Analysis : Eye Movement Desensitization And Reprocessing

William Harrar went into private practice in 1991 and continues to maintain a private practice. He provides professional consultations to other therapists and consults at local psychiatric units as well. He also provides psychotherapy to individuals, couples, and families. Dr. Harrar’s emphasis is brief treatments, especially treatments utilizing EMDR. His expertise in EMDR has afforded him as an approved consultant and certified therapist with the Eye Movement Desensitization and Reprocessing International Association (EMDRIA). Dr. Harrar also facilitates at national EMDR Institute trainings.

This paper will examine, compare and contrast Eye Movement Desensitization Reprocessing (EMDR) and Cognitive Processing Therapy (CPT) in the case of Joe, a fictional client with post-traumatic stress disorder from two tours of combat duty as a Marine Corps sniper in the Middle East, without the use of psychotropic medications. EMDR uses side-to-side eye movements in a one-on-one session with a clinician while the client focuses on a distressing memory until he or she reports reduced symptomology or no psychological distress; the clinician then has the client think of positive thoughts while continuing the exercises. EMDR has been the target of debate over its effectiveness, with some scholars suggesting that it is the “rewiring” of the brain that is most beneficial. CPT is often used when other processes of recovery fail. Therapy, administered individually or in a group, initially focuses on misconstrued beliefs of denial and self-blame for the traumatic incident and then addresses beliefs the client has about himself and the world in general. CPT uses talk therapy and worksheets with the goal of the client learning to make sense of what happened and fit it in with the beliefs about themselves and others. Findings suggest that each therapy has its advantages and which is best depends on how responsive the client is to each mode and the therapeutic alliance between the client and therapist.

I. Theoretical and Research Basis for Treatment While working with Precious it has become clear that she has gone through a number of traumas as a child and up until her young adulthood. Precious, dealing with both sexual and physical abuse, has come a long way in wanting to seek treatment and actually wanting to move past her previous traumas. Relevant treatment choices for Precious would be Eye Movement Desensitization and Reprocessing (EMDR) Trauma focused cognitive behavior therapy Exposure therapy Cognitive Processing Therapy Integrative treatment of complex trauma for adolescents.

Treatment of posttraumatic stress disorder is possible. The current treatment of PTSD encompasses several types of psychotherapy combined with a medication regimen. Cognitive therapy is one type of therapy used to combat PTSD. The goal of cognitive therapy is to allow the patient to slowly experience feelings, thoughts, and events associated with the trauma in a controlled setting. This allows the PTSD sufferer, to categorize the traumatic feelings associated with the event and assign a more positive meaning to them. Thus providing a coping mechanism. Another school of thought places the therapeutic focus on gradually exposing the PTSD sufferer to elements of the trauma. The goal is to desensitize the patient to the traumatic event. This allows the patient to resume a normal life. One other form of therapy used in treatment of PTSD is EMDR. EMDR or Eye Movement Desensitization and Reprocessing is a form of exposure therapy that places the emphasis on guided eye movements. The theory is that the movements help retrain how the brain reacts to memories of the traumatic event. Success has

Foa and her colleagues (2011) created prolonged Exposure (PE) for clients trying to overcome with PTSD that is based on the emotional processing therapy (Foa, 2011). PE treatment plan includes collecting of information associated to both the traumatic experience and the trauma survivor's responses to it, the teaching of breathing retraining techniques, education, the re-experiencing of the trauma in imagination, and in vivo exposure (Foa, 2011). When compared with CPT, PE is a 10-session treatment (60-90 minutes) that is centered on both in-vivo and imaginal exposure to the trauma memory and ensuing adaptation. PE reports that repetitive stimulation of the trauma memory allows the clients to integrate new, counteractive information about themself and their world. Additionally, homework assignments in PE allow the client to face safe situations, which were formerly resolute to be threatening based upon inaccurate post-traumatic beliefs (Foa,

EMDR therapy, EMDR uses an eight-phase approach, referring to the past, present, and future aspects of the traumatic experience, and dysfunctional stress stored memories. The first Phase calls History and Treatment Planning. In this phase the therapist listens the patient's history and develops a treatment plan. In Phase II, the preparation, the therapist teaches the patient how to calm down him/herself with the help of relaxation techniques. The phase III is Assessment in which the therapist asks the patient to visualize the image of the disturbing event, then asks him/her to develop a positive cognition associating with that image. In Phase IV, Desensitization, the patient  focuses on the disturbing memories during short sessions of 15-30 seconds. At the same time, he/she also focuses on the alternative stimulation such as directed eye movements, slapping hands, or voices. This process repeats  many times until the patient's reaction to the target memory becomes less distressed. In Phase V, Installation, the therapist again with the use of bilateral stimulation asks the patient to remember the event about which the positive cognition is developed in the phase III, and makes sure that

