR children’s protocol was used. The aim was to assess whether clinical trauma status significantly diminished to nonclinical status posttreatment. Change in trauma symptoms was evaluated with the Reliable Change Index (RCI). Results showed a significant decrease in trauma symptoms toward nonclinical status from pretreatment to posttreatment. EMDR consequences for epilepsy and intellectual disability are discussed.[Elsevier 2009]
Objective: Eye movement desensitization and reprocessing (EMDR) has been claimed effective in the treatment of a wide variety of psychiatric disorders, including eating disorders. An informal survey suggests that EMDR is now widely offered to patients with eating disorders. Before accepting a new therapy such as EMDR, one must determine that its benefits outweigh its adverse effects. This paper reviews the literature in an attempt to assess the benefits and risks of the use of EMDR in the treatment of eating disorders. Method: We reviewed the literature on the use of EMDR to treat eating disorders and other conditions. Results: Looking at the question of its benefits, we were unable to find any methodologically sound studies that have shown efficacy for EMDR in eating disorders, or, indeed, any psychiatric disorder. We were also unable to find a sound theoretical basis for expecting EMDR to be effective. In addition, EMDR may have adverse effects. First, EMDR is sometimes used in conjunction with efforts to "recover" memories of traumatic events. But "recovered memory" therapy may carry a risk of inducing potentially harmful false memories. Second, use of EMDR may prevent or delay other therapies of established efficacy for eating disorders, such as cognitive behavioral therapy and antidepressants. Discussion: In light of the findings of our review, the risk/benefit ratio of EMDR does not as yet encourage its widespread acceptance.
Eye Movement Desensitization and Reprocessing, abbreviated EMDR, is a recently discovered technique acclaimed as a major breakthrough for the reduction of anxiety. Numerous anecdotal studies have been presented showing the efficacy of EMDR. There are currently no published studies investigating use of EMDR specifically for test anxiety.
The purpose of this study was to use the EMDR technique to study its efficacy for test anxiety. This study also examined whether or not high and low expectancy conditions significantly affected scores on post-session anxiety ratings. In addition, the procedure was used with and without eye movement to see whether or not eye movement was a critical factor in eliciting positive change in anxiety ratings.
A single session of approximately one hour was conducted individually with 41 subjects, college students reporting test anxiety. The subjects were randomly assigned to one of four conditions reflecting varying combinations of eye movement and expectancy conditions. A 2 x 2 analysis of variance was conducted for expectancy and eye movement factors on two dependent measures. These measures were Subjective Units of Disturbance Scale (SUDs) and the Test Anxiety Inventory (TAI).
Results of the study show a significantly greater amount of reduction in the SUDs using the eye movement supporting the hypothesis that eye movement is critical to the efficacy of EMDR. No other statistically significant main effects or interactions were found with measuring the SUDs or TAI. However, it should be noted that all groups showed substantial reductions in post-treatment TAI scores. The expectancy conditions presented to subjects also had no measureably significant effects. There was anecdotal support of the power of the eye movement but no significant behavioral changes other than the reduction in SUDs.
It was concluded that EMDR is worthy of further study with larger samples of the test anxious population. Further study may want to use EMDR in conjunction with other techniques and for more than one session.
The purpose of this study was to replicate the results of previous research with respect to EMD/R (eye movement desensitization and reprocessing) and of this researcher's investigation of EMD/R treatment of public-speaking anxiety (Foley & Spates, 1995). The present study, however, included components to permit more extensive analysis of the elements of treatment that contribute to therapeutic effectiveness. The study investigated the contribution of assessment speeches to treatment effectiveness by using a two factor design in which one factor featured a condition of pre-treatment/post-treatment speeches vs. a condition of post-treatment speeches only. The other factor featured two treatment conditions, permitting consideration of the contribution of the imaginal exposure component of EMD/R to treatment effectiveness. One treatment condition received EMD/R while the other condition received an alternative treatment that differed from EMD/R only in that there were no instructions to visualize the traumatic event during the eye movement component. Subjects were 32 college students who suffered from communication anxiety and had experienced a specific traumatic event related to a communication situation. The research was carried out in a two factor repeated measures design consisting of four treatment groups: EMD/R-speech condition, EMD/R-no speech condition, Alternative treatment-speech condition, Alternative treatment-no speech condition. Results showed a significant decrease from pre to post-treatment for all groups on several measures. There were no significant differences between groups; however, the results on one measure (CAI) suggests that if power were increased, the groups would differ significantly with respect to the pre-treatment behavioral assessment factor. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(7-B), Jan 1997, pp. 4705.
Since Francine Shapiro's first published paper on EMD therapy in 1989, there has been a tendency toward polarization in EMDR research. Those who tend to believe in the effectiveness of EMDR tend to find results which confirm their point of view. Those who have been very skeptical about the effectiveness of EMDR have tended to produce findings which validated their perspective also. The result of this has been years of back and forth research, without a great deal of moving forward by asking new questions based on previous findings. This literature review involved evaluating all available research on EMDR published in English as of March 1, 2002. Studies were categorized as contributing to knowledge about EMDR in general, or emphasizing specific aspects. Specific aspects were breadth of application, subjectivity of effects, EMDR's effect on intrusive PTSD symptoms, the necessity for eye movements, how EMDR works, if it does, and whether it produces lasting change.Findings included a probable effect from EMDR in treating traumatic memories. It has not been found equally effective in treating other kinds of anxiety or other psychological maladies. Subjectivity is an ongoing issue in EMDR research, yet there are several forms of data indicating an effect in a context in which subjectivity could not have been a significant factor. If EMDR works better for intrusive PTSD symptoms compared to others, the difference is minor. The necessity of eye movements has not been clarified, largely because of the use of alternate forms of bilateral brain stimulation as a control condition when these in fact may promote a similar process. EMDR appears to produce change that is as lasting as any other form of psychotherapy. The main conclusion is that there is a paucity of research including a variety of independent variables. The ongoing battle as to whether EMDR works or not has delayed thorough inquiry into for whom it works, compared to for whom it does not work. It is argued that the field, as well as the clinical population, would be well served if research could move in the direction of rectifying this situation. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(1-B), 2004, pp. 455.
Fantasy management for sex offenders
Sexual fantasies of sex offenders are a complex therapeutic issue. First, there is not so much we know yet for sure
about sexual fantasies. Secondly, the question is what role
sexual fantasies play as a risk factor for sexual abuse. And
third, therapists see themselves confronted with the difficult task how to affect the sexual fantasies of their client (if
they are willing to do this at all). In part 1 of this article, we
briefly go through the scientific knowledge about sexual
fantasies of sex offenders and will primarily have to find
out that we do not know much. In part 2 we present four
ethical statements as a therapeutic framework for fantasy
management. Finally we describe six steps to make it practical to get started.
EMDR
with
people
suffering
from
complex
trauma
often
leads
to
difficulties
regarding
the
treatment
plan,
but
also
during
desensitization,
reprocessing,
with
a
risk
of
major
destabilization,
and
treatment
drop
outs.
Often,
many
targets,
especially
those
coming
from
early
childhood,
are
pre-‐verbal
in
nature
and
stay
therefore
implicit.
Should
we
then
renounce
in
doing
EMDR
with
these
people?
Is
it
possible
to
apply
EMDR
safely
and
without
getting
lost,
adjusting
to
each
person,
so
different
from
another,
and
their
life
events
somewhat
chaotic?
The
gearbox,
through
the
metaphor
of
a
journey
by
car,
suggests
a
hierarchical
processing
structure
to
navigate
through
therapy
with
people
suffering
from
complex
trauma,
which
allows
the
therapist
to
adapt
to
the
client,
his/her
life
context,
knowing
what
to
do,
and
why.
The
result
is
a
more
self-‐confident
therapist,
who
is
able
to
adapt
to
the
client,
being
so
more
flexible
and
safe
while
doing
EMDR.
By
integrating
the
current
knowledge
of
EMDR
for
complex
trauma,
the
gearbox
is
a
dynamic
and
adaptive
tool.
EMDR
en
personas
que
sufren
trauma
complejo
a
menudo
conlleva
dificultades
respecto
al
plan
terapéutico
y
también
durante
la
desensibilización
y
reprocesamiento,
con
el
riesgo
de
una
desestabilización
mayor
y
el
abandono
del
tratamiento.
Con
frecuencia,
muchos
de
los
objetivos
y,
muy
especialmente
los
que
tienen
su
origen
en
la
primera
infancia,
son
preverbales
y,
por
lo
tanto,
permanecen
implícitos.
¿Deberíamos
renunciar
al
uso
de
EMDR
con
estas
personas?
¿Es
posible
aplicar
EMDR
de
forma
segura
y
sin
perderse,
adaptándose
a
cada
persona,
tan
distintas
unas
de
otras,
así
como
a
sus
eventos
de
vida,
algo
caóticos?
“Gearbox”,
a
través
de
una
metáfora
de
un
viaje
en
coche,
sugiere
una
estructura
jerárquica
de
procesamiento
para
navegar
por
la
terapia
con
personas
que
sufre
trauma
complejo,
lo
que
permite
al
terapeuta
a
adaptarse
al
cliente,
el
contexto
de
su
vida,
sabiendo
qué
hacer
y
por
qué.
El
resultado
es
un
terapeuta
con
más
confianza
en
sí
mismo,
capaz
de
adaptarse
al
cliente,
con
mucho
más
flexibilidad
y
seguridad
mientras
utiliza
EMDR.
Al
integrar
los
conocimientos
actuales
de
EMDR
en
casos
de
trauma
complejo,
“la
caja
de
cambios”
es
una
herramienta
dinámica
y
adaptativa.
Aprender a utilizar el EMDR con seguridad y eficacia requiere la integración de una amplia gama de conocimientos y competencias. Esta guía quiere ser una orientación para las cuestiones clínicas, profesionales y de gestión de riesgos con las que los profesionales del EMDR se encuentran a diario.
Siguiendo el modelo de las ocho fases de la EMDR, el libro propone una guía clara y detallada para la utilización de los protocolos convencionales de EMDR para el tratamiento del trastorno de estrés postraumático, fobias y ataques de pánico. También se incluyen pautas para la formulación de casos, la planificación del tratamiento y para preparar a los pacientes para el reprocesamiento con EMDR. Además, la guía también contiene muestras de contratos para supervisión y formularios para documentar los resúmenes de los casos y los resultados de los tratamientos, así como:
- gráficos, formularios, ilustraciones, tablas y árboles de decisión para guiar la planificación del tratamiento y la documentación.
- estudios de casos con trascripciones que ilustran los distintos protocolos y pautas para tomar decisiones informadas.
- cuestiones éticas de aplicación clínica, consulta, supervisión e investigación.
Gracias a las pautas de tratamiento claras y concisas sobre el uso clínico del EMDR, este libro es un recurso de incalculable valor para terapeutas en activo, supervisores, consultores y directores clínicos.
Learning to use EMDR safely and effectively requires the integration of a wide range of knowledge and skills. This guide is intended as a guide for clinical, professional and risk management with which EMDR practitioners encounter daily.
Modeled after the eight phases of EMDR, the book offers a clear and detailed guide to the use of EMDR protocols for treating PTSD, phobias and panic attacks. Also included are guidelines for case formulation, treatment planning and to prepare patients for reprocessing with EMDR. The guide also contains samples for monitoring contracts and forms to document summaries of cases and treatment outcomes, as well as:
- Charts, forms, illustrations, tables and decision trees to guide treatment planning and documentation.
- Case studies with transcripts illustrating the different protocols and guidelines to make informed decisions.
- Ethical issues in clinical application, consultation, supervision and research.
With treatment guidelines clear and concise on the clinical use of EMDR, this book is an invaluable resource for practicing therapists, supervisors, consultants and clinical directors.
This book serves as a resource for practicing clinicians, supervisors, clinic directors, and hospital administrators. Leeds provides clear, concise treatment guidelines on the clinical use of EMDR.
This book provides an orientation to the clinical, professional, and risk management issues. Leeds provides sample consultation agreements and forms for documenting treatment planning, case summaries, and treatment outcomes. These forms will be especially helpful for case managers and clinical supervisors in agencies and community health treatment centers.
Key features:
Includes charts, forms, illustrations, tables, and decision trees, presenting essential information clearly and concisely to guide treatment planning and documentation.
Presents case studies with transcripts illustrating the different protocols and presenting guidelines for informed decision making.
Outlines the stages of clinical skill development
Discusses ethical issues in clinical application, consultation, supervision, and research.
Eye Movement and Desensitisation Reprocessing (EMDR) is een effectieve behandeling van traumasymptomen en de positieve effecten worden teruggevonden in het laboratorium, onder goed gecontroleerde omstandigheden. Dat biedt de mogelijkheid om na te gaan hoe EMDR werkt. Er wordt verslag gedaan naar de bevindingen uit een lange reeks experimenten. De hypothese dat oogbewegingen (of andere taken die worden uitgevoerd tijdens het ophalen van herinneringen) overbodig zijn en dat de exposure aan aversieve herinneringen tijdens EMDR de effecten verklaart, is niet houdbaar. Het idee dat ‘bilaterale stimulatie’ noodzakelijk is, snijdt evenmin hout. Je kunt net zo goed de ogen van boven naar beneden laten bewegen of taken laten doen waarbij helemaal geen oogbewegingen worden gemaakt. Belangrijk is dat de taak het werkgeheugen belast. Uit de werkgeheugenverklaring van EMDR is een lange reeks voorspellingen af te leiden. Die blijken wonderwel bestand tegen kritische experimentele tests en er tekent zich een solide verklaring af van hoe EMDR werkt. Die theorie en de empirische bevindingen hebben allerhande implicaties voor de techniek van EMDR.
Eye Movement and Desensitization Reprocessing (EMDR) is an effective treatment of trauma symptoms, while beneficial effects can be reproduced under controlled laboratory conditions. This opens the door for testing how EMDR works. The paper reports data from a long series of experiments. The hypothesis that eye movements (or other dual tasks) are superfluous and that EMDR effects are explained by exposure is untenable. The idea that ‘bilateral stimulation’ is crucial, does not match the data either. One can just as well move the eyes vertically, or carry out tasks that do not involve eye movements. The crucial factor seems to be that the dual task is taxing working memory. From the working memory account of EMDR a long series of predictions can be derived. The predictions survived critical experimental tests. The theory and empirical data have a range of technical implications for carrying out EMDR. These implications are discussed.
The wellbeing of rescuers: Relational, organizational and technical aspects that can affect rescuers' wellbeing during
rescue activities: Stress inoculation, role playing and the role of mirror neurons in training, also through the use of
video recordings. Relaxation techniques, psychological debriefing and EMDR in trainings.
Focus of our intervention is the wellbeing of the rescuer. The study and research
on this matter came and were carried out thanks to the activity done both during
trainings and simulations of the Civil Protection than real emergencies.
Our team work received contribution by some psychologists of OPP (Parma’s
Psychologists’ Observatory: A.Sozzi, E.Pedrelli, F.Frati, A. Bocelli, T. Serra). Wellbeing, defined as a subjective and positive emotional state together with a
global life satisfaction (Diener, 1984), is strongly at risk during rescuer’s
emergency activities and can affect the rescuer both physically and
psychologically. The rescuer's capabilities, that we think are technical “know how” and thorough
knowledge, are essential to give the best performance according to the complexity
and urgency of the intervention. These skills can really contribute to the rescuer's
wellbeing, because they can improve the self-efficiency perception.
To effectively manage and train rescuers, it is furthermore important to consider
and acknowledge the influence of interpersonal relationships on technical
performances. It is, in fact, particularly important to recognize and support the
typical relationships that can be created in a team with the same task and
specialization, as well as in multidisciplinary teams, or teams belonging to
different Institutions but operating in the same scenario.
In recent years increasing attention has been given to training activities, even through the use of the role play for interventions in artificial emergency
scenarios. To recreate scenarios of massive emergencies, different Civil Protection
Associations, as well as First Aid volunteer associations and the local
Institutions have been involved. In these simulations, most cases focus on improving technical performances.
Lately psychologists have been asked to join the rescuers team.
During these simulations, the role-play of emotional and psychological problems
occurs thanks to the cooperation between emergency psychologists and the
medical team. The introduction of the role and expertise of psychologists allowed to extend and
strengthen the attention to cross support and care aspects for the psychological
wellbeing of both victims and rescuers.
The psychologist must therefore consider the “wellbeing” in all the emergency
scenarios and contexts, as a sum of all the components that we talked about here
and the ones we will describe during our intervention.
He must first of all be aware of the complexity of each intervention in the field,
and adopt a kind of approach aimed at creating and recovering wellbeing
strategies, that can be used by himself as well.
Strategies on how to build, recover and maintain the wellbeing identify stress as
the first danger source the rescuer has to face in his training and emergency
activity.
When external events or stimuli are perceived as difficult to face compared with
resources available at that moment, the individual gets stressed.
When the person's efforts are not adaptive to the external requests and/or
coherent with his performance expectations, he becomes vulnerable to emotional,
behavioural, cognitive and physical reactions, which can be even very difficult to
manage both in the short and/or in the medium-long term.
This can happen when the sources of stress depend on the rescuer’s
performance, and it can also happen in case of post traumatic stress, visible in
different stages after the event.
From the psychologist's specialist background and from the integration of this
with the result of field experiences, the demand for a range of different tools to
manage the different kinds of stress emerges, and these tools must be applicable
both to the individual and to the group.
This range is still improving, and the results of our observational activity from
past and present experiences lead us to see the opportunity to carry on our
research of tools of efficacy.
During this speech we would like to underline that approaches like Stress
Inoculation Training (SIT, Michenbaum, 1983) and the use of role playing allow
the technical appraisal and let the rescuers improve their stress management
skills, and all that can lead to a decrease in the risk of PTSD.
In past simulations of emergencies, we found out that the use of videotapes for
the role plays is a tool that should be taken more into account. We think it is
important to evaluate its potential for the rescuers' benefit, because it seems to
be not only “a record of technical performances”, but also an observation and
learning tool about the rescuer's own defence and adaptive strategies.
In fact, during these simulations we found out that the rescuers' psychological
and emotional vulnerability emerged in several situations. The fact that even in these artificial situations there were acute stress episodes and O codes urged us
to focus more on the matter of mutual influence between technical performance
and internal experience of stress.
We understand that such acute stress episodes may occur during real life critical
events but we can see how role playing and video recordings show that such
acute stress episodes affected the simulators themselves even during the
simulation. The videos show that even apparently “high immunity” simulators,
who are considered 'immune' thanks to their comprehensive and strong
experience, experienced acute stress, perhaps because of an incorrect selfevaluation
of their own stress management skills.
The interest in the use of videos as a training and reprocessing tool for rescuers
led some of us to specialize in role playing recording, so as to carry out a more
accurate and comprehensive study on those same videos and use them as a
mirror of reality and better educational tool through a vicar experience or through
“seeing oneself from within the experience” and in the interpersonal dynamics
that took place in the scenario.
Videotapes are a very known and widely used tool in other kinds of trainings,
disciplines and therapies (i.e. Family Therapy and CBT).
The discovery of mirror neurons by Rizzolati, Gallese et Al., provides the evidence
that when someone observes the same action performed by another person, the
neurons "mirrors" the behaviour of that person, as though the observer were itself
acting. Thanks to these researchers it is now proven that this can happen
thanks to the motor neurons in the pre-motor cortex.
Therefore, we would like to underline the role of videos as very useful and
versatile training tools, since they expose a situation in an unexpected realistic
manner “as if” it were true and “as if” we were really experiencing that situation,
with the consequent learning movements at the emotional, cognitive and
behavioural level, at the stress management level, as well as at the level of team
work dynamics.
Visual imagination activates the same brain regions that are active during visual
perception and motor imagination activates the same brain regions activated the
movement is really happening.
More importantly, it was possible for us to verify that the videos recorded by other
operators were not focused on showing the important psychological aspects we
mentioned for the goal of the trainings, thing that happened instead with the
videos recorded by psychologists. We think therefore that the use of videotapes
recorded by psychologists should be given more consideration in the trainings of
rescuers. During this intervention we will devote part of the time to broadcasting
two short videos; the first one shows the role playing of an intervention in an
emergency context, and the second one shows a part of an EMDR session (Eye
Movement Desensitization Reprocessing). We think it is important to recreate and
protect rescuers wellbeing in the post-role playing and post emergency stages
too. For years EMDR has been proven effective in improving the individual's
coping skills and in reprocessing, wherever necessary, the post traumatic
aspects resulting from critical events to whom not only the victims, but also the rescuers too, are exposed during emergencies.
In seguito a un evento traumatico (critico) il cervello potrebbe
immagazzinare una parte delle intense emozioni che scaturiscono al
momento del trauma per elaborarle in un secondo momento,
quando lo stato di sopravvivenza è recuperato e lo shock superato.
Questi eventi critici possono dar seguito ad un Disturbo Post
traumatico da Stress (PTSD). L’autrice espone l’EMDR
(Desensibilizzazione e Rielaborazione attraverso i Movimenti Oculari)
come metodo per risolvere questi disturbi. L’EMDR agisce ad un
livello neuropsicologico ed è basato sulla stimolazione alternata dei
due emisferi attuata nel momento in cui il paziente sta richiamando
l’esperienza traumatica. Le ricerche sperimentali hanno convalidato
l’efficacia del trattamento, che viene ora utilizzato in molte
istituzioni nell’area della psicologia dell’emergenza.
Following a traumatic event (critical) the brain may
store some of the intense emotions that arise in
time of trauma to elaborate later,
when the rule of survival is recovered and the shock passed.
These critical events can act on Disorder Post
Traumatic Stress (PTSD). The author exposes EMDR
(Desensitization and Reprocessing Eye movement)
as a method to solve these problems. EMDR works with a
neuropsychological level and is based on stimulation of AC
two hemispheres implemented when the patient is recalling
traumatic experience. The experimental studies have validated
effectiveness of treatment, which is now used in many
institutions in the area of emergency psychology.
Negli ultimi 20 anni l'Eye movement desensitization and reprocessing (EMDR) come approccio terapeutico e diventato uno instrumento significativo per la practica clinica. L'EMDR costituisce un metodo psicoterapeutico innovativo, attualmente soggetto ad una grand quantita di ricerca specialmente in ambito nerurofisiologico. Attulament esiste molta evidenza empirica scaturita dalla ricerca condotta con gruppi de controllo, che supportano la validita di questo metodo e nuovo approccio terapeutico per il Disturbo Post-Traumatico da Stress (PTSD) e le linee guida internazionali per la pratica clinica lo segnalano come trattament elettivo dei disturbi post-traumatici da stress. Le esperienze traumatiche non elaborate sono in genere considerate la causa primaria della sintomatologia del disturbo post traumatico da stress e possono essere fonte de disagio concorrenti allo sviluppo di altri disturbi d'ansia e dell'umore. Data la sua efficacia nella risoluzione di sintomi da stress dope un evento traumatico particolarmente grave, l'EMDR puo essere applicato con altri disturbi che possono essere conseguenti ad un grosso stress psico-fisico. In alcune condizioni la sterilita potrebbe rientrare tra gli eventi di tipo traumatico o a forte impatto emotivo, a seconda del vissuto soggettiveo della paziente. Tenendo conto che il vissuto traumatico puo avere un impatto anche sui legami affettivi, l'identita della persona, la modulazione affettiva, il comportamento distruttivo rivolto a se o agli altri, ecc., l'EMDR potrebbe essere particolarmente indicato per il trattamento del disagio psicologico legato alla sterilita. Nel case della sterilita puo essere utilizzato per affontare: 1) traumi precedenti che possono constituire un fattore di rischio per l'insorgere della depressione. Per esempio: traumi subiti in eta percoce,compresa la perdita della capacita de regolazione emotiva, possono essere alla base di comportamenti che evidenziano una tendenza cronical ad instaurare rapporti distruttivi, la dissociazinoe e l'amnesia, la somatizzazione, e problemi caratteriali cronici come la auto-colpevolizzazione, il senso de inadeuatezza, ecc. 2) L'impatto de problemi medici e di altri natura che possono essere insorti e possono aver constituto una fonte di stress. 3) L'impatto delle difficolta oggettive e soggettive date dalla nuova condizione. 4) Schemi cognitivi difunzionali come "non sono in grado", non sono all'altezza della nuova situazione familiare", oppure "non sono una brava madre". 5) L'impatto della riattivazione de traume o situazioni disfunzionali nella propria famiglia di origine. 6) Le risorse, i comportamenti positivi e gli schemi adattivi di attaccamento devono essere rafforzati e puo essere usato l'EMDR anche per questo obiettivo.
