EMDR

1. EMDR Eye Movement Desensitization & Reprocessing

2. Background • First discovery of the effects of spontaneous eye movement in 1987 • First controlled study published in the Journal of Traumatic Stress in 1989 • Discovery of other forms of bilateral stimulation in 1990, leading to the creation of EMDR

3. Adaptive Informational Processing Model

4. About EMDR • An integrative psychotherapy approach found to effectively treat trauma-related disorders • Such as PTSD, dissociative identity disorder, and trauma-related borderline personality disorder • Amount of time for complete treatment depends on the client’s history • Addresses the issues that contribute to clinical problems

5. Goals of EMDR • “To achieve the most effective and efficient treatment effects while maintaining client safety” • “To achieve appropriate, adaptive and ecological resolution of presenting problems” • “To incorporate new skills, behaviors and beliefs about self, optimizing clients’ capacity to respond adaptively in the current context of their lives”

6. Three-Pronged Reprocessing Approach • Past Events • First root causal experience • Worst experience • Any additional experiences • Present Triggers • Future- Desired Outcomes

7. 8 Phase Treatment Approach

8. Phase One: Client History • Obtain background information to identify appropriate use of EMDR treatment • Identify the presenting issues and related past experiences • Develop a treatment plan targeting specific events for memory reprocessing • Pregnant women and those with cardiac, respiratory or ocular problems should consult their healthcare providers prior to treatment

9. Phase Two: Preparation • Goal: establish a relationship of trust between therapist and client • Education to client of EMDR practice • Informed Consent • Client is taught affect management skills to cope with any emotional disturbance that may arise

10. Phase Three: Assessment • Processing of targeted event (chosen during Phase One) begins • Identify cognitive distortion “I am worthless” and a positive self-statement that is desirable “I am worthwhile” • Therapist takes baseline measurement of target event • Client will be able to identify the emotions and physical sensations associated with the event

11. Phase Four: Desensitization • Process the experience toward a desirable SUD level • Identify and resolve similar events associated with trigger • Therapist leads client in a set of eye movements with appropriate shifts and changes of focus • Client to be guided through complete resolution of targeted event

12. Phase Five: Installation • Strengthen association of positive cognition • Goal is for client to accept positive self-statement at a level 7 on the Validity of Cognition scale

13. Phase Six: Body Scan • Original targeted event will be assessed again to check if physical sensations still present • If negative physical response present, reprocessing will be repeated until it disipates

14. Phase Seven: Closure • Client needs help to stabilize and orient them to the present • Close of session with plan for between session techniques, such as keeping a daily journal in case processing continues to take place • This is extremely important in cases when complete processing cannot be done in one session

15. Phase Eight: Reevaluation • This phase guides the therapist through proper protocol • Reassess GAF score • Client report on progress between sessions • Re-access the targeted event and emotions to continue treatment plan • Evaluate treatment efficacy

16. References • Van der Hart, O., Nijenhuis, E., and Solomon, R. Dissociation of the Personality in Complex Trauma-Related Disorders and EMDR: Theoretical Considerations. Journal of EMDR Practice and Research, Volume 4, Number 2, 2010. DOI: 10.1891/1933-3196.4.2.76 pages 76-92 • EMDR The breakthrough “Eye movement” therapy for overcoming anxiety, stress, and trauma by Francine Shapiro, Margot Silk Forrest. April 11, 1998. Published by Basic Books:New York.