EMDR Clinical Applications

EMDR is conceptualized as a treatment for the experiential contributors of disorders and health. Expanding the standard protocols (Shapiro, 1995, 2001), additional applications have been developed in direct clinical practice by experts and consultants in a variety of specialty areas. As with all treatments for most of these disorders, little controlled research has been conducted, a state of affairs evident in an evaluation report by a taskforce set in motion by the Clinical Division of the American Psychological Association (Chambless, Baker, Baucom, Beutler, Calhoun, Crits-Christoph, et al., 1998). It revealed that only about a dozen complaints, such as specific phobias and headaches had empirically well-supported treatments. Adding to this is the circumstance that many of the treatments listed as empirically validated had not been evaluated for the degree to which they provided substantial long-term clinical effects. For the latest listing see: http://therapyadvisor.com

While EMDR protocols for PTSD have been widely investigated by controlled research, it is hoped that the additional applications will be thoroughly investigated. Suggested parameters have been thoroughly delineated (Shapiro, 2001, 2002). To aid researchers in identifying protocols available for study, and to assist clinicians in obtaining supervision for proposed applications, published materials and conference presentations are listed below. Many presentations have been taped and are available from the conference coordinators. Presenters may also be accessed directly through the EMDR International Association http://www.emdria.org

Positive therapeutic results with EMDR have been reported with a wide range of populations. As previously noted, however, most of the clinical disorders listed have no empirically validated treatments and widespread investigation with controlled research is needed in all orientations (see Chambless et al., 1998). EMDR clinical applications are based upon the adaptive information processing model (see Shapiro, 2001, 2002) which posits that the reprocessing of experiential contributors can have a positive effect in the treatment of a variety of disorders. To-date, while numerous controlled studies have supported EMDR’s effectiveness in the treatment of PTSD, other clinical applications are based on clinical observations and are in need of further investigation.

Since the initial efficacy study (Shapiro, 1989a), positive therapeutic results with EMDR have been reported with a wide range of populations including the following:

1. Combat veterans from Desert Storm, the Vietnam War, the Korean War, and World War II who were formerly treatment resistant and who no longer experience flashbacks, nightmares, and other PTSD sequelae (Blore, 1997a; Carlson, Chemtob, Rusnak, & Hedlund, 1996; Carlson, Chemtob, Rusnak, Hedlund, & Muraoka, 1998; Daniels, Lipke, Richardson, & Silver, 1992; Lipke, 2000; Lipke & Botkin, 1992; Silver & Rogers, 2001; Thomas & Gafner, 1993; White, 1998; Young, 1995).

2. Persons with phobias and panic disorder who revealed a rapid reduction of fear and symptomatology (De Jongh & ten Broeke, 1998; De Jongh, ten Broeke & Renssen, 1999; De Jongh, van den Oord, & ten Broeke, 2002; Doctor, 1994; Feske & Goldstein, 1997; Goldstein, 1992; Goldstein & Feske, 1994; Kleinknecht, 1993; Nadler, 1996; O’Brien, 1993; Protinsky, Sparks, & Flemke, 2001a). Some controlled studies of spider phobics have revealed comparatively little benefit from EMDR, (e.g., Muris & Merckelbach, 1997; Muris, Merkelbach, Holdrinet, & Sijsenaar, 1998; Muris, Merckelbach, van Haaften & Nayer, 1997) but evaluations have been confounded by lack of fidelity to the published protocols (see De Jongh et al., 1999; Shapiro, 1999 and Appendix D). One evaluation of panic disorder with agoraphobia (Goldstein, de Beurs, Chambless, & Wilson, 2000) also reported limited results (for comprehensive discussion per Shapiro, 2001, 2002; see also Appendix D).

3. Crime victims, police officers, and field workers who are no longer disturbed by the aftereffects of violent assaults and/or the stressful nature of their work (Baker & McBride, 1991; Dyregrov, 1993; Jensma, 1999; Kitchiner & Aylard, 2002; Kleinknecht & Morgan, 1992; McNally & Solomon, 1999; Page & Crino, 1993; Shapiro & Solomon, 1995; Solomon, 1995, 1998; Solomon, & Dyregrov, 2000; Wilson, Becker, Tinker, & Logan, 2001).

4. People relieved of excessive grief due to the loss of a loved one or to line-of-duty deaths, such as engineers no longer devastated with guilt because their train unavoidably killed pedestrians (Lazrove et al., 1998; Puk, 1991a; Shapiro & Solomon, 1995; Solomon, 1994, 1995, 1998; Solomon & Kaufman, 2002).