Over the past 20 years, Eye movement desensitization and reprocessing (EMDR) as a therapeutic approach has become a significant instrumento for clinical practica. EMDR is an innovative psychotherapeutic method which is currently subject to a great deal of research especially in the context nerurofisiologico. Attulament there is plenty of empirical evidence generated by research conducted with groups of control, which support the validity of this method and new therapeutic approach for Post-Traumatic Stress Disorder (PTSD) and international guidelines for clinical practice report it as elective trattament of post-traumatic stress disorder. Traumatic experiences were not processed are generally considered the primary cause of the symptoms of post traumatic stress disorder and can be a source of discomfort to the development of competitors other anxiety and mood disorders. Because of its effectiveness in resolving symptoms of traumatic stress is a particularly serious dope, EMDR can be applied to other disorders that may be associated with a great psycho-physical stress. In some circumstances, the sterility may be among the type of traumatic event or a strong emotional impact, depending on the patient lived soggettiveo. Considering that the traumatic experience can have an impact on emotional relationships, the identity of the person, the emotional modulation, destructive behavior directed at oneself or others, etc.., EMDR may be particularly indicated for the treatment of discomfort psychological linked to infertility. In the case of infertility can be used for men faced: 1) previous trauma that can constitues a risk factor for the onset of depression. For example: age peaches in trauma, including loss of the ability of emotional regulation may be the basis of behaviors that show a tendency to establish relations cronical destructive, and the dissociazinoe amnesia, somatization, and temperament problems such as chronic self-blame, sense of inadeuatezza, etc.. 2) The impact of medical problems and other nature that may be incurred and may have constituta a source of stress. 3) The impact of objective and subjective difficulties given the new condition. 4) difunctional cognitive schemata as "can not" are not up to the new family situation, "or" not a good mother. "5) The impact of the reactivation of trauma or dysfunctional situations in their family of origin . 6) The resources and positive behaviors and adaptive patterns of attachment must be reinforced and EMDR can be used for this purpose.
The Mental Health Treatment Supervisor at the Danville Center for Adolescent Females where I worked previously is a secure, residential treatment program for girls between ages 14 and 18 who have been adjudicated by the courts. Residents are supervised at all times. There is almost continuous interaction with staff, except for brief periods when residents are expected to work on clinical issues in their rooms. Doors to rooms are always open during waking hours, with 15-minute checks performed. Residents deemed to be at risk of hurting themselves or others can be placed on one-to-one supervision. If a resident become physically aggressive or is threatening to herself or others, she can be restrained.
Eye movement desensitization and reprocessing (EMDR) is a recently developed treatment for traumatic memories. The literature on EMDR is characterized by widely contrasting results and interpretations of findings. The author traces this variation to the substantial information gap between those with and without formal EMDR training. Misconceptions are highlighted, and EMDR is reassessed favorably with fidelity to the treatment protocol emerging as a critical factor. Recommendations are made for higher standards of publication, research, and training in EMDR, particularly in light of the wider availability of information and training engendered by the publication of an EMDR textbook. [Author Abstract]
The present study examined assimilative integration, i.e., when techniques from various therapeutic approaches are imported into a single, consistent theoretical framework. Specifically, the aim of this study was to investigate how Eye Movement Desensitization and Reprocessing (EMDR), a manualized therapeutic approach originally developed as a treatment for traumatic memories, is incorporated into clinical practice. In assimilative integration, elements of the EMDR protocol would be expected to be conceptualized and possibly modified in ways that are consistent with the therapist's theoretical framework. A survey design, using web-based questionnaires, was implemented to gather information from therapists who use EMDR. Therapists responded to a broad range of questions regarding their theoretical orientation, involvement in EMDR organizations, and practice of EMDR. A large sample (N = 532) was obtained, and results demonstrated that most therapists integrated EMDR with other therapeutic methods. Further, there was some evidence that therapists were practicing assimilative integration. Specifically, therapists typically added methods consistent with their primary theoretical orientation and conceptualized the effective elements of EMDR as those that were most consistent with their orientation. Most therapists reported using most of the elements of the EMDR protocol, perhaps reflecting the high level of interest in EMDR among therapists in the sample. However, there were some differences related to therapists' level of commitment to EMDR. For example, members of the EMDR International Association used more elements of the protocol and were more likely to report that they did not combine other methods with EMDR when compared to nonmembers. The diagnosis of the client was also an important factor in how EMDR was integrated into treatment. For example, therapists treating clients with PTSD were more likely to report on their use of EMDR as the primary therapeutic approach and to integrate cognitive/behavioral methods than were those treating clients with other disorders. This study was among the first to examine the process of assimilative integration. The findings show that psychotherapy integration varies by therapists' base theoretical orientation, client factors, and therapists' commitment to the treatment method being integrated. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 63(10-B), Apr 2003, pp. 4912.
Many meta-analyses of comparative outcome studies found a substantial association of researcher allegiance (RA) and relative treatment effects. Therefore, RA is regarded as a biasing factor in comparative outcome research (RA bias hypothesis). However, the RA bias hypothesis has been criticized as causality might be reversed. That is, RA might be a reflection of true efficacy differences between treatments (true efficacy hypothesis). Consequently, the RA-outcome association would not be indicative of bias but an epiphenomenon of true efficacy differences. This meta-analysis tested the validity of the true efficacy hypothesis. This was done by controlling the RA-outcome association for true efficacy differences by restricting analysis to direct comparisons of treatments with equivalent efficacy. We included direct comparisons of different versions of trauma-focused therapy (TFT) in the treatment of posttraumatic stress disorder (PTSD). RA was measured from the research reports. Relative effect sizes for symptoms of PTSD were calculated. Random effects meta-regression was conducted. Twenty-nine comparisons of TFTs from 20 studies were identified. Initial heterogeneity among relative effect sizes was low. RA was a significant predictor of outcome and explained 12% of the variance in outcomes. The true efficacy hypothesis predicted the RA-outcome association to be zero; however, a substantial association was found. Thus, this study does not support the true efficacy hypothesis. Given findings from psychotherapy research and other fields that support a biasing influence of researcher preferences, RA should be regarded as a causal factor and conceptualized as a threat to the validity of conclusions from comparative outcome studies.
Les pratiques psychothérapiques se sont multipliées au cours des dernières décennies. On dénombre actuellement dans le monde près de 400 types de psychothérapies. Cette diversité peut entretenir un flou croissant autour de ces approches avec un risque d'amalgame ou de repli sur telle ou telle référence exclusive. Afin d'éviter ce risque et d'orienter les étudiants et les thérapeutes, ce livre propose de présenter les principaux courants psychothérapiques : psychanalytique, cognitivo-comportemental, systémique et stratégique. Le lecteur sera sensibilisé pour chacun des courants à leur histoire, aux enjeux théoriques et psychopathologiques, à la spécificité de la clinique, à la question des indications. Des portraits de personnalités marquantes scandent la présentation de chaque courant, apportant un éclairage biographique. L'ambition est de saisir la pluralité des champs mais également leurs complémentarités car au-delà des spécificités théoriques et techniques, on identifie un certain nombre d'invariants et de facteurs communs au processus psychothérapique. Cet ouvrage espère ainsi contribuer à un mouvement de décloisonnement et de partage des richesses et ressorts des grands courants, dans un esprit d'exigence et de respect mutuel. Des thérapeutes d'horizons et de références différents seront ainsi sensibilisés à la diversité de ces courants et pourront mieux poser les indications d'autres approches que la leur.
Psychotherapeutic practices have proliferated in recent decades. There are currently around the world nearly 400 types of psychotherapy. This diversity can sustain a growing uncertainty around these approaches with a likelihood of confusion or retreat on any particular exclusive reference. To avoid this risk and to guide students and therapists, this book proposes to present the mainstream psychotherapy: psychoanalytic, cognitive-behavioral, systemic and strategic. The reader will be sensitized to each of their common history, theoretical issues and psychopathology, the specificity of the clinic, when asked for directions. Portraits of personalities punctuate the presentation of each course, providing lighting biography. The ambition is to capture the diversity of their fields but also complementary because beyond the specific theoretical and technical, it identifies a number of invariants and common factors in the psychotherapeutic process. This book hopes to contribute to a movement of deregulation and wealth sharing and springs from the mainstream, in a spirit of care and mutual respect. Therapists backgrounds and different references are well aware of the diversity of these streams and can better ask directions other than their own approaches.
Alleanza terapeutica è un tema centrale della ricerca contemporanea e di valutazione in psicoterapia. Sulla base di un riconoscimento della letteratura internazionale e su dati di ricerca, l'alleanza trasversale emerge come un fattore terapeutico comune ai modelli di trattamenti diversi, che quindi, si pone al di là delle tecniche, ma al tempo stesso intreccia con loro e con le loro specificità. Lo studio presentato si propone di osservare l'alleanza terapeutica tra il paziente e il terapeuta, usando Horvath (1981, 1982) strumento di valutazione entro due corsi brevi psicoterapeutico; un corso condotto con un approccio cognitivo-costruttivista, l'altra con il movimento oculare Desensibilizzazione e Rielaborazione (EMDR). I risultati delle analisi descrittiva effettuata sui dati e le osservazioni emerse hanno confermato l'importanza che entrambi gli approcci attribuiscono alla alleanza terapeutica, sul piano teorico e metodologico. In particolare, le valutazioni alleanza fornite dal paziente e dal terapeuta nella terapia con Eye Movement desensibilizzazione e rielaborazione sono stati trovati per essere molto più consistente che riflette la sintonia emotiva distintivo di questo approccio.
Therapeutic alliance is a central theme of contemporary research and assessment in psychotherapy. Based on an acknowledgement of international literature and on research data, the alliance emerges as a common therapeutic factor transversal to the different treatment models, which therefore, sets itself beyond the techniques, but at the same time interlaces with them and with their specificities. The study presented aims to observe the therapeutic alliance between the patient and the therapist by using Horvath's (1981; 1982) assessment tool within two short psychotherapeutic courses; one course conducted with a cognitive-constructivist approach, the other with the Eye Movement Desensitization and Reprocessing (EMDR). The results of the descriptive analysis performed on the data and the observations which emerged have confirmed the importance that both approaches attach to therapeutic alliance on the theoretical and methodological level. In particular, the alliance assessments provided by the patient and by the therapist in the therapy with Eye Movement Desensitization and Reprocessing were found to be much more consistent in reflecting the distinctive emotional attunement of the approach.
In questi anni l’EMDR si è affermata come trattamento di evidenza nel più classico e più grave dei disturbi direttamente legati allo stress, cioè il PTSD (Bisson & Andrew, 2007) e sono stati evidenziati i suoi effetti sul SNC. Nonostante questo ed il suo progressivo impiego in una ampia varietà di situazioni sono ancora poche le riflessioni sull’EMDR dal punto di vista dell’integrazione mente-corpo, in particolare utilizzando i dati offerti dal campo di ricerca della PNEI. Nel presente lavoro ci soffermeremo su alcuni di questi aspetti per evidenziare come l’EMDR rappresenta una delle terapie più rispondenti alle nuove evidenze scientifiche ed alle esigenze di una scienza integrata della salute.
Tre gli elementi salienti offerti dalla ricerca:
1. La vita ha plasmato nel percorso evolutivo strutture altamente integrate, descrivibili come sistemi complessi a rete in retroazione continua con il contesto. In particolare i sistemi nervoso, endocrino ed immunitario costituiscono nel network psicocorporeo un “super-sistema” di relazione e regolazione in grado di assicurare gli equilibri adattativi incorporando l’esperienza e gestendo la dinamica mantenimento-cambiamento (“regolazione allostatica”). Quindi l’organismo non è una macchina fatta di parti autonome tra loro assemblate, ma una realtà che parte dall’unità (zigote) e mantiene tale carattere unitario in tutte le sue articolazioni.
2. Lo stress non è qualcosa di per sé eccezionale e patologico, deve invece essere visto – all’opposto – come l’espressione di un insieme di processi (un sistema) che modulano la regolazione individuo-contesto a fini adattativi. In sostanza il sistema dello stress è sempre attivo e solo in situazioni di eccesso o di carenza (acute o croniche) produce effetti progressivamente dannosi per l’individuo. Le attività legate allo stress producono un “carico allostatico” (peso biologico, energetico) che – in relazione a fattori soggettivi ed esterni – può divenire “sovraccarico” innescando una catena di successive alterazioni nel funzionamento dell’organismo. Parallelamente vi è un “carico” ed un “sovraccarico psicologico” legati al primo da processi circolari.
3. Nel network corporeo e nel sistema dello stress, ovvero nei processi di regolazione generale interni e individuo-contesto, la mente svolge un ruolo cruciale di modulazione come dimensione nella quale i segnali (interni ed esterni) vengono trasformati in informazioni (assegnazione di significati) in base ai percorsi ed alle esigenze individuali di adattamento. La mente rappresenta così la più alta espressione dell’evoluzione della vita e delle sue strategie adattative e ciò spiega il suo ruolo rispetto al funzionamento complessivo dell’organismo. Le recenti acquisizioni delle neuroscienze hanno mostrato l’interdipendenza tra attività psichica, espressione genica e plasticità cerebrale che rende possibile il ruolo della mente.
Il sovraccarico allostatico e psicologico legati allo stress dipendono in gran parte dall’attività mentale e costituiscono il principale fattore di rischio per la salute nelle società occidentali, antecedenti accertati delle patologie più diffuse. Se guardiamo a quanto detto sinora nell’ottica dello sviluppo individuale (fase intrauterina, processi di attaccamento, eventi significativi successivi) possiamo avere una idea di come mente, corpo e contesto interagiscono nella strutturazione dell’individuo ed il ruolo condizionante e de-strutturante delle situazioni e degli eventi che provocano una alterazione da stress. Le ricerche sul rapporto tra stress e sviluppo psicobiologico, tra modalità di attaccamento, strutturazione dei circuiti cerebrali, o tra queste e salute, confermano tali assunti (Lazzari, 2007). Venendo più da vicino all’EMDR, gli studi sulla psicobiologica del PTSD stanno mostrando che siamo di fronte sostanzialmente ad una manifestazione (particolarmente complessa ed accentuata) degli effetti dello stress sul network psicocorporeo (Iribarren et al., 2005). La ricerca sul PTSD (e gli altri disturbi da stress del DSM) deve incrociare necessariamente i filoni di studio sopra richiamati ed utilizzare la cornice concettuale che ne scaturisce.
Gli effetti psicobiologici dello stress estremo e del trauma vanno inquadrati nell’ambito delle
interazioni mente-corpo e della regolazione allostatica (carico vs sovraccarico allostatico).
A nostro avviso, al di là degli specifici effetti sul SNC, l’EMDR si è mostrata efficace nel PTSD in relazione alla sua caratteristica generale di ricercare ed utilizzare come “target” non singoli aspetti di una esperienza, bensì l’esperienza nei suoi diversi aspetti: cognitivi, emotivi, fisiologici e relazionali.
Il lavoro dell’EMR va a recuperare una integrazione perduta e lavora su questa.
Si deve tenere presente infatti che, in via generale e preminente, lo stress compromette i livelli di integrazione, coerenza e flessibilità del sistema: lo stress cronico per processi progressivi di disregolazione, quello acuto per “rotture”, blocchi e sconnessioni. Pertanto l’elaborazione dell’informazione (e delle conseguenze) legata ad eventi e situazioni stressanti passa attraverso una re-integrazione di tutti gli aspetti psicobiologici correlati per giungere ad una ristrutturazione.
Il livello di “penetrazione” (efficacia) di un approccio terapeutico è molto legato alla sua omogeneità con la realtà su cui interviene,cioè al fatto di parlare lo stesso linguaggio.
E questo è un punto di forza notevole per l’EMDR.
I dati disponibili sono coerenti con quanto enunciato: l’EMDR modifica i parametri fisiologici riducendo ed annullando l’attivazione da stress, spostando la bilancia dall’inibizione simpatica all’attivazione parasimpatica (Sack et al. 2007) e risulta associata l’abbassamento dell’arousal fisiologico, cioè con pattern di attività regolari e trofiche (Sack et al. 2008), mostrando similarità con quanto accade durante il sonno REM (Elofsson et al., 2008).
L’EMDR incide altresì su disturbi fisici legati al sistema dello stress, come ad esempio hanno mostrato ricerche su patologie dermatologiche (Gupta, 2002).
In recent years, EMDR has established itself as the treatment of evidence in the most classical and most serious of disorders directly related to stress, that is, PTSD (Bisson & Andrew, 2007) and were highlighted its effects on the CNS. Despite this and its progressive use in a wide variety of situations are still few reflections from the perspective sull'EMDR mind-body integration, in particular using data provided by the search of PNEI. In this work we will focus on some of these issues to highlight how EMDR is one of the therapies are more responsive to new scientific evidence and the needs of an integrated science of health. Three main elements of research are: 1. Life has shaped the evolutionary highly integrated structures, we describe how systems
complex feedback network continues with the context. In particular, the nervous, endocrine immune network and provide psycho in a "super-system" of relationship and adjustment
able to ensure the balance incorporating adaptive expertise and managing the dynamic maintenance-change ( "regulation allostatica"). Then the body is a machine made of autonomous parts, assembled together, but a reality that leaves the unit (zygote) and maintains that unitary in all its joints. 2. Stress is not something in itself exceptional and pathological, but must be seen - in contrast -- as the expression of a set of processes (a system) that modulate the individual-regulation framework for adaptive. In essence, the system of stress is always on and only in situations of excess or deficiency (acute or chronic) effects progressively damaging to the individual. The Stress-related activity produces a "load allostatico" (weight biological energy) that --
relation to subjective factors and external - can become "overloaded" by triggering a chain of subsequent alterations in the functioning of the organism. In parallel there is a "load" and a
"Overload psychological" processes related to the first round. 3. In the network system and body of stress, or in the process of setting general internal and individual-context, the mind plays a crucial role as a dimension of modulation in which signals (internal and external) are transformed into information (assigning meanings) depending on the paths and individual needs of adaptation. The mind is so the highest expression of the evolution of life and its adaptive strategies, which explains its role in relation to the overall functioning of the organism. The recent acquisitions of
neuroscience have shown the interdependence of psychic activity, gene expression and plasticity brain that makes the role of the mind. Overload allostatico and psychological stress-related depend in large part by activism mental and constitute the main risk factor for health in Western societies, antecedents established disease spreading. If we look to the foregoing view of personal development (stage intrauterine attachment process, significant events later) we can have an idea of how mind, body and environment interact in the structuring the individual and the role conditioning and de-structuring of situations and events that cause an alteration by stress. Research on the relationship between stress and psychobiological development, including mode of attachment, structure of brain circuits, or between them and health, confirmation of these given (Lazzari, 2007). Coming closer all'EMDR, psychobiological studies of PTSD are showing that we are dealing essentially an event (especially complex and pronounced) the effects of stress on the network psycho (Iribarren et al., 2005). Research on PTSD (and other stress disorders DSM) must necessarily cross the strands study mentioned above and use the conceptual framework that arises. Psychobiological effects of extreme stress and trauma should be classified within mind-body interactions and regulation allostatica (load vs. overload allostatico). In our view, beyond the specific effects on the CNS, EMDR has been shown effective in PTSD in connection with his characteristic broad research and use as a "target" rather than individual aspects of an experience, but experience in its different aspects: cognitive, emotional, physiological and relational. Work dell'EMR goes to retrieve a lost and working on this integration. It should be remembered that, in general, and prominent, stress affects the levels of integration, consistency and flexibility of the system: chronic stress for progressive process of dysregulation, the acute "broken", blocks and disconnections. Therefore processing information (and consequences) related to events and stressful situations through a re-integration of all aspects related to psychobiological reach a restructuring. The level of "penetration" (effectiveness) of a therapeutic approach is very attached to his homogeneity with the reality on which it operates, namely the fact of speaking the same language. And this is a great asset for EMDR. The available data are consistent with the statement: EMDR change physiological parameters reducing and canceling the activation by stress, shifting the balance from the inhibition nice parasympathetic activation (Sack et al. 2007) and is associated with lowering dell'arousal physiological, ie regular patterns of activity and trophic (Sack et al. 2008), showing similarities with what happens during REM sleep (Elofsson et al., 2008).
EMDR also impacts on physical ailments related to the system of stress, such as have Show searches on dermatological (Gupta, 2002).
Travailler en EMDR avec des personnes souffrant de traumatismes complexes amène souvent à des difficultés concernant le plan de traitement, mais aussi la désensibilisation et le retraitement, avec un risque de déstabilisation majeure et une
rupture du traitement. Souvent, de nombreuses cibles, surtout celles de la petite
enfance sont de nature préverbale et restent de ce fait implicites. Devons-‐nous pour autant renoncer à travailler en EMDR ? Est-‐il possible de travailler en
EMDR de manière sécurisée, en l’adaptant à chaque personne, et leurs événements de vie quelque peu chaotiques, sans se perdre ? La boîte à vitesses, proposant pour la thérapie la métaphore d’un voyage en voiture, à travers la thérapie
avec des personnes ayant des traumatismes complexes, suggère une structure de traitement hiérarchisée, qui permet au thérapeute de s’adapter, tout en sachant ce qu’il fait et pourquoi. En cherchant à intégrer les connaissances actuelles de a thérapie EMDR avec des personnes ayant des trauma complexes, la boîte à vitesses constitue un outil de navigation adaptatif et dynamique.
EMDR work with people with complex trauma often leads to difficulties with the treatment plan, but also desensitization and reprocessing, with a risk of destabilization and a major
termination of treatment. Often, many targets, especially those of small
preverbal children are capable and are thus implied. Need - we giving up work in EMDR? --- Is it possible to work
EMDR in a secure manner, adapting to each person and their life events somewhat chaotic, without getting lost? The gearbox, offering therapy for the metaphor of a road trip through therapy
with people with complex trauma, suggesting a hierarchical processing structure, which allows the therapist to adapt, knowing what he is doing and why. In seeking to integrate current knowledge of a EMDR with people with complex trauma, the gearbox is a navigation tool for adaptive and dynamic.
El trastorno de estrés postraumático está clasificado como uno de los trastornos deansiedad dado como una respuesta patológica a un evento estresante que supone unriesgo físico o psicológico. Corresponde a un problema de salud pública que causagran incapacidad y dificultades en el desarrollo biopsicosocial de la persona afectada.Actualmente se llevan a cabo diferentes métodos terapéuticos para el tratamiento dedicha patología, dentro de las mas estudiadas y con amplios resultados positivos seencuentra la terapia de reprocesamiento llamada Desensibilización y Reprocesamientopor medio de Movimiento Ocular (EMDR por sus siglas en inglés) basado en estimulaciónbilateral ocular, principalmente, que otorga al paciente la oportunidad de asimilar elevento traumático transformando su contenido emocional y brindando adaptación eintegración de la información y equilibrio físico y psicológico con respuestas adaptativasque permite el desarrollo e interacción normal con el entorno. Con la Técnica EMDR paraenfrentar el trastorno de estrés postraumatico, se alcanza que si bien el recuerdo está,ya no hiere.
Posttraumatic stress disorder is classified as an anxiety disorder characterized for apathological response to a stressful event that involves a physical or psychological risk.It is a public health problem that causes great disability and difficulties in biopsychosocialdevelopment of the patient. Currently, there are different therapeutic methods fortreating this disease; the most studied one with positive results is “eye movementdesensitization and reprocessing” (EMDR) based on bilateral visual stimulation, whichgives the patient an opportunity to assimilate the traumatic event, transforming itsemotional content and providing adaptation and integration of information and physicaland psychological balance with adaptive responses allowing normal development andinteraction with the environment. With EMDR to address post-traumatic stress disorderthe memory is there, but it does not hurt.
Molti studi di Risonanza Magnetica (RM) hanno mostrato che in pazienti con Disturbo Post-Traumatico da Stress (DPTS) è presente un volume ippocampale più piccolo se confrontato con i controlli sani. Allo stesso tempo altre indagini hanno mostrato che i farmaci psichiatrici bloccano gli effetti dello stress nell’ippocampo e promuovano la neurogenesi a livello ippocampale. Comunque il solo studio che ha investigato gli effetti di un tipo di psicoterapia non ha evidenziato modificazioni volumetriche significative (1).
Scopo dello Studio: Scopo dello studio è indagare gli effetti del trattamento con EMDR (Eye Movement Desensitization and Reprocessing) sul volume ippocampale e sui sintomi clinici di un gruppo di pazienti con DPTS.
Metodologia: Abbiamo paragonato gli ippocampi di 9 pazienti con DPTS cronico e mai sottoposti ad alcun tipo di terapia (farmacologica e/o psicoterapica) a 9 soggetti sani accoppiati per sesso, età e scolarità. La diagnosi e la severità del DPTS è stata misurata tramite la Clinician-Administered PTSD Scale (CAPS) (Fase 1).
Successivamente tutti i soggetti con DPTS sono stati sottoposti a 12 sedute settimanali di EMDR della durata di 90 minuti ciascuna e nuovamente sottoposti a valutazione clinica e RM (Fase 2).
Risultati:
Fase 1 - E’ stata scelta una p inferiore di .05 per indicare la significatività statistica. L’analisi della covarianza (ANCOVA) con l’emisfero (ippocampo sinistro vs. ippocampo destro) come fattore ripetuto, il volume totale cerebrale come covariata ha mostrato che i soggetti con DPTS hanno il volume ippocampale più piccolo rispetto ai controlli (F=12.53, d.f=1,15, p=.003). La media del punteggio della CAPS nei soggetti con DPTS era 55.78 ± 21.74.
