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Laizeau, Martine. "Psychologie positive et EMDR : questions et perspectives." Thesis, Université de Lorraine, 2013. http://www.theses.fr/2013LORR0340/document.
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L’EMDR est une thérapie intégrative créée en 1987 par Shapiro évaluée comme efficace et rapide sur les états de stress post traumatiques. En 1995, elle améliore pour arriver à ce qu’elle appelle le Traitement Adaptatif de l’Information – TAI - (« Adaptative Informational Process : AIP »), révisé en 2001 et 2006. Cette théorie postule qu’il existe au plan cérébral un système de traitement des informations capable d’intégrer les nouvelles expériences à des réseaux de mémoire existants. Depuis d’autres pathologies ont été traitées avec l’EMDR. D’autre part, en 1998, Seligman donne naissance à la psychologie positive. Au lieu de considérer la «santé mentale » comme la « réduction des troubles neuropsychiatriques », il propose non plus d’aider les gens à passer de - 5 à 0 sur l’échelle de bonheur, mais de permettre à chacun de passer de 0 à + 5 sur un continuum de bonheur. Allier ces deux perspectives pose un certain nombre d’interrogations mais ouvre également des perspectives enthousiasmantes. Trois études ont porté sur les forces de caractères avec un échantillon de 60 sujets, pour la première, 100 sujets pour la seconde et une étude de cas avec pour objectif d’évaluer l’optimisation de l’intégration des forces avec des éléments provenant de l’EMDR. Les deux études suivantes ont porté sur la création d’un protocole EMDR d’optimisme et l’étude de ses possibilités. Nos conclusions sont que, plus que jamais, une théorisation rigoureuse est nécessaire (et elle est déjà à l’œuvre dans le cadre de la psychologie positive) et la validation scientifique des assertions est déterminante pour l’efficacité des interventions alliant psychologie positive et EMDEMDR is an integrative therapy founded in 1987 by Shapiro evaluated as efficient and fast on post traumatic stress. In 1995, she improved the therapy to achieve what she calls the Adaptive Information Processing, or AIP, later revised in 2001 and 2006. This theory posits that there is a map in the brain information processing system able to integrate new experiences to existing networks of memory. Since its inception, other diseases were treated with EMDR. Meanwhile, in 1998, Seligman gave birth to Positive Psychology. Instead of considering mental health as the reduction of neuropsychiatric disorders and help people move from - 5 to 0 on the scale of happiness, he proposed we help everyone go from 0 to +5 on a continuum of happiness. Combining these two perspectives raises a number of questions but also opens up exciting prospects. Three studies have focused on strengths of characters with a sample size of 60 subjects in the first case, 100 subjects in the second, and a case study with the objective of evaluating the value of integrating strengths with elements from EMDR in the third case. The following two studies have focused on the creation of a protocol for an optimism-based EMDR and study its potential. Our conclusions are that, more than ever, a rigorous theory is required (and is already at work in the context of positive psychology) and the scientific validation of assertions is crucial for the effectiveness of interventions combining positive psychology and EMDR
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Pousette, Lisa. "EMDR-behandling vid posttraumatiskt stress-syndrom." Thesis, Ersta Sköndal högskola, S:t Lukas utbildningsinstitut, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1756.
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EMDR, eye movement desentization and reprocessing, är en evidensbaserad psykoterapeutisk metod för behandling av bl. a trauma. Syftet med undersökningen var att undersöka effekten av EMDR-behandling på patienter hos S:t Lukas. Frågeställningar: Hur skattar S:t Lukas patienter Posttraumatisk stress disorder (PTSD)-kriterierna återupplevande, undvikande och överspändhet, före och efter EMDR-behandling? Finns det utifrån bakgrundsvariablerna kön, ålder, typ av trauma, tidigare trauma samt antal behandlingstillfällen några skillnader i personernas skattningar före respektive efter behandlingen? Metod: I denna kvantitativa studie undersöktes 21 kvinnor och 9 män före och efter EMDR behandling. Självskattningsformuläret Impact of Event Scale-Revised, IES-R användes, vilket mäter PTSD-kriterierna återupplevande, undvikande och överspändhet. Resultat och diskussion: Resultaten från studien visar statistiskt signifikant symtomminskning i återupplevande, undvikande och överspändhet. Ingen av patienterna gav indikation på PTSD efter EMDR-behandlingen. Före behandlingen var genomsnittet för IES-värdet 2,8. Efter behandlingen hade genomsnittet för IES-värdet sjunkit till 0,7. Det finns statistiskt signifikanta skillnader mellan IES-värdet när olika bakgrundsvariabler särskiljs: yngre (personer under 40 år) har ett signifikant lägre IES-värde för återupplevande än äldre efter behandling, personer som utsatts för rån har ett signifikant högre IES-värde för överspändhet än personer som utsatts för andra trauma före behandling och personer som utsatts för rån har ett signifikant högre IES-värde för undvikande än personer som utsatts för andra trauma efter behandling. Det genomsnittliga IES-värdet minskade med 2,1 för kvinnor och 2,0 för män. Kvinnor och män svarar således på behandlingen på likartat sätt men de könsbundna variationerna i denna undersökning är inte signifikanta. Personer som utsatts för tidigare trauma har före behandling ett genomsnittligt högre IES-värde, 2,9, än personer som inte utsatts för tidigare trauma, 2,6. Skillnaden i IES-värde är emellertid inte statistiskt signifikant och efter behandling är IES-värdet i stort sett detsamma för de två grupperna.
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Harbert, Carolyn. "EMDR: the client and therapist perspective." Thesis, University of Warwick, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.581993.
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Brendler, Edward H. "How Eye Movement Desensitization and Reprocessing (EMDR) Trained Therapists Stabilize Clients Prior to Reprocessing with EMDR Therapy." Antioch University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1511920560809.
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Sundberg, Anna. "Vad hjälper hjälparen? : Vad upplever erfarna EMDR-terapeuter som riskfaktorer respektive skyddande faktorer vid traumabehandling?" Thesis, Ersta Sköndal högskola, S:t Lukas utbildningsinstitut, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4689.
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Eye Movement, Desensitization and Reprocessing (EMDR) är en evidensbaserad behandling som framförallt erbjuds patienter med Post Traumatiskt Stressyndrom (PTSD) i Sverige. Psykoterapeuter som arbetar med dessa svårt traumatiserade patienter kan vara utsatta för allvarliga hälsorisker. Syftet med studien är att undersöka hur EMDR-utbildade psykoterapeuter upplever sitt behandlingsarbete med traumatiserade patienter, avseende psykologiska risker och skyddsfaktorer för hälsan. Undersökningen gjordes med semistrukturerade intervjuer av sex EMDR-terapeuter enligt kvalitativ metod. Med hjälp av tematisk analys har teman gällande exempelvis arbetsbelastning, handledningsbehov och framgångsupplevelser av EMDR-metoden kunnat skönjas. Undersökningen visar att flertalet av psykoterapeuterna har upplevt risker i form av upplevd psykisk stress med arbetet, men att de också funnit robusta, skyddande och stärkande faktorer i såväl arbetssituationen, som i privatlivet.Eye Movement, Desensitization and Reprocessing (EMDR) is an evidence based treatement that is offered primarily to patients suffering from Post- Traumatic Stress Syndrome (PTSD). Psychotherapists who treat these severely traumatized patients are at risk for turther health concerns compared to other therapists. This essay aims towards examining how EMDR-therapists perceive the risks that EMDR-therapy with traumatized patients can affect the therapist, and the factors that makes the treatment possible to continue with. The study was conducted through semistructured interviews with six EMDR-therapists, based on a qualitative method. With the help of thematic analysis, themes such as workload, need of guidance and succesful experiences concerning EMDR has beend found. The study also shows that many of the informants has experienced risk factors such as mental stress concerning work, but also robust, protective and strengthening factors at the work place and in private life.
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Brennstuhl, Marie-Jo. "Utilisation de la thérapie EMDR - Eye Movement Desensitization and Reprocessing - dans le cadre de la douleur chronique : efficience et perspectives cliniques." Thesis, Université de Lorraine, 2013. http://www.theses.fr/2013LORR0213.
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L'utilisation de la thérapie EMDR - Eye Movement Desensitization and Reprocessing - est novatrice dans le domaine de la douleur chronique, trois étapes ont alors composées ce travail de thèse.La première porte sur l'étude de l'apparition d'une nouvelle composante de la douleur chronique : la composante traumatique. Multifactorielle, la douleur chronique intègre quatre composantes fondamentales : sensorielle, cognitive, comportementale et émotionnelle. Une revue de la littérature sur la comorbidité entre douleur chronique et ESPT a alors été réalisée.La seconde étape constitue une recherche préliminaire qui porte sur l'utilisation de la thérapie EMDR, et d'un protocole EMDR spécifique à la douleur, qui a été testé sur trois patients en pré-test. La thérapie EMDR donne des résultats encourageants. La recherche principale de ce travail de thèse s'est enfin attachée à comparer l'utilisation de la thérapie EMDR vs. une prise en charge éclectique, dans une Unité de prise en charge de la douleur chronique, à l'hôpital. Quarante-cinq patients, répartis en trois groupes, ont alors bénéficié d'une prise en charge avec la thérapie EMDR (protocole standard), avec la thérapie EMDR (protocole douleur), ainsi qu'en thérapie éclectique. Les résultats mettent en évidence l'efficacité de la thérapie EMDR sur les composantes sensitives, cognitives, comportementales, émotionnelles mais aussi traumatiques de la douleur, avec une plus grande efficacité du protocole standard EMDR après 5 séances, et une diminution de la douleur qui se prolonge un mois après la fin du traitementConsidering the use of EMDR (Eye Movement Desensitization and Reprocessing) therapy is an innovative approach in chronic pain management, this research was divided into three steps.The first part focuses on studying the introduction of the traumatic component as a new aspect of chronic pain. As a multifactorial issue, chronic pain includes four key components, namely sensory, cognitive, behavioural and emotional aspects. In this context, a literature review on comorbidity between chronic pain and post-traumatic stress disorder was carried out.The second step includes a preliminary research on the use of EMDR therapy and an EMDR protocol specifically related to pain, which was pre-tested on three patients. Results of EMDR therapy are encouraging. Clinical findings of traumatic memories which emerged during therapy were used as a basis for the third step.As a result, the main focus of this research was to compare the use of EMDR therapy versus eclectic healthcare in a hospital unit specialized in the management of chronic pain. Forty-five patients divided into three groups were treated by standard protocol of EMDR therapy, pain protocol of EMDR therapy and eclectic therapy. Results show the effectiveness of EMDR therapy on sensory, cognitive, behavioural and emotional but also traumatic components of pain, EMDR standard protocol being most efficient after five sessions, and a reduction of pain extending one month after therapy has been discontinued
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Fredin, Ingela. "EMDR-behandling : Barns och ungdomars upplevelser en kvalitetssäkringsstudie." Thesis, Umeå universitet, Psykoterapi, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-41883.
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Föreliggande studie är dels ett led i att kvalitetssäkra EMDR (Eye Movement Desensitization and Reprocessing) som behandlingsmetod för barn och ungdomar och dels att utröna om behandlingen bidragit till ett förbättrat mående. EMDR som behandlingsmetod för barn och ungdomar har stöd i kontrollerade studier, men ytterligare forskning behövs. I den här studien deltog åtta barn och ungdomar med varierande diagnoser, vilka fått EMDR-behandling i barn- och ungdomspsykiatrisk öppenvård. Behandlingen ingick i en individualterapi i ett familjeterapeutiskt sammanhang. Barnen/ungdomarna intervjuades per telefon om hur de upplevt behandlingen och om sitt mående i efterförloppet. Information om diagnoser, C-GAS, antal EMDR-sessioner samt terapeutens bedömning inhämtades som komplement till intervjun. Resultaten visar att EMDR-behandlingen upplevs ha bidragit till att obehagskänslor och symtom minskade, men i olika grad, för alla intervjuade barn/ungdomar. Denna förändring kunde också noteras i terapeutens bedömning och i de bedömda C-GAS-värdena. Alla kände sig trygga under behandlingen och tyckte att de fick tillräcklig information. Hälften tyckte att konfrontationen med de svåra minnena var det mest obehagliga. Vissa detaljer i protokollet, såsom att bestämma målbild, upplevdes svårt för över hälften. Alla intervjuade skulle rekommendera EMDR-behandling till andra. Det positiva resultatet talar för att EMDR är en användbar metod för barn- och ungdomar med traumatiska minnen, och att det är värdefullt att satsa på fortsatt forskning kring EMDR med barn- och ungdomar.
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Ricke, Paula. "Rekonsolidering av minnen i psykoterapi med EMDR : Klienters upplevelser." Thesis, Umeå universitet, Institutionen för psykologi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-180359.
