Eye Movement Desensitization and Reprocessing (EMDR) is a therapy in contemporary medicine that is revolutionizing medical care through its efficacy and application. Developed by Francine Shapiro in the 80s, this therapy aids in the management and treatment of trauma related conditions. Originally developed as the primary therapy for post-traumatic stress disorder (PTSD), this therapy is now being used in other disorders like depression and phobias. The manner in which therapy works is complex. In summary, however, EMDR works by triggering the brain information processing activities. By using eye movements, the affected individuals are able to recall adverse past events. When this is done continuously, the individual learns to put the adverse events behind and focus on the future. However, psychotherapy, of which EMDR is a part, is a complex phenomenon to understand since brain functioning in itself is a complex tenet. It is a psychotherapeutic intervention and because of this, debate rages whether it is the best psychotherapy for PTSD victims. Despite this, it has proved to be an effective tool for these patients. The benefits of EMDR in adults and children affected by PTSD are well documented and researched. Due to its efficacy in treating PTSD, it has been recognized by the National Institute of health and Clinical Excellence (NICE). The aim of this paper is to discuss the effectiveness of EMDR in the treatment of post-traumatic stress disorder and other related adverse outcomes.
EMDR is an effective psychotherapeutic Intervention
Many qualitative and quantitative studies, along with medical reports show have proved that EMDR is an effective intervention in the management of PTSD. There are many interventions for adverse outcomes like post-traumatic stress, and EMDR has been found to be among the most effective. Research by Kath Norgate (2012) reveals that the efficacy of EMDR is evidence based, gauging from the findings of multiple research studies and clinician reports. Norgate’s research article is peer reviewed and has been published in “The Nursing Times”. It gives useful insight into EMDR therapy by giving noteworthy background information about the intervention and two case studies that illustrate the efficacy. The researcher has also used numerous past research studies that have been done on the same in coming up with the conclusion. The researcher asserts that EMDR is effective against all forms of emotional and psychological problems. The case studies mentioned are derived from the researcher’s experience with young people with psychological disturbances as a result of adverse outcomes. The two teenagers presented with various behaviors as a result of past traumatic events, and from numerous EMDR sessions, the symptoms improved and they were able to lead a normal lifestyle. From the case studies and the literature reviewed, Norgate was able to establish the effectiveness of the therapy.
EMDR has been found to improve emotional and psychological outcomes in patients with PTSD. Many clients also report having improved relationships after multiple sessions. Clients not only have improved relationships, but also, they advance in their careers and advance in education (Norgate, 2012). Research by Bisson and Andrew (2007) shows that EMDDR along with trauma-focused cognitive-behavioral therapy (TFCBT) offers better treatment to stress management in treating PTSD when interventions are started early. The same research also concluded that these modalities are more effective than other modalities of managing PTSD. The other modalities include hypnotherapy, supportive therapy, psychodynamic therapy and non-directive counseling. The research by Bisson and Andrew was a review of randomized controlled trials of modalities used to treat PTSD. A total of 29 studies were used in the review. The findings are further evidence of the efficacy of EMDR in managing PTSD. Another meta-analysis by Rodenburg et al., (2009) shows that PTSD has a wide range of therapies, but EMDR is one of the most effective in children. The same message on the efficacy of EMDR in the meta-analysis is superimposed by Seidler and Wagner (2006). This meta-analysis compares EMDR and TFCBT in treating PTSD. The authors acknowledge that these two methods are the most common approaches in managing PTSD. The meta-analysis is motivated by the fact that debate has been ongoing on the merits and demerits of each of the two psychotherapeutic modalities. Therefore, in their study, the researchers wanted to establish whether one is more superior to the other. 8 studies were used for the meta-analysis. However, unlike previous research, none of these modalities were found to be more efficacious than the other. TFCBT and EMDR are equal in clinical significance, but they are both effective modalities in managing post-traumatic stress in children and adults.
Many qualitative and quantitative research studies have been conducted on EMDR, and the advantage is, they add to the already existing knowledge about EMDR and its efficacy. The gaps in knowledge from past research are now being bridged through more meta-analyses. These analyses investigate many research studies and based on this, a similarity is always derived. Based on this, the findings are usually plausible and accurate. Qualitative research by Theodore Morrison of the Naval Center for Combat and Operational Stress Control (NCCOSC) further reveals that EMDR is evidence-based and that multiple research studies continue showing that it is an effective modality for managing stressful outcomes like PTSD. Theodore explains the mechanism of action in the initial pages of this article. The article then goes on to explain how various PTSD treatments compare with EMDR. Research by Bisson and Andrew (2007) is referred by Theodore. In the research, as mentioned above, the findings are that EMDR is slightly better than other therapies in treating PTSD. In the same study, no differences were found in the efficacy of EMDR and TFCBT.