Fase 2 - Il trattamento con EMDR è associate ad un incremento del volume ippocampale sia a destra (5.9 %) (t=-3.34, df=8, p=.010) sia a sinistra (6.1 %) (t=-3.27, df=8, p=.011).
I risultati indicano anche che il trattamento con EMDR produce un significativo decremento del punteggio totale della CAPS (da 55.78±21.74 a 19.33±15.49; t=4.78, df=8, p=.001
Conclusioni: La prima parte dello studio conferma i dati che mostrano che i soggetti con DPTS hanno un ippocampo più piccolo dei controlli sani
La seconda parte suggerisce che il trattamento con EMDR può essere associato ad un miglioramento sintomatologico e ad un incremento del volume degli ippocampi. Questi risultati suggeriscono l’opportunità di continuare ad indagare gli effetti biologici delle psicoterapie.
Many studies of Magnetic Resonance Imaging (MRI) showed that in patients with Post-Traumatic Stress Disorder (PTSD) is a smaller hippocampal volume compared with healthy controls. At the same time other studies have shown that psychiatric drugs block the effects of stress and promote hippocampus neurogenesis in the hippocampus. However, the only study that investigated the effects of a type of psychotherapy showed no significant volume changes (1).
Objective: The purpose of this study is to investigate the effects of treatment with EMDR (eye movement desensitization and reprocessing) on hippocampal volume and clinical symptoms of a group of patients with PTSD.
Methods: We compared the hippocampi of nine patients with chronic PTSD and never subjected to any kind of treatment (pharmacological and / or psychotherapy) in 9 healthy subjects matched for sex, age and education. The diagnosis and severity of PTSD was measured by the Clinician-Administered PTSD Scale (CAPS) (Phase 1).
Then all subjects with PTSD were subjected to 12 weekly sessions of EMDR lasting 90 minutes each and again subjected to clinical evaluation and MRI (Phase 2).
Results:
Step 1 - E 'was chosen p less than .05 to indicate statistical significance. The analysis of covariance (ANCOVA) with hemisphere (left vs. hippocampus. Right hippocampus) as repeated factor, the total brain volume as covariate showed that individuals with PTSD have smaller hippocampal volume than controls (F = 12:53 , df = 1.15, p =. 003). The average score of the CAPS in subjects with PTSD was 55.78 ± 21.74.
Step 2 - Treatment with EMDR is associated with an increase in both right hippocampal volume (5.9%) (t =- 3:34, df = 8, p =. 010) and left (6.1%) (t =- 3.27, df = 8, p =. 011).
The results also indicate that treatment with EMDR produces a significant decrease in the CAPS total score (from 21.74 to 55.78 ± 19:33 15:49 ± t = 4.78, df = 8, p =. 001
Conclusion: The first part of the study confirms the data showing that individuals with PTSD have a smaller hippocampus of healthy controls
The second part suggests that treatment with EMDR may be associated with symptomatic improvement and an increase in the volume of the hippocampus. These results suggest the desirability of continuing to investigate the biological effects of psychotherapy.
Questo mio lavoro di tesi rappresenta una rassegna degli studi compiuti negli
ultimi anni, sui disturbi del comportamento alimentare. Negli ultimi vent’anni
molto è stato detto su questa patologia che ha attirato l’attenzione non solo di
clinici e specialisti ma anche dei mass media. Si tratta, purtroppo, di disturbi che
si stanno imponendo sempre di più nella società occidentale e che iniziano a
comparire anche nelle zone più povere del mondo. Come sarà possibile notare
nel primo capitolo, questi disturbi interessano principalmente, ma non
esclusivamente, soggetti di sesso femminile e gli indici di prevalenza indicano un
valore attorno all’1% per la bulimia nervosa nelle giovani donne adulte, mentre
per l’anoressia nervosa questa percentuale oscilla attorno lo 0,3%. Dopo una
descrizione generale di queste patologie, mi sono occupata dei disturbi specifici
evidenziati dal DSM-IV, redatto dall’American Psychiatric Association nel 1996:
Anoressia Nervosa, Bulimia Nervosa, Disturbo da Alimentazione Incontrollata
(BED). Questi disturbi vengono descritti singolarmente, analizzandone i fattori di
rischio e le caratteristiche cliniche e diagnostiche; nella descrizione ho tralasciato
i fattori eziopatogenetici della Bulimia Nervosa e del BED perché sono
rintracciabili tra quelli evidenziati per l’Anoressia Nervosa.
My thesis is a review of studies made in
last year, about eating disorders. Over the past twenty years
Much has been said about this disease that has attracted the attention not only to
and clinical specialists, but also the media. This is, unfortunately, of disorders
are becoming more and more in Western society and start to
appear even in the poorest parts of the world. As you will notice
in the first chapter, these problems primarily, but not
exclusively, female subjects, and prevalence rates indicate a
value of around 1% for bulimia nervosa in young adult women, while
for anorexia nervosa, this percentage fluctuates around 0.3%. after a
general description of these diseases, I have dealt with specific disorders
highlighted by the DSM-IV, prepared by the American Psychiatric Association in 1996:
Anorexia Nervosa, Bulimia Nervosa, binge eating disorder
(BED). These disorders are described individually, analyzing the factors
risk and the clinical and diagnostic features, I have omitted in the description
causative factors of Bulimia Nervosa and BED because they are
detectable among those highlighted for Anorexia Nervosa.
Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the non-childbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn.
Great strides have been made in applying EMDR
to different populations with a variety of
diagnoses. Integrating this powerful treatment
into couples therapy is relatively new and very
promising. By augmenting EMDR with the
explanatory power and clinical inventiveness of
ego state theory, couples therapy can be brought to new levels of efficacy. Through didactic
presentation and case illustration, participants will
understand the relational nature of the Self,
psychobiological and psychodynamic mechanisms of attachment, the structure of the
relational self, and the challenges of individuation/differentiation. In addition, all participants will learn and be able to access the intergenerational pathogenesis of ego fragmentation, and will be
able to identify clinical manifestations of ego state
conflict in conjoint sessions, including the doublebind,
split loyalty, and reenactments. Participants
will be able to use this learning to diagnose the
interlock of negative cognitions in their client
couples, and implement strategies to contract for
individually-focused EMDR therapy. Participants
will be able to explain to clients the risks and
benefits of conjoint EMDR, and understand the
contraindications for conjoint EMDR. Participants will learn a model of EMDR
treatment planning that includes target selection
and salience, and will be able to utilize a
progressive sequence of techniques for facilitation
EMDR processing with dissociative clients who
are blocked, looping, or at risk of abreaction.
Types of outcomes measures
CORE-OM
Clinical Outcomes in Routine Evaluation
34 items
Covers 4 domains: problems, social
functioning, well-being and risk. [Excerpt]
Research background & objectives: Based on REM-sleep dependent memory reprocessing model, this study examined possible therapeutic mechanisms of eye
movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989,
1995, 2001). Stickgold (2002) proposed that sleep induced change in associative memory
via activation of weak association during REM state and EMs functioned as REM sleep to
integrate the episodic memory of trauma into general semantic memory. Specifically, the
effect of EM in relation to order of relatedness of associations on change of strength of
semantic associations for negative words after saccadic bilateral eye movements was
examined in the present study.
Methods: Sixty-four college students were recruited as participants. Via semantic
priming task, a 2 (eye movement condition: horizontal saccadic eye movements vs. no
eye movements) × 3 (strength of semantic association: strong priming vs. weak priming
vs. unrelated priming) × 2 (block order of presentation: related prime first vs. unrelated
prime first) mixed factorial design was performed, with strength of semantic association
serving as within Ss factor and the other two variables serving as between Ss factors. The
primes consisted of negative word stimuli. Each trials consisted of an 8 seconds saccadic
horizontal eye movement manipulation (200 ms per movement in EM condition),
followed by 500-msec fixation point and then prime displayed for 32msec, which was
followed immediately by the target. The participant was instructed to read the target as
soon as possible and the reaction time was recorded by the compuer. While absolute
primeability index for strong (or weak) association was calculated as (RT
related – RT unrelated) for strong primes or weak primes, respectively, relative primeability index was calculated as (RT related – RT unrelated)/RT
unrelated. The dependent variables were correct (%), error (%), and primeability index for each of strong prime and weak prime. Change of primeability
of weak associations for negative stimuli as opposed to that of strong ones under different
EM conditions and different block order was compared.
Results: For absolute primeability index, the 2 (EM condition) × 2 (order) × 2 (strength
of priming) ANOVA showed that only the interaction effect of EM × strength of semantic
association was approaching significance, indicating that weak priming significantly
exceeded strong priming after EM (F (1, 56)
= 18.01, p < .001; partial ω 2= .210), while the
opposite was true after non-EM (F (1, 56)
= 25.86, p < .0001; partial ω 2 = .280). Further, for weak prime, the priming effect was stronger after EM than after non-EM (F
(1, 56) = 74.62,
p < .0001; partial ω 2 = .535). For relative primeability index, it also revealed that only the interaction effect of EM × strength of semantic association was significant (F (1, 56) = 6.09, p < .02; partial ω 2 = .074), and tests of simple main effects showed similar patterns as those of absolute primeability index. Conclusions: 8s EMs was associated with change of strength of semantic associations.
While EM didn’t weaken the primeability for the strong association, EM did enhance the
primeability for weak associations. Further, weak priming significantly exceeded strong
priming after EM, while the opposite was true after non-EM. The results echoed
REM-sleep dependent memory reprocessing model, suggesting that EM in EMDR might
reflect a shift in associative memory systems by activating different strength of
associations of negative semantic nodes for different semantically related words. Given
that order of relatedness didn’t play a role and previous research showed that EM resulted
in decreased vividness and emotionality and generated greater amount of associations for
negative stimuli as well, the implications of the present results from theoretical and
psychotherapy point of views and future research possibilities are discussed.
Onveilige en ongeorganiseerd bijlagen en het begin van relationele verwaarlozing en trauma diepgaand effect op het ontwikkelingstraject van de toekomstige volwassen en verhogen het risico op het ontwikkelen Borderline persoonlijkheidsstoornis (BPD). Mensen met een borderline-stoornis en een geschiedenis complex trauma hebben veel problemen met zelfregulering en met betrekking tot anderen. Het beheer van deze zelfregulering en relationele problemen zijn centrale aspecten in de behandeling van BPS.
De stabilisatiefase is opgemerkt als essentieel oor trauma werk. Bij de behandeling van de borderline-stoornis en complexe trauma betekent dit vele bijzonderheden die we moeten in gedachten houden, waaronder: de rol van gehechtheid-gerelateerde gemoedstoestanden en fobieën voor de bevestiging, beïnvloeden en traumatische herinneringen. Werken met gevallen van BPS en complex trauma is intrinsiek relationeel en vaak gepaard gaat met de noodzaak om momenten van intense beïnvloeden en invloed hebben op fobieën beheren in de overdracht en tegenoverdracht. Inzicht in deze aspecten en met strategieën voor het aanpakken van hen is van essentieel belang zowel voor als tijdens EMDR opwerking van traumatische herinneringen om ervoor te zorgen dat de verwerking van traumatische herinneringen veilig en effectief kan worden gedaan met deze patiënten. Deze workshop integreert theoretische uiteenzetting met de presentatie van video's gevallen. De algemene structuur van EMDR therapie bij de behandeling van BPD, interventies in de voorbereidings-en overwegingen voor trauma-gerichte EMDR werk zal worden gedemonstreerd en uitgelegd.
Insecure and disorganized attachments and early relational neglect and trauma profoundly affect the developmental trajectory of the future adult and increase the risk of developing Borderline Personality Disorder (BPD). People with BPD and a history complex trauma have many difficulties with self-regulation and relating to others. The management of these self-regulation and relational difficulties are central aspects in the treatment of BPD.
The stabilization phase has been remarked as essential prior to trauma work. In treating BPD and complex trauma this implies many particularities that we should keep in mind including: the role of attachment-related states of mind and phobias for attachment, affect and traumatic memories. Working with cases of BPD and complex trauma is intrinsically relational and often involves the need to manage moments of intense affect and affect phobias in the transference and countertransference. Understanding these aspects and having strategies for addressing them is essential both before and during EMDR reprocessing of traumatic memories to ensure that reprocessing of traumatic memories can be done safely and effectively with these patients. This workshop integrates theoretical exposition with the presentation of videos cases. The general structure of EMDR therapy in treating BPD, interventions for the preparation phase and considerations for trauma-focused EMDR work will be demonstrated and explained.
Eye movement desensitization (EMDR) and exposure therapies
(e.g. prolonged exposure therapy) have both been recommended
as first-line treatments for posttraumatic stress disorder (PTSD).
However, relatively little is known about the comparative efficacy
of the two types of treatments. To date, the few studies that have
been conducted have small sample sizes, making it difficult
to draw conclusions. The goal of the current study was to use
meta-analytic techniques to synthesize the existing data on the
relative efficacy of exposure therapies and EMDR. Through a
comprehensive literature search, we identified six randomized
control trials that met our inclusion criteria. We calculated
Hedges g effect sizes for the continuous variables (positive values
favor exposure therapies) and risk ratios (RRs) for dichotomous
variables (values greater than one favor exposure therapies).
EMDR and exposure therapies did not differ significantly on
clinician-rated PTSD (g = 0.32), self-report PTSD (g = -0.08), selfreport
depression (g = -0.01), loss of PTSD diagnosis (RR = 1.46),
or dropout (RR = 0.79). However, higher-quality studies (based
on Foa & Meadows’ 1997 criteria) consistently favored exposure
therapies. Clinical implications will be discussed
Treatment Studies: I
Eye movement desensitization (EMDR) and exposure therapies
(e.g. prolonged exposure therapy) have both been recommended
as first-line treatments for posttraumatic stress disorder (PTSD).
However, relatively little is known about the comparative efficacy
of the two types of treatments. To date, the few studies that have
been conducted have small sample sizes, making it difficult
to draw conclusions. The goal of the current study was to use
meta-analytic techniques to synthesize the existing data on the
relative efficacy of exposure therapies and EMDR. Through a
comprehensive literature search, we identified six randomized
control trials that met our inclusion criteria. We calculated
Hedges g effect sizes for the continuous variables (positive values
favor exposure therapies) and risk ratios (RRs) for dichotomous
variables (values greater than one favor exposure therapies).
EMDR and exposure therapies did not differ significantly on
clinician-rated PTSD (g = 0.32), self-report PTSD (g = -0.08), selfreport
depression (g = -0.01), loss of PTSD diagnosis (RR = 1.46),
or dropout (RR = 0.79). However, higher-quality studies (based
on Foa & Meadows’ 1997 criteria) consistently favored exposure
therapies. Clinical implications will be discussed.
This workshop explains the neurobiology of trauma in a simple, yet highly usable manner. Upon completion of this workshop, attendees should be able to readily apply this information for better formulating their clients’ issues and treatment planning. The topics include: 1) How does a normal nervous system operate? 2) What is Trauma? 3) What is the “bottom line” of chronic trauma syndromes (e.g., PTSD)? 4) How does childhood development factor into adult trauma symptoms? 5) Treatment.
Introduzione: molti studi concordano sulla riduzione del volume ippocampale nei pazienti affetti da PTSD 1 e che tale alterazione anatomica è correlata con deficit cognitivi e
con la gravità dei sintomi. Comunque ad oggi non è stato ancora chiarito se l’atrofia ippocampale rappresenta l’esito di un effetto neurotossico del trauma o, piuttosto, una condizione
preesistente che predispone allo sviluppo di alcune patologie psichiatriche. Già da tempo studi su animali dimostrano
come lo stress causi atrofia ippocampale e inibizione della
neurogenesi, con meccanismi verosimilmente legati ai glucocorticoidi, all’increzione del fattore corticotropo, all’aumento degli aminoacidi eccitatori, all’inibizione fattore
neurotrofico cerebrale con perdita della plasticità neuronale. Nell’uomo, tuttavia, i risultati non sono così lineari. Da un
lato alcuni studi hanno individuato come fattore principale l’aumento dei glucocorticoidi 2, dall’altro tale teoria è stata fortemente criticata 3. Secondo Yehuda il meccanismo di
atrofia ippocampale è dovuto ad un’alterazione dell’asse
Ipotalamo-Ipofisi-Surrene (HPA), ma in termini di una bassa
increzione di glucocorticoidi che determina un aumento del
feedback negativo dell’asse stesso ed un’ipersensibilità recettoriale.
Indipendentemente dal meccanismo d’azione, la perdita di neuroni a livello ippocampale nei soggetti che hanno subito eventi traumatici sembra sufficientemente dimostrata e, fino a poco tempo fa, era considerata irreversibile. In realtà l’ippocampo sembra presentare una inusuale e spontanea capacità rigenerativa. Questo dato è stato individuato in molte specie animali e, in un unico studio, anche nell’uomo 4. Inoltre recenti evidenze pre-cliniche e cliniche hanno indicato che gli SSRI (Selective Serotonin Reuptake Inhibitors) promuovono la neurogenesi e riducono l’atrofia ippocampale
indotta dallo stress nell’animale 5 e nell’uomo sono in grado
di ridurre i sintomi del PTSD, incrementare le dimensioni
dell’ippocampo e ridurre i deficit mnesici tipici della patologia
6 7. Un altro fattore che sembra essere in grado di stimolare la neurogenesi negli animali sembra essere “l’ambiente arricchito” verosimilmente tramite i meccanismi molecolari dell’apprendimento che sembrano in grado di attivare la trascrizione dell’mRNA per il Brain Derived Neurotrophic Factor. Questo dato della letteratura supporta il razionale dell’efficacia della psicoterapia anche se l’unico studio
che valuta le modificazioni morfostrutturali dopo psicoterapia non ha riportato risultati positivi 8. Gli scopi di questo studio sono:
– valutare la presenza di atrofia ippocampale nei pazienti affetti da PTSD (T0-drug-free);
– valutare l’effetto della terapia: farmacologica con SSRI e
psicoterapica con EMDR (Eye Movement Desensitization and Reprocessing) sia sul piano clinico e neuropsicologico,
che sul volume ippocampale, sia sulla memoria (T1). Metodologia: abbiamo analizzato un campione di 20 pazienti, di età compresa tra i 15 ed i 65 anni, reclutati nell’ambulatorio psichiatrico del Policlinico universitario di
Siena affetti da PTSD e un gruppo di controllo di soggetti
sani appaiati per sesso, età, peso e altezza. I soggetti di entrambi
i gruppi sono stati sottoposti ad uno studio morfovolumetrico
computerizzato dell’Ippocampo tramite RM (Risonanza Magnetica). Inoltre, i diciassette pazienti con PTSD sono stati valutati tramite la somministrazione di test neuropsicologici
e scale psicometriche per approfondire il quadro
psicopatologico e valutare l’eventuale presenza di deficit cognitivi. Nei soggetti affetti da PTSD dopo un periodo di sei mesi di
terapia psicofarmacologica sono stati ripetuti i test neuropsicologici,
le scale psicometriche e l’analisi morfovolumetrica dell’ippocampo tramite RM.
Tre pazienti, dopo le valutazioni al T0, hanno effettuato un protocollo terapeutico con solo EMDR e sono stati rivalutati
dopo 8 sedute (due mesi).
Risultati: i risultati della prima parte sperimentale (T0-drug-free) evidenziano che le dimensioni dell’ippocampo di
sinistra nei soggetti affetti da PTSD sono significativamente minori rispetto ai controlli sani. Dai risultati osservati al follow-up (T1-post-terapia) è possibile
evincere che la terapia nei soggetti considerati è associata ad un miglioramento della sintomatologia e ad un aumento
dei volumi ippocampali, pari al 9,87% per l’ippocampo di destra e dell’8,37% per l’ippocampo di sinistra. Questi dati
sono concordi con i dati presenti in letteratura, anche se la percentuale di recupero su base neuroplastica nel nostro studio
risulta sensibilmente superiore rispetto ai due studi presenti in letteratura incremento pari al 4,6% 6; pari al 5% 7. I tre pazienti che hanno effettuato terapia con EMDR hanno
anch’essi mostrato al T1 un miglioramento sintomatologico (CAPS non più positiva per i criteri diagnostici) ed un aumento
medio dei volumi ippocampali pari a 338,25 mm3 per
l’ippocampo DX e 357,93 mm3 per l’ippocampo SN.
Conclusioni: la terapia nei soggetti considerati si è associata ad un aumento dei volumi ippocampali (9,87%-8,37%).
L’aumento dei volumi ippocampali appare rilevante, consistente con i dati in letteratura, sebbene quantitativamente superiore, sottolineando l’efficacia degli SSRI verosimilmente tramite il meccanismo di attivazione della neurogenesi;
è ipotizzabile che l’aumento di volume non sia da imputare ad un aumento delle cellule gliali ma ad un aumento di neuroni ippocampali visto il contemporaneo miglioramento clinico. Particolarmente interessante ci sembra il dato relativo all’efficacia clinica e sulla plasticità neurale della EMDR.
Questa osservazione su solo tre casi, necessita chiaramente di essere confermata su un campione più ampio ma rappresenta la prima evidenza in letteratura di un’azione della psicoterapia
diretta alla struttura cerebrale.
Introduction: Many studies agree on the reduction of hippocampal volume in patients with PTSD and that an anatomical alteration is correlated with cognitive deficits and the severity of symptoms. However to date has not yet been clarified whether hippocampal atrophy is the result of a neurotoxic effect of trauma or, rather, an underlying condition that predisposes to the development of some psychiatric disorders. For some time animal studies show that stress causes hippocampal atrophy and inhibition of neurogenesis, by mechanisms probably related to glucocorticoids, all'increzione corticotropo factor, increased excitatory amino acid, inhibition of brain neurotrophic factor with loss of neuronal plasticity. In humans, however, the results are not so linear. On the one hand, some studies have identified as the main factor increasing glucocorticoid two other such theory was strongly criticized 3. According to Yehuda mechanism of hippocampal atrophy is due to an alteration of hypothalamic-pituitary-adrenal (HPA), but in terms of a low secretion of glucocorticoids leading to an increase of negative feedback axis and the same receptor hypersensitivity . Regardless of the mechanism of action, loss of neurons in hippocampus in people who have suffered traumatic events seems sufficiently established and, until recently, was considered irreversible. In fact, the hippocampus appears to be an unusual and spontaneous regenerative capacity. This figure has been identified in many animal species and in one study in humans 4. Moreover, recent evidence pre-clinical and clinical studies have shown that SSRIs (Selective Serotonin Reuptake Inhibitors) promote neurogenesis and reduce stress-induced hippocampal atrophy in animals 5 and humans are able to reduce symptoms of PTSD, increase the size of the hippocampus and reduce the deficit mnesic typical of the disease 6 7. Another factor that seems to be able to stimulate neurogenesis in animals seems to be "enriched environment" probably through molecular mechanisms of learning that seem able to activate the transcription of mRNA for Brain Derived Neurotrophic Factor. This finding supports the rationale of the literature of the effectiveness of psychotherapy, even if the only study that evaluates changes morphostructural after psychotherapy has shown positive results 8. The aims of this study are: - To evaluate the presence of hippocampal atrophy in patients with PTSD (T0-drug-free) - to assess the effect of therapy: pharmacological SSRI and psychotherapy with EMDR (eye movement desensitization and reprocessing) is a clinical and neuropsychological, and on hippocampal volume, and memory (T1). Methods: We analyzed a sample of 20 patients, aged between 15 and 65, recruited nell'ambulatorio Psychiatric University Hospital of Siena with PTSD and a control group of healthy subjects matched by sex, age, weight and height. Subjects in both groups were subjected to a computerized study morfovolumetrico dell'Ippocampo using MRI (Magnetic Resonance). In addition, seventeen patients with PTSD were assessed through administration of psychometric scales and neuropsychological tests to study the psychopathological picture and evaluate the possible presence of cognitive deficits. In subjects with PTSD after a period of six months of pharmacological therapy were repeated neuropsychological tests, scales psychometric analysis morfovolumetrica hippocampus by MRI. Three patients at T0 after assessments, carried out a treatment protocol with only EMDR and were reassessed after eight sessions (two months). Results: The results of the first experiment (T0-drug-free) show that the size of the left hippocampus in patients with PTSD are significantly lower compared to healthy controls. The results observed during the follow-up (T1-post-therapy) can be inferred that therapy in patients considered to be associated with improvement in symptoms and an increase in hippocampal volume, equal to 9.87% for the right hippocampus and 8, 37% for the left hippocampus. These data are consistent with the data in the literature, although the recovery rate based on neuroplastic in our study is significantly higher than in the two studies in the literature increase of 4.6% 6; 5% 7. The three patients who have treatment with EMDR have also shown an improvement in symptoms at T1 (CAPS no longer positive for the diagnostic criteria) and an average increase in hippocampal volume amounted to 338.25 mm3 for the hippocampus and DX 357, 93 mm3 for the hippocampus SN. Conclusions: Therapy in patients considered was associated with an increase in hippocampal volume (9.87% -8.37%). The increase in hippocampal volume appear to be relevant, consistent with the literature data, although quantitatively greater, stressing the effectiveness of SSRIs probably through the mechanism of activation of neurogenesis, it is conceivable that the increase in volume is attributable to an increase glial cells but an increase of hippocampal neurons seen the simultaneous clinical improvement. Seems particularly interesting given the relative clinical effectiveness of EMDR and neural plasticity. This observation on only three cases, clearly needs to be confirmed on a larger sample but represents the first evidence in the literature of action of psychotherapy directed at brain structure.