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Denna intervjustudie undersöker klienters upplevelser av hur traumatiska minnen förändrats efter psykoterapi med Eye Movement Desensitization and Reprocessing, EMDR. Informanterna var sex vuxna klienter som utvecklat patologiska symtom efter traumatiska upplevelser och som genomgått psykoterapi med EMDR. Intervjumaterialet transkriberades och analyserades med hjälp av fenomenografisk metod. Med hjälp av tematisk analys skapades tre huvudteman och fem underkategorier. Informanterna beskrev hur de traumatiska minnena med tillhörande känsloregister aktiverades i en trygg kontext som gav en upplevelse av bibehållen kontroll. Minnena upplevdes obetydligt störande efter terapin samt möjliga att sätta i sitt sammanhang och i rätt tidsföljd. Den känslomässiga laddningen i minnena upplevdes i hög utsträckning neutraliserad. Vidare beskrevs positiva förändringar avseende självuppfattning samt att adaptiva upplevelser och hjälpsamma känslor integrerats i de traumatiska minnena. Dessa faktorer indikerar att en process kompatibel med teorin om minnesrekonsolidering skett, utifrån att traumatiska, emotionella minnen processats, ny adaptiv information införlivats genom upplevande och gamla, ursprungliga minnen uppdaterats och rekonsoliderats.
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Smith-Lee, Chong Penelope Anastasia. "The experiences of EMDR therapists when working with PTSD." Thesis, University of Wolverhampton, 2016. http://hdl.handle.net/2436/601134.
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Trauma therapists increasingly use EMDR when working with Posttraumatic Stress Disorder (PTSD) and trauma clients as it is recommended by NICE guidelines (2005) however until recently research focused on the negative impact of trauma work. Posttraumatic Growth (PTG) appears to be the most commonly used term for ‘growth’ however attempts to define and measure it can be criticised for being reductionist in approach as it reduced five factors into three outcomes based on the client’s growth. Research on trauma therapists’ growth has relied on client definitions that is; Vicarious PTG is based on PTG although there are a couple of studies which collaborate these findings. This study aims to address the literature and practitioner gap by exploring EMDR therapists’ lived experiences of ‘vicarious growth’ when working with PTSD symptom clients. Semi-structured interviews were used to collect data from a homogeneous sample of six EMDR therapists who stated that they had positive experiences or experienced growth (positive change) when working with PTSD symptom clients. Interpretative Phenomenological Analysis (IPA) was used to analyse the data. Rich, detailed findings in terms of how ‘growth’ is experienced emerged as four super-ordinate themes: A: Initial struggles; B: Experiences of the “healing journey”; C: Growth through connecting and D: Impact of growth on ‘self’. Implications of experiences of the therapeutic relationship as a “healing journey” for therapists were discussed in terms of a potential power imbalance where they might be viewed as ‘experts’. However, a better understanding of how therapists experience ‘vicarious growth’ with their clients enables them to utilise this knowledge to develop their own growth and self-awareness therefore supervision and training to encourage self-awareness was also discussed. These Positive Psychology (growth) findings such as self-belief in skills; use of ‘special set’ of clients; self-image as 3 ‘guide’ and the spread of growth to areas outside of therapy can be utilised to add Positive Psychology (growth) into existing supervision and training (EMDR and trauma) thereby enhancing existing models or creating new ones. Therapists growth and well-being may lead to lower occupational risk than was previously thought working amongst trauma clients and perhaps greater job satisfaction. KEYWORDS: Eye Movement Desensitization and Reprocessing (EMDR), Posttraumatic Stress Disorder (PTSD), Posttraumatic Growth (PTG), Vicarious Posttraumatic Growth (VPTG), Vicarious Growth (VG), Interpretative Phenomenological Analysis (IPA); EMDR therapists; Positive Psychology.
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Cohen, Steven. "Eye movement desensitization and reprocessing (EMDR), the making of a psychotherapy." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ64135.pdf.
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Cohen, Steven 1973. "Eye movement desensitization and reprocessing (EMDR) : the making of a psychotherapy." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30153.
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Eye Movement Desensitization Reprocessing (EMDR) therapy has burst upon the psychotherapeutic scene as a time-limited, cost-contained, and efficacious treatment for anxiety, stress, and psychological trauma. Although this therapy has been pronounced as revolutionary by its inventor, Francine Shapiro, it has distinct historical precedents. The explanatory models of pathogenic memory and dissociation theory, and the reliance on mechanical inference for objectivity make EMDR therapy familiar and salient. Notions of suggestion and hypnosis, and the eye-movement component of therapy are presented as discontinuous with clinical and theoretical practice, in order to free them from the tainting associations of pseudo-science and quackery. By connecting the current EMDR movement with the conceptual and practical history of traumatic memory, dissociation, and suggestion, I argue that EMDR is not revolutionary. It is a powerful technology of the self, normalizing and valourizing certain ways of behaving and thinking. Shapiro's implicit assumptions that psychological suffering is pathological, and that early traumatic events are indelibly encoded, stored and dissociated in the brain are problematized. A brief commentary on the moral, political, and psychotherapeutic implications of EMDR therapy is provided.
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Negadi, Fethi. "Intérêt de la thérapie EMDR dans le traitement des troubles phobiques." Paris 6, 2008. http://www.theses.fr/2008PA066201.
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Parallèlement aux médicaments, le développement des traitements psychothérapeutiques acquière une légitimité thérapeutique de plus en plus confortée par les connaissances scientifiques. Actuellement, pour le traitement des troubles anxieux, la littérature met en avant l’efficacité des thérapies à base d’exposition comme la thérapie EMDR qui a été développée par Shapiro pour traiter surtout le stress post traumatique, mais aussi les phobies. Cette thérapie a été largement étudiée dans le traitement de l’Etat de Stress Post Traumatique avec des résultats satisfaisants, mais a fait l’objet de peu d’études dans le traitement des phobies et notamment avec composante traumatique. Notre travail a consisté à tester l’efficacité de cette thérapie dans les troubles phobiques avec ou sans composante traumatique. Pour cela nous avons d’abord effectué une méta-analyse pour déterminer la robustesse des résultats des études publiées, puis une étude contrôlée, randomisée en comparant dans un premier temps un groupe traité à un groupe non traité, et en utilisant des échelles psychométriques standardisées, une mesure physiologique, et un Test d’Evitement Comportemental. Les résultats de notre essai thérapeutique montrent que l’EMDR est supérieure à l’abstention de traitement, notamment sur le plan de l’évitement et de la sévérité symptomatique. Les mêmes résultats sont retrouvés lors de la réplication de la thérapie chez le groupe contrôle. Il ressort aussi en terme d’efficacité, que chez un tiers des patients, l’EMDR est remarquablement efficace et peut de ce fait être considérée comme une thérapie brève puisque, ces résultats sont en majorité obtenus à l’issue de six séances de thérapie seulement. Les résultats montrent aussi que le facteur traumatique constitue un marqueur en faveur d’une meilleure efficacité de l’EMDR.
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Teneycke, Tricia L. "Utilizing the Standard Trauma-Focused EMDR Protocol in Treatment of Fibromyalgia." Antioch University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1357592863.
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Spinney, Ashley Amara. "Exploring How EMDR Social Workers in Eastern Canada Experience Vicarious Trauma." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7195.
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Social workers are increasingly using eye movement, desensitization, and reprocessing (EMDR) to help clients recover from trauma. Little is known about how social workers who work with traumatic client material while using EMDR as their main psychotherapeutic modality experience vicarious trauma. The purpose of this phenomenological study was to explore the experience of vicarious trauma among social workers in Eastern Canada who used EMDR in their practice with clients. Constructivist self-development theory was the framework that informed this study. Data were collected using semistructured interviews with 7 EMDR social work participants who were selected using purposive sampling. Participants were required to have a masters level social work designation, EMDR training, and practice with trauma material at least 40% of the time they see clients. Findings from the narrative analysis showed that participants' concepts of 'self' changed over time, with the changes becoming less acute. Understanding how EMDR social workers experience vicarious trauma has implications for policy, practice, future research, and for social change related to trauma. Social workers who are less likely to become traumatized may fit a prototype that may be more appealing to organizational stability. Clinicians may be able to see the signs and symptoms of vicarious trauma and take more time for education and self-care. Finally, study findings may further research on vicarious trauma and EMDR.
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Vaillant-Ciszewicz, Anne-Julie. "Les stimulations bilatérales alternées dans la prise en charge des troubles du comportement de la personne âgée en EHPAD : Usage d’une technique de la psychothérapie EMDR en gérontologie." Thesis, Université Côte d'Azur, 2020. http://www.theses.fr/2020COAZ2003.
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De nombreuses études scientifiques valident l’efficacité de la thérapie EMDR (Eye Movement Desensitization and Reprocessing) pour le traitement du TSPT (Trouble de Stress Post Traumatique, DSM-5). L’EMDR s’édifie sur un traitement adaptatif de l’information qui s’établit grâce à la spécificité de son protocole en huit phases (Shapiro, 1989) et à l’action des Stimulations Bilatérales Alternées (SBA). Le champ thérapeutique de l’EMDR ne cesse de s’élargir vers les troubles de l’humeur, les phobies, les addictions, les douleurs chroniques et le champ sanitaire (annonce cancer). De nos jours, des protocoles EMDR existent pour les enfants (Lavett, 1999), pour les personnes avec déficits intellectuels (Mevissen, Lievegoed, Seubert & Jongh, 2011), mais peu de littérature s’intéresse à la personne âgée avec troubles cognitifs majeurs. Hyer (1995) reporte uniquement des cas cliniques de séances d’EMDR effectuées avec des patients présentant des troubles cognitifs légers. Amano et al., (2015) sont les seuls chercheurs à avoir rédigé un protocole « d’EMDR sur le champ » applicable aux troubles cognitifs sévères. Objectif : L’étude du CHU de Nice vise à mettre en place une méthode thérapeutique non médicamenteuse empruntée à l’EMDR dans le but de réduire les troubles du comportement de type agitation verbale chez le sujet âgé en EHPAD avec troubles cognitifs majeurs. La gestion des émotions dans le cadre des pathologies neurocognitives est déficitaire au même titre que les processus mnésiques. Les symptômes du TSPT et ceux induits par la démence sont similaires : angoisse, hyper vigilance, comportement d’évitement, etc. Si les SBA produisent un apaisement immédiat du système parasympathique dans le TSPT, il est probable que nous retrouvions ce même effet pour les SCPD . Méthode : Le protocole s’est déroulé en EHPAD. Les critères d’inclusion sont ceux de pathologies neurodégénératives à un stade sévère (MMSE<10) ainsi que l’agitation verbale mesurée avec les équipes soignantes (NPI-ES, Covi, CMAI scale). 15 résidents ont été inclus dans cette étude de faisabilité. Les sujets ont été randomisés et attribués dans un groupe contrôle et un groupe SBA après enquête étiologique. Des sessions de 10 minutes de SBA ont été attribuées aux participants du groupe expérimental. Pour le groupe contrôle : des sessions de 10 minutes ont permis de tenir la main de la personne âgée (stimulation tactile continue). Le second temps de l’étude consiste en un suivi à long terme de trois résidents. Les SBA seront administrées sur 45 sessions en 5 mois. Le protocole est encadré par une RCP afin de permettre aux SBA d’intégrer le « soin usuel ». Résultats : Les résultats quantitatifs retrouvent une tendance à une meilleure efficacité des SBA par rapport au groupe contrôle entre les interventions 1 et 2 pour 5 items (fréquence, durée, intensité, échelle de Pittsburgh, échelle CMAI) sur 6. Le suivi à long-terme des résidents a permis de confirmer les résultats des travaux de Cohen Mansfield (2012) concernant la corrélation entre cris, vocalisations et besoins primaires non assouvis. Discussion : le protocole SBA adapté pour les troubles cognitifs sévères pourrait faire l’objet de recommandations dans le cadre des approches communicationnelles non médicamenteuses, même si, en EHPAD, le manque de moyens et le turn-over des équipes soignantes constituent un frein à ces approchesMany scientific studies validate the effectiveness of EMDR (Eye Movement Desensitization and Reprocessing) therapy for the treatment of PTSD (Post Traumatic Stress Disorder, DSM-5). The EMDR is developing an adaptive treatment of information that is established thanks to the specificity of its protocol in eight phases (Shapiro, 1989) and the action of Alternate Bilateral Stimulations (SBA). The therapeutic field of EMDR continues to expand towards mood disorders, phobias, addictions, chronic pain and health field (cancer announcement). Today, many EMDR protocols exist for children (Lovett, 1999), for people with intellectual deficits (Mevissen, Lievegoed, Seubert-Jongh, 2011), but little literature is interested in the elderly with major cognitive impairments. Hyer (1995) reports only clinical cases of EMDR sessions performed with patients with mild cognitive impairment. Amano et al., (2015) are the only researchers to have written a " nursing home field " protocol for severe cognitive impairment. Objective : The study of the University Hospital of Nice aims to establish a non-drug therapeutic method borrowed from EMDR with the aim of reducing behavioral disorders type verbal agitation in the elderly subject in nursing homes with major cognitive disorders. The management of emotions in the context of neurocognitive pathologies is in deficit in the same way as the medical processes. The symptoms of PTSD and those induced by dementia are similar: anxiety, hyper-vigilance, avoidance behaviour, etc. If ABSs produce an immediate appeasement of the parasympathetic system in PTSD, it is likely that we will find the same effect for BPSDs. Method : The protocol took place in nursing homes. The inclusion criteria are those of severe neurodegenerative pathologies (MMSE-10) as well as verbal agitation measured with health care teams (NPI-ES, Covi, CMAI scale). 15 residents were included in this feasibility study. Subjects were randomized and assigned in a control group and an ABS group after primary needs satisfaction verification. 10-minute SBA sessions were assigned to participants in the experimental group. For the control group: 10-minute sessions held the elderly person's hand (continuous tactile stimulation). The second phase of the study is training nursing's homes health care teams and long-term follow-up in a CPR to allow SBAs to integrate "usual care." Results : The descriptive statistitics showed a benefit of efficiency for the ABS group vs control concerning 5 on 6 items (Duration, Frequency, Intensity, Pittsburgh Scale and CMAI scale). The long-term follow-up of three residents confirmed the results of Cohen Mansfield's (2012) work on the correlation between cries, vocalizations and unmet primary needs. Discussion: The suitable ABS protocol for severe cognitive impairment could be recommended for non-drug communication approaches, although in nursing homes the lack of resources and the turn-over of health care teams is a hindrance to these approaches
16
Steffens, Nathalie. "L’ajustement du thérapeute : ce que nous apprend l’étude des objets discursifs dans les phases 3 et 4 du protocole de la psychothérapie EMDR." Thesis, Université de Lorraine, 2017. http://www.theses.fr/2017LORR0250.
