EMDR Psychotherapy for the Treatment of PTSD Research Paper

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Effectiveness of EMDR Psychotherapy for the Treatment of PTSD

Introduction

Most people who undergo traumatic life experiences often find it difficult to cope and adjust and may, from time to time, not only contend with uncontrollable thoughts about the experience, but also experience severe anxiety. In essence, this could effectively impede their day-to-day functioning. It should be noted that in the past, various interventions have been applied with an intention of treating post-traumatic stress disorder (PTSD) amongst adults. The said interventions include, but they are not limited to, eye movement desensitization and reprocessing (EMDR), trauma-focused cognitive-behavioral therapy (CBT), psychological first aid (PFA), and critical incident stress debriefing (CISD). This text concerns itself with eye movement desensitization and reprocessing (EMDR). In so doing, the text will seek to assess and evaluate current research on EMDR as applied to adults suffering from PTSD. It should be noted that in the past, the effectiveness of EMDR as a psychotherapeutic intervention for persons suffering from PTSD has been questioned, with most deeming it a controversial intervention. In that regard, therefore, the relevance of reviewing current research on this particular intervention with an aim of assessing its effectiveness cannot be overstated.

Discussion

A traumatic event, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), could be defined “as an event experienced, witnessed, or confronted by a person that involves (a) actual or threatened death, (b) serious injury, or (c) a threat to the physical integrity of self or others” (Vieweg, Julius, Fernandez, Beatty-Brooks, Hettema, and Pandurangi, 2006, p. 385). When exposure to a traumatic event goes untreated in some people, normal stress reactions (such as anger and anxiety) could worsen and lead to the development of PTSD-like symptoms. The post-traumatic stress disorder diagnostic criterion (DSM-IV-TR) highlights the criterion as well as the description or symptom. EMDR, in the words of Shapiro (2014) “is an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice” (71). As a psychological treatment approach to persons exposed to trauma, EMDR attempts to lessen or diminish the impact of the feelings a person experiences in relation to their recollection of a traumatic event. It is important to note that this intervention happens to be largely focused on both the symptoms as well as emotions associated with the traumatic event, as opposed to the traumatic event itself. The treatment process is in this case inclusive of the utilization of hand motions to guide the movements of the patient’s eyes from one side to another – in what is believed to mute or diminish the power of memories that happen to be emotionally charged. It should, however, be noted that as it has been pointed out in the introductory section, the effectiveness of PTSD as a psychotherapeutic intervention has been questioned in the past. While some studies have questioned the workings of the intervention, other studies indicate that the intervention is not only effective, but also potent in the treatment of various mental-health conditions such as PTSD.

In an attempt evaluate and assess the role eye movement desensitization as well as reprocessing therapy plays in medical sciences, especially with regard to the treatment of symptoms of a physical or psychological nature arising from exposure to life experiences that happen to be adverse, Shapiro (2014) finds out that EMDR comes in handy in clinical settings as an important tool for clinicians as they seek to attend to persons exhibiting symptoms (physiologic and psychological) consistent with exposure to traumatic life events. This is more so the case given that the intervention comes in handy in the determination of the extent to which the traumatic event serves as a contributing factor. In the words of the author, “EMDR therapy research has shown that processing memories of such experiences results in the rapid amelioration of negative emotions, beliefs, and physical sensations” (Shapiro, 2014, p. 76). As far as the relevance of these findings to advanced nursing practice is concerned, it is clear from the said findings that EMDR does have practical application amongst patients exhibiting symptoms that are consistent with disorders that are stress-related. As a matter of fact, Shapiro (2014) is of the opinion that EMDR therapy should be embraced by the medical community as a rehabilitative as well as preventive approach in seeking to advance further support to not only patients, but also their family members.

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In essence, the approach Shapiro (2014) utilizes in this study, i.e. in relation to the review of clinical reports and randomized studies relating to the intervention, enables him to present a strong case for EMDR as a potent tool as far as memory processing is concerned in seeking to treat physiologic and psychological symptoms amongst those with exposure to adverse life events.

Like Shapiro, Siedler and Wagner (2006) are also of the opinion that EMDR is highly effective in the treatment of PTSD. In their study seeking to compare two PTSD intervention approaches – i.e. trauma-focused cognitive-behavioral therapy (CBT) and EMDR, the authors found out that both methods are equally effective. In their own words, “in the treatment of PTSD, both therapy methods tend to be equally efficacious” (Siedler and Wagner, 2006, p. 1522). According to the authors, although both approaches have been widely utilized in PTSD treatment, concerns had been raised over how they compared as far as their efficacy is concerned. The authors in this case undertake a comprehensive review of literature in an attempt to assess how both approaches relate when it comes to their treatment outcomes. This effectively enhances the reliability of their findings. It is important to note that trauma-focused CBT happens to be an evidence-based treatment approach especially when it comes to the resolution of various behavioral as well as emotional problems associated with exposure to traumatic events. The fact that trauma-focused CBT lacks a clear leverage over EMDR as far as treatment outcomes are concerned is a clear indication of the efficacy of EMDR. It should, however, be noted that as per the outcomes of the Siedler and Wagner study, the contribution the eye movement component makes to the overall outcomes of treatment remains unclear (Siedler and Wagner, 2006). The finding there are no clinically significant differences between EMDR and trauma-focused CBT is of great relevance to advanced psychiatric nursing practice as it indicates that little benefit can be gained from the discrimination of one over another.

It should, however be noted that while a study conducted by Chen et al. (2014) confirmed that indeed EMDR was a valid psychotherapeutic intervention, the effectiveness of EMDR in the elevation of PTSD symptoms was found to be largely influenced or affected by the experience of the therapist in the conduction of PTSD group therapy. In this particular study, the authors sought to perform a “meta-analysis of clinical studies by investigating the effects of eye-movement desensitization and reprocessing (EMDR) therapy on the symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and subjective distress in PTSD patients treated” within a 20 year span (Chen et al., 2014, p. 75). The authors in this case appreciate the complex nature of the intervention approach and point out that it largely works by both the desensitization of those suffering from PSTD and stress, and the integration of information processing. It should be noted that as has been pointed out elsewhere in this text, the contribution the eye movement component makes to the overall outcomes of treatment remains unclear (Siedler and Wagner, 2006). However, as Chen et al. (2014) observe, eye movement in this intervention approach happens to be the dual-attention stimulus. In that regard, therefore, the authors are of the opinion that the said eye movement should be considered to be a critical EMDR constituent/element “because it induces certain physiological conditions that activate information processing” (Chen et al., 2014). The findings of this particular study are of relevance to advanced psychiatric nursing practice as they introduce the concept of therapist experience into the effectiveness equation. It is also important to note that as the authors further point out, “a duration of treatment >60 min per session also contributed to reductions in the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients following EMDR therapy” (Chen et al., 2014, p. 76). This is a critical component that should also be taken into consideration in session planning and design. It should, however, be stated that the accuracy of the findings of….....

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