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EMDR Research FAQs

Where can I get a list of EMDR Journal articles?

How can I find out about research grant opportunities?

I'm trying to get my clinic to adopt EMDR and am having some trouble convincing the administrator to do so.  What would be some articles about research that would be helpful to give the administrator?

Where can I find some full-text articles on EMDR on the internet?

How can I go about developing and researching a new EMDR treatment protocol I'm thinking about?

How can practitioners contribute to EMDR Research?

 

Where can I get a list of EMDR Journal articles?

The best current listing of EMDR journal articles is in the Francine Shapiro Library. After entering the Library, you can select articles by format, title, author, key word, year, and language. In addition to journal articles, formats include audio, books, magazines, conference presentations, videos and others.


How can I find out about research grant opportunities?

There are many sources of information about grant opportunities. For starters, join our Research Support Listserv. David Baldwin’s Web site (see above on “EMDR Articles”) has some valuable links related to grants; click on Option 6, “Site Index & Web Links” and then scroll down to “Research Issues” where you’ll find a link to Grants & Funding. Also, you might find the following Web sites helpful:

EMDR Research Foundation

The Foundation Center

The Grantsmanship Center

APA (American Psychological Association)

DHHS (Department of Health and Human Services)

Ittleson Foundation


NIH (National Institutes of Health)

NSF (National Science Foundation)

SAMHSA (Substance Abuse & Mental Health Services Administration)


I'm trying to get my clinic to adopt EMDR and am having some trouble convincing the administrator to do so.  What would be some articles about research that would be helpful to give the administration?

First, if you haven’t already done so, you might want to obtain the EMDRIA Presentation Packet, developed by the Public & Professional Relations Committee. This packet includes many excellent materials that could help you. This packet is available for purchase online at the EMDRIA Store.

Click here for a listing of EMDR trauma research findings and further reading. Updated 5-11


Where can I find some full-text articles on EMDR on the Internet (we’ll add to this periodically, but for starters, check these out):

Ballcom, D., Call, E., & Pearlman, D.N. (2002). Eye Movement Desensitization and Reprocessing treatment of internalized shame. Traumatology, 6 (2). 

Bergmann, U. (1998). Speculations on the neurobiology of EMDR. Traumatology, 4 (1).

Bergmann, U. (2000). Further thoughts on theneurobiology of EMDR: The role of the cerebellum in Accelerated Information Processing. Traumatology, 6 (3).

Denny, N.T. (1995). An orienting reflex/external inhibition model of EMDR and Thought Field Therapy. Traumatology, 1 (1).

Lipke, H. (1996). A Four Activity Model of psychotherapy and its relationship to Eye Movement Desensitization and Reprocessing (EMDR) and other methods of psychotherapy. Traumatology, 2 (2).

Maxfield, L. (1999). Eye Movement Desensitization and Reprocessing: A review of the efficacy of EMDR in the treatment of PTSD. Traumatology, 4 (4). 

Perkins, B.R., & Rouanzoin, C.C. (2002). A critical evaluation of current views regarding eye movement desensitization and reprocessing (EMDR): Clarifying points of confusion. Journal of Clinical Psychology, Vol. 58(1), 77-97. 

Puffer, M.K., Greenwald, R., & Elrod, D.E. (1997). A single session EMDR study with twenty traumatized children and adolescents. Traumatology, 3 (2)

Russell, M. (2006).
Treating Combat-Related Stress Disorders: A Multiple Case Study Using EMDR With Battlefield Casualties From The Iraqi War.


How can I go about developing and researching a new EMDR treatment protocol I'm thinking about?

We are often asked about how to develop and test a treatment protocol, or how to research the application of EMDR to a new population. Different types of research are appropriate at different stages of development of a new protocol. Here are the stages most commonly used to develop a protocol:

1. You get an idea and decide to try it out. You have good luck with a case, and wonder if you could do it again. You may have used standard EMDR in a new type of treatment problem (new for EMDR at least), or you may have adapted EMDR in some way; or you may have combined EMDR with other interventions in a unique way.

2. You try more cases with the same treatment problem, using some of the same approaches you used in the first one, and experimenting with other things as well. This will help you to figure out whether the first success was just a fluke or whether you might have discovered an innovation. At this stage, it's helpful to begin keeping a log that tracks key characteristics of the client and provides a place for brief notes on treatment response and variations to your approach that you've had to make.

3. You discern a pattern from your experience with #2, and develop a protocol. For example, if there are 5 steps and most people require most of the steps, you may simply include all 5 steps in the protocol to make sure that you're always covered. If most people only need two of the steps, you figure out what the difference is between those that need only two and those that need all five, and you identify the decision rules (this is where the log can be quite helpful).