Full textAbstract:
Si l’efficacité des psychothérapies semble maintenant faire consensus, la recherche vient aujourd’hui interroger directement le processus psychothérapeutique. Notre travail s’inscrit dans cette démarche et se fonde sur l’étude de l’interaction verbale issue d’une psychothérapie émergente, la psychothérapie EMDR, Eyes Movement Desensitization and Reprocessing. La traduction française est désensibilisation et retraitement par les mouvements oculaires. Ce dispositif thérapeutique s’avère prometteur dans le champ du soin psychique, et est principalement identifié parmi les pratiques psychothérapeutiques comme étant celle où le thérapeute exerce une action physique sur son patient et ce, au moyen de stimulations bilatérales alternées (notamment par le biais de mouvements oculaires). L’EMDR bénéficie dans le champ de la recherche majoritairement d’études s’intéressant aux effets physiologiques en lien principalement avec les mouvements des yeux pendant le traitement. Or, en vertu du fait que l’EMDR s’agence aussi autour d’un protocole verbal, nous nous inscrivons dans le champ des études qui considèrent que la psychothérapie est avant tout un « événement de parole » (Labov et Fanshel, 1977). Ainsi, en nous appuyant sur l’étude du langage, à la fois tel qu’il est prévu par le protocole et tel qu’il est dispensé par le thérapeute en séance, nous venons compléter ces travaux en nous plaçant à un niveau de description clinique, à hauteur du sujet. Dans une première partie, nous nous situons sur le plan théorique, nous éclairons les phases 3 et 4, prototypes du protocole EMDR à la lumière de théories issues du champ de la pragmatique mais aussi à la lumière des théories issues de la psychanalyse. Dans une seconde partie de recherche empirique, nous examinons un corpus constitué de trois suivis psychothérapeutiques filmés et retranscrits. En nous inscrivant dans le réel de la pratique telle qu’elle se donne à entendre, nous mettons en œuvre une méthodologie d’analyse exploratoire et qualitative issue du paradigme de la pragmatique. Pour ce faire, nous nous référons aux travaux menés au sein de l’analyse linguistico-pragmatique des interventions du thérapeute et de la Logique Interlocutoire. Nous dégageons certaines caractéristiques de la matrice langagière qui viennent souligner son importance, son rôle et ses effets dans l’instauration d’un processus de changement qui apparaît bénéfique pour le patientAs the efficiency of psychotherapies is now widely recognized, research questions the psychotherapeutic process. In this vein, we review and study the verbal interactions resulting from an emerging psychotherapy, the Eyes Movement Desensitization and Reprocessing (EMDR) psychotherapy. This therapy is very promising in the field of psychic care. It is a psychotherapeutic practice in which the therapist exercises a physical action on his patient by means of alternating bilateral stimulations – notably by ocular movements. Thus far, research on EMDR has primarily examined the physiological effects related mainly to eye movements during treatment. Because EMDR also has a verbal protocol, we review it in the framework of studies that consider psychotherapy as a "speech event" above all (Labov and Fanshel, 1977). Based on a study of language, both as provided for in the protocol and as used by the therapist in session, we attempt to pursue these works by placing ourselves at a level of clinical description, at the level of the subject. In a first part, we follow a theoretical approach, and review phases 3 and 4 and prototypes of the EMDR protocol, in light of theories in the field of pragmatics and theories stemming from psychoanalysis. In a second part of empirical research, we examine a corpus consisting of three psychotherapeutic follow-ups, which have been filmed and transcribed. By placing ourselves into the reality of the practice, as it is commonly understood, we implement a methodology of exploratory and qualitative analysis emerging from the paradigm of pragmatics. To do this, we refer to the works carried out within the linguistic-pragmatic analysis of the interventions of the therapist as well as to interlocutory logic. We highlight some characteristics of the language matrix that demonstrate its importance, its role and its effects in the implementation of a process of change that appears to be beneficial for the patient
17
au, chris lee@murdoch edu, and Christopher Lee. "Efficacy and mechanisms of action of EMDR as a treatment for PTSD." Murdoch University, 2006. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20061123.120536.
Full textAbstract:
The first aim of this thesis was to describe the characteristics of Posttraumatic Stress Disorder (PTSD) and to elucidate its place as a symptom disorder that sometimes develops when people are exposed to a traumatic event. The current major theoretical approaches to account for why some people who are exposed to trauma develop PTSD and the mechanisms by which this occurs were described. Three classes of theories were reviewed: conditioning/learning approach; information processing theories with a particular focus on the meaning of the trauma event; and biological models with an emphasis on recent neurocircuitry and neurochemistry models.
Successful treatment approaches were then reviewed which indicated two major contenders for the most efficacious treatment for PTSD: traditional cognitive behaviour therapies (CBT) using either stress inoculation or prolonged exposure; and eye movement desensitisation and processing (EMDR). Prior to the first study (Lee, Gavriel, Drummond, Richards, & Greenwald, 2002), a review of the literature indicated equivalent effects for EMDR and CBT. There had been very few direct comparison studies and each had serious methodological flaws, particularly with respect to random assignment and treatment fidelity. Therefore, the first study ensured adequate attention to these areas and involved a direct comparison between the two procedures using a sample of 24 participants diagnosed with PTSD. EMDR and stress inoculation training with prolonged exposure were found to lead to similar symptom improvement at the end of treatment, apart from a slight advantage for EMDR on intrusion symptoms. Both treatments led to significantly greater symptom reduction than a wait list control condition. At follow-up, EMDR led to greater gains on both self-report and observer rated measures of PTSD and self-report measures of depression. Overall, the findings were similar to those described in previously published studies, with a suggestion that EMDR was slightly more efficient than the standard CBT approach.
Given that the evidence suggested that EMDR was a more efficient treatment, it became critical to understand the underlying processes. A process study was undertaken that examined the responses of people with PTSD receiving EMDR treatment (Lee, Taylor, and Drummond, 2006). Guided by process studies of other treatments and theories that might account for why EMDR is effective, participants responses were examined to see which models better accounted for symptom improvement. The main analysis tested whether or not the responses were consistent with processes that occurred during traditional CBT treatment, which prior research had identified as reliving, or whether they were more consistent with Shapiros proposal that enhanced information processing occurs because there is a dual focus of attention (that is, the person simultaneously focuses on an external stimulus and on the traumatic memory) (Shapiro, 1995). The responses made by 44 participants were coded by an independent rater according to whether they were primarily reliving, distancing, affect or material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement occurred when the participant processed in a more detached or distant manner, whereas reliving responses were not associated with improvement. Cross-lagged panel correlations suggested that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that co-varied with improvement. The findings underscored a difference in the processes that underlie EMDR and traditional CBT.
The major question left unanswered from this second study was what causes this distancing process? Competing views were that it was facilitated by eye movement; alternatively, the therapists instructions to participants might have precipitated this distancing phenomenon. The third study tested these ideas by randomly assigning 48 participants to either an eye movement or a no eye movement condition under two types of therapist instructions (reliving or distancing). Participants recalled personal distressing memories, and measures of distress and vividness were taken after treatment and at follow up. Only the eye movements made a significant difference to peoples level of distress.
This conclusion appeared at odds with some of the previous literature that had tested the effects of eye movement on levels of distress. A meta-analysis of some of this research had suggested that there was no significant advantage of including eye movement in EMDR treatment unless the person had been diagnosed with PTSD. However, a close examination of this meta-analysis indicated some major methodological flaws in the computation; therefore, this was recalculated. The conclusion from this fourth study was consistent with study three in that EMDR with eye movement was found to lead to significantly greater improvement that EMDR without eye movement.
The results of these four studies were then discussed in terms of their implications for the theoretical models presented in Chapter 1. Aspects of learning theory that might account for EMDR efficiency were discussed as well as the failure of this model to account for treatment gains following EMDR. Information processing models were seen to better account for some of the phenomena observed in EMDR and for the findings from the four studies. Some suggestions of how eye movements might facilitate improved information processing were presented.
Finally, the relative merits of EMDR and CBT treatments were discussed and suggestions made for when to combine approaches. The conclusions highlight the point that EMDR appears to be the most promising treatment for PTSD.
18
Rodríguez, Merino Clodomiro. "Psicoterapia "EMDR" aplicado a un grupo de pacientes con síndrome de depresión." Doctoral thesis, Universidad Nacional Mayor de San Marcos, 2010. https://hdl.handle.net/20.500.12672/277.
Full textAbstract:
El propósito de la investigación es verificar la efectividad de la psicoterapia “EMDR”: Eye Movement Desensitization and Reprocessing (Desensibilización y reprocesamiento por medio de movimientos oculares) en el tratamiento de pacientes con síndrome de depresión.
La muestra de estudio estuvo formado por ocho pacientes de clase social media con cuadro de depresión, distribuidos aleatoriamente en dos grupos: 4 pacientes que integraron el grupo experimental (G.E.) y 4 pacientes el grupo de control (G.C.), cuyas edades fluctuaron entre 24 y 26 años, de ambos sexos. La investigación corresponde al método experimental con el diseño pre-prueba y post-prueba con dos grupos aleatorizados. Concluido el tratamiento de psicoterapia, los resultados arrojaron una diferencia significativa a favor de los pacientes del grupo experimental, en comparación con pacientes del grupo de control, que no fueron sometidos a tratamiento, lo que implica que EMDR como método de psicoterapia en el tratamiento del síndrome de depresión, ha demostrado efectividad que permite confirmar la hipótesis planteada.
Palabras Clave: Psicoterapia “EMDR” y depresión-- The purpose of the research is to verify the effectiveness of psychotherapy "EMDR," in the treatment of patients with depressive syndrome. The study samples, consisted of eight patients of middle class with a picture of depression were randomly divided into two groups: 4 patients who comprised the experimental group (EG) and 4 patients Group Control (GC) The ages ranged between 24 and 26 years and both sexes. The Experimental research is the method to the design: Pre-test and post-test withtwo randomized groups. Psychotherapy completed treatment, the results showed a significant difference for patients in the experimental group, compared to control group patients, who were not treated, which means that EMDR as a method of psychotherapy in the treatment of depressive syndrome, has demonstrated effectiveness which confirms the hypothesis. Key Words: psychotherapy "EMDR and Depression
Tesis
19
Lee, Christopher. "Efficacy and mechanisms of action of EMDR as a treatment for PTSD." Thesis, Lee, Christopher (2006) Efficacy and mechanisms of action of EMDR as a treatment for PTSD. PhD thesis, Murdoch University, 2006. https://researchrepository.murdoch.edu.au/id/eprint/152/.
Full textAbstract:
The first aim of this thesis was to describe the characteristics of Posttraumatic Stress Disorder (PTSD) and to elucidate its place as a symptom disorder that sometimes develops when people are exposed to a traumatic event. The current major theoretical approaches to account for why some people who are exposed to trauma develop PTSD and the mechanisms by which this occurs were described. Three classes of theories were reviewed: conditioning/learning approach; information processing theories with a particular focus on the meaning of the trauma event; and biological models with an emphasis on recent neurocircuitry and neurochemistry models.
Successful treatment approaches were then reviewed which indicated two major contenders for the most efficacious treatment for PTSD: traditional cognitive behaviour therapies (CBT) using either stress inoculation or prolonged exposure; and eye movement desensitisation and processing (EMDR). Prior to the first study (Lee, Gavriel, Drummond, Richards, and Greenwald, 2002), a review of the literature indicated equivalent effects for EMDR and CBT. There had been very few direct comparison studies and each had serious methodological flaws, particularly with respect to random assignment and treatment fidelity. Therefore, the first study ensured adequate attention to these areas and involved a direct comparison between the two procedures using a sample of 24 participants diagnosed with PTSD. EMDR and stress inoculation training with prolonged exposure were found to lead to similar symptom improvement at the end of treatment, apart from a slight advantage for EMDR on intrusion symptoms. Both treatments led to significantly greater symptom reduction than a wait list control condition. At follow-up, EMDR led to greater gains on both self-report and observer rated measures of PTSD and self-report measures of depression. Overall, the findings were similar to those described in previously published studies, with a suggestion that EMDR was slightly more efficient than the standard CBT approach.