The purpose of this chapter is to critically examine novel or controversial interventions for psychological trauma and its sequelae. Because the field of trauma treatment has recently witnessed a substantial increase in unusual treatments with questionable claims of efficacy, careful scrutiny of these treatments is warranted. We begin by discussing psychological trauma and its prevalence. We next describe the symptoms of PTSD, and discuss data concerning the risk of developing this disorder following a trauma. We outline current cognitive-behavioral theories of PTSD, and describe empirically supported treatments based on such theories. Finally, we describe a number of novel and controversial trauma interventions, including eye movement desensitization and reprocessing (EMDR), thought field therapy (TFT), and critical incident stress debriefing (CISD). We examine the theoretical and empirical bases of these three treatments and discuss the implications of their promotion for the field of clinical psychology. [Text, p. 243]
Många personer som exponerats
för traumatisk stress kan
inte verbalisera sina upplevelser
och känslor vilket försvårar
krisbearbetningen. En del av
dessa riskerar psykisk invaliditet,
posttraumatiskt stresssyndrom
(PTSD).
Many people who were exposed
of traumatic stress can
not verbalize their experiences
and feelings which complicates
emergency processing. Some of
these risk mental disability,
post-traumatic stress syndrome
(PTSD).
In the previous issue of Psychology & Health Havermans Jim wrote a critical forum posting about mindfulness. His thesis, that the efficacy of mindfulness meditation is insufficient evidence to its application in health care to justify, this issue argued contradicted by Schroevers Maya and her colleagues and by Ivan Nyklicek. Zijmenen mindful that the impact study, while still more extensive and better, but that the investigation so far has yielded enough evidence to justify the application. Nyklíčekmerkt in psychology here that a new therapy in clinical practice usually first applied for years before being properly scientifically investigated whether the therapy works. Havermans appears far from convinced the fillets and put forward evidence mercilessly. This interesting discussion raises the question if we may call evidence-based treatment. The view that this only if there can be controlled study the efficacy of treatment has shown, most colleagues will be endorsed. But what is 'controlled study'? Is a waiting list control group or to the (new) treatment are compared with other active interventions whose effectiveness has already been demonstrated?
The relationship between practice and theory is interesting. Apart from the question whether the remark Nyklicek still holds water in this era of evidence-based interventions, it is widely recognized for a new psychological intervention should be as specific activity or effectiveness is not proven? Havermans believes that a new behavioral intervention developed on the basis of promising clinical observations and behavioral science, in other words, there is also a theoretical justification for the intervention. For the latter is indeed much to say, but history shows that the theories initially as an explanation for the efficacy of the intervention were formulated, mostly on closer inspection the test of scientific criticism could not stand. Research in the tradition of experimental psychopathology (Jansen, Van den Hout & Merckelbach, 2010) has a lot of work cleaning the theoretical field.
On closer examination of many evidence-based interventions shown to be effective, but how they work is often unclear whether the theoretical substantiation is found insufficient support. The last Autumn Congress of the Association for Behavioral and Cognitive Therapy (VGCt)'s theme was "Change. Change mechanisms and cognitive behavioral therapy. During the conference it became clear that the change mechanisms of evidence-based interventions much uncertainty and that the research on this surprising results show (Jaspers, 2011). It provides not only EMDR (Eye Movement Desensitization and Reprocessing), which the theoretical views have changed, even as to the efficacy of the intervention no doubt. In the next issue of Psychology & Health You can read more about.
In this issue you will find a forum posting where the proverbial cat among the pigeons thrown. The provocative title "Current treatment depression is a waste of money 'invites at least into reading. Why wasted? If there is a problem for which evidence-based treatments exist, it is indeed depression. Cook and colleagues reveal that despite the enormous sums spent each year in the Netherlands for the treatment of depression in the current financing of health care is still insufficiently taken into account the high risk of relapse in depression. By many, for various reasons detested system DBC (Diagnosis Treatment Combination) discourages long-term treatments to continue. Existing effective interventions to reduce the risk of relapse are rarely used, while in the treatment of a chronic condition such as depression often explicitly designated. This, the authors implied a major weakness in the current outcome research: the lack of evaluation of the long-term effects of the tested intervention. For psychological interventions for depression is clear that this work. And already includes a long depression that we do not know the specific mechanisms of action (how they work), the necessity of implementation of evidence-based interventions to prevent relapse or delay can not be overstated. The recurrent nature makes depression after a disease with both high social cost as a very high disease burden, distress and risk of suicide.
Post-traumatic stress disorder (PTSD) is a disorder which can develop following exposure to one or more severely traumatic events. Symptoms experienced by PTSD suffers include re-experiencing the trauma through intrusive ‘flashbacks’ and recurrent dreams or nightmares, distress when exposed to reminders of the trauma, hyperarousal and emotional blunting. These symptoms can cause significant impairment of function and reduction in quality of life for suffers. Both psychotherapies, including cognitive behavioural therapies (CBTs) and eye movement desensitisation and reprocessing (EMDR), and pharmacotherapy are used in the treatment of PTSD.
Method
We audited patients with PTSD in Bedford East performed in November 2008. A re-audit was performed using data from August 2010 patient database. Demographic information, risk factors, co-morbidities, psychological therapy and pharmacotherapy were compared between these audit and re-audit.
Results
There is increased use of antidepressant augmentation between 2008 and 2010. While no patients in 2008 were on antidepressant augmentations, by 2010, 9 patients were. All 25 patients on anti-psychotics have important identified risk factors. There is no evidence of Psychosis in our PTSD patients except in two cases. There is an increase in Anti-psychotic use in our PTSD Patients. There is an increased use of Mood Stabilisers in our patients with PTSD.
Discussion
PTSD is being identified more frequently in our patients, probably because of greater awareness and more accurate identification.
Conclusion
New patients being identified represent a group of more difficult to treat patients who represent severe risks. Present psychotherapies offered are not all recommended in present guidelines.
We investigated the relationship between plasma levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) and responses to eye movement desensitisation and reprocessing (EMDR) in complex PTSD. Before and after EMDR, plasma levels of neurotrophic factors and scores in the indices of self-questionnaires were obtained for 8 men with complex PTSD. Baseline plasma levels of BDNF and NGF of responders and of non-responders were compared. The plasma BDNF levels of responders were higher than those of non-responders. However, plasma NGF levels did not differ in two groups. Plasma BDNF level might contribute to the therapeutic response to EMDR in trauma-related psychiatric disorders, such as complex PTSD. [Text]
This study investigated the differences between play therapy and Eye Movement Desensitization and Reprocessing (EMDR) when applied to children. Eleven participants from Homan Elementary School, Fresno, California, participated in this study. The treatment consisted of four combinations of varied administrations of play therapy and EMDR. Dependent variables included the self-reporting instruments of the Trauma Reaction Indicators Child Questionnaire (TRICQ), the Subjective Units of Disturbance Scale (SUDS), the Validity of Cognition Scale (VOC), and the Global Feelings Self-Report Scale. Qualitative data included observed changes in behaviors on the educational risk assessment. No clinical significance was demonstrated on the self-report instruments; however, statistical significance was found on the qualitative data using the chi-square goodness-of-fit test on the posteducational risk assessment. Positive changes were reported in the qualitative analysis on the educational risk assessment.
This poster will describe a girl who is 13 years of age and how she is living with mother and
stepfather, her symptoms and her obsessive thought and actions. The poster will give
information about a girl who is a very lively and charming person and who is strongly
motivated to get help. There will be information about how the girl's life is strongly
influenced by obsessions both thoughts and actions and her symptoms. For example, she
feels frequently she must ask whether it will be a fire, if there is any risk for her being
contaminated, or if she will get different diseases like AIDS, or even getting pregnant. How
the girl thinks she can hurt other persons and that she will get hurt herself. For example the
girl has to check and dry off the toilet several times before, leaving, she also thinks she must
wash her hands several times a day. She could seldom stay or play with her friends. Further
the poster will describe how she enjoys school and feels sorry for having to do all the constant
asking and the different rituals - how she understands that it is stupid to go on doing what she
does - and that she can not help it. The poster will give examples of targets, how and when
the EMDR is used in the treatment. Information on the poster about the treatment, and the
experience and effect of the EMDR interventions. This information from the therapeutic
process will be separately provided and presented from the girl, the mother and the therapist.
Rosen and Davison [Rosen, G.M. and Davison, G.C. (2003). Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27, 300–312] recommended that empirically supported principles be listed instead of empirically supported treatments because the latter approach enables the creation of putatively new therapies by adding functionally inert components to already listed effective treatments. This article attempts to facilitate inquiry into empirically supported principles by reviewing possible mechanisms responsible for the effectiveness of systematic desensitization and exposure therapy. These interventions were selected because they were among the first empirically supported treatments for which some attempt was made at explanation. Reciprocal inhibition, counterconditioning, habituation, extinction, two-factor model, cognitive changes including expectation, self-efficacy, cognitive restructuring, and informal network-based emotional processing explanations are considered. Logical problems and/or available empirical evidence attenuate or undercut these explanations. A connectionist learning-memory mechanism supported by findings from behavioral and neuroscience research is provided. It demonstrates the utility of preferring empirically supported principles over treatments. Problems and limitations of connectionist explanations are presented. This explanation warrants further consideration and should stimulate discussion concerning empirically supported principles.
Psychological victimology concerns crime victims in need of emotional
support. Sources of support include significant others1, victim
assistance volunteers, and mental health professionals. In the
wider victimological context, victim needs spark controversy and
are subject of a seemingly endless and recurring debate (Ten
Boom & Kuijpers, 2007). The issue who is in need has a rather
straightforward answer: victims with chronic post traumatic stress
disorder (PTSD) are in need of emotional treatment, and victims
at risk of this condition are in need of preventive counseling. The
more controversial issue here is why these needs develop, and
what constitutes a helpful and effectual response.
This paper provides an overview of recent developments in the literature on post-traumatic stress disorder. Epidemiological studies indicate that approximately 15-25% of individuals experiencing a significant trauma will go on to develop post-traumatic stress disorder, although approximately half will recover without formal intervention. Potential vulnerability factors for post-traumatic stress disorder have been identified, but the mechanisms and complexities require further exploration, with recent research suggesting that prevalence rates and risk factors may differ across populations. Studies of psychological treatment have demonstrated prolonged exposure and cognitive therapies to be equally beneficial, whereas eye movement desensitization and reprocessing may be useful but perhaps less effective in the long term. Pharmacological treatment studies indicate that selective serotonin reuptake inhibitors may be the first choice of drug treatments for post-traumatic stress disorder. Non-selective primary prevention strategies remain contentious, although secondary prevention, in the form of cognitive behavioural interventions for acutely symptomatic survivors, appears to reduce the subsequent development of post-traumatic stress disorder.
To investigate the posttraumatic growth and its impact factors in victims having experienced Wenchuan earthquake and
living in community in one of the most severe disaster area. With the Impact of Event Scale- Revised (IES-R), Posttraumatic
Growth Inventory (PTGI) and questions about the objective and subjective influences (e.g. economic loss, personal feelings)
of the earthquake to the subjects, data were collected from 2403 victims living in a temporary community of Pengzhou,
a severe disaster impacted area. 2106 valid questionnaire were analyzed for the related factors influencing posttraumatic
growth.
The age of subjects and PTSD symptoms could predict posttraumatic growth significantly. Both objective and subjective
influence of the earthquake on victims contributed significantly to posttraumatic growth, whereas they became less or not
significant when PTSD symptoms were accounted into the regression model. PTSD symptoms were the most important factor
to predict posttraumatic growth; economic loss for individual experiencing the earthquake could also predict posttraumatic
growth stably.
The role of psychological trauma (e.g., rape, physical assaults, torture, motor vehicle accidents) as an etiological factor in mental disorders, anticipated as early as the 19th century by Janet, Freud, and Breuer, and more specifically during World War I and II by Kardiner, was "rediscovered" some 20 years ago in the wake of the psychlogical traumas inflicted by the Vietnam war and the discussion "in the open" of sexual abuse and rape by the women's liberation movement. 1980 marked a major turning point, with the incorporation of the diagnostic construct of PTSD into DSM-III and the definition of its main diagnostic criteria (reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, and symptoms of increased arousal). Initially described as resulting from a onetime severe traumatic incident, PTSD has now been shown to be triggered by chronic multiple traumas as well. This "state-of-the-art" article discusses past and current understanding of the disorder, with particular emphasis on the recent explosive developments in neuroimaging and other fields of the neurosciences that have highlighted the complex interrelationships between psychological, psychiatric, biological, and neuroanatomical components of the disorder, and opened up entirely new therapeutic perspectives on how to help the victims of trauma overcome their past. [Author Abstract]
Background: What to do with women who experienced childbirth as so
traumatic that they keep having nightmares, flashbacks and problems
concentrating, who do not want to become pregnant again or demand a
cesarean section at the next delivery? One to two percent of women
suffers from posttraumatic stress disorder (PTSD) following childbirth,
which may affect mother-child bonding as well as future pregnancies.
Methods: Based on current knowledge from literature, including own
research, an overview will be presented of the prevalence, risk factors,
diagnosis and treatment of PTSD following childbirth. Results: PTSD
is an anxiety disorder affecting 1-2 percent of women after childbirth.
Risk factors include [a] obstetric complications and interventions
(emergency cesarean section, preterm birth), [b] history of psychiatric
problems or depression/anxiety during pregnancy, [c] psychosocial
factors (low coping skills, low social support). Furthermore, 50 percent
of women with PTSD following childbirth also suffers from
postpartum depression. When PTSD is suspected, clinicians can use the
self-report measure Traumatic Event Scale-B to quantify symptoms,
and refer to a psychiatrist/psychologist if necessary. Several studies
indicate that spontaneous remission of PTSD following childbirth is
uncommon. Possible negative consequences of the condition include
insecure attachment of the infant, impaired partner relationship,
avoiding future pregnancies and demanding a cesarean section in a
subsequent pregnancy. Although these possible adverse outcomes
justify treatment and prevention, effective interventions and prevention
strategies have not been adequately researched in this patient group.
International guidelines regarding PTSD in other (non-pregnant)
populations point to eye-movement desensitization and reprocessing
(EMDR) and cognitive behavioral therapy (CBT) as the most
promising treatments. Identification of women at risk, both during
pregnancy and postpartum, is key to early intervention and possible
prevention. Conclusions: Posttraumatic stress disorder following
childbirth is a serious condition affecting 1-2 percent of postpartum
women, with higher prevalence rates among women with complicated pregnancies/deliveries and those with a history of mental health issues.
Adequate identification of women at risk and those with clinical
symptoms is key to early intervention and eventually prevention.
Eye Movement Desenzibilizácia a prepracovanie predstavuje sľubný prístup k liečbe poúrazových porúch. Medzi špecifické faktory, z ktorých jej účinnosť spoliehajú predovšetkým na bilaterálnej stimulácie, ktorá ako sa zdá, vyvolať špecifickú neurobiological odpoveď počas traumatické odvolanie najmä u jedincov s PAS. Empirické poznatky poskytujú dôkazy o vplyve BLS na autonómneho nervového systému dosiahnuť rovnováhu smerom aktivácia parasympatiku (zníženie vzrušenie), ako aj vplyv na subjektívne vnímanú živosťou a emocionálne záťaž z autobiographic pamätí (pokles). Najdôveryhodnejší hypotézy odvodiť účinky z neurobiologických mechanizmov pracujúcich v duálnom zamerať pozornosť, orientujúca reflex a REM spánok. Ďalší výskum je potrebné preskúmať procesy zahrnuté v terapii EMDR podrobnejšie a objasniť úlohu bilaterálne stimulácie. (PsycINFO Database Record (c) 2012 APA, všetky práva vyhradené)
Eye Movement Desensitization and Reprocessing represents a promising approach to treatment of posttraumatic disorders. The specific factors underlying its effectiveness rely particularly on bilateral stimulation, which seems to provoke a specific neurobiological response during traumatic recall particularly in individuals with PTSD. The empirical findings provide evidence for the effect of BLS on autonomic nervous system shifting the balance towards parasympathetic activation (reducing arousal) as well as the effect on subjectively perceived vividness and emotional burden of autobiographic memories (decrease). The most credible hypotheses derive the effects from neurobiological mechanisms employed in dual focus attention, orienting reflex and REM sleep. Further research is needed to explore the processes included in the EMDR therapy in more detail and clarify the role of bilateral stimulation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
When working with complex trauma, where there is secondary or tertiary or dissociation, the EMDR therapist must be
cautious or emotional parts that are overwhelming to the client can be evoked. Care must be taken to provide sufficient
assessment and stabilization and knowledge of the personality system or there is the risk of opening Pandora’s box and
overwhelming the client. However, there are ways to safely work with emotional parts of the personality. If the ANP is able to
stay present, the client has sufficient emotional stabilization and strategies to lower emotional arousal, then integration can
place. This workshop will provide guidelines on assessment and stabilization, and then discuss strategies to work with EPs.
Video tapes of client sessions will illustrate teaching points.
Background: Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce. Mthod: Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective interventions, particularly those designed to reduce war-related post-traumatic stress disorder (PTSD) symptoms, were identified and reviewed. The findings are summarised. Results: Young refugees are frequently subjected to multiple traumatic events and severe losses, as well as ongoing stressors within the host country. Although young refugees are often resilient, many experience mental health difficulties, including PTSD, depression, anxiety and grief. An awareness of relevant risk and protective factors is important. A phased model of intervention is often useful and the need for a holistic approach crucial. Promising treatments for alleviating symptoms of war-related PTSD include cognitive behavioural treatment (CBT), testimonial psychotherapy, narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR). Knowledge of the particular needs of unaccompanied asylum-seeking children (UASC), working with interpreters, cross-cultural differences, medico-legal report writing and the importance of clinician self-care is also necessary. Conclusion: More research is required in order to expand our limited knowledge base.
Negative autobiographical memories are effectively treated using EMDR
with patients making eye movements during the recall of negative
autobiographical memories. While several studies have measured the effects of
different types of stimulations, we are not aware of any research assessing the
combined effects of two different stimulations applied simultaneously during the
recall of the event.
For this preliminary study involving 15 adult patients from both sexes, 4 EMDR
counselor therapists measure 17 symptoms of the list proposed by Weimann
(1968)). Each patient is evaluated before, during and at the end of each session.
We control the effect of the sequence of one versus two types of stimulations by
assigning each patient to both conditions but in a random way: (a) first target first
session with one type of stimulation following with a second target first session,
including two types of stimulation; (b) the inversed sequence. We compare the
mean level intensity of each symptom (within factor) between one type vs. two
types of stimulations (between factor) using the Anova and the t- Student tests.
We hypothesize that an attenuation of intensity of the stress symptoms occurs
when the patient is treated simultaneously with two types of bilateral stimulation
(eye movements and tactile stimuli), compared to one (eye movements).
The paper presents preliminary data, as well as a discussion of the results in the
light of the theory of the working memory (Andrade et al.1997) and the
reassurance reflex model of EMDR proposed by MacCulloch and Feldman (1996).
Los
recuerdos
autobiográficos
negativos
son
tratados
con
efectividad
usando
el
EMDR
con
pacientes
a
través
del
movimiento
ocular
de
ojos
durante
el
acceso
al
recuerdo
negativo
autobiográfico.
Mientras
muchos
estudios
han
medido
dos
tipos
diferentes
de
estimulación,
no
estamos
al
corriente
de
ninguna
otra
investigación
que
informe
de
los
efectos
combinados
de
los
dos
tipos
de
estimulación
aplicada
simultáneamente
durante
este
acceso
al
recuerdo
del
evento.
En
este
estudio
preliminar
contamos
con
los
datos
de
15
pacientes
adultos
de
ambos
sexos,
4
consultores
EMDR
midieron
17
síntomas
de
la
lista
propuesta
por
Weimann
(1968).
Cada
paciente
era
evaluado
antes,
durante,
y
al
final
de
cada
sesión.
Controlamos
los
efectos
de
una
secuencia
en
función
de
los
2
tipos
de
estimulación,
asignando
a
cada
paciente
ambas
condiciones
pero
de
manera
aleatorizada:
(a)
Primer
recuerdo
Diana,
primera
sesión
con
un
tipo
de
estimulación
seguido
de
un
Segundo
recuerdo
de
la
primera
sesión
incluyendo
dos
tipos
de
estimulación;
(b)
invertimos
la
secuencia
anterior.
Comparamos
la
media
del
nivel
de
intensidad
de
cada
síntoma
(dentro
del
factor)
entre
un
tipo
y
dos
tipos
de
estimulación
(entre
factores)
usando
cálculos
estadísticos
de
Anoia
y
una
t-‐Student
para
los
resultados.
Nuestra
hipótesis
es
que
ocurrirá
una
atenuación
de
los
síntomas
de
estrés
cuando
el
paciente
es
tratado
simultáneamente
con
dos
tipos
de
estimulación
bilateral
(movimientos
oculares
y
estímulos
táctiles),
comparados
con
la
de
un
solo
tipo
(Movimientos
oculares).
Este
artículo
presenta
el
análisis
preliminar
de
los
datos,
así
como
la
discusión
de
los
resultados
en
línea
con
la
teoría
de
la
memoria
de
trabajo
(Andrade
y
cols
1997)
y
la
reafirmación
del
modelo
refractario
del
EMDR
propuesto
por
MacCulloch
y
Feldman
(1996).
Il PTSD abbraccia una gamma ampia di fenomeni: dagli eventi naturali catastrofici, dalle violenze maltrattamenti ed abusi su bambini ed adulti ad altre forme di aggressioni fisiche, gravi malattie ed interventi chirurgici, gravi problemi nel lavoro, come il mobbing ed altro ancora.
L prevalenza del PTSD oscilla tra l’1 ed il 9% della popolazione generale e può raggiungere il 50/60% in sottogruppi di soggetti esposti a traumi considerati di particolare gravità.. Tra i disturbi mentali conseguenti a traumi solo il PTSD è identificato dall’evento traumatico che in questo disturbo assume un ruolo specifico, tanto che la presenza di uno stressor a cui collegare i sintomi è l’elemento necessario per fare diagnosi. Si discute se lo stesso possa e debba sufficientemente essere rappresentato da un evento che ha le qualità per minacciare alla vita e qualità della vita di un soggetto o se sia identificabile esaurientemente con un vissuto soggettivo di impotenza che cambia l’adattamento della persona alla realtà in modo disfunzionale. Sembra comunque che la malattia oncologica e le sue fasi evolutive nonché i processi di guarigione che implica presentano occasioni ripetute per il paziente oncologico a rischio di traumatizzazione sia a causa delle circostanze oggettive che mettono in pericolo la qualità di vita della persona e la sua vita medesima, sia per le simbolizzazioni drammatiche che a volte essa può assumere nell’immaginario collettivo e soggettivo. Gli studi epidemiologici indicano come il PTSD interessi maggiormente il sesso femminile (11% vs 5% del sesso maschile) sulla cui prevalenza può anche influire il tipo di trauma (violenze e molestie sessuali, neglect ed abusi infantili vs. aggressioni fisiche, minacce con armi prigionia e rapimento negli uomini.
IL PTSD rappresenta una sfida in psichiatria non solo in generale perché i sintomi che emergono sono diversi e sintetizzano una miscela di processi sociali, biologici e psicologici, ma anche soprattutto in oncologia perché esiste una vasta gamma di sintomi dello spettro post-traumatico, come ad esempio i disturbi dell’adattamento, ma si è spesso in presenza di un PTSD sottosoglia difficilmente discriminabile anche agli occhi di esperti preparati.
Così possiamo intendere i disturbi dell’adattamento come tutte quelle manifestazioni in cui, in assenza di vulnerabilità individuale, un evento stressante, ad esempio la diagnosi di cancro ed i trattamenti ad essa legati, rappresenta il fattore causale ed esclusivo di insorgenza dei sintomi, che si presume non sarebbero altrimenti occorsi. Essi influiscono negativamente sull’adattamento del soggetto alla malattia e sul funzionamento psicofisico generale. I sintomi possono essere rappresentati da reazioni depressive, reazioni d’ansia o miste (ansioso-depressive), reazioni con altri aspetti emozionali (irritabilità, aggressività labilità emotiva) o con disturbi della condotta (comportamenti inadeguati). Importante risulta la diagnosi differenziale con i disturbi d’ansia e depressivi. I disturbi dell’adattamento rappresentano i quadri di sofferenza psicologica più frequentemente diagnosticabili nei pazienti con cancro, avendo una prevalenza del 30-35%. I sintomi sottosoglia possono rappresentare invece i prodromi di una sindrome conclamata oppure i sintomi residui di un PTSD in remissione parziale. E’ importante volgere l’attenzione ai PTSD in oncologia, alla diagnosi differenziale con altri tipi di disagi psicooncologici, ed in particolare alla peculiarità, gravità cronicità del quadro clinico per la possibilità di attuare una prevenzione efficace prima che il disturbo insorga o si strutturi, e per le potenzialità di comprensione di alcuni meccanismi di funzionamento cerebrale che creano un ponte fra psicologico e biologico.
