Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training.

The authors examined the efficacy, speed, and incidence of symptom worsening for 3 treatments of posttraumatic stress disorder (PTSD): prolonged exposure, relaxation training, or eye movement desensitization and reprocessing (EMDR; N=60). Treatments did not differ in attrition, in the incidence of symptom worsening, or in their effects on numbing and hyperarousal symptoms. Compared with EMDR and relaxation training, exposure therapy (a) produced significantly larger reductions in avoidance and reexperiencing symptoms, (b) tended to be faster at reducing avoidance, and (c) tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment. EMDR and relaxation did not differ from one another in speed or efficacy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The information gap in the EMDR controversy.

Eye movement desensitization and reprocessing (EMDR) is a recently developed treatment for traumatic memories. The literature on EMDR is characterized by widely contrasting results and interpretations of findings. The author traces this variation to the substantial information gap between those with and without formal EMDR training. Misconceptions are highlighted, and EMDR is reassessed favorably with fidelity to the treatment protocol emerging as a critical factor. Recommendations are made for higher standards of publication, research, and training in EMDR, particularly in light of the wider availability of information and training engendered by the publication of an EMDR textbook. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative case study of diffusion of eye movement desensitization and reprocessing in two clinical settings: Empirically supported treatment status is not enough.

An in-depth comparative case study was conducted of two attempts at diffusion of an empirically supported, but controversial, psychotherapy: eye movement desensitization and reprocessing (EMDR). One Department of Veterans Affairs (VA) treatment setting in which there was substantial uptake was compared with a second VA setting in which it was not adopted. Qualitative interviews were conducted with 10 mental health clinicians at the first site, and 19 at the second. Critical selling points for EMDR were a highly regarded champion, the observability of effects with patients, and personally experiencing its effects during a role training session. Compatibility with existing psychotherapist practices and values further allowed the therapy to become embedded in the organizational culture. At the second site, a sense that EMDR was not theoretically coherent or compelling overwhelmed other considerations, including its empirical status. Comparative studies contrasting settings in which innovative therapies are implemented versus those in which they were rejected may aid in refining theories of and strategies for dissemination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma.

The present study is a 15-month follow-up of the effects of eye movement desensitization and reprocessing (EMDR) therapy on the functioning of 66 participants, 32 of whom were diagnosed with posttraumatic stress disorder (PTSD) prior to treatment. PTSD participants improved as much as those without the diagnosis, with both groups maintaining their gains at 15 months. At 15-month follow-up, the three 90-min sessions of EMDR previously administered (S. A. Wilson, L. A. Becker, & R. H. Tinker, 1995) produced an 84% reduction in PTSD diagnosis and a 68% reduction in PTSD symptoms. The average treatment effect size was 1.59; the average reliable change index was 3.37. Implications of the maintenance of EMDR treatment effects are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three- and 6-Month Follow-Up of EMDR Treatment of PTSD in an HMO Setting.

Eye movement desensitization and reprocessing (EMDR) treatment was found to maintain superiority to newly initiated standard Kaiser Care, which consisted of individual therapy plus variations of medication and group therapy. A 3- and 6-month follow-up of individuals randomly assigned to either EMDR treatment or standard care (SC) treatment for posttraumatlc stress disorder (PTSD) indicates that significantly greater improvements found with EMDR at posttreatment in an earlier article (S. Marcus, P. Marquis, & C. Sakai, 1997) were maintained on measures of PTSD, depression, anxiety, and general symptoms. Of the original 67 participants in this large HMO study, 44 were assessed at 3-month follow-up and 36 were assessed at 6-month follow-up by an independent assessor. The study indicates that a relatively small number of EMDR treatment sessions result in substantial benefits that are maintained over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral and neurochemical methods in research on new psychotropic drugs

The present study is a 15-month follow-up of the effects of eye movement desensitization and reprocessing (EMDR) therapy on the functioning of 66 participants, 32 of whom were diagnosed with posttraumatic stress disorder (PTSD) prior to treatment, PTSD participants improved as much as those without the diagnosis, with both groups maintaining their gains at 15 months. At 15-month follow-up, the three 90-min sessions of EMDR previously administered (S.A. Wilson, L.A. Becker, & R. H. Tinker, 1995) produced an 84% reduction in PTSD diagnosis and a 68% reduction in PTSD symptoms. The average treatment effect size was 1.59; the average reliable change index was 3.37. Implications of the maintenance of EMDR treatment effects are discussed.     

Social skill training in an integrated preschool program.