Given that the evidence suggested that EMDR was a more efficient treatment, it became critical to understand the underlying processes. A process study was undertaken that examined the responses of people with PTSD receiving EMDR treatment (Lee, Taylor, and Drummond, 2006). Guided by process studies of other treatments and theories that might account for why EMDR is effective, participants' responses were examined to see which models better accounted for symptom improvement. The main analysis tested whether or not the responses were consistent with processes that occurred during traditional CBT treatment, which prior research had identified as reliving, or whether they were more consistent with Shapiro's proposal that enhanced information processing occurs because there is a dual focus of attention (that is, the person simultaneously focuses on an external stimulus and on the traumatic memory) (Shapiro, 1995). The responses made by 44 participants were coded by an independent rater according to whether they were primarily reliving, distancing, affect or material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement occurred when the participant processed in a more detached or distant manner, whereas reliving responses were not associated with improvement. Cross-lagged panel correlations suggested that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that co-varied with improvement. The findings underscored a difference in the processes that underlie EMDR and traditional CBT.
The major question left unanswered from this second study was what causes this distancing process? Competing views were that it was facilitated by eye movement; alternatively, the therapist's instructions to participants might have precipitated this distancing phenomenon. The third study tested these ideas by randomly assigning 48 participants to either an eye movement or a no eye movement condition under two types of therapist instructions (reliving or distancing). Participants recalled personal distressing memories, and measures of distress and vividness were taken after treatment and at follow up. Only the eye movements made a significant difference to people's level of distress.
This conclusion appeared at odds with some of the previous literature that had tested the effects of eye movement on levels of distress. A meta-analysis of some of this research had suggested that there was no significant advantage of including eye movement in EMDR treatment unless the person had been diagnosed with PTSD. However, a close examination of this meta-analysis indicated some major methodological flaws in the computation; therefore, this was recalculated. The conclusion from this fourth study was consistent with study three in that EMDR with eye movement was found to lead to significantly greater improvement that EMDR without eye movement.
The results of these four studies were then discussed in terms of their implications for the theoretical models presented in Chapter 1. Aspects of learning theory that might account for EMDR efficiency were discussed as well as the failure of this model to account for treatment gains following EMDR. Information processing models were seen to better account for some of the phenomena observed in EMDR and for the findings from the four studies. Some suggestions of how eye movements might facilitate improved information processing were presented.
Finally, the relative merits of EMDR and CBT treatments were discussed and suggestions made for when to combine approaches. The conclusions highlight the point that EMDR appears to be the most promising treatment for PTSD.
20
Lee, Christopher. "Efficacy and mechanisms of action of EMDR as a treatment for PTSD." Lee, Christopher (2006) Efficacy and mechanisms of action of EMDR as a treatment for PTSD. PhD thesis, Murdoch University, 2006. http://researchrepository.murdoch.edu.au/152/.
Full textAbstract:
The first aim of this thesis was to describe the characteristics of Posttraumatic Stress Disorder (PTSD) and to elucidate its place as a symptom disorder that sometimes develops when people are exposed to a traumatic event. The current major theoretical approaches to account for why some people who are exposed to trauma develop PTSD and the mechanisms by which this occurs were described. Three classes of theories were reviewed: conditioning/learning approach; information processing theories with a particular focus on the meaning of the trauma event; and biological models with an emphasis on recent neurocircuitry and neurochemistry models.
Successful treatment approaches were then reviewed which indicated two major contenders for the most efficacious treatment for PTSD: traditional cognitive behaviour therapies (CBT) using either stress inoculation or prolonged exposure; and eye movement desensitisation and processing (EMDR). Prior to the first study (Lee, Gavriel, Drummond, Richards, and Greenwald, 2002), a review of the literature indicated equivalent effects for EMDR and CBT. There had been very few direct comparison studies and each had serious methodological flaws, particularly with respect to random assignment and treatment fidelity. Therefore, the first study ensured adequate attention to these areas and involved a direct comparison between the two procedures using a sample of 24 participants diagnosed with PTSD. EMDR and stress inoculation training with prolonged exposure were found to lead to similar symptom improvement at the end of treatment, apart from a slight advantage for EMDR on intrusion symptoms. Both treatments led to significantly greater symptom reduction than a wait list control condition. At follow-up, EMDR led to greater gains on both self-report and observer rated measures of PTSD and self-report measures of depression. Overall, the findings were similar to those described in previously published studies, with a suggestion that EMDR was slightly more efficient than the standard CBT approach.
Given that the evidence suggested that EMDR was a more efficient treatment, it became critical to understand the underlying processes. A process study was undertaken that examined the responses of people with PTSD receiving EMDR treatment (Lee, Taylor, and Drummond, 2006). Guided by process studies of other treatments and theories that might account for why EMDR is effective, participants' responses were examined to see which models better accounted for symptom improvement. The main analysis tested whether or not the responses were consistent with processes that occurred during traditional CBT treatment, which prior research had identified as reliving, or whether they were more consistent with Shapiro's proposal that enhanced information processing occurs because there is a dual focus of attention (that is, the person simultaneously focuses on an external stimulus and on the traumatic memory) (Shapiro, 1995). The responses made by 44 participants were coded by an independent rater according to whether they were primarily reliving, distancing, affect or material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement occurred when the participant processed in a more detached or distant manner, whereas reliving responses were not associated with improvement. Cross-lagged panel correlations suggested that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that co-varied with improvement. The findings underscored a difference in the processes that underlie EMDR and traditional CBT.
The major question left unanswered from this second study was what causes this distancing process? Competing views were that it was facilitated by eye movement; alternatively, the therapist's instructions to participants might have precipitated this distancing phenomenon. The third study tested these ideas by randomly assigning 48 participants to either an eye movement or a no eye movement condition under two types of therapist instructions (reliving or distancing). Participants recalled personal distressing memories, and measures of distress and vividness were taken after treatment and at follow up. Only the eye movements made a significant difference to people's level of distress.
This conclusion appeared at odds with some of the previous literature that had tested the effects of eye movement on levels of distress. A meta-analysis of some of this research had suggested that there was no significant advantage of including eye movement in EMDR treatment unless the person had been diagnosed with PTSD. However, a close examination of this meta-analysis indicated some major methodological flaws in the computation; therefore, this was recalculated. The conclusion from this fourth study was consistent with study three in that EMDR with eye movement was found to lead to significantly greater improvement that EMDR without eye movement.
The results of these four studies were then discussed in terms of their implications for the theoretical models presented in Chapter 1. Aspects of learning theory that might account for EMDR efficiency were discussed as well as the failure of this model to account for treatment gains following EMDR. Information processing models were seen to better account for some of the phenomena observed in EMDR and for the findings from the four studies. Some suggestions of how eye movements might facilitate improved information processing were presented.
Finally, the relative merits of EMDR and CBT treatments were discussed and suggestions made for when to combine approaches. The conclusions highlight the point that EMDR appears to be the most promising treatment for PTSD.
21
Rodríguez, Merino Clodomiro, and Merino Clodomiro Rodríguez. "Psicoterapia "EMDR" aplicado a un grupo de pacientes con síndrome de depresión." Doctoral thesis, Universidad Nacional Mayor de San Marcos, 2010. http://cybertesis.unmsm.edu.pe/handle/cybertesis/277.
Full textAbstract:
El propósito de la investigación es verificar la efectividad de la psicoterapia “EMDR”: Eye Movement Desensitization and Reprocessing (Desensibilización y reprocesamiento por medio de movimientos oculares) en el tratamiento de pacientes con síndrome de depresión.
La muestra de estudio estuvo formado por ocho pacientes de clase social media con cuadro de depresión, distribuidos aleatoriamente en dos grupos: 4 pacientes que integraron el grupo experimental (G.E.) y 4 pacientes el grupo de control (G.C.), cuyas edades fluctuaron entre 24 y 26 años, de ambos sexos. La investigación corresponde al método experimental con el diseño pre-prueba y post-prueba con dos grupos aleatorizados. Concluido el tratamiento de psicoterapia, los resultados arrojaron una diferencia significativa a favor de los pacientes del grupo experimental, en comparación con pacientes del grupo de control, que no fueron sometidos a tratamiento, lo que implica que EMDR como método de psicoterapia en el tratamiento del síndrome de depresión, ha demostrado efectividad que permite confirmar la hipótesis planteada.
Palabras Clave: Psicoterapia “EMDR” y depresión-- The purpose of the research is to verify the effectiveness of psychotherapy "EMDR," in the treatment of patients with depressive syndrome. The study samples, consisted of eight patients of middle class with a picture of depression were randomly divided into two groups: 4 patients who comprised the experimental group (EG) and 4 patients Group Control (GC) The ages ranged between 24 and 26 years and both sexes. The Experimental research is the method to the design: Pre-test and post-test withtwo randomized groups. Psychotherapy completed treatment, the results showed a significant difference for patients in the experimental group, compared to control group patients, who were not treated, which means that EMDR as a method of psychotherapy in the treatment of depressive syndrome, has demonstrated effectiveness which confirms the hypothesis. Key Words: psychotherapy "EMDR and Depression
Tesis
22
Silvestre, Michel. "Une approche intégrative des dimensions diachronique et synchronique en psychothérapie du trauma au travers des perspectives intra et interactionnelles chez l’enfant et sa famille." Thesis, Université de Lorraine, 2015. http://www.theses.fr/2015LORR0311.
Full textAbstract:
Ce travail raconte un parcours professionnel guidé par la pratique, la curiosité et l’envie de comprendre. Il propose un modèle thérapeutique pour prendre en compte plus finement la complexité des situations cliniques en tricotant dans un ensemble congruent les informations relationnelles de l’ici et maintenant avec celles de l’histoire personnelle de chacun des acteurs de la relation. Une présentation de différentes publications illustrent ce cheminement de pensée à travers des expériences diverses pour arriver à la modélisation d’une approche thérapeutique de l’individu en relationThis work is about a professionnal journey guided by clinical practice, curiosity and desire to understand. It proposes a therapeutic model to better apprehend the complexity of clinical situations by interweaving in a congruent fashion relationnal information from the here and now with the historical personal information of every individual involved. A presentation of different publications highlights this evolution of thinking as expressed in different experiences which provides a therapeutic approach model of the individual in relation with others
23
Von, Tersch Elise. "Modified Eye Movement Desensitization Therapy Protocol Treating Substance Abuse Disorders." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7346.
Full textAbstract:
Quality substance abuse treatment is needed to help fight the battle against drug addiction. This qualitative study was designed to explore some of the approaches to eye movement desensitization (EMDR) therapy that therapists trained in Parnell's adapted EMDR model use in conjunction with treatment for addictions. The purpose of this narrative inquiry was to investigate the experience of therapists who incorporate substance abuse treatment with Parnell's adapted EMDR model when treating trauma and substance use disorders. The population studied comprised licensed mental health therapists who had completed Parnell's EMDR training and implemented Parnell's modified EMDR protocol in their professional practice. The data from 9 participant interviews were coded and NVIVO data analysis software was used to identify key concepts and themes including deviations from Parnell's modified protocol, incorporating addiction treatment within the modified protocol, and the importance of the resourcing phase in the modified protocol. The study findings provided a deeper understanding of the types of addiction therapies that therapists are using in conjunction with Parnell's EMDR model. The results also showed that that participants perceived Parnell's EMDR model, combined with addiction therapeutic techniques and approaches, as beneficial in treating those with trauma and substance use disorders. By integrating addiction therapies with Parnell's EMDR protocol, EMDR certified trainers may better educate EMDR trainees about useful strategies for treating dual diagnosed clients. The strategies may shorten the client's time in treatment and provide a strong foundation for therapists as they conduct therapy for dual diagnosed people.
24
Ricci, Ronald J. "Trauma resolution treatment as an adjunt to stand treatment for sexual offenders." Diss., Virginia Tech, 2004. http://hdl.handle.net/10919/27808.
Full textAbstract:
This study explored the use of adding trauma resolution therapy to standard cognitive-behavioral relapse prevention therapy for sex offenders. Ten adjudicated sex offenders with sexual abuse histories were treated with eye movement desensitization and reprocessing as an adjunct to standard outpatient sex offender treatment. Data points include self-report, other-report, assessment instruments, session transcripts, research journals, and physiological measures. Systematic treatment research and development methods (Bischoff, McKeel, Moon, & Sprenkle, 1996) resulted in a proposed treatment protocol. Emergent themes from a cross-case, grounded theory data analysis are presented. The data suggests the adjunct treatment provided some benefit both to participants and to the goals of standard sex offender-specific treatment. Implications for treatment providers, marriage and family therapy, and future research are discussed.Ph. D.
25
Schmitt, Alicia. "Conséquences des violences conjugales sur la santé psychologique des victimes, prise en charge par la thérapie EMDR." Thesis, Metz, 2011. http://www.theses.fr/2011METZ014L.