The PTSD embraces a wide range of phenomena: from natural catastrophic events, from violence and abuse, ill-treatment of children and adults with other forms of physical assaults, serious illness and surgery, severe problems in the work, such as bullying and more.
The prevalence of PTSD ranges between 1 and 9% of the general population and can reach 50/60% in subgroups of subjects exposed to trauma considered particularly serious .. Among the mental disorders resulting from trauma, PTSD is identified only by the traumatic event that in this disorder takes on a specific role, so that the presence of a stressor that link symptoms is a necessary element to diagnose. It was discussed whether the same can and should be sufficiently represented by an event that has the quality to threaten the life and quality of life of an individual, or whether it is fully identifiable with a subjective experience of powerlessness that changes to adapt to the reality of the person in dysfunctional way. It seems that the oncological disease and its evolutionary phases as well as the healing process that involves repeated opportunities to present the cancer patient at risk of trauma and because of objective circumstances that endanger the quality of life of the person and his life itself , both for the dramatic symbolization that sometimes it can take in the collective and subjective. Epidemiological studies indicate that PTSD interests most of the women (11% vs. 5% of males) on the prevalence of which may also affect the type of trauma (violence and sexual harassment, child abuse and neglect Vs. Physical attacks, threats with weapons imprisonment and kidnapping in men.
IL PTSD represents a challenge in psychiatry not only in general because the symptoms that emerge are different and synthesize a mixture of social processes, biological and psychological, but also especially in oncology because there exists a wide range of symptoms spectrum post-traumatic, such such as adjustment disorders, but it is often in the presence of a subthreshold PTSD hardly discriminated even in the eyes of experts prepared.
So we can understand the adjustment disorders like all those events where, in the absence of individual vulnerability, a stressful event, such as the diagnosis of cancer and the treatments associated with it, is the causal factor and exclusive of onset of symptoms, which it is assumed would not otherwise have occurred. They have a negative impact on the adaptation of the subject to physical and mental illness and the general operation. Symptoms may be represented by depressive reactions, anxiety reactions or mixed (anxious-depressive), reactions with other aspects of emotional (irritability, aggressiveness, emotional lability) or conduct disorder (inappropriate behavior). Important results in the differential diagnosis of anxiety disorders and depression. The adjustment disorders represent the paintings of psychological distress more frequently diagnosed in patients with cancer, having a prevalence of 30-35%. The subthreshold symptoms may instead represent the beginnings of a full-blown syndrome or residual symptoms of PTSD in partial remission. It 'important to turn our attention to PTSD in oncology, the differential diagnosis with other types of inconvenience psicooncologici, and in particular to the peculiarities, chronicity, severity of the clinical picture for the possibility of implementing effective prevention before the disorder arises or is structured, and the potential of understanding of some mechanisms of brain function that create a bridge between psychological and biological.
A special variety of dynamic therapy is presented which was successfully
combined with EMDR. A new diagnostic category is tentatively proposed.
A man in his twenties, successful in studies and in political and welfare
organizations, managed his life by intellectual consideration but with hardly any
emotional assessment being at a loss when confronted with demands for a personal
stand.
He disliked his lack of integrity and indecision which he liberated himself
from during the initial three years of therapy in so far as friends and societies were
concerned. However, all his intimate relations kept breaking up. He could not account
for why and in this context he appeared to be alexithym.
When the partner left him it was a total surprise to him, he got very upset in a
diffuse way and quite bewildered. At some occasions he got regressive spells of
yelling, crying and struggling. They seemed to be flashbacks and not a hysterical
acting out.
As a trauma might be an etiological factor I proposed EMDR and he accepted
to try it. During four EMDR-sessions memories with intense emotional involvement
appeared. Altogether the material made me venture a construction of him as a baby
yelling and kicking in desperate need for a mother who kept being absent. Shortly
afterwards he entered a relation that was satisfying to both him and his partner. The
therapy was terminated. In a follow up two years later the relation was still good and
he told me that the construction had made him grasp his life-history.
A prerequisite for the EMDR-sessions and their effect was the three years of
psychotherapy with the focusing of his central problem, but the liberation from this
problem could not have been reached without EMDR -at least not in such a short
time.
L’incremento costante di interesse nei confronti dei disturbi post-traumatici sta
portando non soltanto ad un costante e rapido approfondimento delle conoscenze in questo
campo, ma anche ad una continua riscoperta della psicoterapia ipnotica e ad un suo
raffinamento come approccio psicoterapico. La psicoterapia ipnotica, infatti, non solo è la
più antica delle psicoterapie, ma anche la prima ad essere stata in grado di trattare con
successo gli esiti di esperienze traumatiche o altamente stressanti e ad attribuire ad esse
una adeguata rilevanza in seno ad una comprensione trasversale della psicopatologia tutta.
Nonostante l’evidente esistenza di frequenti esperienze traumatiche nel corso della vita
delle persone, con ogni probabilità, però, solo le conseguenze sociali drammatiche di
continui coinvolgimenti bellici (insieme alla rivoluzione della cultura femminista) hanno
portato definitivamente al centro dell’attenzione la presenza di esperienze reali come
implicate nello sviluppo di stati di sofferenza (Hacking, 1995). La rinascita del cosiddetto
“modello traumatico” di Pierre Janet ha portato ad una iniziale riscoperta dei traumi
secondo una concezione di essi come di esperienze discrete, circoscrivibili, rilevanti
essenzialmente per la loro grandezza oggettiva; una tale visione, infatti, viene ufficializzata
dalla pubblicazione della terza edizione del manuale Diagnostico e Statistico dei Disturbi
Mentali (DSM-III; American Psychiatric Association, 1980) e progressivamente diventa la
concezione dominante in tema di Disturbo Post-traumatico da Stress (PTSD). Il progresso
delle conoscenze, però, sta portando sempre più in luce che nella comprensione dei disturbi
post-traumatici sono necessari modelli molto più complessi e non lineari (Pennati, 1995,
2001; Pennati, Grecchi, 2001), valutativi di un insieme di condizioni cliniche molto più
vasto ed articolato di quello previsto dal DSM-IV (Wilson, Friedman, Lindy, 2001),
pienamente immersi nei molteplici e affatto secondari fattori di rischio: psicologici,
genetici, neurologici, biochimici, interpersonali, sociologici (per una rassegna: Yehuda,
1999). Oltre a ciò, anche nei confronti del più studiato e prototipico dei disturbi post2
traumatici, ovvero il Disturbo Post-traumatico da Stress, vengono sempre più decisamente
sollevate obiezioni concettuali che renderebbero quantomeno parzialmente discutibili le
ricerche sull’efficacia delle psicoterapie nel loro trattamento. Infatti, sebbene la quasi
totalità della ricerca si concentri sulla valutazione testistica dei sintomi di intrusione,
evitamento ed iperattivazione, nondimeno sembra opportuno pensare che il PTSD sia
costituito anche da alterazioni del sistema motivazionale dell’attaccamento, delle strategie
interpersonali e della strutturazione del Sé (Wilson, Friedman, Lindy, 2001) (Tabella 1).
The steady increase of interest in the post-traumatic stress is leading not only to a constant and rapid advancement of knowledge in this field, but also to a continuous rediscovery of hypnotic psychotherapy and its refinement as a psychotherapeutic approach. The hypnotic psychotherapy, in fact, not only is the oldest of psychotherapy, but also the first to be able to successfully treat the sequelae of traumatic or highly stressful experiences and to give them a proper understanding of relevance within a transverse all of psychopathology. Despite the apparent existence of frequent traumatic experiences in people's lives, in all likelihood, however, only the social consequences of dramatic escalation continues (along with the feminist revolution of culture) have finally brought to light the presence of real experiences as involved in the development of states of suffering (Hacking, 1995). The rebirth of the "trauma model" by Pierre Janet has led to a rediscovery of the initial trauma according to a conception of them as experiences of discrete constrained, mainly relevant for their size objective, such a vision, in fact, be formalized by publication of third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, American Psychiatric Association, 1980) and gradually became the dominant view in terms of Posttraumatic Stress Disorder (PTSD). The advancement of knowledge, however, is bringing more and more light in the understanding of post-traumatic stress models are needed much more complex and nonlinear (Penn, 1995, 2001; Pennati, Grecchi, 2001), evaluation of a set of conditions Clinical much more vast and that provided by the DSM-IV (Wilson, Friedman, Lindy, 2001), not fully immersed in multiple and secondary risk factors: psychological, genetic, neurological, biochemical, interpersonal, sociological (for a review: Yehuda, 1999). Moreover, even against the most studied and prototypical post2 traumatic disorder, or Posttraumatic Stress Disorder, are decidedly more conceptual objections that would make at least partially questionable research on the effectiveness of psychotherapy in their treatment. Although almost all of dissertation research focuses on evaluation of symptoms of intrusion, avoidance and hyperactivity, however, it seems appropriate to suggest that PTSD is also consist of changes in the motivational system of attachment, interpersonal strategies and structuring of the self ( Wilson, Friedman, Lindy, 2001) (Table 1).
Intraoperative awareness with subsequent recall is a rare but serious complication with an incidence of 0.1–0.2%. In approximately one third of the patients who have experienced awareness, late severe psychiatric sequelae may develop. The psychiatric symptoms in these patients fulfil the diagnostic criteria for post traumatic stress disorder. To prevent awareness as a negative outcome after anaesthesia, a thorough perioperative management of anaesthesia is necessary. The definite risk for post traumatic stress disorder following awareness indicates the necessity of postoperative clinical routines to identify awareness patients. The problem must be acknowledged. Professional psychiatric assessment and follow up should constitute standard practice. The treatments of choice are Eye Movement Desensitisation Reprocessing and Cognitive Behaviour Therapy.
This work presents psychological specificities of situations where torture victims are
witnesses at the court trial of perpetrators at the same time. Witnesses are subject to the
risk of secondary traumatisation, retraumatisation and revictimatisation, which may lead to
the deterioration of existing PTSD symptoms. Starting from the very act of reaching the
decision whether to testify, witnesses are in a state of ambivalence associated with a need
for truth and justice, the need that perpetrators should be adequately punished and thus
certain compensation be provided as well as with fear of the course that the trial itself may
take, they being partially aware of the risk for retraumatisation and retraumatisation. The
author sets forth the need for psychological-psychiatric preparation of the witness prior to
the trial, as well as co-operation between judicial organs and psychiatric-psychological
service. The paper features examples from the Centre for Rehabilitation of Torture Victims
– IAN Belgrade.
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 Group’s 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.
Fire fighters are at increased risk of developing mental health problems due to the nature of their work, which can sometimes be extremely traumatic. Arranging for immediate access to mental health specialists can often take a protracted time to arrange, leading to the individual remaining disabled and off work. The South Wales fire and rescue service have responded to this challenge and formed a partnership with their local NHS traumatic stress service. This has enabled fire fighters to receive early psychological assessment and treatment from a nurse therapist trained in cognitive behaviour therapy or referred to a consultant liaison psychiatrist. This paper will describe 3 cases which all suffered with PTSD and were treated via the partnership with a controversial therapy, EMDR. [Author Abstract]
Post-traumatic stress disorder (PTSD) involves a number of cognitive factors in its aetiology and, therefore, in the criteria required for diagnosis. Whilst psychobiological theories and treatments are considered very briefly, the focus of this contribution is the role of cognitive factors in the onset, maintenance and treatment of PTSD. This contribution, therefore, reviews the role of cognitive factors in the genesis and development of PTSD before examining early cognitive theories, through the work of Mowrer on two-factor theory to the work of Foa and Kozak on emotional processing. The contribution then considers the current state of cognitive theorizing about PTSD, with particular reference to the theories of Brewin, Clark and Ehlers. The particular role of memory, the importance of previously held and current beliefs and the crucial part played by cognitive strategies are all considered and seen to be most important if the phenomenon of PTSD is to be fully understood. The two primary cognitively based treatments for PTSD – cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR) – are then introduced and considered in turn, particularly from the point of examining how each treatment approach targets cognitive factors involved in the maintenance of post-traumatic symptomatology and distress.[Journal abstract]
The present research evaluated the psychometric properties of the credibility/expectancy questionnaire, a quick and easy-to-administer scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. The results suggested that this questionnaire derives the two predicted factors (cognitively based credibility and relatively more affectively based expectancy) and that these factors are stable across different populations. Furthermore, the questionnaire demonstrated high internal consistency within each factor and good test-retest reliability. The expectancy factor predicted outcome on some measures, whereas the credibility factor was unrelated to outcome. The questionnaire is appended to the paper, yet the authors stress care when utilizing the scale. During the administration of the questionnaire, the participant sees two sections -- one related to thinking and one related to feeling. However, the researcher needs to be aware that the 2 factors derived are not grouped into those questions. Instead credibility was found to be derived from the first three think questions and expectancy was derived from the fourth think question and the two feel questions. [Author Abstract]
Burn injury is often a devastating event with long-term physical and psychosocial effects. Burn scars after deep dermal injury are cosmetically disfiguring and force the scarred person to deal with an alteration in body appearance. In addition, the traumatic nature of the burn accident and the painful treatment may induce psychopathological responses. Depression and PTSD, which are prevalent in 13-23% and 13-45% of cases, respectively, have been the most common areas of research in burn patients. Risk factors related to depression are pre-burn depression and female gender in combination with facial disfigurement. Risk factors related to PTSD are pre-burn depression, type and severity of baseline symptoms, anxiety related to pain, and visibility of burn injury. Neuropsychological problems are also described, mostly associated with electrical injuries. Social problems include difficulties in sexual life and social interactions. Quality of life initially seems to be lower in burn patients compared with the general population. Problems in the mental area are more troublesome than physical problems. Over a period of many years, quality of life was reported to be rather good. Mediating variables such as low social support, emotion and avoidant coping styles, and personality traits such as neuroticism and low extraversion, negatively affect adjustment after burn injury. Few studies of psychological treatments in burn patients are available. From general trauma literature, it is concluded that cognitive (behavioral) and pharmacological (selective serotonin reuptake inhibitors) interventions have a positive effect on depression. With respect to PTSD, exposure therapy and eye movement reprocessing and desensitization [EMDR] are successful. Psychological debriefing aiming to prevent chronic post-trauma reactions has not, thus far, shown a positive effect in burn patients. Treatment of problems in the social area includes cognitive-behavioral therapy, social skills training, and community interventions. Sexual health promotion and counseling may decrease problems in sexual life. In conclusion, psychopathology and psychological problems are identified in a significant minority of burn patients. Symptoms of mood and anxiety disorders (of which PTSD is one) should be the subject of screening in the post-burn phase and treated if indicated. A profile of the patient at risk, based on pre-injury factors such as pre-morbid psychiatric disorder and personality characteristics, peri-traumatic factors and post-burn factors, is presented. Finally, objective characteristics of disfigurement appear to play a minor role, although other factors, such as proneness to shame, body image problems, and lack of self-esteem, may be of significance. [Author Abstract]
It often has been theorized that psychopaths have a fundamental deficit
with respect to emotions (Cleckley, 1976). They would be unable to
experiment acute emotional reactions, like posttraumatic stress. The study
compares posttraumatic stress between psychopaths and non psychopaths.
as defined by the Hare Psychopathy Checklist (1991). The specific
contribution of factor 1 (narcissistic characteristics) and factor 2 (behavioral
characteristics) of psychopathy is analysed. The population includes 44 Belgian male offenders coming from a forensic hospital. Traumatic stress is
assessed by the Stanford Acute Stress Reaction Questionnaire ISASRQ (Cardena, Classen, Koopman, & Spiegel, 1996). The authors will discuss the
therapeutic implications.
Background:
Psychosocial interventions are widely used for the prevention of psychological disorders in law enforcement officers.
Objectives:
To assess the effectiveness and comparative effectiveness of psychosocial interventions for the prevention of psychological disorders in
law enforcement officers.
Search strategy:
CCDANCTR-References was searched on 12/5/2008, electronic databases were searched, reference lists of review articles and included
studies were checked, a specialist journal was handsearched, specialist books were checked and we contacted experts and trialists.
Selection criteria:
Randomised and quasi randomised controlled trials were eligible. The types of participants were people employed directly in law
enforcement, including police officers and military police, regardless of gender, age and country of origin, and whether or not they
had experienced some psychological trauma. All types of psychosocial intervention were eligible. The relevant outcome measures were
psychological symptoms, adverse events and acceptability of interventions.
Data collection and analysis:
Datawas entered intoReviewManager 4.2 for analysis, but this reviewwas converted toRevMan 5.0 for publication.Quality assessments
were performed. Two authors independently selected studies, extracted data and assessed the quality of studies. Summary effects were
to be calculated using RevMan but no meta-analyses were possible. For individual studies, dichotomous outcome data are presented
using relative risk, and continuous outcome data are presented using the weighted mean difference. These results are given with their
95% confidence intervals (CI).
Main results:
Psychosocial interventions for prevention of psychological disorders in law enforcement officers (Review) 1
Copyright © 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.
Ten studies were included in the review but only five reported data that could be used. Three of the ten studies were related to exercisebased
psychological interventions. Seven were related to psychological interventions. No meta-analyses were possible due to diversity of
participants, interventions and outcomes. Two studies compared a psychosocial intervention versus another intervention. Three studies
compared a psychosocial intervention to a control group. Only one primary prevention trial reported data for the primary outcomes
and, although this study found a significant difference in depression in favour of the intervention at endpoint, this difference was no
longer evident at 18 months. No studies of primary prevention comparing different interventions and reporting primary outcomes of
interest were identified.
The methodological quality of the included studies was summarised. No study met our full quality criteria and one was regarded as
low-quality. The remainder could not be rated because of incomplete data in the published reports and inadequate responses from the
trialists.
Authors’ conclusions:
There is evidence only from individual small and low quality trials with minimal data suggesting that police officers benefit from
psychosocial interventions, in terms of physical symptoms and psychological symptoms such as anxiety, depression, sleep problems,
cynicism, anger, PTSD, marital problems and distress. No data on adverse effects were available. Meta-analyses of the available data
were not possible. Further well-designed trials of psychosocial interventions are required. Research is needed on organization-based
interventions to enhance psychological health among police officers.
Die Posttraumatische Belastungsstörung (PTBS) ist ein häufiges Krankheitsbild und mit einer Standardtherapie, die die spezifische Problematik der Störung unberücksichtigt lässt, nur eingeschränkt behandelbar. Der Beitrag geht auf aktuelle diagnostische Kriterien sowie spezifische Risikofaktoren für die Ausbildung chronischer und komplexer PTBS-Symptome ein. Verschiedene Behandlungsansätze – Konfrontationstherapie, Kognitive Restrukturierung, EMDR, psychodynamische Therapie, angeleitetes Schreiben – werden auf der Basis validierter Therapiestudien vorgestellt. Ausführlicher berücksichtigt werden Behandlungsmöglichkeiten für sexuell traumatisierte Frauen mit chronischer PTBS und komorbiden Beschwerden.
Post-traumatic stress disorder (PTSD) is a frequent disorder. But standard treatments which neglect the specific characteristics of the symptomatology are only of limited outcome. The paper focuses on recent diagnostic criteria and specific risk factors that are likely to influence the development of chronic and complex PTSD symptoms. Different treatment programmes and techniques are presented on the basis of validated therapy studies: prolonged exposure, cognitive restructuring, EMDR, psychodynamic therapy and writing assignments. Particular attention is payed to the psychotherapy of sexually traumatised women who suffer from chronic PTSD and comorbid disorders.
Although psychotherapy is successful in altering emotional distress, the biological mechanism by which it achieves this has not been the subject of intensive neurobiological investigation. Mindful processing of emotion has been proposed to be a key factor in prevention of relapse in depressive illness and here that hypothesis is developed and extended to include other conditions in which emotion processing may be obstructed or dysregulated. Cognitive therapy, interpersonal psychotherapy, psycho-dynamic psychotherapy, and dialectical behaviour therapy, each in a different way and with a distinct emphasis, encourage awareness of emotions and their associated cognitions and biographies, and their varying success may depend on the degree to which they achieve activation of internal healing processes. In eye movement desensitisation and reprocessing (EMDR), the selected target is formatted for endogenous processing which is facilitated and accelerated by eye movements or alternating bilateral auditory or tactile stimulation. The ability to sustain focussed attention on the affect and its visceral, cognitive, and biographical components is postulated to activate a homeostatic process of distress resolution, seen most clearly in treatment of PTSD with EMDR, in which resolution of distress can be intense and rapid while therapist input is non-directive, although supportive, empathic, and non-judgemental. Once the therapist has helped to frame the questions, the patient's brain will find the answers needed for the resolution of the distress and all the components of the traumatic event, whether visceral, cognitive, affective, or interpersonal. The anterior cingulate cortex, especially the dorsal and rostral components, is suggested to be the key neurobiological substrate for the efficacious psychotherapeutic relief of distress, and relevant functional neuroimaging studies are summarised. One limitation of some previous imaging studies of emotion is that they have tended to use mild stimuli to discrete emotions. An alternative approach would be to image the brain during reprocessing of an unpleasant event which has profoundly affected the person so that the associated intense emotions could be clearly labelled and correlated with changes in regional brain functioning. [Author Summary]
In March 2007 an EMDR Europe HAP project, in conjunction with the University of Birmingham & Edge Hill University,
commenced in Northern Pakistan in the aftermath of the earthquake. Presently over 75 mental health workers have now
been trained in EMDR. In August 2009 six of these Pakistani mental health workers had successfully completed their EMDR
Facilitator training. As a means of evaluating their EMDR training a Q Methodology was utilised. Q methodology provides
a foundation for the systematic study of subjectivity, a person’s viewpoint, opinion, beliefs, and attitudes (Brown 1993). It is
an inverted form of factor analysis which then considers discourse patterns. Typically, in a Q methodological study people
are presented with a sample of statements about a topic called the Q-set. By Q sorting research participants give their
subjective meaning to the statements, and by doing so reveal their subjective viewpoint (Smith 2001) or personal profile
(Brouwer 1999). These individual rankings (or viewpoints) are then subjected to factor analysis to determine factor solution
and interpretation. Results highlighted important issues around the facilitators training experience, how cultural sensitivities
play an important part in the application of EMDR in Pakistan, and considered how EMDR trainings can be adapted and improved for the future.
This paper is a further progress report (see Blore, Farrell & Clifford 2008; Blore
2007) on data analysis from N=12 interviews from an Interpretative
Phenomenological Analysis (IPA) study into Post Traumatic Growth (PTG) following
successful EMDR treatment. The second round of hermeneutic analysis identified eight
categories of PTG outcomes. Five of the categories: New Directions in Life; Enhancement of
Social Development; Enhancement of Personal Development; Appreciation of Life and
Spiritual & Philosophical Development, are consistent with the five factor analysis categories
of the Post Traumatic Growth Inventory (PTGI)(Tedeschi & Calhoun 1996). The remaining
three categories are: Development of ‘Success Heuristic’; Expression of Positive Emotions;
and Growth Aspirations which can be seen as yet-to-be-attained PTG. One implication of
these categories is that positive outcomes of EMDR are consistently being under-reported in
the scientific literature simply because evidence-based practice is focussed solely on
reducing negative symptomatology.
Eye Movement Desensitization and Reprocessing therapy (EMDR) is a psychotherapy that uses
rapid eye movements to alleviate traumatic memories. This experiment examined two working
memory hypotheses proposed to explain how performing rapid eye movements can affect the
vividness, emotionality and completeness of traumatic memories. Participants (N=25) recalled
three traumatic memories and rated them on vividness, emotionality and completeness before
and after performing rapid eye movements. Participants also completed six working memory
tasks to see if a correlation existed between working memory and the effect of rapid eye
movements on memory rating variables. Findings illustrate that there was a significant decrease
pre-test to post-test in vividness. Additionally, the factor underlying the reading span operation
task and the Sternberg item order task significantly correlated with the effect of rapid eye
movements for all memory ratings. The results of the current study support the central executive
hypothesis explanation more than the visuospatial sketchpad storage hypothesis for EMDR.
3
Rapid Eye Movement Effects on Traumatic Memories: A Test of the Working Memory
Hypothesis
In 1987, Francis Shapiro discovered that performing horizontal eye saccades while
holding a traumatic event in mind helped her alleviate the negative symptoms she experienced
from that memory. She developed this intuition into a psychotherapy that is called Eye
Movement Desensitization and Reprocessing (EMDR). This therapy is now a widely-used
technique to treat victims of trauma, people suffering from post-traumatic stress disorder
(PTSD), and people suffering from phobias and other anxiety disorders (Muris & Meckleberger,
1999). Shapiro (2001) describes EMDR as an eight-phase treatment method that includes history
taking, client preparation, assessment, desensitization, installation, body scan, closure and reevaluation.