This study examined the effectiveness of a commercially available social skills training program plus classroom reinforcement for use with preschoolers with developmental delays. Two groups of 19 participants (mean age 49.73–52.9 mo old) each received either the combined treatment package or classroom reinforcement of target behaviors only. An additional 20 participants served as a control group. The combination of social skills training plus classroom reinforcement of target behaviors resulted in statistically significant increases in sharing behavior over those obtained by both control participants and participants receiving reinforcement of classroom behavior alone. Group behavior was increased over that shown by control participants through the use of either the social skills plus classroom reinforcement treatment package or classroom reinforcement alone. Social skills interventions were viewed favorably by both classroom teachers and preschool participants. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals.

The effects of 3 90-min eye movement desensitization and reprocessing (EMDR) treatment sessions on traumatic memories of 80 participants were studied. Participants were randomly assigned to treatment or delayed-treatment conditions and to 1 of 5 licensed therapists trained in EMDR. Participants receiving EMDR showed decreases in presenting complaints and in anxiety and increases in positive cognition. Participants in the delayed-treatment condition showed no improvement on any of these measures across the 30 days before treatment, but after treatment participants in the delayed-treatment condition showed similar effects on all measures. The effects were maintained at 90-day follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Controlled study of treatment of PTSD using EMDR in an HMO setting.

67 individuals (aged 18–73 yrs) diagnosed with posttraumatic stress disorder (PTSD) were randomly assigned to either Eye Movement Desensitization and Reprocessing (EMDR) treatment or Standard Care (SC) treatment. Participants were assessed pretreatment, after 3 sessions, and at the completion of treatment using the SCL-90, Beck Depression Inventory, Impact of Event Scale (M. Horowitz et al, 1979), modified PTSD Symptom Scale (S. A. Falsetti et al, 1993), State Trait Anxiety Inventory, and other measures. In addition, an independent evaluator assessed participants using Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for PTSD including Global Assessment of Functioning at the 3 data points. Ss in the EMDR treatment group showed significantly greater improvement with greater rapidity than those in the SC treatment group on measures of PTSD, depression, anxiety, and general symptoms. Ss who received EMDR treatment used fewer medication appointments for their psychological symptoms and needed fewer psychotherapy appointments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eye movement desensitization and reprocessing: Four case studies of a new tool for executive coaching and restoring employee performance after setbacks.

The effects of eye movement desensitization and reprocessing (EMDR) integrated into executive coaching are reported in 4 case studies illustrating varied job titles and industries. Participants received 1–10 hrs of coaching in which EMDR was used to desensitize an upsetting event that had impaired their performance at work. Outcomes indicated that EMDR desensitized the disturbing incident and that participants shifted their negative view to a more positive one. Work performance was restored or enhanced. In the 4th case EMDR appeared to decrease anxiety about job interviewing and the participant reported a satisfactory result. Findings suggest that EMDR is a promising adjunct to coaching for workplace performance enhancement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eye movement desensitization and reprocessing (EMDR): A meta-analysis.

Eye movement desensitization and reprocessing (EMDR), a controversial treatment suggested for posttraumatic stress disorder (PTSD) and other conditions, was evaluated in a meta-analysis of 34 studies that examined EMDR with a variety of populations and measures. Process and outcome measures were examined separately, and EMDR showed an effect on both when compared with no treatment and with therapies not using exposure to anxiety-provoking stimuli and in pre–post EMDR comparisons. However, no significant effect was found when EMDR was compared with other exposure techniques. No incremental effect of eye movements was noted when EMDR was compared with the same procedure without them. R. J. DeRubeis and P. Crits-Christoph (1998) noted that EMDR is a potentially effective treatment for noncombat PTSD, but studies that examined such patient groups did not give clear support to this. In sum, EMDR appears to be no more effective than other exposure techniques, and evidence suggests that the eye movements integral to the treatment, and to its name, are unnecessary. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A life review interview guide: a structured systems approach to information gathering

To study the efficacy of eye movement desensitization and reprocessing (EMDR) with traumatized young women, 60 women between the ages of 16 and 25 were randomly assigned to two sessions of either EMDR or an active listening (AL) control. Factorial ANOVA interaction effects and simple main effects for outcome measure (Beck Depression Inventory, State-Trait Anxiety Inventory, Penn Inventory for Posttraumatic Stress Disorder, Impact of Event Scale, Tennessee Self-Concept Scale) indicated significant improvement for both groups and significantly greater pre-post change for EMDR-treated participants. Pre-post effect sizes for the EMDR group averaged 1.56 compared to 0.65 for the AL group. Despite treatment brevity, the posttreatment outcome variable means of EMDR-treated participants compared favorably with nonpatient or successfully treated norm groups on all measures.     

Sport psychology training within a clinical psychology program and a department of intercollegiate athletics.

Many applicants to clinical and counseling psychology programs are interested in receiving the training needed to practice competently in the professional specialty area of sport psychology. In this article, the authors describe a collaborative training and service relationship between an APA-accredited clinical psychology program and an intercollegiate athletics department. Sport Psychology Services provides performance enhancement, program evaluation, and mental health services to the athletic department. In return, graduate students receive applied training, financial support, and opportunities to conduct research. The authors present program evaluation data and offer practical guidelines to graduate programs wishing to establish similar training opportunities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of the RECAP intervention program for children with concurrent internalizing and externalizing problems.