Full textAbstract:
Les violences conjugales représentent un problème de santé public majeur. En 2011, en France, tous les 2,5 jours, une femme meurt sous les coups de son compagnon. Les violences conjugales résultent de la conjonction de facteurs individuels, conjugaux, sociaux mais également culturels, qui seront détaillés dans cette recherche qui présentera également l’état de l’art concernant les conséquences de ces violences, leurs possibilités de prise en charge et la thérapie EMDR. Quatre études ont été menées dans cette recherche. La première porte sur les conséquences des violences conjugales auprès d’un public de femmes bénéficiant d’un accompagnement social. Il s’agissait d’apporter une contribution aux résultats déjà observés dans la littérature. La seconde étude porte sur la prise en charge de 5 femmes ayant vécu un évènement traumatique en couple et s’étant séparées de leur agresseur. La thérapie EMDR donne des résultats véritablement encourageants, ce qui nous amène à la tester auprès d’un public plus lourdement traumatisé, ayant vécu des violences conjugales d’intensité et de nature variable, durant de nombreuses années (étude 3). Les résultats de l’étude 3 mettent en évidence l’importance de l’adaptation de l’outil thérapeutique à la problématique de la victime et les limites de l’utilisation de l’EMDR auprès de certains types de publics, dont les victimes de violences conjugales. Une analyse de contenu des séances EMDR nous a permis d’affiner nos analyses grâce à une vignette clinique présentée dans l’étude 4. De plus, des personnes n’ayant pas pu être intégrées dans le protocole expérimental ont malgré tout été suivies, ce qui permet une réflexion autour de l’adéquation de la méthode thérapeutique et du cadre expérimental à la victime grâce à une étude de cas, également présentée dans l’étude 4. Toutes ces observations permettront l’émergence de suggestions concernant la prise en charge des victimes de violences conjugalesDomestic violence represents a major problem for public health. In France, every 2,5 days, a woman dies by the hands of her partner. Domestic violence is the result of the conjunction of individual, domestic, social and also cultural factors to be detailed in this research that will also present the state of art, regarding the consequences of this violence, its means of management and EMDR therapy. Four studies were led in this research. The first one is about the consequences of domestic violence for a group of women benefiting from social support. The idea was to bring a contribution to the results already observed in literature. The second study is about the caretaking of five women who experienced a traumatic event during their couple life, and then split up with their molester. EMDR therapy gives really encouraging results, and it led us to test it with a public more heavily traumatized, who lived intensity and variable violence during many years (study 3). The results of the third study highlight the importance of the adaptation of the therapeutic tools to the problematic of the victim, and the limits of the use of EMDR with some public, included the victims of domestic violence. An analysis of the EMDR sessions content allowed us to refine our analyses thanks to a clinical “vignette” showed in study 4. Moreover, people that could not be included in the experimental protocol were all the same followed up, allowing a reflection around the appropriateness of the therapeutic method and of the experimental frame to the victim thanks to a case study, also presented in study 4. All these observations will allow the emergence of suggestions concerning the caretaking of the domestic violence victims
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Rojas, Saffie Juan Pablo. "Terapia EMDR : un análisis a la luz de la obra de Santo Tomás." Doctoral thesis, Universitat Abat Oliba CEU, 2017. http://hdl.handle.net/10803/456901.
Full textAbstract:
El present treball s'ha proposat investigar la Teràpia EMDR a la llum de l'obra de Sant Tomàs d'Aquino, seguint una triple aproximació: antropològica, teòrica i pràctica. La limitada concepció de l'ésser humà subjacent al model EMDR contrasta amb una teoria que conté importants encerts, però sobretot, amb una proposta psicoterapèutica que demostra un profund coneixement de la naturalesa humana. La psicologia tomista ofereix una nova manera de comprendre la Estimulació Bilateral, el Model SPIA i el Protocol Estàndard. Això permet fonamentar la pràctica EMDR en un sòlid cos de coneixement tradicional. A més, posa aquesta meravellosa eina en mans dels que volen basar la seva tasca terapèutica en l'antropologia del Aquinat. L'anàlisi de la Teràpia EMDR il·lumina una manera concreta d'aterrar la doctrina de Sant Tomàs en el context de la pràctica psicològica, el que suggereix que és possible idear un model de psicoteràpia basat íntegrament en l'obra del Doctor Humanitas.El presente trabajo se ha propuesto investigar la Terapia EMDR a la luz de la obra de Santo Tomás de Aquino, siguiendo una triple aproximación: antropológica, teórica y práctica. La limitada concepción del ser humano que subyace al modelo EMDR contrasta con una teoría que contiene importantes aciertos, pero sobre todo, con una propuesta psicoterapéutica que demuestra un profundo conocimiento de la naturaleza humana. La psicología tomista ofrece una nueva manera de comprender la Estimulación Bilateral, el Modelo SPIA y el Protocolo Estándar. Esto permite fundamentar la práctica EMDR en un sólido cuerpo de conocimiento tradicional. Además, pone esta maravillosa herramienta en manos de quienes desean basar su labor terapéutica en la antropología del Aquinate. El análisis de la Terapia EMDR ilumina un modo concreto de aterrizar la doctrina de Santo Tomás en el contexto de la práctica psicológica, lo que sugiere que es posible idear un modelo de psicoterapia basado íntegramente en la obra del Doctor Humanitas.
The present work has been proposed to investigate the EMDR therapy in the light of the work of Saint Thomas Aquinas, following a triple approach: anthropological, theoretical and practical. The limited conception of the human being that underlies the EMDR model contrasts with a theory that contains important successes, but above all, with a psychotherapeutic proposal that demonstrates a deep knowledge of human nature. Thomist psychology offers a new way of understanding Bilateral Stimulation, the SPIA Model and the Standard Protocol. This allows EMDR practice to be based on a solid body of traditional knowledge. In addition, it puts this wonderful tool in the hands of those who wish to base their therapeutic work on the anthropology of Aquinas. The analysis of EMDR Therapy illuminates a concrete way of landing the doctrine of St. Thomas in the context of psychological practice, suggesting that it is possible to develop a model of psychotherapy based entirely on the work of Doctor Humanitas.
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DiNardo, Jeff. "Eye Movement Desensitization and Reprocessing Clinicians' Discourse on Cultural Dynamics in EMDR Therapy." Thesis, The George Washington University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10748113.
Full textAbstract:
The following study looks at how Eye Movement Desensitization and Reprocessing (EMDR) clinicians consider cultural dynamics within the EMDR treatment approach. A literature review provides the empirical foundation of EMDR treatment, a broad inquiry into general influences of cultural dynamics, and a review of the intersection of EMDR and culture in existing literature. In a mixed-methods approach, background information of EMDR clinicians and written responses to a composite case vignette allowed for the investigation into how 56 EMDR clinicians discuss cultural issues within their work. Participants were recruited via listservs maintained by EMDR communities in the United States, the United Kingdom & Ireland, and Israel. While a cluster analysis was able to create clusters emerging from participant data, these influences were minimal in the subsequent qualitative analyses. However, it is worth noting that the variables that emerged as important criteria for clusters included length of experience and national origin. Both are theoretically consistent with Vygotsky’s sociocultural theory, which underlies the rationale of the study. In the qualitative component of data analysis, the researcher employed basic interpretive design and discourse analysis methodologies. Basic interpretive results found multiple approaches ranging from deeming culture a non-essential focus of the work to considering how certain identity markers may affect the course of information processing in treatment. When culture was considered, the focus was typically on the client’s background as opposed to the clinician’s background. Discourse analysis suggested a number of potentially meaningful linguistic patterns including shifts between Germanic and Latinate word origins depending on perceived audience, shifts between active and passive voice depending on temporal relation to the traumatic event, and the personification of the brain as an active character in the treatment process. As an exploratory study, considerable follow-up research would be needed before concrete suggestions are implemented though the potential implications for EMDR training might include a more intentional review of language use and the preparation of multiple styles of communicating to increase resonance with a client’s worldview.
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De, Villiers Elizabeth Fredericka. "An integrative approach to narrative therapy and eye movement desensitization and reprocessing (EMDR)." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/21210.
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Thesis (MEdPsych)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: As I engaged in a therapy journey with a single client, the possibilities for research on the integrative use of narrative therapy and EMDR unfolded. I investigated recent literature and realised that much had been written about narrative therapy as single approach to therapy within the postmodern paradigm. There was also extensive writing on EMDR and its integrative use with other therapies in assisting people who struggle with upsetting memories of trauma. Since I was unable to find any literature to date on the integrative use of narrative therapy and EMDR, I realized that there was much to be discovered and learned on such an integrative research journey. The client's experiences and descriptions of overwhelming emotional distress (as the problem in her life) during the process of integration was the main focus of this qualitative case study. During our therapy conversations knowledges were gathered and deconstructed. Video or tape recordings, photographs, work with clay, sketches, letters and other documents were useful in keeping track of the research journey. A reflecting team and the participation of the client's boyfriend contributed and enriched both the therapy and research journeys.
AFRIKAANSE OPSOMMING: Tydens terapeutiese werk met 'n enkele kliënt het die moontlikhede van navorsing oor die integrasie van narratiewe terapie en EMDR vir my 'n werklikheid geword. Ek het onlangse navorsing bestudeer en besef dat narratiewe terapie as 'n enkele benadering tot terapie binne die post-moderne paradigma, al 'n geruime tyd lank nagevors is. Daar bestaan ook literatuur oor EMDR en die integrasie daarvan met ander terapeutiese benaderings in die ondersteuning van persone wat probleme ondervind met ontstellende herinnerings van trauma. Aangesien ek tot op hede geen literatuur oor die integrasie van narratiewe terapie en EMDR kon vind nie, het ek vermoed dat 'n navorsingsreis op hierdie terrein verskeie ontdekkings en die ontginning van nuwe kennis moontlik sou maak. Die fokus van hierdie kwalitatiewe gevallestudie val op die kliënt se belewing en beskrywings van oorweldigende emosies (as probleem in haar lewe) tydens die terapeutiese integrasieproses. Waarhede of kennis is tydens terapiegesprekke versamel en gedekonstrueer. Video- of bandopnames, foto's, kleiwerk, sketse, briewe en ander dokumente was waardevol om die koers van die navorsingsreis aan te dui. Insette en deelname van 'n refekterende span, asook die kliënt se kêrel, het beide die terapie- en navorsingsreise verryk en uitgebrei.
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Krings, Astrid. "Etat de Stress Postraumatique (ESPT) suite à l'accouchement : nouvelles recherches et évaluation de la prise en charge avec la psychothérapie EMDR (Eye Movement desensibilisation and Reprocessing)." Thesis, Université de Lorraine, 2013. http://www.theses.fr/2013LORR0339/document.
Full textAbstract:
Un vécu traumatique de l’accouchement et ses conséquences représentent un problème majeur souvent sous-estimé pour la santé de la femme (Ayers, 2004). Certaines femmes peuvent développer après leur accouchement un état de stress post-traumatique (ESPT). Une prévalence moyenne de 2% de femmes qui manifestent un ESPT postpartum est reconnu et un tiers des femmes présentent des symptômes cliniquement significatifs d’un ESPT (revue de la littérature Olde et al., 2006 ; Denis & Callahan, 2009). Partie 1 : une étude longitudinale quantitative avec quatre temps d’évaluation (fin de grossesse et 2, 6, 12 mois postpartum) a été menée auprès de 400 femmes. A deux mois postpartum 163 femmes ont répondu aux questionnaires, 32 femmes (19,6%) présentent des symptômes d’un ESPT suite à l’accouchement. A six mois postpartum, 97 femmes ont poursuivi l’étude et 11 présentent des symptômes d’ESPT (11,5%). L’analyse longitudinale et multifactorielle a montré des différences significatives entre le groupe des femmes « ESPT postpartum » et le groupe témoin concernant le sentiment d’auto-efficacité, les stratégies de coping et la qualité de vie. A douze mois postpartum, 80 femmes ont répondu aux questionnaires, 13 d’entre elles (16,5%) présentent des symptômes d’un ESPT postpartum. Une analyse de régression linéaire indique que les antécédents obstétricaux-gynécologiques, la présence d’affects dépressifs en prépartum et l’utilisation de la stratégie de coping d’auto-blâme ainsi que la difficulté à réinterpréter les situations de manière positive en postpartum (T2) prédisent l’apparition de symptômes d’ESPT postpartum à un an. Les résultats de l’analyse de médiation montrent un effet de la stratégie de coping auto-blâme (T2) sur la relation entre la perception du soutien à l’autonomie par l’équipe soignante à T2 et le score d’ESPT à un an postpartum (T4). Partie 2 : une étude qualitative a été menée afin de connaître les représentations des soignants sur le développement d’un état de stress post-traumatique suite à l’accouchement à l’aide une étude par entretiens. Indépendamment, un protocole de prise en charge des femmes présentant un ESPT consécutif à l’accouchement a été élaboré afin d’évaluer l’effet d’une prise en charge psychothérapeutique (thérapie EMDR) chez ces femmes en souffrance. Conclusion : les résultats de cette étude confirment la présence d’un ESPT postpartum chez un certain nombre de femmes. A partir de ces résultats, une réflexion clinique est proposée sur les améliorations possibles de la prise en charge des femmes souffrant d’un ESPT suite à l’accouchementA traumatic birth experience and its consequences are representing a major health issue in women, much too often underestimated (Ayers, 2004). However some women develop posttraumatic stress disorder (PTSD) following childbirth. Prevalence is estimated about 2% of women presenting postpartum PTSD, one third present clinically significant symptoms of PTSD (2 reviews: Olde et al., 2006; Denis & Callahan, 2009). Part 1: A quantitative longitudinal study was carried out within 400 women and with four times of evaluation (late pregnancy and 2, 6, 12 month postpartum. At 2 month postpartum, 163 women answered the questionnaire, 32 women (19.6%) presented symptoms of PTSD postpartum. At six month postpartum, 97 women were followed and 11 presented symptoms of PTSD (16.5%). Multifactor and longitudinal analysis showed significant differences between women within “PTSD group” or “control group” in relation to self-efficacy, coping and quality of life. At twelve month postpartum, 80 women answered questionnaire, 11 presented symptoms of PTSD (11.5%). Regression analysis indicates gynecological or obstetrical history, presence of prepartum depression and coping strategies such as blame and difficulties in positive re-interpretation of a given situation as predicting postpartum PTSD symptoms. The effect of perception of support for autonomy provided by health professionals on the score of PTSD at one year following birth is mediated by using coping strategy “blame” at T2. Part 2: Our qualitative study was implemented in order to understand health professionals perception of the postpartum PTSD development. Qualitative interviews were conducted. Furthermore, a research protocol was elaborated for a treatment of women presenting PTSD following childbirth and for evaluating the effects of psychotherapy (EMDR treatment). Conclusion: These results confirm the presence of postpartum PTSD in some women. Following these results, clinical implications are offered to improve the provided health care
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Byron, Holly, and n/a. "Clinician adherence to and combination of methods with EMDR for Post Traumatic Stress Disorder." University of Canberra. Professional & Community Education, 1999. http://erl.canberra.edu.au./public/adt-AUC20060626.132112.