An important, and distinguishing, component of the EMDR procedure involves the
patient performing rapid bilateral eye movements while thinking about their traumatic memory
and communicating any negative cognition associated with that memory. The horizontal saccadic
eye movements generally involve watching the therapist’s quickly moving finger for 15-20
seconds/set (Shapiro, 2001). Eye saccade sets continue until the patient begins to report that
negative aspects of the memory are being alleviated, and that positive self-cognitions have
replaced the negative self-cognitions associated with the memory (Shapiro, 2001).
In order to effectively reduce the risk of developing long-lasting mental disorders in the aftermath
of traumatic stress exposure, interventions must be offered early on. Therefore, access
to expert assistance can have significant effects on prognosis. Rapid eye movements are
part of the Eye Movement Desensitization and Reprocessing procedure that gained considerable
attention in previous years. The authors present a patient suffering from an acute stress
disorder, treated by rapid eye movements through telepsychiatry services.
Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.
Some basic ideas and experiences with Self-administration of EMDR are reported and
three different zones are discriminated: the self-administration zone, the selfadministration
standard protocol zone and the zone of therapy. Different strategies for
self-administration in the case of small trauma "t" and life events "less than t" are
explored, the probably existing risk of a habituation effect is mentioned and a first
modest proposal for a protocol for every day use of EMDR self-administration is
recommended. The development of the EMDR field, the training in EMDR and the
further course of EMDR to a more complete form of psychotherapy are taken into
considerations.
Trauma therapists must make clinical judgments about which
upsetting memories to target in what order, taking into account the
particular client’s ability to tolerate a potentially challenging
trauma-focused session. This paper presents the results of a study
with 119 participants in 10 trauma workshops (either EMDR or
Progressive Counting, an exposure variant) in 4 countries.
Participants first provided a SUDS rating of an identified
distressing memory, then “floated back” and worked on an earlier
memory, and finally provided another SUDS rating on the initial
(not worked-on) identified memory. The final SUDS rating was
lower for almost every participant, often substantially so,
indicating that work on earlier related memories is likely to reduce
the distress associated with a later memory. Follow-up with a
subset of participants at 1 and 4 weeks post-treatment indicated
some deterioration but substantial maintenance of effect. When
the client’s affect tolerance is a potentially limiting factor in
proceeding with trauma work, the present findings support the
strategy of first working through earlier related memories.
EMDR practitioners must make clinical judgments about which memories to target in what order, taking into
account the particular client’s ability to tolerate a potentially challenging trauma-focused session. This paper
presents the results of a study in which x participants in trauma training (both EMDR and Progressive Counting,
an exposure variant) first provided a SUDS rating on an identified distressing memory, then “floated back” and
worked on an earlier memory, and finally provided another SUDS rating on the initial (not worked-on) target. The
final SUDS rating was consistently lower, often substantially so, indicating that work on earlier related memories
is likely to reduce the distress associated with a later memory. When the client’s affect tolerance is a potentially
limiting factor in proceeding with EMDR, the present findings support the strategy of first working through earlier
related memories.
I conceptualize EMDR as the process of linking the trauma from one part of the brain to a solution in
another part of the brain, to reach an adaptive resolution. The standard EMDR protocol proposes
accomplishing this by focusing heavily on the trauma. Most of my clients are adult survivors of
childhood trauma and their tolerance of a trauma-focused protocol is often low. I wondered if the
same adaptive resolution could be accomplished by focusing primarily on the part of the brain
holding the solution rather than the trauma. I recently began developing a resource-focused
protocol, which borrows from Sandra Paulsen’s (1994, 1995, & 1996) suggestions for integrating
EMDR with ego state therapy, and Andrew Leeds’ (1997) protocol for resource development and
resource installation (RD/RI). This new protocol puts significant emphasis on developing and
strengthening the felt sense of well-being connected to resource ego states before EMDR processing,
and maintenance of the sense of well-being during EMDR processing. It involves using the clients’
drawings of resource ego states and traumatized ego states (drawn with the dominant and nondominant
hand) as anchors for ego state processing, and as the focal points in eye movements (EMs).
In this protocol, traumatic material is elicited only when sufficient internal resources, represented by
drawings, are displayed in front of the client. The intention of this approach is to minimize risk of
affect overwhelm and maximize the probability that the part of the brain holding the trauma will link
to the part of the brain holding the solution.
In my experience the resource-focused protocol
Eye Movement und Desensitizer Wiederaufbereitung (EMDR) ist ein etabliertes mittlerweile Ansatz in der Behandlung der posttraumatischen Belastungsstörung (PTSD). EMDR Focus auf die Aufarbeitung der traumatischen Erinnerungen und anderes Trauma-Symptomen, wie zB Trigger oder derzeitigen Trauma verbundenen dysfunktionalen Verhaltens. Eine Laissez-faire Durchsetzung und dazu beitragen, "die unzureichende technische Mai Akkumulieren Unannehmlichkeit für den Patienten. Risiken und Nebenwirkungen des EMDR con Ansatz durch umfassende diagnostische Verfahren, Bewertung der Stabilitäts-Patienten, Zubereitung, Behandlung Planung und präzisen Anwendung von EMDR entgegengewirkt werden. Die Berufsorganisationen "versuchen sollte, zu dem höchsten Niveau der ethischen und professionellen Verhaltens getroffen, um das Risiko von Nebenwirkungen zu minimieren. (PsycINFO Database Record (c) 2008 APA, alle Rechte vorbehalten).
Eye Movement Desensitization and Reprocessing (EMDR) is a meanwhile well established approach in the treatment of posttraumatic stress disorder (PTSD). EMDR focuses on the reprocessing of traumatic memories, and other trauma-related symptoms, e.g., triggers or current trauma-related dysfunctional behaviors. A laissez-faire application and insufficient technique may contribute to accumulating patient discomfort. Risks and adverse effects of the EMDR-approach con be counteracted by comprehensive diagnostic procedures, assessment of patient stability, preparation, treatment planning and precise application of EMDR. The professional organizations should try to ensure the highest level of ethical and professional conduct in order to minimise the risk of adverse effects. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Contemporary treatment approaches for Posttraumatic Stress Disorder
(PTSD) include traditional approaches such as Cognitive-Behavioral therapy,
Psychodynamic therapy, Group Therapy, Pharmacotherapy, et cetera, as well as
experimental approaches such as Body therapies (e.g., Sensorimotor Processing)
(Ogden & Minton, in press) and other Asian-based approaches (often termed
“Energy Therapies”). These approaches have varying degrees of data in support of
their effectiveness, that range from anecdotal case reports to randomized and
controlled studies (e.g., see Dietrich, et al., 2000; Foa, Keane, & Friedman, 2000;
Shalev, Bonne & Eth, 1996; van der Kolk, McFarlane, & van der Hart, 1996).
Over the past two decades, professional psychology has witnessed a growing
movement towards the utilization of psychotherapies that have empirical support.
Despite this development, therapies that have not been empirically supported
continue to experience widespread use. Concurrently, a collection of novel
interventions, known as Power/Energy therapies (P/ET’s), has emerged. Although
these therapies are based on questionable theoretical foundations and enjoy little or no
empirical support, their popularity with clinicians appears to be strong and growing.
There is scant research examining individual differences with respect to the practice
habits of professional psychologists. The present study examined whether critical
thinking skills are a factor in psychologists’ choice of therapeutic interventions,
including their use of P/ET’s. As hypothesized, participants who reported using a
number of techniques from Power and Energy therapies scored significantly lower on
a measure of critical thinking skills. Also as hypothesized, individuals who reported
using a number of cognitive-behavioral techniques scored significantly higher on the
measure of critical thinking skills. Implications and suggestions for future research
are discussed.
Research background & aims: This study examined possible therapeutic mechanisms of eye
movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989,
1995, 2001) in terms of exposure and information processing model. While exposure model
contended process of extinction and response habituation, Stickgold (2002) proposed that
sleep induced change in associative memory via activation of weak association during REM
state and EM functioned as REM sleep to integrate the episodic memory of trauma into
general semantic memory. In this study, the effect of EM compared to that of Exposure-Only
(non-EM) on process measures of SUDs, ratings of cockroach phobia across sessions, along
with outcome measures were examined. Specifically, the degree of return of fear and response
habituation was explored.
Methods: Thirty-six college students with cockroach phobias were recruited as participants
and invited after informed consent for 4 1-week interval treatment sessions and a 1 month
follow-up session. The instruments for outcome measures included Cockroach Phobia
Questionnaire, fear ratings of cockroach slides, FSS, STAI-S, BDI, short form of SCL-90, the
Revised Thought-Action Fusion Questionnaire, White Bear Suppression Inventory, and
cognitive tasks for measuring strength of associations. The SUDs, credibility and therapeutic
relationship rating, and physiological measures such as HR, HRV, EOG, served as process
measures. Due to space limitations, the results of cognitive task and physiological measures
were reported elsewhere. The participants were randomly assigned to one of the four groups:
EM condition (EM vs. Non-EM exposure only) × block order of cockroach theme
presentation (negative cognition first vs. positive cognition first). A 2 (EM condition) × 2
(order of valence presentation) × 9 (time: pre-assessment and post-assessment for each of the
4 sessions plus 1 month follow-up assessment) mixed factorial design was performed, with
time serving as within Ss factor and the other two variables serving as between Ss factors.
There were 20 trials in each therapeutic session. The duration of each trial was 30s for both
the EM and Exposure-Only conditions.
Results: After preliminary analyses for group differences on pretreatment variables, credibility-relationship ratings, and outcome variables were explored, the 2 (EM condition) ×
2 (order of valence presentation) × 9 (time) ANOVA on SUDs showed that the main effects of
time and EM were both significant (p < .001 and p < .034). Subsequently, two 2 (order of
valence presentation) × 9 (time) ANOVAs were performed for EM condition and
Exposure-Only condition, respectively. The results showed that for EM condition, only time
effect was significant (p < .006); while for Exposure-Only condition, there were a significant
time effect (p < .001) and an approaching significant valence presentation order effect (p
< .065), with the SUDs being higher in negative cognition presented first condition compared
to positive cognition presented first condition; whereas the effect was not significant for the
EM condition. Using trend analyses and inspection of time effect showed that significant
within session SUDs reduction for Exposure-Only conditions. Notwithstanding, the pairwise
comparisons for the 9 time points indicated salient phenomena of return of fear among several
of the 5 sessions for this condition when comparing the pre-assessment of each session with
post-assessment of its previous session. Whereas for EM condition the return of fear between
sessions was small and the trend analysis showed a reduction with linear trend.
Conclusions & Discussion: Compared to Exposure-Only, EM resulted in less degree of
sufferings while participants encountering negative theme which in turn might facilitate
further processing of negative memory. In addition, EM might add something beyond the
mechanism of pure exposure. The less return of fear indicating that information processing in
addition to response inhibition might take place between sessions. The results echoed
Shapiro’s Adaptive Information Processing model and Stickgold’s REM-sleep dependent
memory reprocessing model, suggesting that EM in EMDR might reflect a shift in associative
memory systems by activating different strength of associations of negative semantic nodes
for different semantically related words. Given that previous research showed that EM
decreased emotionality and also generate greater amount of associations for negative stimuli,
the implications of the present results from theoretical and therapeutic point of views and
future research possibilities are discussed.
Research background & aims: This study examined possible therapeutic mechanisms of eye
movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989,
1995, 2001) in terms of exposure and information processing model. While exposure model
contended process of extinction and response habituation, Stickgold (2002) proposed that
sleep induced change in associative memory via activation of weak association during REM
state and EM functioned as REM sleep to integrate the episodic memory of trauma into
general semantic memory. In this study, the effect of EM compared to that of Exposure-Only
(non-EM) on process measures of SUDs, ratings of cockroach phobia across sessions, along
with outcome measures were examined. Specifically, the degree of return of fear and response
habituation was explored.
Methods: Thirty-six college students with cockroach phobias were recruited as participants
and invited after informed consent for 4 1-week interval treatment sessions and a 1 month
follow-up session. The instruments for outcome measures included Cockroach Phobia
Questionnaire, fear ratings of cockroach slides, FSS, STAI-S, BDI, short form of SCL-90, the
Revised Thought-Action Fusion Questionnaire, White Bear Suppression Inventory, and
cognitive tasks for measuring strength of associations. The SUDs, credibility and therapeutic
relationship rating, and physiological measures such as HR, HRV, EOG, served as process
measures. Due to space limitations, the results of cognitive task and physiological measures
were reported elsewhere. The participants were randomly assigned to one of the four groups:
EM condition (EM vs. Non-EM exposure only) × block order of cockroach theme
presentation (negative cognition first vs. positive cognition first). A 2 (EM condition) × 2
(order of valence presentation) × 9 (time: pre-assessment and post-assessment for each of the
4 sessions plus 1 month follow-up assessment) mixed factorial design was performed, with
time serving as within Ss factor and the other two variables serving as between Ss factors.
There were 20 trials in each therapeutic session. The duration of each trial was 30s for both
the EM and Exposure-Only conditions.
Results: After preliminary analyses for group differences on pretreatment variables, credibility-relationship ratings, and outcome variables were explored, the 2 (EM condition) ×
2 (order of valence presentation) × 9 (time) ANOVA on SUDs showed that the main effects of
time and EM were both significant (p < .001 and p < .034). Subsequently, two 2 (order of
valence presentation) × 9 (time) ANOVAs were performed for EM condition and
Exposure-Only condition, respectively. The results showed that for EM condition, only time
effect was significant (p < .006); while for Exposure-Only condition, there were a significant
time effect (p < .001) and an approaching significant valence presentation order effect (p
< .065), with the SUDs being higher in negative cognition presented first condition compared
to positive cognition presented first condition; whereas the effect was not significant for the
EM condition. Using trend analyses and inspection of time effect showed that significant
within session SUDs reduction for Exposure-Only conditions. Notwithstanding, the pairwise
comparisons for the 9 time points indicated salient phenomena of return of fear among several
of the 5 sessions for this condition when comparing the pre-assessment of each session with
post-assessment of its previous session. Whereas for EM condition the return of fear between
sessions was small and the trend analysis showed a reduction with linear trend.
Conclusions & Discussion: Compared to Exposure-Only, EM resulted in less degree of
sufferings while participants encountering negative theme which in turn might facilitate
further processing of negative memory. In addition, EM might add something beyond the
mechanism of pure exposure. The less return of fear indicating that information processing in
addition to response inhibition might take place between sessions. The results echoed
Shapiro’s Adaptive Information Processing model and Stickgold’s REM-sleep dependent
memory reprocessing model, suggesting that EM in EMDR might reflect a shift in associative
memory systems by activating different strength of associations of negative semantic nodes
for different semantically related words. Given that previous research showed that EM
decreased emotionality and also generate greater amount of associations for negative stimuli,
the implications of the present results from theoretical and therapeutic point of views and
future research possibilities are discussed.
Pseudoscience and questionable science are largely neglected problems in police and other law enforcement work. In this
primer, the authors delineate the key differences between science and pseudoscience, presenting 10 probabilistic indicators
or warning signs, such as lack of falsifiability, absence of safeguards against confirmation bias, and lack of self-correction,
that can help consumers of the police literature to distinguish scientific from pseudoscientific claims. Each of these warning
signs is illustrated with an example from law enforcement. By attending to the differences between scientific and
pseudoscientific assertions, police officers and other law enforcement officials can minimize their risk of errors and make
better real-world decisions.
Objective: Lifetime history of sexual abuse is estimated to range between 15% and 25% in the general female population. People
who are sexually abused are at greater risk for a whole host of physical health disorders that may occur many years after the abusive
incident(s). Despite the high prevalence of this trauma and its association with poor health status, abuse history often remains hidden
within the context of medical care. The aims of this review are to determine which specific health disorders have been associated
with sexual abuse in both women and men, to outline the types of sexual abuse associated with the worst health outcome, to discuss
some possible explanations and mediators of the abuse/health relationship, to discuss when and how to talk about abuse within a
clinical setting, and to present evidence for which psychological treatments have been shown to improve the mental health of
patients with past sexual abuse. Method: To meet these objectives, we have reviewed a wide literature on the topic of sexual abuse.
Results: We demonstrate that abuse appears to be related to greater likelihood of headache and gastrointestinal, gynecologic, and
panic-related symptoms; that the poor health effects associated with abuse are also seen in men; that abuse involving penetration
and multiple incidents appears to be the most harmful, and that exposure-type therapies with and without cognitive behavioral
therapy hold promise for those with abuse history. Conclusion: We need more research examining psychological treatments that
might be efficacious in treating the physical health problems associated with sexual abuse history.
Shame is often a key component of post-traumatic stress and one that can inhibit processing because the person concerned feels no compassion for the self that was shamed. Shame may lead to despising or hating that self so that allowing the self to grow, to recovered, feels almost impossible. Shame is experienced cognitively, emotionally, and somatically: in “brain, heart, and body.”
Shame may lead to blocked processing that does not respond to cognitive interweaves or other approaches such as changes in speed, modality and direction of bilateral stimulation, or “TICES’ strategies, changing aspects of images, cognitions or emotional and sensory interventions. Typically, Subjective Units of Distress scale scored stick at 4.
This paper will draw on clinical work with people who have experienced rape, torture and organized violence and explore ways of unlocking the inhibiting factors of shame, enabling the victim of personal violence to have compassion for themselves, and forgiveness. With compassion, a person can allow themself to recover, and processing the memories of the traumatic incident or incidents can move to adaptive resolution.
The paper will present case material using the adaptive information processing model as a helpful way of enabling clinets to normalize their mental, emotional and somatic reactions, to structure what often seems like a chaotic inner world and to address issues including shame.
This paper will propose a protocol for EMDR psychotherapy with people who have been victims of rape, torture, and organized violence and will introduce a “protocol interweave” for working with people for whom shame is a factor that impedes effective processing.
The “protocol interweave” focuses on the ‘self who has been shamed” and adapts the desensitization phase to enable the individual to process material associated with their thoughts, feelings, and sensations with regards to the self of whom they are ashamed and whom they may despise. The paper will also examine recent thinking about shame, compassion and forgiveness and reflect on similarities across psychotherapeutic modalities such as gestalt and cognitive behaviour therapy and the way in which EMDR is an integrative model that accommodates these.
The presentation will include PowerPoint and video clips of clinical consultations.
Allgemeine spirituellle Aspekte der Traumatherapie
Viktor Frankl entwickelte Ideen zu Psychotherapie und psychischer Gesundheit am
schrecklichsten Ort, den die Welt je sah: in einem Konzentrationslager der NS-Zeit. Seine
Schriften lesen sich gleidhwohl alles andere als schrecklich, todesnah oder morbide.
Vielmehr geht es um tiefe existentielle Fragen, die Frankl stellt und fur sich selbst voll
Glauben, ~i tmenschl ichdeiut nd spiritueller Einsicht beantwortet.
1st es ein Zufall, dass gelrade ein ~olocaust -~ber lebenddeer r Begrijnder der Logotherapie
ist, die die "Frage nach dem Sinn" (Frankl, 1985) zum obersten Gebot des "Sinn-voll
heilen" (1984) in der psychologischen Behandlung erhebt?
Ich denke nicht. Die Auseinandersetzung mit dem Trauma - dem eigenen wie dem anderer
- wirft vielmehr ganz voh selbst existentielle und spirituelle Fragen auf. Therapeuten wie
Patienten haben sich diesen zu stellen. Ich denke, von der Gute der Antwort auf die Frage
nach dem Sinn des schicksalhaften Leidens hangt die zukunftige Lebensqualitat eines
Traumatisierten ab.
Unsere therapeutische Aufgabe muss daher sein, gerneinsam mit dem Patienten eben diese
Fragen zu stellen und ihh auf der Suche nach einer befriedigenden Antwort zu begleiten.
Dabei nutzt es nichts, sith groOe Worte, wie sie in der Politik so leicht uber die Lippen
gehen, anzueignen, etwa von "innerem Frieden", von "Schuld und Suhne" bzw. von
"Unschuld" oder gar von "Vergebung" zu sprechen. Es zahlt nur das, was fuhlbar wird, was
als innere Erfahrung auf$teigt, was als "Eingebung", "Erleuchtung", "Gedankenblitz" oder
"innere Weisheit" aus delm Patienten selbst heraus entwickelt wird.
In der modernen Psychotherapieforschung werden diese therapeutischen Momente als
Therapieeinheiten mit bdsonders hoher Kongruenz (Grawe, 2005) beschrieben und damit
als anzustrebende Therapiegestaltung: "Je intensiver solche Erfahrungen der Kongruenz
sind, desto mehr wird sich sein [des Patienten] Inkongruenzniveau verringern mit all den
weit reichenden positiven Folgen, die sich aus den [...KIorrelationen zwischen
Verringerungen der Inko~ngruenzu nd klinischen Verbesserungen ergeben" (Grawe, 2005).
Hellinger (2003), verlangt als Abschluss seiner Familienaufstellungen stets das Erweisen
von Respekt, ja Versohnung und Vergebung - auch Eltern gegenuber, die ihr Kind
misshandelt, ignoriert, rrhissbraucht oder weggegeben haben.
Aus traumatheoretischer Sicht birgt dieses Vorgehen das Risiko einer erneuten
Traumatisierung. Ganz alnders, wenn derselbe Patient ganz von allein, aus seinem eigenen
Prozess heraus, zu einer Haltung der Vergebung finden kann: dann ist es mehr als eine
Genesung, ein wirkliches Ganz und Heil werden, ein groOer Schritt zu einern spirituellen
Bewusstsein.
Wie wir noch sehen werden, wird dieser Schritt durch EMDR haufig gefordert. Er Iasst sich
nicht erzwingen, aber ich durfte mehrfach Zeuge werden, wie er ganz von allein geschieht.
Zunachst aber kehren wir zu der Feststellung zuruck, dass die Auseinandersetzung mit den
spirituellen Seiten des Seins ihren festen Platz in der Traumatherapie hat.
Spiritual general aspects of trauma therapy Viktor Frankl developed ideas on psychotherapy and mental health in the most horrible place that the world has ever seen: in a concentration camp during the Nazi period. His papers read gleidhwohl anything but terrible, todesnah or morbid. The issue is deep existential questions that Frankl makes for himself and full of faith, i ~ nd tmenschl ichdeiut spiritual insight answered. 1st it a coincidence that Paddlewheel a ~ olocaust - ~ over lebenddeer r Begrijnder is of logotherapy, the "question of the meaning" (Frankl, 1985) the supreme command of the "cure sensible" (1984) in the psychological treatment does? I think not. Dealing with the trauma - their own as the others - quite the contrary voh throws himself on existential and spiritual questions. Therapists and patients have to face them. I think the best answer to the question of the meaning of the fatal disease depends the future Lebensqualitat from a traumatized. Our therapeutic task must be, therefore, like to make alone with the patient on this very issue and ihh to accompany the search for a satisfactory answer. It is no use sith Grooe words, as in politics go so easily over the lips, to appropriate to speak of such "inner peace", from "Crime and Suhner" or of "innocence" or even "forgiveness" . It pays only what is palpable, as the inner experience of what teigt $, which as "inspiration", "enlightenment", "mind flash" or "inner wisdom" is developed from delme patients themselves out. In modern psychotherapy research, these therapeutic moments as therapy sessions with bdsonders high congruence (Grawe, 2005) described and so as to be aimed at treatment planning: "The more such experiences of congruence, the greater will reduce his [the patient] Inkongruenzniveau far with all the reaching positive consequences arising from the [... KIorrelationen between reductions in Inko ngruenzu ~ nd clinical improvements result "(Grawe, 2005). Hellinger (2003), required as a conclusion of his family always lists the demonstration of respect, even reconciliation and forgiveness - to about parents who abused their child, ignored, have rrhissbraucht or given away. Trauma from a theoretical perspective this approach carries the risk of re-traumatization. All of ALND if the same patient come about solely from his own trial, may related to an attitude of forgiveness: it is more than a recovery, a true and full salvation to a einern groOer step spiritual awareness. As we shall see, this step by EMDR is often required. He Iasst force is not, but I could go back and witness how it happens all by itself. At first but we return back to the finding that the conflict is with the spiritual side of being a permanent place in trauma therapy.