5. Children and adolescents healed of the symptoms caused by trauma (Chemtob, Nakashima, Hamada & Carlson, 2002; Cocco & Sharpe, 1993; Datta & Wallace, 1994, 1996; Fernandez, Gallinari, & Lorenzetti, 2004; Greenwald, 1994, 1998, 1999, 2000, 2002; Jaberghaderi, Greenwald, Rubin, Dolatabadim, & Zand, in press; Johnson, 1998; Korkmazler-Oral & Pamuk, 2002; Lovett, 1999; Pellicer, 1993; Puffer, Greenwald & Elrod, 1998; Russell & O’Connor, 2002; Scheck, Schaeffer, & Gillette, 1998; Shapiro, 1991; Soberman, Greenwald, & Rule, 2002; Stewart & Bramson, 2000; Taylor, 2002; Tinker & Wilson, 1999).

6. Sexual assault victims who are now able to lead normal lives and have intimate relationships (Edmond, Rubin, & Wambach, 1999; Hyer, 1995; Parnell, 1994, 1999; Puk, 1991a; Rothbaum, 1997; Scheck, Schaeffer, & Gillette, 1998; Shapiro, 1989b, 1991, 1994; Wolpe & Abrams, 1991).

7. Victims of natural and manmade disasters able to resume normal lives (Chemtob et al, 2002; Fernandez, et al, 2004; Grainger, Levin, Allen-Byrd, Doctor, & Lee, 1997; Jarero, Artigas, Mauer, Lopez Cano, & Alcala, 1999; Knipe, Hartung, Konuk, Colleli, Keller, & Rogers, 2003; Shusta-Hochberg, 2003)

8. Accident, surgery, and burn victims who were once emotionally or physically debilitated and who are now able to resume productive lives (Blore, 1997b; Hassard, 1993; McCann, 1992; Puk, 1992; Solomon & Kaufman, 1994).

9. Victims of marital and sexual dysfunction who are now able to maintain healthy relationships (Keenan & Farrell, 2000; Kaslow, Nurse, & Thompson, 2002; Levin, 1993; Protinsky, Sparks, & Flemke, 2001b; Snyder, 1996; Wernik, 1993).

10. Clients at all stages of chemical dependency, and pathological gamblers, who now show stable recovery and a decreased tendency to relapse (Henry, 1996; Shapiro & Forrest, 1997; Shapiro, Vogelmann-Sine, & Sine, 1994; Vogelmann-Sine, Sine, Smyth, & Popky, 1998).

11. People with dissociative disorders who progress at a rate more rapid than that achieved by traditional treatment (Fine, 1994; Fine & Berkowitz, 2001; Lazrove, 1994; Lazrove & Fine 1996; Marquis & Puk, 1994; Paulsen, 1995; Rouanzoin, 1994; Twombly, 2000; Young, 1994).

12. People engaged in business, performing arts, and sport who have benefited from EMDR as a tool to help enhance performance (Crabbe, 1996; Foster & Lendl, 1995, 1996; Graham, 2004).

13. People with somatic problems/somatoform disorders, including chronic pain, who have attained a rapid relief of suffering (Brown, McGoldrick, & Buchanan, 1997; Dziegielewski & Wolfe, 2000; Grant, 1999; Grant & Threlfo, 2002; Gupta & Gupta, 2002; Ray & Zbik, 2001; Wilson et al., 2000.)

14. Clients with a wide variety of PTSD and other diagnoses who experience substantial benefit from EMDR (Allen & Lewis, 1996; Brown, McGoldrick, & Buchanan, 1997; Cohn, 1993; Fensterheim, 1996; Forbes, Creamer, & Rycroft, 1994; Gelinas, 2003; Ironson, et al., 2002; Korn & Leeds, 2002; Lee, et al., 2002; Manfield, 1998; Manfield & Shapiro, 2003; Madrid, Skolek, Shapiro, in press; Marcus, Marquis, & Saki, 1997; Marquis, 1991; McCullough, 2002; Parnell, 1996; 1997; Pollock, 2000; Power et al., 2002; Protinsky, Sparks, & Flemke, 2001a; Puk,1991b; Renfrey & Spates, 1994; Ricci, in press; Rittenhouse, 2000; Shapiro & Forrest, 1997; Spates & Burnette, 1995; Spector & Huthwaite, 1993; Sprang, 2001; Vaughan, et al., 1994; Vaughan, Wiese, Gold, & Tarrier, 1994; Wilson, Becker, & Tinker, 1995, 1997; Wolpe & Abrams, 1991; Zabukovec, Lazrove & Shapiro, 2000).

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