Full textAbstract:
The clinical adherence to and combination of methods with EMDR to
treat PTSD has not been explored. This is of some concern as 27 000
clinicians are trained in EMDR globally. This exploratory study gained
information on Australian trained EMDR clinicians' adherence to EMDR,
and the methods they combined with EMDR to treat PTSD. Survey
responses from 126 clinicians were analysed using predominantly
descriptive statistics.
The findings of this study showed that the majority of respondents
perceived that they closely adhered to the standard EMDR treatment.
However, respondents reported adhering more closely to the phases than
the steps of EMDR. Statistically significant findings showed that more
experienced EMDR level 1 clinicians were more likely to add steps and
phases to EMDR, and to change the standard sequence of steps. Clinicians
with greater years of experience were also more likely to change the
standard sequence of steps. In addition, more experienced EMDR level 2
clinicians, were less likely to educate their clients about PTSD. Almost all
respondents combined EMDR with other methods to treat PTSD. Combined
methods included CBT, hypnosis / relaxation, system / solution focused
methods and exposure.
This research has contributed to theory and practice by uncovering
that clinicians appear to use EMDR differently to researchers, by changing
EMDR to meet client needs, combining EMDR with other methods and
Holly Byron 16/9/99 vi
therapies, and introducing EMDR in the mid stage of treatment. These
findings are vital to reduce the scientist-practitioner divide by accurately
testing EMDR's efficacy and enabling future controlled trials to reflect the
clinical use of EMDR.
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Powell, Shon. "Evaluation of the Veteran Resilience Project." Antioch University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1562201907914759.
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Richard, Katie. "Treating Binge Eating Disorder with Eye Movement Desensitisation Reprocessing: A preliminary randomised controlled trial." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/18905.
Full textAbstract:
Cognitive Behavioural Therapy and Interpersonal Therapy have been recognized as the gold standard treatments used for people with binge eating disorder (BED). However, these treatments are lengthy - usually about 22 sessions and usually exclude the goal of weight loss despite the fact that the majority of binge eaters struggle with weight management. Because Eye Movement Desensitization Reprocessing (EMDR) is an evidence-based treatment found to an effective and efficient treatment for post traumatic stress disorder (PTSD) and trauma is prevalent in the BED population, a newly developed EMDR protocol was trialled for BED. This new protocol was based on Forester’s bulimia nervosa EMDR protocol designed in a ten 1-hour session format and included a resource development to improve engagement in exercise. Results indicated that the 16 participants randomly assigned to the EMDR treatment, administered by three trained experienced registered psychologists with EMDR training/certification, fared better than the 22 waitlisted participants in terms of BED symptoms (as assessed by the Eating Disorder Examination, Binge Eating Scale, Eating Beliefs Questionnaire), weight loss, mental health symptoms including anxiety and sleep (as assessed by the Trauma Symptom Checklist-40) and engagement in exercise (IPAQ). Though this is only a preliminary trial with a limited sample size, was not compared to an active control group and no follow-up period to see if results are maintained and weight further decreases, results are nevertheless encouraging. Furthermore, BED and comorbid weight management problems may be best treated with a multidisciplinary approach.
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Plagge, Jens [Verfasser]. "Ergibt sich durch die EMDR-Methode ein positiver Effekt in der Depressionsbehandlung? / Jens Plagge." Kiel : Universitätsbibliothek Kiel, 2019. http://d-nb.info/1190644681/34.
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Brotherton, Natalie Louise. "Eye Movement Desensitisation and Reprocessing (EMDR) for trauma : a qualitative analysis of clients' experiences." Thesis, University of Lincoln, 2009. http://eprints.lincoln.ac.uk/18975/.
Full textAbstract:
This study aimed to explore clients‟ experiences of receiving eye movement desensitisation and reprocessing (EMDR) as an intervention for trauma-related symptomatology, consistent with post traumatic stress disorder (PTSD). Seven outpatients who had experienced EMDR as an intervention for trauma-related symptomatology were interviewed using a semi-structured interview schedule, from which the verbatim transcripts provided the raw data for an interpretative phenomenological analysis (IPA). The themes that were extracted from the data were considered under five superordinate headings which were: „living with trauma‟, „doubt and apprehension; „making safe and making sense‟, „the process of „processing‟ and „change‟. Both active and passive processes were identified within participants‟ descriptions of the process of EMDR and change. Discussion focuses on the themes in relation to previous literature and further, in respect of the unique understanding of EMDR that a qualitative phenomenological study provides. Implications for future clinical and theoretical research are suggested and the limitations and theoretical underpinnings of the study are made explicit. The conclusions drawn from the study suggest that EMDR should be viewed as a holistic approach with elements such as the development of the therapeutic alliance given equal investment to the search for the active mechanism of the bi-lateral component. Additionally, it is argued that the bi-lateral element potentially involves more than a single mechanism, particularly in relation to the enhancement of positive affect and that this would benefit from further exploration.
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Folland, Caroline H. "Working with psychological trauma : an interpretative phenomenological analysis of trauma-focused CBT and EMDR." Thesis, University of Derby, 2017. http://hdl.handle.net/10545/621586.
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Purpose: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD), acknowledged repeated or extreme indirect exposure to aversive details of traumatic event(s) in the course of professional duties, can lead to symptoms of PTSD. This has led to discussions around impact and prevalence of vicarious trauma in psychological therapists treating trauma clients. This study considers how therapists delivering trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) make sense of their experiences and protect themselves from any negative effects of the work. Furthermore, it considers if there is a distinction in therapist experience between the two modalities. Methodology/Method: An Interpretative Phenomenological Analysis (IPA) was conducted to explore how trauma-focused CBT and EMDR therapists engaged in trauma work, interpreted and made sense of their experiences; with a view to identifying any protective practice that informed clinical practice and helped ameliorate vicarious trauma. Recorded, semi-structured interviews were conducted with CBT and EMDR therapists (N=11). Before analysis, interviews were transcribed verbatim and sent to individual participants for validation of their authenticity. Data was analysed using descriptive, linguistic and conceptual comments to identify an initial seventy nine emergent themes. When refined, four master themes of ‘Nature of Trauma’, ‘Participant sense of self and managing the process of hearing trauma narrative’, ‘Participant experience of delivering the trauma models’ and ‘Protecting and sustaining the participant sense of self’ were identified to answer the research question and are discussed herein. Findings: This study forms part of the growing body of evidence towards understanding therapist vicarious traumatisation. It both supports and challenges findings of previous studies. It also introduces new concepts in relation to the vicarious trauma phenomenon. Whilst there are clear limitations associated with making generalisations from an IPA study, the findings from the study suggest EMDR may be a protective factor against the negative effects of hearing repeated trauma narrative. Furthermore, certain strategies such as time management, comprehensive trauma training and specific trauma supervision, may also reduce the negative effects of hearing trauma narrative. Finally, regardless of the difficulties faced, therapists enjoy their trauma work and feel a great sense of professional satisfaction. Implications/Recommendations: Indications from the findings of the study are that therapists working within primary care in particular, are becoming increasingly pressurised by cuts to funding within mental health services. Recommendations are that those components of trauma work which promote therapist wellbeing should be supported. In particular, realistic timeframes within which to work, good quality training and supervisors, ideally external to the workplace, who can provide trauma-specific supervision.
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Kemp, Michael. "Single event paediatric trauma: Sample representation and the efficacy of response-focused exposure and EMDR." Thesis, Kemp, Michael (2014) Single event paediatric trauma: Sample representation and the efficacy of response-focused exposure and EMDR. PhD thesis, Murdoch University, 2014. https://researchrepository.murdoch.edu.au/id/eprint/23705/.
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This thesis focused on paediatric populations who had been exposed to single event trauma such as motor vehicle accidents, burns, falls, animal bites, anaphylaxis and near drowning. The planning for the thesis commenced 16 years ago and the related PhD candidature commenced a few years later1. Since then, the volume of research investigating child trauma and, more specifically, treatments for child trauma has increased markedly.
The aims of the thesis were to determine: i) the efficacy of EMDR compared to a waitlist control condition in children aged 6 to 12 years following a motor vehicle accident, ii) if those who participated in a trauma study were representative of the population compared to those who did not participate in a trauma study; iii) if an assessment involving additional exposure to response focused trauma memories (based on Lang’s 1977, 1979, 1983 bio-informational theory) facilitated recovery, and if so iv) compare the efficacy of a treatment based on response-focused exposure to an established treatment condition such as EMDR. These aims were met by the following four studies.
Study one compared four EMDR sessions to a six week wait-list control condition amongst 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor vehicle accident. The efficacy of EMDR was confirmed. In comparison to the wait list condition, EMDR was superior on primary outcome measures including the Child Post Traumatic Stress – Reaction Index and clinician rated diagnostic criteria for PTSD. EDMR was also superior on process measures including Subjective Units of Disturbance and Validity of Cognition scales. Notably, 100% of participants in both groups met two or more PTSD criteria at pre-treatment. At post treatment, this remained unchanged in the wait-list group, but decreased to 25% in the EMDR group. These therapeutic gains were maintained at three and 12 month follow-up.
Study two compared 211 participants with 2333 non-participants in a trauma study on several measures of trauma and injury severity such as duration of hospital visit, heart rate in the emergency department, emergency transport to hospital, admission to hospital, injury severity score, and triage code. Participants were exposed to more severe trauma or injury than non-participants and within the non-participant group, those who had requested further information about the study (N = 573) were exposed to more severe trauma or injury than other non-participants (N = 1760). These findings were contrary to the view that non-participants could be more severely traumatised than participants, and the discovery of a gradient effect within non-participants suggests that participation or greater interest in participation may be associated with greater trauma and injury severity.
In study three, 52 of the children and adolescents from study two with at least moderate PTSD symptoms completed a standard assessment one month after their trauma. A random sample of 22 of these completed an additional response focused assessment task based on Lang’s (1977, 1979, 1983) bio-informational theory which involved the detailed recall of five components of their trauma memory. The stimulus component consisted of visual and auditory memories, whereas the response information consisted of four domains: verbal (words, sounds, thoughts and feelings), somato-motor (head and body position, gross body actions), visceral or autonomic (changes in heart rate, sweating or hot flushes), and processor (mental processes such as dream-like perceptions, racing or muddled thoughts). The response focused assessment resulted in an accelerated rate of recovery in avoidance symptoms from one week to two months later. There was also a reduction in the proportion of participants meeting the PTSD (DSM-IV) criterion for avoidance and a decrease in parent ratings of their child’s somatic complaints.
Study four compared Eye Movement Desensitisation and Reprocessing (EMDR) to a Response Focused Exposure Therapy condition based on the assessment utilised in study three. A total of 28 children and adolescents (aged six to 16 years) who continued to experience persistent PTSD symptoms three months after their trauma were recruited from study two. The EMDR protocol was consistent with the protocol used in study one and the detailed protocol described by Tinker and Wilson (1999). The Response Focused Exposure Therapy condition henceforth referred to as “exposure therapy” involved the repeated and detailed exposure to information from the five components of the trauma memory (as per study three), including one stimulus component (e.g., visual and auditory memories) and four response components (verbal, somato-motor, visceral or autonomic and processor). Both treatment conditions resulted in robust improvements in child, parent and clinician rated PTSD measures and child and parent rated non-PTSD measures. Whilst there was no difference in the duration of treatment sessions between the EMDR and exposure group, the exposure condition involved fewer exposure periods than the EMDR condition [4.8 (+2.1) versus 17.8 (+6.4), p<.001] but longer periods of exposure [157.7 (+58.3) versus 23.5 (+4.7) seconds, p<.001] and a greater total duration of exposure in each session [12.3 (+8.0) versus 7.0 (+3.2) minutes, p<.05]. This result provides support for the efficiency of EMDR, although more research is necessary. The efficacy of both treatments is best explained by the use of vivid and repeated exposure to the trauma memory in a safe environment along with other non-specific elements common to both treatments.
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PLUMMER, CHARLES D. "PERFORMANCE ENHANCEMENT FOR BRASS MUSICIANS USING EYE MOVEMENT DESENSITIZATION AND REPROCESSING." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1178855934.
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El-Khoury, Myriam. "Peripheral and central mechanisms involved in post-traumatic stress disorder and its treatment by eye-movement desensitization & reprocessing." Thesis, Aix-Marseille 2, 2011. http://www.theses.fr/2011AIX20664/document.