The strategic developmental model (SDM) for EMDR originated in Canada in 1996. It is a model that was born out of desperation in the face of the overwhelming treatment needs of severe- and multiple trauma victims, forensic clients, and short-term funded high-risk individuals. It is an efficient and comprehensive method for maximally delivering the benefits of EMDR to high-needs clients before their therapy might be prematurely interrupted by the realities of funding or of a multiproblem life. Such a method, I felt, would need to effectively facilitate rapid engagement and address or circumvent the fear, hostility, anxiety, and resistance that so often undermine or sabotage therapy with high-need and high-risk populations. Clinical experience also suggested the importance of having some systematic manner of assessing and treating the often multiple fundamental underlying causes of pathology and symptomatology in order to assist these high-risk and high-need clients to break the cycles and patterns that likely would repeat in their lives. I hypothesized that any process or strategies that might facilitate healing in these ways could also be anticipated to optimize therapeutic outcome for high-functioning clients and diverse client populations. [Text, p. 8] [Pilots]
An efficient strategic model is described, one that systematically facilitates a developmental hypothesis about the symptoms or psychopathology of clients and which then efficiently implements EMDR with that developmental perspective or template. Four major features of the model are described including a strategic history-taking format which yields a “Developmental Baseline” from which a macro treatment plan can be formulated; strategic Ericksonian (hypnotic) language to mobilize client resources and bypass resistance; flexible targeting options; and therapeutic attunement. The four features of the Model are designed to facilitate developmental recapitulation and “catch-up,” and therapeutic attunement in particular may also potentiate right-brain repair leading to increased self-regulation. The model has application with challenging adult ad adolescent client populations, such as short-term funded, multiple trauma, high-risk, forensic addicted, and chronically ill, and also with high-functioning self-referred individuals and couples.
This article discusses a once-in-a-lifetime meeting of living legends in psychology and psychotherapy held on February 22-24, 2002. Included will be Drs. James F.T. Bugental, Albert Ellis, Alvin R. Mahler and Rachel Hare-Mustin. In addition to the "living legends," students will have the chance to hear from and talk with another esteemed cohort of "cutting edge" therapists and psychologists: Drs. Norman Ables (Geriatric Psychotherapy and Assessment), James Bray (Psychotherapy in Primary Care Settings), Gary DeNelsky (Tobacco Addiction), Hanna Levinson (Time-limited Dynamic Psychotherapy for Personality Disorders), Don David Lusterman (Divorce Mediation), Francine Shapiro (EMDR), and Jeffery Younggren (Risk Management).
Conjoint use of systemic family therapy and EMDR is examined.
A young adult in the "leaving home" phase of the family life cycle, affected by panic attacks and concomitant anxious/depressive disorder has been treated following the systemic approach , with family sessions and individual sessions including the use of EMDR at specific times.
The clinical case is taken as an example for theoretical and practical considerations and for the analysis of the possible integration of the two approaches. This analysis underlines the use of EMDR as a "stimulating factor" in different moments of the family therapy treatment.
EMDR helped to focus and elaborate a strong but undefined feeling of serious personal danger in the young identified patient and, on the other side, it helped to define clusters of cognitive conflicts which prevented the development of more adaptive behaviors.
Elements that suggest a careful and skillful use of EMDR are presented together with the corresponding need for minor modifications, if associated with family therapy.
The aspect of timing individual sessions with EMDR is also considered. The problem of how to interweave elements deriving from EMDR sessions and contents deriving from family sessions is discussed and useful hints about the integration are suggested.
[Author abstract]
Objectives: Dysesthetic vulvodynia plays an important role in the sexology of the most common female genital system disorders; its psychosomatic origin is by now widely acknowledged.
Its main symptoms are: acute pain at each penetration attempt (dyspareunia), pain under local pressure on the vaginal vestibule, erythemas of different intensities.
In recent years the role of childhood sexual abuse as one of the possible predisposing (vulnerability) factors of vulvodynia development has found positive confirmations in the literature. Author's aims are to verify this correlation and check efficacy of specific psychotherapeutical approaches.
Method: The choice of psychodiagnostic reactive tests, such as the Sexuality Questionnaire (symptomatology screening), the recent Female Sexual Disorders Analytical Questionnaire (screening and sexual abuse) and the Chronic Pain Risk Factors Questionnaire, assessing stressful and traumatic events such as sexual abuse, to identify vulvodynia is of particular importance.
The therapeutic approach presented here is integrated: gynecological, physical-rehabilitational, psycho-educational and psycho-sexological.
Results and conclusions; The psychological therapies recommended for the treatment of this disorder and the associated abuse (substantiated by international literature and years of clinical practice) are EMDR and hypnotic psychotherapy, integrated with sexological techniques, starting from the assumption that any eventual effective therapy of vulvodynia cannot but include appropriate (psychosomatic and not merely verbal) processing of the childhood sexual abuse.
Existing research into the after effects of
traumatic experiences with regard to children and adolescents
is scanty. Early intervention is intended to prevent or at least
reduce chronic manifestation of acute traumatic strain (Zehnder,
Hornung & Lanolt, 2006) since such strain has a negative
impact on the child's day-to-day quality of life and overall development, including the development and functioning of the
brain (Cohen, Perel, DeBellis, Friedman & Putnam, 2002).
Studies of multiple trauma among adults and adolescents have
shown that the severity of any impairment upon their psychological
health must be seen in relation to the number of traumatic experiences
that took place during childhood (Turner RJ, Lloyd DA
1995, Finkelhor D, Omrod RK, Turner HA 2007-1, Finkelhor D,
Omrod RK, Turner HA 2007-11, Holt MK. Finkelhor D, Kantor CK
2007). In this process, interpersonal traumatic experiences such
as accidents or severe illnesses can adversely affect development
as much as traumatic exposure connected to elements of crime.
Objectives: Interventions following acute traumatic strain will
be examined with regard to the symptoms and the mental
health of children and adolescents with multiple trauma experience
in the long term. The study will examine whether early
intervention has a positive effect on symptoms and whether
such effects are of a short or long-term nature.
The study should show whether gender specific and/or age
specific correlation can be identified in the development of
symptoms according to specific types of trauma, and whether
risk groups can be identified as a result.
The study will examine whether there exists an independent sub-group of children with multiple trauma under the age of 6,
whose symptoms correspond to a developmental trauma disorder
(van der Kolk 2005).
Methods: The study will be divided into a retrospective and
prospective part. The retrospective part will contain an examination of the treatment results of 150 children and adolescents
with multiple trauma experiences in the Vestische Children's
Clinic in Datteln between 2002 and 2009. This will be followed
by an evaluation of the treatment results by way of a newly
developed telephone catamnesis, based on validated questionnaires
(CRIES-13, ILK, Telekat) for measurement points TI-T3
Results: First results of the retrospective examination of children
and adolescents with multiple trauma experience will be presented
in comparison to the results of the evaluation of specific
therapeutic early interventions following acute strain among
children and adolescents with mono trauma experience.
Clients with complex and severe trauma histories require stabilization of
symptoms, and containment of affect before ever beginning EMDR. A wealth
of stabilization tools helps mitigate the impact of dysregulated affect and
physiology. The tools reduce risk of retraumatization, client loss of hope,
and abandonment of treatment. They also protect practitioners from
reenacting unprocessed client material, ethical and clinical error, and therapist
overwhelm. The presenters will identify risks and manifestations of client
affect dysregulation, bridging theory and practice, and equipping participants
with both a rich toolkit of specific tactics, as well as a decision process for
matching tool and circumstance.
This presentation will help clinicians recognize and address the confusing or inexplicable aspects of trauma as they follow standard EMDR protocol. Children who experienced complex trauma, adults who had childhood trauma and individuals who have had medical trauma may be at risk for confusion that interferes with executive functioning, learning and attachment. This workshop will present ways to address confusion through cognitive interweaves, developmentally appropriate explanations, cohesive narrative and specific targeting of physical sensations. The presentation will provide case studies accompanied by slides, videos, practicum and discussion.
For those clients who are suffering from Complex PTSD, especially those whose condition originates in childhood abuse or neglect,
dissociation is likely to be part of the presenting clinical picture. To the extent that dissociation is occurring, the healing power of EMDR
may be blocked, and more importantly, the use of the standard EMDR protocol may put the client at risk for a non-therapeutic dissociative
abreaction.
Como aplicar las 8 fases a distintas edades en
relación a:
• Informar que es EMDR y que sucede en el
cerebro
• Acceder a la Estimulación Bilateral como una
experiencia segura
• Maneras de armar y amplificar la función del
Lugar Seguro
• Introducir el I C E S (Imagen- Creencia –
Emoción – Sensación Corporal).y las Escalas
del SUD y VOC
• Reconocimiento y tolerancia de las emociones• Fase de desensibilización. Su diferencia con
los adultos.
• Como detectar y superar: ab-reacciones -
bloqueos – riesgo de disociación
• Modos de instalar y amplificar la creencia
positiva.
• Como hacer cierre de sesión en las distantes
edades y situaciones
• Importancia del Seguimiento o reevaluación
con la ayuda de los padres.
How to apply the 8 stages at different ages in
relation to:
• Report is EMDR and what happens in the
brain
• Access to a Bilateral Stimulation
safe experience
• Ways to set up and amplify the role of
Safe Place
• Enter the I C E S (Picture-Belief -
Emotion - Feeling Body). And Scales
of SUD and VOC
• Recognition and tolerance of emotions • Phase desensitization. The difference with
adults.
• How to identify and overcome: ab-reactions -
blocks - the risk of dissociation
• Ways to set up and amplify the belief
positive.
• How to logout in the distant
ages and situations
• Importance of monitoring or reassessment
with the help of parents.
En este trabajo se describe el tratamiento de la mujer víctima de 03.11 ataques terroristas que habían desarrollado un trastorno de estrés postraumático y depresión mayor. Técnicas de EMDR, la exposición en vivo, higiene del sueño y la planificación de tareas, se utilizaron entre otras técnicas terapéuticas. Hasta ahora, los objetivos terapéuticos han logrado los siguientes: disminución de volver a experimentar e hiper-activación, la restauración del estado de ánimo, afecta a la expresión de recuperación y una mejor concentración y memoria. Dado que el paciente tuvo que hacer frente a un factor estresante vida pre-existente relacionada con el trabajo, el tratamiento fue suspendido temporalmente y se reanudará a este problema ha sido resuelto. Las diferentes etapas del tratamiento también se describen. (Registro de bases de datos PsycINFO (c) 2008 APA, todos los derechos reservados)
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This paper describes the treatment of female victim of 3/11 terrorist attacks who had developed a PTSD and a major depression. EMDR techniques, in vivo exposure, sleep hygiene and task planning, were used among other therapeutic techniques. So far, the following therapeutic goals have been achieved: decreasing re-experiencing and hyper-activation, mood restoration, affect expression recovering and improved concentration and memory. Since the patient had to tackle a pre-existing job-related life stressor, treatment was temporarily suspended and it will be resumed as this issue has been worked out. The different stages of treatment are also described. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Complesso caratteristiche sintomatologiche del disturbo. Qui troviamo, mescolati tra loro, i sintomi
di ansia, panico, depressione, dissociazione, evasione, deterioramento della memoria. La Società per traumatica
Stress Studies (ISTSS) le linee guida suggeriscono alcuni passi: da un debriefing psicologico top
e la terapia cognitivo-comportamentale (CBT), seguita dal trattamento farmacologico e di alcuni altri
approcci: tecniche psico-sociale e riabilitativo, il movimento degli occhi desensibilizzazione e rielaborazione
(EMDR), ipnosi, psicoterapia di coppia e di gruppo, psychothery psicoanalitico. Nel
ultimi anni, molti dati dalla ricerca fornire consulenza per l'avvio forte CBT e farmacologiche
trattamento subito dopo il trauma (entro 72 ore) solo per gestire dissociazione peritraumatico, ad alto rischio
fattore per lo sviluppo di PTSD. Inoltre, quando si avvicina al trattamento del PTSD, è
importante prendere in considerazione altre comorbidità con asse I e II e con disturbi abuso di sostanze.
Complex symptomatological features of the disorder. Here we find, mixed up together, symptoms
of anxiety, panic, depression, dissociation, avoidance, memory impairment. The Society for Traumatic
Stress Studies (ISTSS) guidelines suggest some steps: on the top psychological debriefing
and cognitive-behavioral therapy (CBT), followed by pharmacological treatment and some other
approaches: psychosocial and rehabilitative tecniques, eye movement desensitization and reprocessing
(EMDR), hypnosis, couple and group psychotherapies, psychoanalitic psychothery. In the
last years, many data from the research give strong advice for starting CBT and pharmacological
treatment soon after trauma (within 72 hours) just to manage peritraumatic dissociation, high risk
factor for the development of PTSD. Moreover, when approaching to the treatment of PTSD, it’s
important to consider comorbidity with other axis I and II disorders and with substance abuse.
Because of their vulnerability children as well as adults
with developmental disorders are supposed to be at greater risk to suffer from the disruptive effects of trauma or cumulating
negative life events. Resulting psychopathology or behavioral
problems might bring them into contact with institutional psychiatric
or educational care.
On the basis of four video-illustrated clinical vignettes various aspects
according the use of EMDR are discussed.
Institutionalization in itself can be traumatizing as shown by
EMDR treatment of an adult with autism and traumatic memories
of being outplaced and long-term isolated.
Outplacement might be a consequence of untreated trauma. EMDR
can relieve suffering as shown by the treatment of a 12-year
old boy with behavioral problems who's family ties were broken.
Outplacement can be traumatic and as a consequence block
personal growth as illustrated by the case of a 48-year old man
with mild to moderate intellectual disability and autism, who
had been institutionalized at the age of 8.
Desperate parents regain educational skills by using a combination
of EMDR and intensive psychiatric family support as illustrated
by the case of an 8 years old girl with supposed multi-complex
developmental disorder (McDD).
Adaptations of the standard protocol might be necessary when
using EMDR in patients with psychiatric disorders as shown in
two of the cases that will be presented.
As posttraumatic stress symptoms can be manifested differently
in this population there is a risk of diagnostic errors.
Learning objectives: Participants take note of possibilities to
make EMDR beneficial to the institutionalized population; are
able to identify adaptations to the EMDR protocol required by
particular needs of clients with developmental disorders; are
able to use EMDR to help parents to overcome the trauma of
having a child with developmental disorders; become aware of
nonspecific symptoms of trauma in this special population.
Aim: People with ID might be particularly vulnerable to significant
life events and at high risk to develop Post Traumatic Stress Disorder.
In the general population EMDR (Eye Movement Desensitization and
Reprocessing) is an evidence-based trauma treatment method. On
small-scale EMDR is used in people with ID and seems to be efficacious
and not placing a load on clients. However research on PTSD
and EMDR in this population is missing so has to be done. Method:
Research on the relationship between life events en mental health
problems in people with ID is listed and analysed. The findings are
compared with the outcomes of single case studies on clients with ID,
treated with EMDR.
Results: Correlational and retrospective analyses
of case files consistently show an association between life events on
one hand and behaviour problems and depression on the other hand.
The only prospective study that is found indicates a causal relationship.
EMDR treatment effects also suggest a causal relationship
between mental health problems and being exposed to overwhelming
events. Conclusions: Further research is necessary to develop evidence
based assessment and treatment procedures for people with ID
who suffer from complaints due to traumatic experiences.
Traumatic stress and its impact on the individual, family and society have been described in the literature for over one hundred years. Controversy exists regarding etiology, determinants and therapeutic intervention for traumatic stress. There is limited research regarding the comparative value of treatment of trauma. In 1989 Eye Movement Desensitization and Reprocessing (EMDR) emerged as a therapeutic intervention for traumatic stress. Studies have shown the benefits of EMDR to be equal to or superior to those of other therapies in the treatment of PTSD. To date, the value of EMDR has been measured primarily by the decrease or amelioration of symptoms. Limited research has focused on the client's experience of EMDR and life changes after EMDR. The specific aim of this study was to: (a) generate a description of the personal experience of the EMDR process, (b) identify whether life changes had occurred after EMDR, and (c) if any life changes had occurred describe the changes and the nature of these changes.Data were collected via unstructured interviews with seven individuals who had experienced some form of trauma, and who had experienced EMDR as a therapeutic intervention for trauma. Van Manen's and Heidegger's interpretive processes were used to guide the method of data analysis. The shared meanings identified were: (a) Set-up for Harm, (b) Being Stuck, (c) Willing to Risk in Spite of..., (d) Release, (e) Movement and (f) Ongoing Movement. The participants all described childhood events of being put in harm's way. As adults participants felt frustrated with their inability to change personal and relational alienation which resulted from the childhood events. However, in spite of incredulity and fears, risking the experience of EMDR was primarily dependent on trust in the therapist. All experienced emotional, cognitive and physical release in response to the EMDR experience which allowed participants to move forward with their lives. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 61(1-B), Jul 2000, pp. 549.
Trauma treatment after sexual abuse for people with developmental disabilities People with disabilities have an increased vulnerability to experience violence and abuse. Also they have more negative experiences in general and are more often treated in an unpleasant manner. They are therefore at greater risk to develop trauma. Beside that they have fewer capacities to cope with traumatic experiences in a healthy way. For a long time it was thought that people with developmental disabilities couldn’t profit from psychotherapy. Still people with developmental disabilities are being told that they can’t get treatment. In this workshop we will show that psychotherapy is very well possible for people with developmental disabilities and we will show how adjustments can be made to the regular approach to meet the special needs of these people. We will explain that to meet these needs a broader scope is necessary which include therapeutic interventions towards key persons and organizations in their lives. We will introduce two women with mental disabilities who both have been sexually abused. We will tell about the therapy in which we used this broader approach (involving parents, group counselor, church) combined with EMDR, solution focused therapy methods, cognitive behavioral techniques and creative techniques.
Learning Outcomes Participants will know that trauma treatment is possible for people with developmental disabilities. Participants will know adjustments can be made to the regular approach to meet the special needs of people with developmental disabilities. Participants will know how to involve key persons from the network of the developmentally disabled client in order to make trauma treatment work well.
Incidence of heart disease: 43 % of all death cases are
caused by heart disease. In total this means 32,294 persons a
year in Austria.
Stationary treatment receiving 314,010 patients, with an average
term of hospitalization of 8 days (Statistics Austria 2008). For Germany the total figures are around 10 times higher. This
is the largest single patient group.
11.25% of the heart disease patients get PTSD, adjustment
disorder or other reactions to severe stress (Titscher. 2008).
Only for Austria a minimum of 35.000 patients could benefit
from a trauma treatment like EMDR. For Germany the
figure rises up to 350,000 patients a year who could benefit
from EMDR. To physicians the problem is well known, but
the only treatment they can offer is medication or further diagnostics
like angiography which doesn't cure the problem.
Despite the high number of traumatized heart patients, there are
only publications about trauma as a risk factor for heart disease.
There are a few publications about heart disease causing trauma,
but there are nearly no publications about treating trauma
caused by heart disease.
Typical symptoms for trauma after heart attack: Feeling of
tightness or pressure on the chest, tightness in the throat, with
difficulties in breathing. Ascending feeling of heat from the
stomach, trembling, weeping, fear and panic. Flashbacks of the
heart attack, with symptoms looking similar to angina pectoris.
Reduced stress tolerance by getting easily angry or depressed.
Useful questions for differential diagnostics between organic
and mental symptoms: What are the symptoms? How long do
they last? Were there any symptoms prior to the heart disease?
Which symptoms were present during the heart attack? Is it
distressing to remember the heart attack? How distressing on a
SUD-scale 0 to 10.
What are the medical findings? Two specifics:
1. Mainly I use the butterfly hug or tapping on the chest for
processing. This form of tapping is easy applicable and the patients
like it.
2. Weaving in Positive Cognitions (PCs) during the processing,
makes the processing less stressful, I offer PCs during the
processing and look if they help to reduce the stress.
Useful PCs: I survived. I am still alive. I am through. It is a long
time ago. i have trust in my body and my heart. If that doesn't
work: Even when my trust in my heart is shattered, I love and accept
myself. I am grateful. I live as long as I may I am confident.
Usually I use them in that succession with some adoptions according
to the process.
What is special about my presentation.
1. Hear about a large group of patients who can benefit from
EMDR.
2. Mostly heart disease are to consider as mono-traumatic. With
some specific knowledge and experience they are not difficult
to treat.
3. Notice the advantage of bipolar tapping on the chest.
4. Understand the advantage of weaving in PCs during the
processing.
5. The big question is: How to install EMDR in the rehabilitation
system?
In questo articolo descriveremo tre interazioni tra trauma, disturbo da stress post-traumatico (PTSD) e psicosi: 1. molti pazienti con disturbi psicotici hanno subito esperienze di vita traumatiche che giocano un ruolo fondamentale nell’insorgenza e nel dar forma al contenuto della loro psicosi; 2. sia l’esperienza psicotica sia il suo trattamento psichiatrico possono causare la sintomatologia da stress post-traumatico; 3. nel caso in cui la psicosi ricorra assieme ad un PTSD, vi è un rischio sostanziale che i due quadri clinici si rinforzino reciprocamente in maniera negativa, oltre a un potenziale protrarsi della traumatizzazione. Sebbene queste interazioni siano clinicamente molto rilevanti, raramente vengono tenute in considerazione durante la pratica clinica di routine. Le tre interazioni verranno illustrate attraverso un caso singolo e una descrizione di un trattamento con EMDR. In conclusione raccomandiamo di prestare attenzione, durante la pratica clinica di routine, alla traumatizzazione e a una co-diagnosi di un PTSD nei casi che presentano un disturbo piscotico, oltre che offrire un trattamento a questi pazienti.
In this article we describe three interactions between trauma, post-traumatic stress disorder (PTSD) and psychosis: 1. many patients with psychotic disorders suffered from traumatic life experiences that play an important role in the onset and content of their psychosis; 2. the experience of psychosis as well as its psychiatric treatment may result in post-traumatic stress symptoms; 3. if psychosis and PTSD occur simultaneously, there is a substantial risk for reciprocal negative reinforcement of both symptom groups as well as for potentially ongoing traumatization. Although these interactions are highly relevant from a clinical perspective, they usually remain unattended in routine care. The three interactions will be illustrated by a case history as well as an impression of the psychological treatment including EMDR. We recommend to pay attention to traumatization and comorbid PTSD in routine care for people with psychosis, as well as to offer them treatment.
The associations between trauma and psychosis are diverse and complex. The majority of people suffering from psychosis have been traumatized as a child and trauma appears to be an important causal factor in becoming psychotic later in life. About 35 percent of the people with psychosis suffer from a comorbid Post Traumatic Stress Disorder (PTSD). The psychotic experience itself and the sometimes horrific experiences in psychiatric treatment (e.g., solitary confinement) are traumatizing experiences for many patients. The presence of a comorbid PTSD leads to negative vicious cycles in which the patient can become stuck if effective treatment is not provided. Despite all this, comorbid PTSD is rarely diagnosed, and if so, application of EBP is not common practice.
Learning objectives:
During this workshop these different interactions between trauma, psychosis and PTSD will shortly be discussed. Evidence from research and practice showing that trauma in psychosis can be treated effectively and safely, will be presented. Further, the workshop will focus on the practical application of EMDR within a general cognitive behavioural treatment plan for psychosis. Moreover, the following questions will be addressed. How is trauma history conceptualized within a case formulation? When can EMDR be used? And how can this be done? General problems one may encounter when using EMDR in patients with psychosis will be discussed.
Recommended reading before the workshop:
•W. Larkin and A. Morrison (eds.) Trauma and Psychosis: New directions for theory and therapy. 2006 London: Brunner-Routledge.
After this workshop attendees will be aware of the great importance of assessing the life histories of patients with psychosis, how to incorporate this in a case formulation and how to use EMDR with these patients.
Participants will learn: 1) to understand and define the term "trauma-based diagonsis;" 2) to detail the differences between trauma-based diagnoses and DSM-IV diagnoses; 3) to detail trauma characteristics that affect treatment length in EMDR; 4) to indicate which trauma characteristics exert a major effect on treatment length in EMDR; 5) to indicate which trauma characteristics exert a minor effect on EMDR treatment length; and 6) to understand risk factors in PTSD and how these factors relate to treatment paramaters in EMDR.
A high proportion of patients in child and adolescent psychiatry with significant dissociative symptomatology after early childhood traumatization may go undiagnosed, be wrongly diagnosed and/or inappropriately treated. The diagnostics and treatment of dissociative disorders have been limited by lack of comprehensive, reliable and valid instruments and the ongoing polarization and fierce controversy regarding treatment. However, recent neurobiological findings of neurochemical, functional and structural cerebral consequences of early stressful childhood experiences point out a need for active, early and effective identification and treatment interventions. We present an update on assessment tools available in the Nordic countries, and an overview of different appropriate therapeutic intervention models for children and adolescents. A systematic overview of studies of dissociation in children and adolescent published over the last decade disclosed a total of 1019 references. The 465 papers describing aspects of assessment tools and/or treatment were studied in detail. Reliable and valid screening questionnaires and diagnostic interviews for children and adolescents now allow for effective early identification of dissociative disorders. A combination of individual psychotherapy, pharmacotherapy and family therapy are often required to handle dissociative disorders in children and adolescents. Cognitive-behavioural therapy, hypnotherapy, Eye-Movement Desensitization-Reprocessing (EMDR), psychodynamic therapy and an integrated approach are the main described psychotherapeutic approaches, but treatment of dissociation in children and adolescent does not require allegiance to any one particular treatment model. However, achievement of physical safety by providing a safe environment is a primary goal that supersedes any other therapeutic work. Assessments tools are now available, and appropriate therapeutic intervention models may hopefully contribute to reduce the risk of wrong diagnoses and inappropriate treatment of dissociative symptomatology in children and adolescents. However, controlled clinical trials of the various interventions and longitudinal outcome studies are needed.