The authors evaluated the efficacy of RECAP, a psychosocial intervention developed to treat concurrent internalizing and externalizing problem in children. Participants included 93 4th-grade children assigned to the treatment group or a no-treatment control group. The school-based program, which lasts the 9-month academic year, provides individual, group, classroom, teacher, and parent training in the RECAP skills-development curriculum, which was derived from empirically supported treatment programs for nonconcurrent internalizing and externalizing problems. Outcome assessments included parent-, teacher-, self-, and peer reports. A mixed hierarchical linear models analysis indicated that, overall, treatment children's rate of improvement in both internalizing and externalizing problems was significantly greater than that for control participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EMDR for panic disorder with agoraphobia: Comparison with waiting list and credible attention-placebo control conditions.

In a randomized controlled trial, eye movement desensitization and reprocessing (EMDR) for panic disorder with agoraphobia (PDA) was compared with both waiting list and credible attention-placebo control groups. EMDR was significantly better than waiting list for some outcome measure, (questionnaire, diary, and interview measures of severity of anxiety, panic disorder, and agoraphobia) but not for others (panic attack frequency and anxious cognitions). However, low power and, for panic frequency, floor effects may account for these negative results. Differences between EMDR and the attention placebo control condition were not statistically significant on any measure, and, in this case, the effect sizes were generally small (η?=?.00–.06), suggesting the poor results for EMDR were not due to lack of power. Because there are established effective treatments such as cognitive–behavior therapy for PDA, these data, unless contradicted by future research, indicate EMDR should not be the first-line treatment for this disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of training on the accuracy of Direct Behavior Ratings (DBR).

To date, extant research has not established how rater training affects the accuracy of data yielded from Direct Behavior Rating (DBR) methods. The purpose of the current study was to examine whether providing users of DBR methods with a training session that utilized practice and performance feedback would increase rating accuracy. It was hypothesized that exposure to direct training procedures would result in greater accuracy than exposure to a brief familiarization training session. Results were consistent with initial hypotheses in that ratings conducted by trained participants were more accurate than those conducted by the untrained participants. Implications for future practice and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When training with a partner is inferior to training alone: The importance of dyad type and interaction quality.

Dyad training, where trainees learn in pairs but ultimately perform individually, has been shown to be an effective method for training some skills. The effectiveness of this approach, however, may be tied to the type of task to be trained and the quality of the interaction in the dyad. We report two studies on the effectiveness of dyad training and the role of metacognitive activity for learning a software program. In Study 1, participants completed training alone or with a partner. Performance was assessed individually immediately after training and again after a 1-week nonuse interval. Results of Study 1 suggested that learning retention is superior when people are trained individually. Study 2 examined performance for individuals, task-switching dyads, and interdependent dyads. Results also showed that performance for individuals was superior to dyads and that the type of dyad collaboration did not affect performance. However, partner-prompted metacognitive activity was helpful for interdependent dyads and harmful for task-switching dyads, suggesting that the quality of collaboration varies by dyad type. Our findings suggest that dyad training may not be effective for all types of tasks. Possible boundary conditions for effective dyad training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The emergency department as a violence prevention center

No longer confined to the criminal justice system alone, violence is now regarded as a major health care issue in America. Changes are apparent not only in health care delivery, but also in medical school curricula, residency training board examinations, and accreditation. Although tertiary prevention demands the most acute attention, opportunities for secondary prevention are important and often neglected, especially when the immediate health care issue is not related to violence. This article describes the development of the Emergency Department as a Violence Prevention Center program, established at The George Washington University Medical Center. The program moves beyond responding to acute cases of violence only and considers the hospital emergency department as an active player in a community-wide effort to end violence. It does this through universal screening, assessment, treatment and other interventions, documentation, and patient and professional education.     

Enhancing the transfer of computer-assisted training proficiency in geographically distributed teams.

The authors examined factors that determine whether knowledge gained from computer-assisted (i.e., technology-based) team training in a geographically distributed team (GDT) context transfers to organizational results. They examined the moderating effects of team trust, technology support, and leader experience on the relation between teams' average individual training proficiency on a computer-assisted (i.e., CD-ROM-based) training program and team performance as assessed by team customer satisfaction ratings. Using data collected from 40 GDTs in a high-technology company, the authors found that the relation between teams' average training proficiency and team performance was complex and moderated by several factors. In particular, teams' average training proficiency had a positive association with customer satisfaction when GDTs were higher, rather than lower, in both trust and technology support and when team leaders had longer, rather than shorter, levels of tenure with their specific team. (PsycINFO Database Record (c) 2010 APA, all rights reserved)