EMDR Therapy Variations: Evidence-Based Approaches for Trauma Healing
Trauma can have a profound impact on mental health, and finding effective treatment methods is crucial for recovery. Eye Movement Desensitisation and Reprocessing (EMDR) therapy is a widely recognised approach for trauma treatment, offering a structured method to help individuals process distressing memories. This blog explores the standard EMDR protocol and its variations, providing evidence-based information on how these techniques support clients in their healing journey.
The Standard EMDR Protocol: A Comprehensive Approach
The standard EMDR protocol, developed by Francine Shapiro, is grounded in the Adaptive Information Processing (AIP) model. Research has shown that EMDR can be effective in activating the brain's natural healing mechanisms to resolve psychological disturbances. The protocol consists of eight phases:
1. History Taking and Treatment Planning
2. Preparation
3. Assessment
4. Desensitisation
5. Installation
6. Body Scan
7. Closure
8. Re-evaluation
Each phase is designed to systematically address traumatic memories and associated negative beliefs, with the goal of reducing emotional distress and fostering adaptive resolution.
Variations of EMDR: Tailoring Treatment to Individual Needs
While the standard EMDR protocol is effective for many, some clients may benefit from modified approaches. These variations are particularly important for individuals who may find the standard protocol overwhelming or ineffective due to the complexity of their trauma or their specific psychological needs.
Clients who may benefit from modified EMDR approaches include:
- Those with complex PTSD or multiple traumas
- Individuals with dissociative disorders
- Clients who become easily overwhelmed or emotionally flooded
- Those with severe anxiety or panic disorders
- Individuals with cognitive impairments or intellectual disabilities
- Clients with a history of treatment-resistant PTSD
For these individuals, the intensity of standard EMDR may be too challenging, potentially leading to re-traumatisation or treatment dropout. Modified approaches aim to provide a gentler, more gradual exposure to traumatic memories, allowing for better emotional regulation and a stronger sense of safety during the therapeutic process.
Variations of EMDR: Tailoring Treatment to Individual Needs
While the standard EMDR protocol is effective for many, some clients may benefit from modified approaches. Roy Kiessling's Continuum offers a flexible framework for adapting EMDR therapy to meet the unique needs of each client. This continuum ranges from less intensive to more comprehensive processing, allowing therapists to adjust the treatment based on the client's emotional stability and readiness.
The Kiessling Continuum includes:
EMD (Eye Movement Desensitisation)
EMD focuses solely on Desensitisation without full reprocessing, making it suitable for clients who become easily overwhelmed. This approach can help build a client's tolerance for addressing traumatic memories without the risk of emotional flooding.
EMDr (Restricted EMDR)
EMDr provides a controlled exploration of traumatic memories, allowing for some reprocessing while limiting the extent to prevent overwhelming the client. This can be particularly beneficial for individuals with complex trauma histories who need a more measured approach to processing their experiences.
Other Adaptions not included in Roy Kiessling’s Continuum:
R-TEP (Recent-Traumatic Episode Protocol)
R-TEP is designed specifically for early intervention following recent traumatic events. It addresses a traumatic episode rather than a single event, involving multiple targets known as Points of Disturbance (PoDs). This protocol is typically used within days or weeks of a traumatic event and aims to process the trauma before it becomes more deeply entrenched.
The Flash Technique: A Complementary Approach
The Flash Technique, developed by Philip Manfield, is a minimally intrusive intervention designed to reduce the disturbance associated with traumatic memories. It can be used prior to EMDR sessions to help lower distress levels.
Comparing EMDR Protocol Variations*
**Please note there is a range of other EMDR variations not included in this table or blog.
Evidence-Based Practice in EMDR Therapy
Research has consistently demonstrated the efficacy of EMDR in treating post-traumatic stress disorder (PTSD) and other trauma-related conditions. A meta-analysis published in PLOS ONE by Chen et al. (2014) found that EMDR therapy significantly reduced the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients.
Furthermore, a systematic narrative review published in Frontiers in Psychology highlighted that EMDR therapy was shown to be effective across different cultures and improved PTSD diagnosis, reduced PTSD symptoms, and reduced other trauma-related symptoms.
Conclusion: A Flexible Framework for Trauma Treatment
The variations within EMDR therapy provide mental health professionals with the flexibility to adapt the treatment to the specific needs of their clients. This adaptability is crucial for clients who may be easily overwhelmed by the standard protocol, allowing them to engage in therapy at a pace that feels manageable and supportive.
It's important to note that EMDR therapy should only be administered by qualified mental health professionals with specific training in this modality. If you're considering EMDR therapy, consult with a registered psychologist or mental health practitioner to determine if it's appropriate for your individual needs.
Remember, while EMDR has shown promising results for many individuals, treatment outcomes can vary. Always seek professional advice for mental health concerns and treatment options.
If you're interested in exploring the benefits of personalised EMDR therapy, our experienced telehealth psychologist, Natasha Kiemel-Incorvaia, is here to help. Tailored EMDR approaches can be effectively delivered online to address stress, anxiety, and trauma, all from the comfort of your home. When you're ready to take the next step towards better mental health, book your telehealth appointment by calling 0457427876 or clicking HERE to schedule an appointment online.
[This blog post is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare provider for personalised recommendations.]
References
- Shapiro, F. (2001). Eye Movement Desensitisation and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures (2nd ed.). Guilford Press.
- Chen, Y. R., Hung, K. W., Tsai, J. C., Chu, H., Chung, M. H., Chen, S. R., Liao, Y. M., Ou, K. L., Chang, Y. C., & Chou, K. R. (2014). Efficacy of eye-movement Desensitisation and reprocessing for patients with posttraumatic-stress disorder: a meta-analysis of randomized controlled trials. PloS one, 9(8), e103676.
- Wilson, G., Farrell, D., Barron, I., Hutchins, J., Whybrow, D., & Kiernan, M. D. (2018). The Use of Eye-Movement Desensitisation Reprocessing (EMDR) Therapy in Treating Post-traumatic Stress Disorder—A Systematic Narrative Review. Frontiers in psychology, 9, 923.