Theodore then mentions research conducted by Davidson and Parker in the form of a meta-analysis. In this study, however, the researchers could not find the efficacy of EMDR over other modalities of treatment. However, as long as a control group is used, EMDR is an effective tool for PTSD. Theodore further mentions the research done by Seidler and Wagner above (2006). Just like the rest, this is a meta-analysis of 7 studies that compares the efficacy of EMDR with cognitive behavioral therapy. Similarly, like the meta-analysis by Davidson and Parker, the study could not establish whether one modality was more effective than the other. However, what is clear from the findings is that EMDR is an effective treatment option for PTSD. Another study mentioned in the article is that of Albright and Thyer (2010). This is a more recent research that focuses on the efficacy of EMDR in reducing PTSD in combat veterans. 9 studies were reviewed in this exercise. While 3 studies were able to show that EMDR causes improvement of conditions, 5 others showed that there was no improvement of symptoms and worsening condition with EMDR. While this study does not support the efficacy of EMDR in totality, it gives indications of the application of EMDR in combating post- traumatic stress. Analysis of this study shows that there were limitations that affected research outcomes. This includes and is not limited to: few reported treatment sessions, low statistical power, poor adherence to treatment and inadequate clinician treatment. All these must be taken into consideration before one can accurately assert that EMDR is not an effective intervention in adverse outcomes.
Francine Shapiro, the doctor credited with the theory surrounding EMDR, is one of the latest researchers to give overwhelming evidence on the application of EMDR in medicine. In a 2014 article, Shapiro superimposes the widespread agreement that widespread research has shown that EMDR is effective in treating trauma. Shapiro reviews recent and past studies on the application of EMDR in medicine and how it compares top other interventions. 24 randomized control trials assert that EMDR is effective in treating PTSD (Shapiro, 2014). In the same research, 7 studies revealed that EMDR is more effective than other interventions. While not all the studied articles prove that EMDR is effective, the conclusion by Shapiro is that clinicians need to embrace EMDR in managing PTSD. There is need to conduct more research just like Shapiro in order to conclusively come up with the findings.
There is limited evidence supporting the efficacy of EMDR
While many studies outline that EMDR is an effective treatment measure for patients with PTSD, other studies assert that the findings are not conclusive due to deficiencies in most studies and due to evidence basis. Factors like low statistical power and inadequate treatment interventions cannot be used to gauge efficacy of a therapy over the rest. The efficacy of a treatment measure needs to be compared with others in numerous studies before it can adequately be determined to be effective. Most meta-analyses employ less than 10 studies in concluding that EMDR is an effective psychotherapeutic intervention. The low statistical power of fewer studies used in meta-analyses makes the findings of the efficacy of EMDR questionable in some cases. For instance, research by Albright and Thyer (2010) did not emerge with the desired outcomes like most past studies. Employing 9 studies to analyze the efficacy of PTSD, the findings did not support the idea that EMDR is effective in treating PTSD. As mentioned above, only 3 of the studies proved this. The rest came up with opposite findings. For this reason, the authors concluded that the evidence to prove that EMDR is effective in PTSD is l based on many factors like the low statistical power of the analyzed studies.
Other studies assert that PTSD is akin to a placebo treatment in behavioral medicine (Theodore, 2014). In his study, Theodore refers to earlier works of McNally (1999) and Lohr et al., (1995). These two researchers conclude that the evidence that EMDR is effective clinically is limited. Rather than being an effective therapy, it is an exposure therapy. The researchers also do not see the importance of the eye movement in the therapy. Based on these findings, it cannot be conclusively stated that EMDR is an effective intervention for PTSD as compared to other interventions. Despite showing promise and success in some populations, it has also failed in some. It would take more and accurate research to conclusively state that EMDR is effective (Theodore, 2014).
