Traumatic experiences are common in our society and can be caused by a range of events such as, combat related trauma, domestic abuse, or rape. Eye movement desensitization and reprocessing (EMDR), delayed treatment, biofeedback-assisted relaxation and prescription drugs are only a few of the theorized treatments for PTSD. EMDR is a treatment where the client is asked to think about an image from the trauma and while doing so they are instructed to move their eyes quickly from side to side, following the therapists fingers for about 15 to 10 seconds. Sessions such as these continue until desensitization of the trauma is complete and positive self-cognition has replaced previous negative self-cognition. The client then describes the thoughts,
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.
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
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
I would also utilize eye movement desensitization and reprocessing (EMDR) therapy, which is commonly used for individuals suffering from post traumatic
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).
This therapy involves a combination of non-trauma focused therapy, eye movement desensitization and reprocessing (EMDR), and exposure therapy. The non-trauma portion of this therapy does not address the underlying traumatic event that caused the PTSD, but teaches the use of relaxation techniques and involves non-directive counseling. The EMDR therapy involves the military personnel identifying a traumatic memory and discussing a negative or positive thought related to that memory. The therapist then would move an object, back and forth, in front of the patient’s eyes, while focusing on the negative memory. The procedure would continue until the positive thoughts related to that memory, increased and the negative decreased (Burke et al., 2009). The exposure therapy takes place in a controlled environment and involves the gradual exposure to a replica of the stimuli, which triggered a negative reaction. Some of the creative exposure techniques being utilized involve computer technology and have proven to be both practical and effective (Burke et al.,
Your introduction is very engaging and emphasizes the important role of communication after experiencing trauma. I believe your topic is very relatable because there is a sense of denial, seclusion, and dissociation that correlates with trauma and loss that many of us have experienced. Open communication within a family unit provides opportunities to express thoughts and feelings and develop appropriate coping strategies (Zambianchi & Bitti, 2014). In your intro you stated, "The impact childhood trauma has on our society and on children." As a suggestion, maybe you could expand on this statement or state specific impacts childhood trauma has on our society or on children. I love your examples of evidenced based interventions and how
The difference in effectiveness between trauma -focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) were identified in this article. The identified outcome is stipulated as post traumatic stress symptoms (PTSS). The study found a lack of significant difference between the two modalities. The mean difference was 0.69. The study’s outcome prorvided results that both TF-CBT and EMDR yielded decreased symptoms. The article notes the importance of children obtaining therapeutic services to reduce PTSS. Additionally, dropout rates and lack of symptom reduction in TF-CBT affords an alternative of implementing EMDR as a secondary modality. Although it appears TF-CBT has an array of research
The use of several therapeutic methods to treat children with PTSD increases the argument among clinicians about the most effective treatment for PTSD. The clinical literature describes a wide variety of interventions besides CBT including, psychoanalytic techniques, creative arts, play therapy, crisis intervention, eye movement desensitization and reprocessing, and pharmacotherapy; which raises the question about what could be the most effective treatment for children with PTSD (Cohen, Mannarino & Rogal 2001). Several of these therapies have been recognized as effective PTSD treatments. For instance, Eye-Movement Desensitization and Processing (EMDR), has become an increasingly accepted treatment modality for childhood PTSD; however, very
Eye Movement Desensitization Reprocessing (EMDR). EMDR is an extension of this PET in which the patient is exposed to the traumatic memories coincident with a small distraction. In the original version of EMDR, the distraction consisted of hand movements of the therapist to direct movements of the patient?s eyes. More recent versions of EMDR include other types of distractions such as hand-tapping or audio cues.160,178 Results with EMDR have been obtained from a few studies showing large symptom reduction in military populations,179 including results maintained at 9-month follow-up and 78% of completers no longer meeting criteria for PTSD.180 However, other studies conducted were either in very small samples or over only a few EMDR sessions.181-183 As such, much of the evidence supporting EMDR is still from studies in the general population.184
Catarina is a 33yo, G5 P4004, who is currently 34 weeks 4 days as dated by a certain and regular LMP. She had late PNC as she established only recently. She has 4 prior full-term deliveries; all in Guatemala at home without complications. I communicated with her through CryaCom.
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
EMDR is another evidence-based therapy for trauma including PTSD. EMDR is a comprehensive method that helps adaptive information processing, and it consists of eight phases to address and reprocess traumatic memories and relieve psychological stress. The eight components of EMDR comprise of “client history, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation” (Shapiro & Laliotis, 2010). Researchers conduct studies and examine the efficiency of EMDR for trauma treatment. According to Francine Shapiro (2014), the article stated that all randomized studies and clinical reports associated with EMDR therapy for psychological and somatic disorders are reviewed, and components of EMDR are evaluated as well, the evidences showed that EMDR is beneficial for improvement of negative emotions, beliefs, and physical sensations resulted from adverse life experiences. Similarly, researchers recruited 36