The Aggregate Evidence for EMDRs Efficacy in the Treatment of PTSD

The results of six of the civilian studies and one of the combat veteran studies suggest that EMDR is an effective therapy for PTSD. It appears to be more effective than active listening, standard Kaiser care, relaxation therapy and no treatment. There are preliminary indications that it may be equivalent in effectiveness to CBT exposure therapies.

EMDR had the largest influence on measures of PTSD symptoms, with fairly consistent improvement across the civilian studies. Improvement on measures of other types of symptoms such as depression were not as robust, and varied within and between studies. Most studies offered only a few treatment sessions and it may be that more distressed clients would have benefitted from additional sessions. More distressed clients may also have more comorbid disorders. Wilson et al. (1997) found that those clients reporting higher levels of distress at 3-month follow-up were the most likely to seek further treatment over the next year.

Persons who have suffered multiple traumas, such as combat veterans, may require more extensive therapy. Marcus et al. (1997) reported that EMDR resolved PTSD more rapidly for those clients with a single trauma. The only combat veteran study which provided extensive treatment was the only one that achieved positive treatment outcome (Carlson et al., 1998). This suggests that research evaluating EMDR treatment of chronic PTSD must provide a full course of therapy to adequately assess efficacy.

Another issue that may explain the range of outcomes across studies is methodological rigor. The civilian study which reported a poor outcome (Devilly & Spence, 1999) and several of the combat veteran studies were limited by various methodological flaws, which may have obscured true treatment effects. It appears that differences in outcome are related to differences in methodology, and that higher ratings of methodological rigor predict treatment effect sizes (Maxfield & Hyer, in press).

Further research is required to examine the responses of different PTSD populations to EMDR treatment. At present the research indicates that EMDR is effective for civilian PTSD. Only tentative conclusions can be reached concerning EMDRs effectiveness for combat PTSD until further research replicates studies like Carlson et al. (1998) and compares EMDR with other effective treatments for combat PTSD. Research should evaluate individual response to EMDR to determine if there are differential effects for persons with comorbid disorders, multiple traumas, or with chronic PTSD.

Source Full Story: http://www.fsu.edu/~trauma/a1v5i4.htm