However, the deficiencies in the findings in some studies seem to not only emanate from the low statistical power of the studies but also due to the inaccurate interventions. For instance, it would require well-trained personnel to offer EMDR services adequately. In the event that the personnel have some deficiencies, then the therapy will not be effective and the conclusions will not be plausible. Another challenge lies in the treatment. EMDR requires multiple sessions in order to bring out the best results. Some clients have low adherence to treatment; hence, the intervention will appear to be flawed. Another challenge picked in many studies is that of few reported treatment sessions. This brings the overall picture of low efficacy, but the clear picture is that; with low reported treatment sessions, one cannot accurately determine the efficacy of EMDR. These limitations need to be surmounted in order to determine the efficacy of EMDR accurately. For example, the research by Albright and Thyer (2010) hurriedly concludes that there is limited evidence to show the efficacy of EMDR. However, with these many limitations, it will not be easy to know whether it is the researchers who are inaccurate in their assertions or the many meta-analyses that conclusively state that EMDR is an effective intervention.
The efficacy of EMDR in treating PTSD has also been questioned by other researchers who see no difference between this research and other interventions like stress management and cognitive therapy. While most researchers have dwelled on the efficacy of EMDR, an equally significant number has dwelled on the efficacy as compared to the other therapies. The argument is that, if other therapies are more effective in treating PTSD as compared to EMDR, then the latter cannot be deemed effective. While most of these researchers have established that there is a slight efficacy when EMDR is compared to other therapies, others have not discovered any differences. This is a gap that needs to be bridged because it is not clear as to why there are differences between different research studies on the same issue. Theodore (2014) asserts that the studies showing the efficacy of EMDR have been showing contradicting results. Such outcomes do not instill confidence in the stakeholders of this subject. This calls for more research so that these controversies are well addressed and there is uniformity in the findings.
More research needs to be conducted to conclusively state that EMDR is an effective therapeutic intervention in the treatment of PTSD. Many studies have shown the efficacy, but many others have also poked holes in the findings. The limitations that are bringing about the contradicting results need to be bridged before stakeholders can accurately demonstrate the efficacy of EMDR. More meta-analyses need to be used so as to enhance the statistical power. The concerned bodies that offer treatment also need to enhance training so that the therapy I accurate to the affected people. Patients also need to be taught about the benefits of adherence. It is only after there is adherence to an accurate intervention that one can accurately investigate the efficacy. Research by Albright and Thyer (2010) shows that; while many studies continue, concluding that EMDR is effective, most of these are studies have limitations that first need to be addressed. There is a need for more studies on all PTSD therapies.
Nonetheless, many health bodies recognize that PTSD is an evidence-based approach that has proved to be effective in the management of PTSD. Further research would be needed to seal any loopholes in these conclusions (Theodore, 2014).
Developed in the 80s, EMDR is an intervention that has been widely reported to be effective in managing PTSD. EMDR is a complex mechanism that is difficult and complex. However, of importance is not the mechanism of action, but rather how effective it is in treating PTSD. It has also been found to be slightly effective when compared with other equally effective interventions of PTTS like stress management and behavioral therapy. The efficacy is evidence-based since many studies and clinical outcomes have proven that it is indeed effective in managing PTSD. Many meta-analyses conclusively state that this therapy is effective generally; therefore, should be embraced by many. The research evidence on the effectiveness of EMDR has even ensured that it is included as part of the guidelines for health bodies worldwide.
Research on the efficacy of EMDR has been ongoing for the past three decades and still ongoing. This is because; the findings in some cases have deficiencies and are contradictory. For this reason, more research is needed to bridge this gap. While most research studies have shown that EMDR is more effective than other therapies in managing PTSD, other researchers have asserted that there is limited evidence to show for this widely reported efficacy. This is because, in some studies, patients have been seen not to recover from PTSD as compared to others. These studies assert that there is low statistical power in most meta-analyses; hence, the findings are currently not conclusive. It would take multiple research studies with the same findings to prove that EMDR is indeed effective. Most of the studies that hurriedly conclude that PTSD is effective use less than 10 studies, and this makes the finding not plausible. Other limitations like inadequate training and non-adherence to treatment further makes the findings not plausible. Other researchers have rubbished EMDR as being merely a placebo treatment in behavioral medicine. This is because the findings are not conclusive in all cases investigated.
While most research studies prove that EMDR is an effective intervention, including the latest by Shapiro in 2014, the challenge is bridging the gaps and contradictions that exist in past findings. Due to the contradicting findings on the efficacy of EMDR, it would be necessary for more research to be conducted. More research studies also need to be conducted on other therapies so that this can be compared to EMDR before conclusively stating that the latter is more effective.
However, despite these contradictions, the strong point in asserting that EMDR is effective is because this is evidence based. Many have proved in practice that EMDR is indeed effective. It is almost impossible to conduct perfect research. The limitations of research may be the ones leading to the contradictions. This is what needs to be addressed by researchers so that there is total agreement on EMDR and its use in psychotherapy.
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