From this assignment, I learned that the immediate crisis based interventions for trauma are vastly different than a treatment plan which may incorporate long-term goals and strategies, such as cognitive behavioral therapy and/or Eye Movement Desensitization and Reprocessing (EMDR). I have to shift my thinking towards strategies as immediate as eye-contact and tone of voice, as well as make adjustments in how I searched for resources and

I would also utilize eye movement desensitization and reprocessing (EMDR) therapy, which is commonly used for individuals suffering from post traumatic

Developed by Edna Foa, prolonged exposure therapy exposes patients to their traumatic event over and over again while being in a safe place (Blankenship 277). Although prolonged exposure therapy is one treatment it has four main elements including education, breathing retraining, in vivo exposure, and imaginal exposure. Education consists of learning about the treatment, treatment symptoms, and goals of the treatment. Breathing retraining helps patients to relax and calm themselves when they become anxious. In vivo exposure allows patients with PTSD to be put in real-life situations that they are not comfortable with due to the trauma they have faced. Lastly, imaginal exposure allows the patients with post-traumatic stress disorder to talk through their traumatic event while it is recorded. After repeatedly talking through their event, the patient then listens to what they have said (Swan 28). Prolonged exposure therapy occurs over eight to fifteen sessions. Each session can range from 60 to 90 minutes depending on the patient and their specific needs (Blankenship 278). This treatment helps patients with post-traumatic stress disorder by allowing them to face their fears associated with the traumatic event and gain control over their emotions (Swan 28). Prolonged exposure therapy is proven to be a very effective therapy and is highly supported for the use of treating PTSD (Blankenship

It has been proven to have a better response rate.The Institute of Medicine recognized exposure therapies as the only treatment approach with sufficient empirical data to be deemed effective for PTSD (Institute of Medicine, 2007).While pharmacotherapy with SSRI can reduce symptoms, the most effective treatments involve understanding and overcoming avoidance behaviors (Foa & Rothbaum, 1998) Exposure therapy is a behavioral treatment for PTSD that aims to reduce your fear, anxiety and avoidance behavior by having you fully face, or be exposed to, thoughts, feelings or situations that are feared. During exposure therapy, the patient will face varying stimuli that stimulate the PTSD. This will go on until the intensity of the stimuli is

Exposure and cognitive restructuring are thought to be the most effective components. Exposure-based treatments involve having survivors repeatedly re-experience their traumatic event. There is strong evidence for exposure therapy, one of which being Prolonged Exposure (PE). PE includes both imaginal exposure and in vivo exposure to safe situations that have been avoided because they remind the person of the traumatic event. Cognitive Processing Therapy has a primary focus on challenging and modifying maladaptive beliefs related to the trauma, but also includes a written exposure component. Veterans with chronic military-related PTSD who received CPT showed better improvements in PTSD. EMDR is recommended in most practice guidelines. Patients receiving EMDR engage in imaginal exposure to a trauma while simultaneously performing saccadic eye movements. Overall, these therapy treatments are considered first-line treatments for PTSD and have strong evidence bases and effective

According to Sharf, (2008) the eye movement desensitization and reprocessing (EMDR) was designed to treat posttraumatic stress disorder. EMDR requires that the clients visualize an upsetting memory and accompanying physical sensations. The clients repeat negative self-statements that they associate with the scene. The procedure is repeated again and again until the client’s anxiety is reduced. EMDR focuses on desensitizing strong emotional reasons in clients and help them to reframe their belief systems to accommodate new emotional states (Sharf, 2008).

Prolonged exposure (PE) is a specific exposure therapy program that derives from Emotional Processing Theory (EPT). The idea of emotional processing is to interpret realistic information and accommodate that information into a fear structure which in turn diminishes the fear (Foa, 2011). Foa (2011) acknowledges that the idea of failing to process trauma is

For some patients with excessively traumatic experiences, the following preparation stage will last longer than the 1 to 4 sessions that most patients take. In the preparation phase, the therapist has to build a trustful relationship with the client in order to help establish appropriate expectations for the patient during the treatment. Since EMDR therapy does not require the patient to completely confide in the therapist her experiences, a therapeutic relationship between client and clinician is very important. Otherwise, the following sessions and treatments would be misdiagnosed since the patient’s statements to the therapist may not be completely true. After they establish a connection, the theory, procedures, and expectations of Eye Movement Desensitization and Reprocessing therapy is clarified by the clinician to the patient. Also explained to the patient is the concept of Bilateral Stimulation (BLS), oscillating eye movements, sounds, and sensations. BLS aids the left and

In this paper the therapies related to Cognitive Behavioural Therapy (CBT) will be studied in order to determine the applicability thereof for the treatment (and prevention) of Post Traumatic Stress Disorder (PTSD). PTSD will be summarised as described in the Diagnostic and Statistical Manual of mental disorders edition 4 with revisions (DSM-IV-TR). The therapy models, their theory and techniques will be discussed. The therapies this paper has in scope are, CBT, Exposure therapy and it’s different related techniques, Stress Inoculation Training (SIT), and Eye Movement Desensitisation