Download A wide variety of research studies have been implemented

A wide variety of research studies have been implemented using various treatment
aspects and protocols as their focus since EMDR’s initial development. Many of these
studies support EMDR as an empirically validated treatment of trauma. Several types of
research models are utilized - meta-analyses, randomized clinical trials, and
nonrandomized studies. These are:
META ANALYSES
Bisson, J., & Andrew, M. (2007). Psychological treatment of post-traumatic stress
disorder (PTSD). Cochrane Database of Systematic Reviews, 3, Art. no. CD003388.
DOI: 10.1002/14651858.CD003388.pub3.
This review concerns the efficacy of psychological treatment in the treatment of
PTSD. There is evidence that individual trauma focused cognitive-behavioural
therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR),
stress management and group TFCBT are effective in the treatment of PTSD.
Other non-trauma focused psychological treatments did not reduce PTSD
symptoms as significantly. There is some evidence that individual TFCBT and
EMDR are superior to stress management in the treatment of PTSD at between 2
and 5 months following treatment, and also that TFCBT, EMDR and stress
management are more effective than other therapies. There is insufficient
evidence to show whether or not psychological treatment is harmful. Trauma
focused cognitive behavioural therapy or eye movement desensitisation and
reprocessing should be considered in individuals with PTSD. Psychological
treatments can reduce symptoms of post traumatic stress disorder (PTSD).
Trauma focused treatments are more effective than non-trauma focused
treatments.
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005, February). A
multidimensional meta-analysis of psychotherapy for PTSD. American Journal of
Psychiatry, 162(2), 214-227.
The authors present a multidimensional meta-analysis of studies published
between 1980 and 2003 on psychotherapy for PTSD. Method: Data on variables
not previously meta-analyzed such as inclusion and exclusion criteria and rates,
recovery and improvement rates, and follow-up data were examined. Results:
Results suggest that psychotherapy for PTSD leads to a large initial
improvement from baseline. More than half of patients who complete treatment
with various forms of cognitive behavior therapy or eye movement
desensitization and reprocessing improve. Reporting of metrics other than effect
size provides a somewhat more nuanced account of outcome and
generalizability. Conclusions: The majority of patients treated with
psychotherapy for PTSD in randomized trials recover or improve, rendering
these approaches some of the most effective psychosocial treatments devised to
date. Several caveats, however, are important in applying these findings to
patients treated in the community. Exclusion criteria and failure to address
polysymptomatic presentations render generalizability to the population of
PTSD patients indeterminate. The majority of patients posttreatment continue to
have substantial residual symptoms, and follow-up data beyond very brief
intervals have been largely absent. Future research intended to generalize to
patients in practice should avoid exclusion criteria other than those a sensible
clinician would impose in practice (e.g., schizophrenia), should avoid wait-list
and other relatively inert control conditions, and should follow patients through
at least 2 years. [Author Abstract]
Davidson, P. R., & Parker, K. C. H. (2001, April). Eye movement desensitization and
reprocessing (EMDR): A meta-analysis. Journal of Consulting & Clinical Psychology,
69(2), 305-316.
Eye movement desensitization and reprocessing (EMDR), a controversial
treatment suggested for posttraumatic stress disorder (PTSD) and other
conditions, was evaluated in a meta-analysis of 34 studies that examined EMDR
with a variety of populations and measures. Process and outcome measures were
examined separately, and EMDR showed an effect on both when compared with
no treatment and with therapies not using exposure to anxiety-provoking stimuli
and in pre–post EMDR comparisons. However, no significant effect was found
when EMDR was compared with other exposure techniques. No incremental
effect of eye movements was noted when EMDR was compared with the same
procedure without them. R. J. DeRubeis and P. Crits-Christoph (1998) noted
that EMDR is a potentially effective treatment for noncombat PTSD, but studies
that examined such patient groups did not give clear support to this. In sum,
EMDR appears to be no more effective than other exposure techniques, and
evidence suggests that the eye movements integral to the treatment, and to its
name, are unnecessary. (PsycINFO Database Record (c) 2009 APA, all rights
reserved)
Maxfield, L., & Hyer, L. (2002, January). The relationship between efficacy and
methodology in studies investigating EMDR treatment of PTSD. Journal of Clinical
Psychology, 58(1), 23-41.