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Bien que la plupart des personnes soient exposées à un traumatisme au cours de leur vie, toutes ne développent pas de stress-post traumatique (PTSD). La prévalence de vie du PTSD est en effet estimée à 10%. Il peut survenir à la suite d’un événement traumatique tel un accident, agression, deuil, viol ou incendie, mais aussi un désastre naturel (inondation, tremblement de terre…) ou humain (guerre, terrorisme…). En raison de l’augmentation contemporaine des sources traumatiques, les rapports récents de l'Organisation Mondiale de la Santé décrivent le PTSD comme un problème de santé mondiale croissant, en raison de sa fréquence, sévérité, comorbidité et de son coût élevé. Un corpus de recherche enquête sur divers aspects du PTSD concernés par les pensées intrusives, l'hypervigilance, les déficits émotionnels, les troubles cognitifs et les problèmes de mémoire.Comme d'autres problèmes de santé mentale, le PTSD est à ce jour assez méconnu. Comme d'autres troubles anxieux, il est surtout marqué par une peur excessive. Il n'est donc pas surprenant que l'hypothèse la plus répandue dans le PTSD soit celle d'un déficit du traitement de la peur. S’il est vrai que la conceptualisation du PTSD comme un trouble de la peur parait phénoménologiquement étroite, elle a été néanmoins pragmatique en permettant l’approfondissement de la recherche translationnelle de l'animal à l’humain, en passant par la paillasse. Les études sur le sujet ont suggéré que les déficiences centrales et périphériques du PTSD tourneraient autour d’altérations du réseau neuronal de la peur. Ceci impliquerait un dérèglement des mécanismes qui sous-tendent le conditionnement à la peur, ainsi que le traitement des émotions et de l'attention, qui sont en effet bouleversés dans le PTSDAlthough most people encounter at least one traumatic event over their lifetime, not all of them will develop post-traumatic stress disorder (PTSD). Lifetime prevalence of full-blown PTSD, known as an anxiety disorder, is in fact around 10%. In addition to accidents, aggression, grief, rape, fires, traumatic events can be caused by natural (flooding, earthquake…) or man-made stressors (war, terrorism…). With the contemporary rise in traumatic sources the World Health Organization recent reports describe PTSD as an increasing global health issue, due to its high frequency, severity, comorbidity and cost. A body of research has thus started investigating various aspects of PTSD concerned with intrusive thoughts, hypervigilance, emotional deficits, cognitive disturbances and memory issues. Similarly to other mental health problems, much remains unknown about PTSD, and similarly to other anxiety disorders it is marked by excessive fear. It comes as no surprise that the most prevalent hypothesis in PTSD is that of a fear-processing deficit. Conceptualizing PTSD as a fear disorder can be phenomenologically quite narrow. It has been nonetheless pragmatic in allowing thorough translational research from animal to bench-side and clinical studies. Most studies have suggested that central and peripheral impairments in PTSD revolve around altered neural fear processing network. These alterations involve mechanisms implicated in fear conditioning, as well as emotional and attentional processing, all of which are altered in PTSD
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Williams, Christine J. "The effectiveness of eye movement desensitization and reprocessing (EMDR) in the treatment of psychologically traumatized individuals." Online version, 2001. http://www.uwstout.edu/lib/thesis/2001/2001williamsc.pdf.
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Dellucci, Hélène. "Une approche intégrative en psychothérapie EMDR du trauma complexe et des troubles dissociatifs auprès des adultes." Thesis, Université de Lorraine, 2016. http://www.theses.fr/2016LORR0326/document.
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Ce travail de thèse raconte un cheminement de clinicienne, avec des allers retours entre une pratique psychothérapeutique et une réflexion conceptuelle, tentant de cheminer vers une démarche intégrative permettant d’aborder les situations psychotraumatologiques complexes. Guidée par l’envie d’apprendre, mais aussi par la mise à l’épreuve du terrain, nous avons élargi pas à pas notre démarche psychotraumatologique, pour aboutir à la proposition d’un modèle intervention intégratif et original. Nous espérons que ce modèle puisse permettre au clinicien de s’adapter, sans se perdre, à la réalité complexe des personnes souffrant de traumatisations complexes et chroniques. La présentation de différentes publications et de cas cliniques illustrera ce cheminement de pensée et de pratiques pour arriver à un modèle rigoureux pouvant être soumis à l’épreuve scientifique et au terrainThis thesis tells a journey of a clinician, with back and forth between a psychotherapeutic practice and conceptual thinking, trying to move towards an integrative approach for addressing complex situations in psychotraumatology. Guided by the desire to learn, but also examining field practice, we have expanded, step by step, our psychotraumatologic approach, coming to a proposal of an integrative and original treatment model. We hope this model may allow clinicians to adapt to the complex reality of complex and chronic traumatized persons, without getting lost. The presentation of different publications and clinical cases illustrate this line of thought and practices in order to achieve a rigorous model that can be subjected to scientific testing as well as put to the proof of the psychotherapy field
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Rousseau, Pierre-François. "Etude des mécanismes d'actions neurobiologiques de la thérapie EMDR dans le trouble de stress post-traumatique." Thesis, Aix-Marseille, 2018. http://www.theses.fr/2018AIXM0527/document.
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Le Trouble de Stress Post-Traumatique (TSPT) est une pathologie fréquente, touchant près de 8 % de la population générale. Cette pathologie psychiatrique s’exprime par un carré symptomatique incluant un syndrome de répétition, d’évitement, une hyperactivation neurovégétative ainsi qu’une altération négative des cognitions et de l’humeur. Un des traitements les plus efficaces dans cette pathologie est une psychothérapie nommée EMDR pour Eye Movement Desensitization and Reprocessing. Bien que cette thérapie ne soit plus à faire la preuve de son efficacité, les mécanismes d’actions de celle-ci demeurent encore aujourd’hui à l’état d’hypothèse. L’objectif de notre travail de thèse fut d’explorer le mécanisme d’action de la thérapie EMDR à travers différents paradigmes en EEG, TEP-scanner et IRMf, en comparant l’activité cérébrale avant et après traitement ou pendant les stimulations bilatérales alternées. Nous avons pu démontrer que la thérapie EMDR modifiait l’activité cérébrale d’un réseau cérébral impliqué dans le traitement émotionnel et la mémoire et d’une structure en particulier, le précuneus. Les stimulations bilatérales alternées qui sous-tendent l’action de l’EMDR activent elles aussi une partie de ce réseau expliquant l’impact de l’EMDR sur la mémoire traumatique. Pour la première fois, nous avons également montré que l’activité du précuneus avant traitement est capable de prédire l’intensité de la diminution des symptômes de TSPT. La durée du sommeil paradoxal avant traitement permet quant à elle de prédire le nombre de séances nécessaires pour obtenir la rémissionPost-Traumatic Stress Disorder (PTSD) is a common condition affecting nearly 8% of the general population. This psychiatric pathology is expressed by a symptomatic square including a syndrome of repetition, avoidance, neurovegetative hyperactivation and a negative alteration of cognitions and mood. One of the most effective treatments in this pathology is a psychotherapy called EMDR for Eye Movement Desensitization and Reprocessing. Although this therapy no longer needs to prove its effectiveness, its mechanisms of action are still at the hypothesis stage today. The objective of our thesis work was to explore the mechanism of action of EMDR therapy through different paradigms in EEG, PET-scanner and fMRI, comparing brain activity before and after treatment or during bilateral alternating stimuli. We were able to demonstrate that EMDR therapy altered the brain activity of a brain network involved in emotional treatment and memory and of a particular structure, the precuneus. The alternating bilateral stimuli underlying the action of EMDR also activate part of this network explaining the impact of EMDR on traumatic memory. For the first time, we also have shown that the activity of the precuneus before treatment is able to predict the magnitude of the decrease in PTSD symptoms. The length of REM sleep before treatment can predict the number of sessions needed to reach remission
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Hendriks, Erika Erna. "Exploring eye movement desensitization and reprocessing (EMDR) as a technique for therapeutic intervention of adolescents experiencing trauma." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95946.
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Thesis (PhD)--Stellenbosch University, 2014.ENGLISH ABSTRACT: The research explores Eye Movement Desensitisation and Reprocessing (EMDR) as a possible therapeutic technique in interventions dealing with trauma. The study focuses specifically on the adolescent phase. A distinction is made between developmental trauma and single-incident trauma and its impact on development. An attempt is made to acquire a deeper insight into adolescents’ experience of trauma. The purpose of the adolescent phase is the development of a sound identity. The challenges and the impact of traumatic experiences on the development of the adolescent on the road to adulthood are examined more closely. The symptoms of trauma and specifically the effect of trauma on the adolescent are highlighted. The study adopted an interpretivist paradigm. A qualitative design with multiple case studies was selected for the research. The research included five cases. The study was limited to adolescents who ranged in age from 13-19 years in an Afrikaans school in Johannesburg. Intake discussions were held with the parents. Intake discussions in accordance with the EMDR approach were held with the participants. Each participant attended 4 sessions. Various themes were identified in each interview, but two main themes emerged: the emotions of the adolescents regarding the trauma they experienced; the influence of trauma on the self-concept of the participants; that led to a deeper grasp of the participants’ experiences. An insight was gained into the influence that traumatic experiences had on the lives of the participants as well as the influence of these experiences on their families, school and social contexts. The main findings indicate that EMDR as a therapeutic technique does have the potential to provide support to adolescents who have been exposed to single-incident or developmental trauma.
AFRIKAANSE OPSOMMING: Die navorsing handel daaroor om Oogbeweging Desensitisasie en Herprosessering (Eye Movement Desensitization and Reprocessing) (EMDR) as terapeutiese tegniek te eksploreer as moontlike intervensie vir trauma. Die studie fokus spesifiek op die adolessente fase. Daar sal onderskei word tussen ontwikkelingstrauma en ʼn enkele traumatiese ervaring en die impak daarvan op ontwikkeling. Daar is gepoog om ʼn verdieping van insig met betrekking to die adolessent in sy ervaring van trauma ter verkry. Die adolessente fase het ten doel tot die ontwikkeling van ʼn gesonde identitieit. Die uitdagings en die impak van traumatiese ervarings op die die ontwikkeling van die adolessent op sy pad na volwassenheid word van naderby bekyk. Die simptome van trauma en spesifiek die effek van trauma op die adolessent word uitgelig. Die studie was vanuit die interpretivistiese paradigma onderneem. ʼn Kwalitatiewe navorsingsontwerp met meervoudige gevallestudies was geselekteer. Vyf gevallestudies is in die navorsing ingesluit. Die studie was beperk tot adolessente wat wissel tussen die ouderdom van 13-19 jaar wat verbonde is aan ʼn Afrikaanse skool in Johannesburg. Invoergesprekke is met die ouers gehou. Invoergesprekke volgens die EMDR benadering is met die deelnemers afgelê. Daar is 4 EMDR sessies aan elke deelnemer gebied. Verskeie temas is in elke onderhoud geïdentifiseer. Daar het twee hooftemas na vore gekom: die emosies van die adolessente ten opsigte van die trauma wat hulle beleef het, die invloed wat trauma op die self-konsep van die deelnemers uitgeoefen het wat ondersteun het tot ʼn diepe begryping van die deelnemers se ervarings. Insig is verkry in watter invloed traumatiese ervarings op die lewe van die deelnemers gehad het asook die invloed daarvan op hul gesinne, skool en sosiale konteks. Die hoof-bevindinge dui daarop dat EMDR as terapeutiese tegniek wel oor die potensiaal beskik in die ondersteuning aan adolessente wat aan ʼn enkel-insident of ontwikkelingstrauma blootgestel is.
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Forster, Sara. "How Does Eye Movement Desensitization and Reprocessing (EMDR ) Work? An Examination of the Potential Mechanisms of Action." Thesis, Pepperdine University, 2021. http://pqdtopen.proquest.com/#viewpdf?dispub=28086013.
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A mounting body of evidence suggests that Eye Movement Desensitization and Reprocessing therapy (EMDR) is successful in reducing the impact of posttraumatic symptoms. Although the exact mechanisms of action remain unknown, theories from the psychological to the neuroscientific continue to emerge, expand, and evolve. This study will examine four of the most prominent theories to date and weigh the evidence for and against each one. It will also review, compare, and contrast the theories, evaluate the research supporting each one, and propose the most likely explanation for EMDR’s success given the state of the research. Neurobiological mechanisms and correlates as well as the controversy over the use of eye movements will also be reviewed. Implications for future research will also be discussed.
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Schubert, Sarah. "EMDR therapy : crucial processes and effectiveness in a non-clinical and a post-war, cross-cultural context." Thesis, Schubert, Sarah (2016) EMDR therapy : crucial processes and effectiveness in a non-clinical and a post-war, cross-cultural context. PhD thesis, Murdoch University, 2016. https://researchrepository.murdoch.edu.au/id/eprint/32424/.
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The aim of this thesis was to clarify mechanisms that contributed to the treatment of adult posttraumatic stress disorder (PTSD) with eye movement desensitization and reprocessing therapy (EMDR). An initial review highlighted that: EMDR is efficacious for treatment of PTSD; the processes in EMDR differ from other PTSD treatments; controversy remained about the necessity and role of the eye movement (EM) component; and although the underlying mechanisms of EMDR remained unclear, evidence was emerging supporting orienting response, REM-sleep, and working memory theories of EMDR.