Where children have suffered traumatic experience, parents may also have been affected by the same event and
may themselves suffer significant post traumatic symptoms. Parents affected in this way are often unable to
attend as well as they would like to the needs of their children, to respond appropriately, or to provide optimal
support for their children. It is well known that parental mental ill-health – especially maternal mental health
problems - is a risk factor for mental health problems and the development and perpetuation of PTSDs in
children. Our clinic has seen many children with parents who have been affected in this way. This paper
describes a brief EMDR intervention developed by our team for providing help to these traumatized parents. It
is shows how a brief intervention of this kind can be useful in bringing rapid relief to parents suffering from PTSs
and how the resulting improvement in attunement and responsiveness to the child is associated with
improvements in the child’s functioning.
Since September 2006, more than 725 service members from the global war on terrorism have survived combat-related traumatic amputations that often result in phantom limb pain (PLP) syndrome. Combat amputees are also at high risk of developing chronic mental health conditions such as posttraumatic stress disorder (PTSD) and clinical depression as they deal with wartime experiences, rehabilitation, and postrehabilitation adjustments. One active-duty patient was referred to a military outpatient clinic for treatment of PLP and PTSD following a traumatic leg amputation from a noncombat-related motor vehicle accident. Four sessions of eye movement desensitization and reprocessing (EMDR) led to elimination of PLP and a significant reduction in PTSD, depression, and phantom limb tingling sensations. A detailed account of this treatment, as well as a review of the benefits of EMDR research and treatment in the military, is provided. The results are promising but in need of further research.
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.
This study examined the effects of EMDR (Shapiro, 2002) and DeTUR (Popky, 2005) on three sexual offenders' risk to re-offend. Participants were given pretests and treatment outcomes were measured post treatment and 90 days thereafter using the IES-R (Weiss & Marmar, 1997), the TSI (Briere, 1995), the SOI (Kafka, 1997), the ACUTE 2007 (Hanson, Harris, Scott, & Helmus, 2007), and the Monarch 21 PPG Assessment (Byrne, 2006). The Reliable Change Index (RCI; Jacobson, Follette, & Revenstorf, 1984; as cited by Wise, 2004) was used to measure reliable differences. The results suggest there was no significant change in the level of trauma symptoms; however there was significant change in deviant arousal which lowered the risk level of two offenders. One offender experienced an increase in his risk level due to an increase in trauma symptoms. [Author abstract]
A disproportionate fear of vomiting, or emetophobia,
is a chronic and disabling condition
which is characterized by a tendency to avoid a
wide array of situations or activities that might
increase the risk of vomiting. Unlike many
other subtypes of specific phobia, emetophobia
is fairly difficult to treat. In fact, there are only
a few published cases in the literature. This
paper presents a case of a 46-year old woman
with emetophobia in which a trauma-focused
treatment approach was applied; that is, an
approach particularly aimed at processing disturbing
memories of a series of events which
were considered to be causal in the etiology of
her condition. Four therapy sessions of Eye
Movement Desensitization and Reprocessing
(EMDR) produced a lasting decrease in symptomatology.
A 3-year follow up showed no indication
of relapse.
Through case material, the usefullness of EMDR is illustrated for the treatment of children's fears and phobias. The issue of
integrating EMDR treatment with more traditional treatment is also addressed, especially with more complex contextual problems.
Three case histories are presented with emphasis on the most complicated case. Family therapy treatment espouses the notion that
psychopathology in the child results from dysfunctional family functioning, and as such the entire family system has to be treated.
This concept is broadened with the use of EMDR.
The first case illustrates a single trauma event in which a 6 year old boy was bitten by a rottweiler. Presenting symptoms were
nightmares, fear of sleeping alone, poor school performance, persistent thoughts and fear of dogs. The first session of EMDR was
successful in eliminating most of these fears. A second EMDR session focusing on a nightmare was also successful. Two follow
up sessions with the family dealt with other parenting issues and the possibility of attention deficit disorder. The targeted problem
was eliminated via EMDR.
The second case demonstrates a successful one session treatment of an otherwise healthy 6 year old girl who had fears of the dark
and had slept in her parent's bed for years.
In the third case, a complex symptomatology is presented of a nine year old girl (Lily) with a severe, life threatening heart condition
for which she has undergone 4 delicate aortal surgeries since age 2 and is on a medication maintenance regimen. Future surgery is
anticipated during adolescence. Family history is significant for mother's struggle to overcome alcohol addiction, depression and
past abuse. The family has financial pressures. Family system analysis reveals over involvement between mother and daughter,
peripheral father and sibling rivalry (daughter 11). Family treatment involved boundary and limit setting, hierarchical restructuring
and family communication skills. The illness as an organizing factor in the family system was repeatedly addressed.
Interspersed with this treatment approach were EMDR sessions for daughters and mother. Lily had fears of separation fiom mother,
fears of dying, choking, becoming ill, swimming, going to bed, and fears of the devil (as learned in their fundamentalist religion) as
well as several other fears. EMDR sessions targeted these fears, and sometimes several fears were intertwined, such as fear of
sleeping, the devil coming into her room and taking her away to die. Cognitive interweave was used when she appeared stuck.
Through the EMDR treatments, Lily was able to deeply examine her fears, based on the real life uncertainties she faced. Her
progress demonstrated a particularly poignant attempt to make sense of the meaning of life and cope with the threat of death.
There is evidence to suggest that people with developmental disabilities are at greater risk to suffer from the disruptive effects of traumatic events. However, parents, teachers, caregivers and even clinicians who offer specialized outpatient treatments often lack awareness of this. In general, emotional and behavioural problems are attributed to other diagnosed disorders such as genetic syndromes, cognitive impairments, ADHD or autism. Taking history with regard to behavioural changes following overwhelming events appears not to be a common practice at all. Moreover, the expression of trauma symptoms as well as the interpretation of distressing experiences often differs in comparison with the general population. Furthermore, because of their limited communication skills, common treatment methods are not appropriate. As a result, this patient category seldom receives treatment for exposure to disturbing events, including apparent symptoms of PTSD.
Preliminary research findings illustrate that EMDR, because of its strongly non-verbal character, seems to be an applicable, effective and efficient treatment method for this patient category. But how far can we go? During this workshop these findings will be presented, illustrated by many video clips of treatments of patients carried out in a centre for child and adolescent psychiatry and an outpatient treatment of adults with mental health problems. Special attention is given to creative adaptations of the EMDR protocol and the cooperation with parents, who are often traumatized themselves and have to be treated as well, either to make them able to function as a co-therapist or to strengthen their skills in educating a child with special needs.
Learning objectives:
After this workshop attendees will be aware of the specific expression of PTSD symptoms in people with various serious developmental disabilities and the various possibilities of EMDR treatment in this population.
In contrast with the learning model which proposes a strategy of gradual exposure to the
44 feared stimuli, the primary goal in EMDR is the processing of traumatic memories which are thought to be impaired. One advantage of EMDR above an exposure approach involves client comfort. Prolonged real-life exposure to anxiety provoking stimuli or thought is not always easy to pursue. Consequently, clients are not always ready or motivated enough to
endure such a procedure; a procedure which also holds a potential risk of drop out before
treatment can often not be successfully concluded. Another possible advantage of EMDR
relates to the costs of treatment. For example, it may be more useful to apply EMDR than
exposure in vivo treat flying phobia for which in many cases, as part of their in vivo
treatment, clients have to take costly flights. The most important advantage seems to be the possibility of utilising EMDR for situations
where the critical triggers cannot be reproduced or simulated in real life (e.g., certain sexual,
illness or death situations) or, more generally, for which phobic stimuli are hard to obtain.
This workshop focuses on the clinical application of EMDR with specific phobias.
Participants will learn when and how to apply EMDR with phobias and integrate this into a
general (cognitive-behavioural) treatment approach. This approach is illustrated by several
video taped treatments.
It is generally accepted that pain, particularly chronic pain, involves
psychological factors, whether as a reaction to pain (Fordyce 1975; Turk
& Meichenbaum, 1989) or as a predisposing factor for pain (Engel,
1959, Goodwin & Attias, 1999). Different theoretical approaches emphasize
the role of psychological factors differently. For example, Cognitive-
behavioral approaches emphasize people’s reactions [to injury and
pain] as a factor in causing and maintaining pain. One of the main theoretical
constructs of CBT is secondary gain which is based on operant
conditioning and posits that pain can be maintained by ‘rewards’ such as
too much attention or sympathy. Psychodynamic approaches place
more emphasis on pre-existing trauma and emotional states as a causal
factor for chronic pain (Engel, 1959, Goodwin & Attias, 1999). One of
the main psychodynamic theories of pain is .. which posits that pain is ..
There is evidence to suggest that there is some truth to both approaches.
However, the research regarding behavioral theories of
chronic pain has often produced mixed results (..) and been found to
have many problems (King..). However, there is reliable data to suggest
that trauma and emotional processes associated with trauma are often
associated with chronic pain.
One of the most intriguing aspects of traumatic stress has been the repeated learning and forgetting of lessons about its importance as a cause of psychopathology. It remains the case that the broader body of psychiatry and psychology has an ambivalent relationship with the field of traumatic stress and the nature of posttraumatic stress disorder. The origins of this ambivalence and their impact will be discussed. It is important that practitioners in the field of traumatic stress be aware of these barriers and how to address them in a research setting and clinical practice.
The underlying phenomenology of posttraumatic stress disorder will be explored and its neurobiological origins will be highlighted. It is important to deconstruct posttraumatic stress disorder into the different symptom components, as they have substantially different mechanisms underpinning their intensity and presentation. Posttraumatic stress disorder is a dynamic condition in which symptoms fluctuate with time and are substantially influenced by the environmental demands placed upon the individual.
It is often forgotten that somatic symptoms are a core element of the experience of individuals with PTSD. The nature of these somatic dimensions of distress and their significance will be discussed.
The epidemiology of posttraumatic stress disorder highlights how the prevalence of these conditions is seemingly increasing. However, this reflects the developments in the measurement of the effects of trauma in research settings. This has major implications for clinicians as to how best take a history about exposures to traumatic events. The evidence is that systematic investigation is critical and that unless questions are asked, symptoms will frequently go unreported. Recent evidence suggests that PTSD may be in fact more common than major depressive disorders. Equally, it should not be forgotten that depression is an important dimension of posttraumatic reactions. There is also an associated comorbidity with substance abuse. The risks associated with trauma exposure have a long tale of effect and these will be described.
The challenges of treatment will be discussed in the context of early intervention and workplace intervention. Treatment needs to be a sequential process where there are a variety of strategies, including EMDR, which can be used in treatment. The sequence of these strategies in treatment is a challenging question that has not been systematically addressed in research.
It remains the case that one of the primary issues in treatment is early identification, and this raises questions about the importance of screening in at-risk populations. Again, there are significant differences in opinion; however, the militaries around the world are now regularly screening populations returning from deployment. A recent novel approach to considering the issues of treatment is whether a staging approach should be used for conditions such as PTSD.
In summary, it is critical that clinicians have an explicit model of the mind and its neurobiology. Posttraumatic stress disorder can best be understood as an information processing disorder, which both impacts upon an individual's ability to engage with their day to day environment as well as integrate past experiences as a source of information to influence current behaviour. The integration and modulation of neural systems that manage environmental input is critical to adaptive functioning. The ways that these systems become dysregulated in PTSD will be highlighted and how these underlying deficits can be addressed in treatment will be focused upon.
A further issue that needs to be considered in the treatment of PTSD is the long-term risk of individuals, who have developed this condition, to have relapses after a successful intervention. Some long-term treatment outcome data will be presented.
After the events of September 11, 2001, and at a time in world history when refugees and displaced persons are moving about the world in numbers that are unprecedented (United States Committee for Refugees, 2001), the likelihood of counselors encountering refugees is increased regardless of their treatment settings, from schools to government agencies. Civilians are increasingly at risk for being victimized by organized political violence (Porter & Haslam, 2001), and the United States alone hosts almost half a million refugees (United States Committee for Refugees, 2001). In the article "Refugee Survivors of Torture: Trauma and Treatment," Gorman (2001) illustrated dynamics that may go unrecognized by clinicians who work with these complex individuals and families, and he provided a holistic conceptualization of these dynamics.
The workshop provides novel concepts regarding the nature of Acute Stress Syndromes following research in Israel. The use of a single session, modified protocol for EMDR in ASS is described, following terror attacks, motor vehicle accidents, and the war with Lebanon. The following themes will be covered in the workshop.
Part one: Novel approaches to Acute Stress Syndromes – Redefining the time axis of SS; the diagnosis of Immediate; Acute Stress Reaction (ASR) and Prediction of Risk Vulnerability: A novel assessment tool; a review of Acute Post Traumatic Stress Syndromes and how they differ from chronic PTSD; the characteristics of intrusive phenomena in ASS; and a phase oriented intervention model for ASS.
Part Two: EMDR in ASS – A brief review regarding the nature of EMDR and PTSD; the modified brief EMDR Protocol; the use of a single session EMDR in ASS – in a GH practice, during terror attacks and following war situations; clinical demonstrations of a single session EMDR in ASS patients (video movies); indications, advantages and precautions using the single session EMDR intervention; and possible psycho-physiological mechanisms.
Trauma experienced within the earliest attachment relationships leave children and adults at great risk for the development of psychiatric disorders. Maltreatment by attachment figures and traumatic losses are both closely associated with attachment disorganization, the attachment category identified in 70% of patients in psychiatric hospitals. Research shows insecure and disorganized attachments to be transmitted transgenerationally at a rate of between 70 and 80%.Adults and children with disturbed attachments frequently experience severe emotional dysregulation along with intense feelings of despair, anxiety, shame, and mistrust of others. Affected children and adults frequently lack helpful or adaptive information or insights and exhibit behaviors that elicit negative responses from those around them. Due to heavy defenses and poor self-regulation and self-awareness, patients suffering from attachment trauma are traditionally difficult to treat. However, with proper adaptations, the EMDR approach becomes a powerful method for healing attachment injuries in adults, children, and parent-child dyads. Participants will learn creative methods of adapting EMDR for the special challenges that accompany attachment injury. Participants will learn to utilize attachment resource development techniques designed to strengthen the capacity for closeness, trust, and self-compassion. They will discover how to coach an attachment figure to provide emotional regulation and help with cognitive interweaves. Participants will be able to write a therapeutic story to help process pre-verbal trauma and develop adaptive information for successful reprocessing. Creative interweaves, contained reprocessing, and methods for weaving together of past, present, and future will help participants experience successful EMDR with their most challenging cases. Case studies, video, and EMDR/attachment research will be presented.
Background: Trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for posttraumatic stress disorder. However, little is known about their neurobiological effects. The usefulness of neurobiological measures to predict the treatment outcome of psychotherapy also has yet to be determined. Methods: Systematic review of randomized controlled trials (RCTs) focused on neurobiological treatment effects of TF-CBT or EMDR and trials with neurobiological measures as predictors of treatment response. Results: We included 23 publications reporting on 16 separate trials. TF-CBT was compared with a waitlist in most trials. TF-CBT was associated with a decrease in heart rate and blood pressure and changes in activity but not in volume of frontal brain structures and the amygdala. Neurobiological changes correlated with changes in symptom severity. EMDR was only tested against other active treatments in included trials. We did not find a difference in neurobiological treatment effects between EMDR and other treatments. Publications on neurobiological predictors of treatment response showed ambiguous results. Conclusion: TF-CBT was associated with a reduction of physiological reactivity. There is some preliminary evidence that TF-CBT influences brain regions involved in fear conditioning, extinction learning and possibly working memory and attention regulation; however, these effects could be nonspecific psychotherapeutic effects. Future trials should use paradigms aimed specifically at these brain regions and physiological reactivity. There are concerns regarding the risk of bias in some of the RCTs, indicating that methodologically more rigorous trials are required. Trials with neurobiological measures as predictors of treatment outcome render insufficient results to be useful in clinical practice.
Copyright © 2013 S. Karger AG, Basel.
Problématique : L’outil thérapeutique EMDR est recommandé par l’HAS dans la prise en charge du psycho-traumatisme. Mais comment le mettre en place en pratique dans nos unités d’urgence psychiatrique ?
Méthode : La structuration suit les 8 phases du protocole validé, dont la « préparation » où l’on détermine l’indication et les cibles à traiter , une phase « ressources » indispensable dans les traumatismes complexes et en cas de risque de déstabilisation. Enfin, la phase de « désensibilisation des cognitions inadaptées et « d’installation » des cognitions plus adaptées amenant à une restructuration cognitive.
Résultats : 83 patients (sex ratio=0.76) ont mobilisé 330 interventions, soit 3.9 interventions/patient en moyenne. Ces PEC ont conduit à 6% de séances complètes de désensibilisation à l’impact de souvenir traumatique, 10% de séances incomplètes de désensibilisation, 13% d’arrêts précoces en raison d’une déstabilisation persistante ce qui est la Contre-Indication fonctionnelle principale . Dans le cas des traumatismes récents, l’efficience de l’EMDR a été confirmée avec un nombre moyen de 3 séances de 90 min par patient, permettant d’obtenir une désensibilisation complète. Dans les cas de traumatismes complexes, le nombre de séances de préparation est plus important (>5 séances) car ils nécessitent une recherche de ressources.
Discussion : L’EMDR est un outil utilisable aux urgences psychiatriques qui peut être très efficace dans le cas de traumatismes récents et simples. Le protocole est structurant et permet ainsi une bonne implication des patients et des intervenants. Mais cela nécessite une formation exigeante et couteuse. L’organisation est plus difficile dans le cas des traumatismes complexes, anciens, avec comorbidités psychiatriques. L’espacement des séances de 10j est difficile à respecter en pratique hospitalière, elles sont chronophages et fatigantes, aussi bien pour le soigné que le soignant. Projet : à la suite de cette observation, démontrer en 2013 que cette approche pourrait réduire la durée d’hospitalisation et la fréquence des récidives dans les cas de troubles de la personnalité souvent associés à des traumatismes anciens en permettant en quelque sorte d’activer une restructuration cognitive.
Problem: The EMDR therapeutic tool is recommended by the HAS in the management of psychological trauma. But how to set up in practice in our emergency psychiatric units? Method: The structure follows the eight phases of the validated protocol, the "preparation" where we determine the indication and the target process, a phase "resources" essential in complex trauma and in case of risk of destabilization. Finally, the phase of "desensitization inadequate cognitions and" installation "cognitions leading to a more appropriate cognitive restructuring. Results: 83 patients (sex ratio = 0.76) mobilized 330 interventions, or 3.9 interventions / patient on average. These PEC led to 6% of full sessions of desensitization to the impact of traumatic memories, 10% incomplete desensitization sessions, 13% of stops early due to a persistent destabilization which is the main functional Counter Indication . In the case of recent trauma, EMDR efficiency was confirmed with an average of 3 sessions of 90 minutes per patient to obtain a complete desensitization. In cases of complex trauma, the number of preparation sessions is larger (> 5 sessions) because they require research resources. Discussion: EMDR is a useful tool for psychiatric emergencies that can be very effective in the case of recent trauma and simple. The protocol allows structuring and good involvement of patients and stakeholders. But it requires a demanding and costly. The organization is more difficult in the case of complex trauma, elders with psychiatric comorbidities. The spacing of sessions 10j is difficult to achieve in hospital practice, they are time consuming and tiring for both the cared caregiver. Project as a result of this observation, in 2013 demonstrate that this approach could reduce the duration of hospitalization and the frequency of relapses in cases of personality disorders often associated with trauma Oldest to somehow activate a cognitive restructuring.
EMDR kan een waardevolle bijdrage leveren aan de vaak moeizame behandeling van cliënten met een eetstoornis. Het behandelplan is bij voorkeur opgezet vanuit een cognitief leertheoretisch kader, gebaseerd op het model van Fairburn (2003), omdat dit het best en meest onderzochte verklaringsmodel is voor in stand blijven van de eetstoornis (Beer & Tobias, 2011). Ook bij behandelingen op basis van andere verklaringsmodellen kan EMDR worden ingezet.
Negatieve lichaamsbeleving is een van de meest hardnekkige aspecten van een eetstoornis. Het is de belangrijkste in standhoudende en de moeilijkst te beïnvloeden factor. Als de lichaamsbeleving nog steeds negatief is bij afsluiting van de behandeling, dan is dit een significante voorspeller voor terugval (Jansen e.a., 2006). Welke rol kan EMDR hier spelen?
Deelnemers van de SIG EMDR en eetstoornissen presenteren ideeën, hypothesen en eerste bevindingen m.b.t. de toepassing van EMDR op een negatieve lichaamsbeleving bij cliënten met een eetstoornis:
- opties voor targetselectie (protocol aanscherping)
- eerste resultaten van een pilot t.a.v. toepassing van EMDR bij cliënten met een eetstoornis en de effecten daarvan op negatieve lichaamsbeleving (voor- en nametingen)
- de veronderstelde relatie tussen lichaamsbeleving en zelfbeeld; wat kunnen zeggen over de effecten op het zelfbeeld?
De presentatie zal worden geïllustreerd met beeldmateriaal. Revolutionaire benadering? Of helemaal niet?
EMDR can be a valuable contribution to the often laborious treatment of clients with eating disorders. The treatment is preferably designed from a cognitive learning theory framework, based on the model of Fairburn (2003), because this is the best and most researched explanatory model for perpetuation of the eating disorder (Beer & Tobias, 2011). Even with treatments based on different explanatory models can be used EMDR.
Negative body image is one of the most intractable aspects of eating disorders. It is the most important in sustaining and the hardest to influence factor. If the body perception is still negative at the end of treatment, then this is a significant predictor of relapse (Jansen et al, 2006). What role can EMDR play here?
Participants of the SIG EMDR and eating disorders presenting ideas, hypotheses and initial findings regarding the application of EMDR to a negative body image in clients with eating disorders:
- options for target selection (protocol tightening)
- first results of a pilot concerning application of EMDR with clients with eating disorders and their effects on negative body image (for-and post)
- the supposed relationship between body image and self-esteem, what can be said about the effects on body image?
The presentation will be illustrated with images. Revolutionary approach? Or not at all?
Severe behavioural problems in children (and adults) are always inextricably linked with problems of affect regulation, the most problematic of which is out of control expression of angry feelings. Such behaviour is often seen as organically based, ADHD or ODD (i personally refer ADD: Absent Dad Disorder), and pharmacological treatments are often suggested, yet early or more recent trauma is frequently a factor and EMDR has a potentially important role to play in helping these children, through enabling old truama to be processed and helping them manage their behaviour on a day to day basis without resorting to the self medicating aspects of violence. I describe work in two school settings, an EBD Primary School and a Catholic Secondary School, using EMDR with pupils whose angry impulses have been causing serious probolems in their lives, sometimes meaning they risk permanent exclusion from school.
Work with Dissociative Identity Disorder is a complex therapy process. Many warnings have been made about
using EMDR with this group of patients. But problems with EMDR therapy in DID are basically attributable to the
risk always involved in working directly on traumatic memories in complex dissociative disorders. If we know the
general principles of the treatment of dissociative disorders, we should be able to use EMDR safely. Work with
alters or parts is a specific aspect of therapy in DID patients. This work should be used throughout the therapy
stages: stabilization; trauma work; integration. In this workshop we will show how to implement EMDR protocols
working with dissociative parts or alters in DID therapy. The exposition will be illustrated with clinical vignettes
and short therapy fragments on video.
Work with Dissociative Identity Disorder is a complex therapy process. Many warnings have been made about
using EMDR with this group of patients. But problems with EMDR therapy in DID are basically attributable to the
risk always involved in working directly on traumatic memories in complex dissociative disorders. If we know the
general principles of the treatment of dissociative disorders, we should be able to use EMDR safely. Work with
alters or parts is a specific aspect of therapy in DID patients. This work should be used throughout the therapy
stages: stabilization; trauma work; integration. In this workshop we will show how to implement EMDR protocols
working with dissociative parts or alters in DID therapy. The exposition will be illustrated with clinical vignettes
and short therapy fragments on video.
This column is devoted to statements that
were made in the workshop that should be
ingrained in the mind of every EMDR
practitioner. Since EMDR is still in the
"experimental stage" (i.e., replication studies
have not yet confiremed its efficacy, the
EMDR-trained clinicians are the frontline
spokespeople. In order to avoid misunderstandings
of untrained clinicians and
laypeople, please recall the following: EMDR is not a "cookiecutter; Reprocessing a trauma is like removing a quilt from the bed; Using EMDR is like opening a stuck faucet; Client safety is paramount; Never attempt EMDR In a nonclinical
setting; EMDR is an interface with your
clinical skills; Clients are at risk if EMDR is attempted by untrained clinicians; and Clients should not be placed at risk
without their informed consent.