The controlled treatment outcome studies that examined the efficacy of Eye
Movement Desensitization and Reprocessing (EMDR) in the treatment of PTSD
have yielded a range of results, with the efficacy of EMDR varying across
studies. The current study sought to determine if differences in outcome were
related to methodological differences. The research was reviewed to identify
methodological strengths, weaknesses, and empirical findings. The relationships
between effect size and methodology ratings were examined, using the Gold
Standard (GS) Scale (adapted from Foa and Meadows). Results indicated a
significant relationship between scores on the GS Scale and effect size, with
more rigorous studies according to the GS Scale reporting larger effect sizes.
There was also a significant correlation between effect size and treatment
fidelity. Additional methodological components not detected by the GS Scale
were identified, and suggestions were made for a Revised GS Scale. We
conclude by noting that methodological rigor removes noise and thereby
decreases error measurement, allowing for the more accurate detection of true
treatment effects in EMDR studies (Pilots).
Rodenburg, R., Benjamin, A., de Roos, C., Meijer, A. M., & Stams, G. J. (2009,
November). Efficacy of EMDR in children: A meta-analysis. Clinical Psychology
Review, 29(70), 599-606.
The efficacy of eye movement desensitization and reprocessing (EMDR) in
children with posttraumatic stress symptoms was meta-analytically examined
from the perspective of incremental efficacy. Overall post-treatment effect size
for EMDR was medium and significant (d = .56). Results indicate efficacy of
EMDR when effect sizes are based on comparisons between EMDR and nonestablished trauma treatment or no-treatment control groups, and incremental
efficacy when effect sizes are based on comparisons between EMDR and
established (CBT) trauma treatment. The discussion focuses on future
replication of EMDR findings and further research on posttraumatic stress in
children.
Seidler, G. H., & Wagner, F. E. (2006, November). Comparing the efficacy of EMDR
and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: A metaanalytic study. Psychological Medicine, 36(11), 1515-1522.
Background: Eye movement desensitization and reprocessing (EMDR) and
trauma-focused cognitive-behavioral therapy (CBT) are both widely used in the
treatment of PTSD. There has, however, been debate regarding the advantages
of one approach over the other. This study sought to determine whether there
was any evidence that one treatment was superior to the other. Method: We
performed a systematic review of the literature dating from 1989 to 2005 and
identified 8 publications describing treatment outcomes of EMDR and CBT in
active-active comparisons. 7 of these studies were investigated metaanalytically. Results: The superiority of one treatment over the other could not
be demonstrated. Trauma-focused CBT and EMDR tend to be equally
efficacious. Differences between the two forms of treatment are probably not of
clinical significance. While the data indicate that moderator variables influence
treatment efficacy, we argue that because of the small number of original
studies, little benefit is to be gained from a closer examination of these
variables. Further research is needed within the framework of randomized
controlled trials. Conclusions: Our results suggest that in the treatment of PTSD,
both therapy methods tend to be equally efficacious. We suggest that future
research should not restrict its focus to the efficacy, effectiveness, and efficiency
of these therapy methods but should also attempt to establish which trauma
patients are more likely to benefit from one method or the other. What remains
unclear is the contribution of the eye movement component in EMDR to
treatment outcome. [Author Abstract
van Etten, M. L., & Taylor, S. (1998). Comparative efficacy of treatments for
posttraumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy,
5(3), 126-144.
A meta-analysis was conducted on 61 treatment outcome trials for PTSD.
Conditions included drug therapies (TCAs, carbamazepine, MAOIs, SSRIs, and
BDZs), psychological therapies (behaviour therapy, Eye-Movement
Desensitization and Reprocessing (EMDR), relaxation training, hypnotherapy,
and dynamic therapy), and control conditions (pill placebo, wait-list controls,
supportive psychotherapies, and non-saccade EMDR control). Psychological
therapies had significantly lower drop-out rates than pharmacotherapies (14%
versus 32%), with attrition being uniformly low across all psychological
therapies. In terms of symptom reduction, psychological therapies were more
effective than drug therapies, and both were more effective than controls.
Among the drug therapies, the SSRIs and carbamazepine had the greatest effect
sizes, although the latter was based upon a single trial. Among the psychological
therapies, behaviour therapy and EMDR were most effective, and generally
equally so. The most effective psychological therapies and drug therapies were
generally equally effective. Differences across treatment conditions were
generally evident across symptom domains, with little matching of symptom
domain to treatment type. However, SSRIs had some advantage over
psychological therapies in treating depression. Follow-up results were not
available for most treatments, but available data indicates that treatment effects
for behaviour therapy and EMDR are maintained at 15-week follow-up. [Author
Abstract]