The first study in this thesis investigated the necessity of EMs in EMDR, and the psychophysiological correlates of EM tasks used during therapy. Sixty-two non-clinical participants with negative autobiographical memories received a single EMDR session either without EMs, or with EMs of either varied or fixed rate of speed. EMDR-with-EMs led to greater reduction in distress than EMDR-without-EMs. Physiologically, when EMs began heart rate decreased significantly; skin conductance decreased during EM sets; heart rate variability and respiration rate increased significantly as EMs continued; and orienting responses were more frequent in the EM than no-EM condition at the start of exposure. Findings indicated that the eye movements in EMDR were beneficial, and were coupled with distinct psychophysiological changes that aid memory processing.
A following study confirmed these findings by examining the effectiveness and physiological correlates of EMDR to treat trauma symptoms in a real world, post-war/conflict, developing nation, Timor Leste. Participants were 23 Timorese adults with symptoms consistent with PTSD, who served as their own waitlist control. EMDR was followed by significant and large reductions in PTSD symptoms, depression, and anxiety. Physiological responses associated with therapy confirmed changes seen previously in Western treatment sessions; physiological dearousal occurred within desensitisation sessions; heart rate decreased as EM sets began; skin conductance decreased within EM sets; and skin conductance responses that habituated in size and number in EM sets characteristic of an orienting response. Findings demonstrate EMDR can be effectively used cross-culturally, post-war/conflict, in Timor Leste, and this research adds to the body of theoretical knowledge as to how EMDR therapy works to facilitate processing of trauma memories.
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Block, Charlotte. "Var finns hjälpen? : om komplex traumatisering och traumabehandling." Thesis, Ersta Sköndal högskola, S:t Lukas utbildningsinstitut, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1746.
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Det finns ett klart samband mellan komplex traumatisering och psykisk och fysik ohälsa. Många människor har stora problem med det dagliga livet och relationer. Förutom det personliga lidandet är effekterna av komplex traumatisering av stor samhällsekonomisk betydelse. Syftet med studien är att undersöka psykoterapeutisk behandling av traumatiserade patienter inom icke specialiserade enheter. Frågeställningarna i studien är: Vad innebär effekterna av komplex traumatisering för individen? Vilka är terapeuters upplevelse av att arbeta med komplext traumatiserade individer? Får individer med diagnosen komplex PTSD den hjälp de behöver? Den metod som använts är en kvalitativ studie där sex legitimerade psykoterapeuter med psykodynamisk inriktning intervjuas. Resultatet av studien visade att effekterna av komplex traumatisering är omfattande och svåra att diagnostisera. Tillståndet har ofta utvecklats till kroniska besvär, t ex ångest och depression, somatiska besvär och personlighetsstörning. Det finns svårigheter och hinder för att traumatiserade patienter ska få adekvat hjälp och utifrån resultatet saknas det i dag både resurser och effektiva behandlingsmetoder. Kunskapen om trauma och dess effekter måste i ökad utsträckning uppmärksammas och prioriteras i tidigare skede inom vård- och behandling.
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Tomback, Alexandra. "An Investigation into the Most Effective Therapy for Female Victims of Sex Trafficking." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/scripps_theses/965.
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The current literature on victims of sex trafficking lacks adequate research on effective therapeutic treatments for this population. This study aims to find an effective therapy for female victims of sex trafficking to treat trauma-related symptoms including PTSD, depression, anxiety, self-blame, self-esteem, and overall well-being by testing the effectiveness of eye-movement desensitization reprocessing (EMDR), trauma recovery and empowerment model (TREM), and psychoeducation. In this study, approximately 180-200 female victims of sex trafficking ages 18 or older will be randomly assigned to either the EMDR, TREM, psychoeducation, or a control-wait-list group. Trauma-related symptoms will be assessed pre-treatment (Time 1), post-treatment (Time 2), and 6- months post-treatment (Time 3) to assess the effectiveness of each intervention over time. It is expected that participants in all therapy groups will display significantly improved trauma-related symptoms compared to participants in the control-wait list group at time 2. It is further expected that participants in the TREM group will display significantly reduced self-blame and increased self-esteem and overall well-being at time 2 compared to participants in the EMDR and psychoeducation groups. Lastly, it is expected that improvement in trauma-related symptoms will be maintained from time 2 to time 3. These expected findings suggest that TREM will be the most effective long-term therapy for female victims of trafficking.
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Wise, Joanna. "Caring for the carers : exploring clinicians' experiences of using Trauma-Focused CBT and EMDR Therapy to treat PTSD." Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/19936/.
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WHO (2013), NICE (2015) and UKPTS (McFetridge et al., 2017) guidelines equally recommend trauma-focused cognitive behavioural therapy (TF-CBT) and eye movement desensitization and reprocessing therapy (EMDR Therapy) as the psychological therapies of choice for post-traumatic stress disorder (PTSD) in terms of patient outcomes. However, although trauma treatments such as these are generally acknowledged to present a risk of compassion fatigue and burnout for the therapists who carry them out, (Figley, 1995) no research to date has distinguished between TF-CBT and EMDR Therapy in terms of their impact on the clinicians who deliver them. This study employed a qualitative design to explore clinicians’ own experiences of administering EMDR Therapy and TF-CBT, both during treatment sessions and cumulatively over time, when treating clients referred with PTSD. Nine counselling and clinical psychologists working in an NHS Traumatic Stress Clinic setting, qualified in both treatment approaches, and with experience of working with at least one client in each modality, were each invited to participate in a semi-structured audio-recorded interview. Transcripts were analysed using Interpretative Phenomenological Analysis. The first of three main themes to emerge arose from the experience common to all participants that “It’s not about the modalities, really”. Rather, trauma work in general was experienced as having both negative and positive impacts for clinicians; these formed four subthemes, ‘Compensatory rewards’, ‘Connection with clients’, ‘Cumulative costs’ and ‘Coping strategies’. However, a more complex and nuanced account emerged as two further themes. Many participants identified their original training in TF-CBT as “My comfort zone”; sub-themes differentiated this as either ‘Containing’ of both their own and their clients’ anxieties, enabling clinicians to feel competent, confident and in control, or ‘Constraining’, where clinicians felt frustrated by the “clunky” and more confrontational aspects of this modality. The final theme acknowledged that learning to “Trust the process” of EMDR Therapy, in particular sub-themes regarding ‘Intense physical communication’ required ‘Confidence to “trust the process”’, but this in turn gave rise to the experience that ‘EMDR Therapy Clears traumas TF-CBT cannot shift’. The implications of these findings are discussed with particular relevance for how counselling psychologists can contribute towards best practice in trauma treatment which both ‘cares for the carers’ and offers clients a potentially more rapid and complete recovery.
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Skinner, D. J. "A mixed methods case study examination of the role of the therapeutic alliance in EMDR within primary care." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/47640/.
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The therapeutic relationship within psychotherapy is well recognised as a pertinent component of successful treatments. In particular, the alliance component of the therapeutic relationship has demonstrated a moderate and robust correlation to positive outcomes. The alliance is considered the change mechanism within the more relationally focused therapies (e.g., psychodynamic). In contrast, therapies that focus on specific techniques related to underlying theory regarding the development and amelioration of mental health difficulties, prioritise the protocols as the change mechanism. Mental health services can be seen to have moved towards offering more time-limited, protocol driven therapies (e.g., CBT) to widen access to therapy and to meet financial incentives. EMDR is a relatively new psychotherapy which has amassed evidence of efficacy since its development by Francine Shapiro in the 1980s and is now recommended within the NICE guidelines. EMDR is predominantly a protocol driven therapy based on its underlying theory which suggests that mental health difficulties are a result of dysfunctionally stored memories. Currently, little is known about the role of therapeutic relationship within EMDR and whether additional focus on relational aspects within the therapy could enhance outcomes. A single-case design with two therapist-client dyads was used to explore the therapeutic alliance within two EMDR therapy cases in a primary care setting. The study had three aims; to investigate the relationship between the therapeutic alliance and outcome; to investigate the fluctuations of the alliance throughout EMDR; and to explore how the alliance is experienced by the client and therapist during EMDR treatment. The principal findings, presented via visual analysis, display a strong alliance and positive outcomes in the two EMDR cases, suggesting the presence of the alliancewithin a predominantly protocolised therapy. This is further supported by the qualitative data, in which the alliance was a highly valued aspect by therapist and clients in both cases. Whilst this study is limited by generalisability given the small sample size and correlational design, it draws researchers’ and clinicians’ attention to the paucity of information guiding the practice of EMDR in terms of the relational imperative.
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Shields, Susannah. "An investigation into EMDR and imagery rescripting for PTSD in adult survivors of childhood sexual abuse: A case series." Thesis, Shields, Susannah (2015) An investigation into EMDR and imagery rescripting for PTSD in adult survivors of childhood sexual abuse: A case series. Masters by Coursework thesis, Murdoch University, 2015. https://researchrepository.murdoch.edu.au/id/eprint/42487/.
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In clinical settings, PTSD related to a history of childhood sexual abuse (CSA) is associated with more severe symptom complexity and worse prognosis, when compared to adult onset PTSD. Relatively little is known about how best to deal with this symptom profile. The current study reviewed three cases in which Imagery Rescripting (ImRs) or Eye Movement Desensitisation and Reprocessing (EMDR) was administered in survivors of CSA experiencing current PTSD symptoms. In the first case a survivor of prolonged CSA received 12 sessions of ImRs and demonstrated clinically significant improvement in PTSD symptoms at the conclusion of treatment, and by an eight week follow-up they no longer met criteria for a PTSD diagnosis. In the second case a survivor of a single incident of CSA received eight sessions (in full) of EMDR and at post-treatment assessment showed clinically significant improvement and an absence of a PTSD diagnosis was observed. The final case investigated the effect of 12 sessions of EMDR in a survivor of prolonged multiple CSA and multiple adult sexual assaults. In this case, clinically significant change was revealed at the conclusion of treatment, but was not maintained at follow-ups. All three cases revealed symptom improvement to some degree, as well as clinical observations and self-report of functional gains; however, finer analysis reveals these gains cannot yet be confidently attributed to ImRs and EMDR. Further investigation of EMDR and ImRs are needed in a RCT design before efficacy of treatment within this population can be determined. The current study's positive findings suggest it is feasible to conduct such a large scale investigation of these treatments. However, several design weaknesses were identified in this pilot including insufficient recruitment and retention rates and iatrogenic consequences of one of the measures. Recommendations are provided on how to address these issues.
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Fouchier, Capucine de. "Évaluation d'un protocole psychothérapeutique associant la psychoéducation, la relaxation et l'EMDR dans la prise en charge des réfugiés victimes de torture d'Afrique centrale et de l'Ouest." Paris 8, 2013. http://octaviana.fr/document/182058379#?c=0&m=0&s=0&cv=0.
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Ce travail de recherche a pour ambitions d’apporter un éclairage sur les spécificités psychopathologiques des réfugiés victimes de torture d’Afrique Centrale et de l’Ouest et d’évaluer l’efficacité thérapeutique d’un protocole de dix séances associant la psychoéducation, la relaxation et l’EMDR, tout en comparant ses effets en modalité de traitement hebdomadaire ou intensive. Pour cela, 52 participants ont été répartis dans trois conditions de traitement : « EMDR », « Stabilisation » et « Intention de traiter par médicaments » et ont bénéficié d’une évaluation psychologique au début, à la fin et 4,5 mois après l’arrêt de la thérapie. Nos résultats indiquent que l’État de Stress Post-Traumatique (ESPT) est le trouble le plus représenté et que l’hébergement et la situation de la demande d’asile sont les variables sociales ayant le plus d’influence sur l’intensité de la psychopathologie. Le protocole « EMDR » montre une efficacité thérapeutique forte et supérieure aux deux groupes contrôles pour l’ensemble des variables considérées comme pathologiques lors de l’évaluation initiale (ηp2 entre. 41 et. 96). De plus, la modalité de traitement intensive majore l’efficacité thérapeutique du protocole « EMDR » pour l’ESPT, la dépression, l’anxiété, et le fonctionnement global (ηp2 entre. 87 et. 93). En conclusion, cette recherche montre l’importance d’interroger les patients sur leur situation sociale et migratoire dans le pays d’accueil et fait la preuve que l’association de l’EMDR à la psychoéducation et à la relaxation est un protocole thérapeutique pertinent et efficace dans la réhabilitation psychologique de cette population, en particulier dans sa forme intensiveThe aims of this research are to provide information on the psychopathological specificities of refugees torture survivors from Central and West Africa and to assess the therapeutic efficiency of a 10 session protocol associating psychoeducation, relaxation technique and EMDR while comparing its effect when applied in weekly or intensive treatment modality. To achieve these goals, 52 participants were allocated in three treatment conditions: “EMDR”, “Stabilization” and “Intent to treat with medication” and were assessed at the beginning, at the end and 4,5 months after the end of psychotherapy. Our results show that Post-Traumatic Stress Disorder (PTSD) is the most frequent pathology and that accommodation and the asylum claim situation in the host country are the social variables with the most influencing impact on psychopathology. The “EMDR” protocol shows a large and superior therapeutic efficiency in comparison with the control groups for all the variables that were considered pathological during the initial assessment (ηp2 entre. 41 et. 96). Also, the intensive treatment modality increases the therapeutic efficiency for PTSD, depression, anxiety and functioning (ηp2 entre. 87 et. 93). In conclusion, this research shows this importance to ask patients about their social and migration situation in the host country and demonstrates that associating EMDR with psychoeducation and relaxation techniques is a relevant and efficient psychotherapeutic protocol in the psychological rehabilitation of this population, especially when it is applied in a intensive way