4. You test the protocol, and your theory underlying the protocol, in a single system design (SSD) series with outcome measures appropriate to the treatment targets. SSDs are systematic case studies that employ repeated measurement over time so trends (and changes in trends) in behavior can be examined. At this point it's important to write down the protocol with as much specificity as possible, so that others who use your "treatment manual" can do what you did. In addition to creating a narrative that describes your protocol, a checklist (that covers each step) will make it much more likely that others will be able to implement your protocol correctly.

5. Generally, if you've changed the EMDR protocol in some way, you'll also need to present some single system design cases that also show how why a change in the standard EMDR protocol was necessary. One good method for doing this is the A-B-C single system design, where A is a baseline (pre-intervention) phase, B is the standard EMDR protocol; and C is the adapted protocol that you've created. The only time that this might not be necessary is when you're targeting something that is contraindicated for standard EMDR (such as behaviors to stabilize clients to increase readiness for trauma processing). The general rule is: if there is an established protocol already for what you're doing, you'll need to show how what you're doing is an improvement.

6. If the case series results are encouraging, try teaching your protocol to some other practitioners. Ideally, obtain their feedback, questions, & concerns on implementing the protocol (through a log, or through consultation). This step will identify steps in the protocol you haven't articulated well (usually because they were intuitive steps for you, but not intuitive for others!), and will help to refine your treatment manual for the next stage of this process.

7. You conduct a controlled study comparing your treatment to a wait-list control or to a standard-care-only control. Note that "standard care" at your research site may not be the same as "state of the art," so be prepared to provide some description of it.

8. If the controlled study results are encouraging, you conduct an additional controlled study comparing your protocol to the other leading approach to this treatment problem.

9. If the results of the controlled, comparative treatment study are positive, then step 8 should ideally be repeated by some other research team.

For steps 4-9, it can be especially helpful to consult researchers prior to beginning that particular step, so that you ensure that you've designed the methodologically strongest study for that stage. All of the steps above are such that at each phase of development, you are investing the minimum resources required to determine whether going to the next level is warranted. Sometimes the findings are not positive, and you have to decide whether your study was conducted poorly, whether you can modify your protocol to improve effectiveness, or whether it's not really worthwhile after all. If you choose to persist, you will probably want to repeat the "failed" step successfully before going further.

This model can also be used by those who wish to conduct a research project in a specific area of interest. By reviewing the literature you can determine the current stage of development for EMDR for your treatment problem of interest. With careful analysis you can decide whether the studies to date have been conducted properly, paving the way for the next phase, or whether something needs to be redone in a better way. Using this model can help researchers to avoid conducting case studies in areas where controlled studies have already been completed, as well as to avoid conducting controlled studies when case studies have not yet demonstrated that a larger project is warranted. With this model, researchers can use their resources to best contribute to the literature by accomplishing the natural "next step."

Helpful Resources for Developing & Testing New Protocols

Bloom, M., Fischer, J., & Orme, J.G. (1999). Evaluating practice (3rd ed.). Boston: Allyn & Bacon.

Rothman, J., & Thomas, E.J. (Eds.)(1994). Intervention research: Design and development for human service. Binghamton, NY: Haworth.

Rubin, A. (July, 1997). Empirically validating EMDR with single case designs: A step-by-step guide for EMDR therapists. Workshop presented at the EMDR International Association Conference, San Francisco, CA. (Contact Lisa Jones for an electronic copy of handout).

Thomas, E.J. (1984). Designing interventions for the helping professions. Beverly Hills, CA: Sage


How can practitioners contribute to EMDR Research?

Many EMDR practitioners inquire about how they might contribute to the research on EMDR. Some basic guidelines on doing research are presented here—they have been adapted from an EMDR Institute Listserv post by Louise Maxfield.

The purpose of research is to test the effectiveness of a specific protocol. To do this, we have to be able to say that the results would not have been achieved without the treatment; i.e., that the person would not have improved as a result of time or attention. There are 2 simple designs that can be used by practitioners to collect such data. These are single case designs and waitlist designs. A third design is treatment comparison, which tests whether EMDR is more effective than another therapy. This other therapy might be CBT, standard care, or modifications of EMDR, etc. The following are simple descriptions of these designs. Please note that these can often be more complex.

In a single case design, measures are administered to evaluate the severity of symptoms.  It is recommended that the clinician use recognized and standardized inventories or tests, so that other therapists and researchers can readily understand the extent of the client’s problem and its improvement.  It is also possible to use individualized counts of targeted problems or behaviors.  For example, in the treatment of agoraphobia, in addition to using standardized measures of pathology, one could count the number of panic attacks per week, and the number of weekly hours that the client spends in a crowded public place.

The measurements are taken on several occasions prior to the start of treatment to establish a baseline. This evaluates the severity of symptoms over time without treatment. Then, when treatment starts, the measures are administered on a regular basis. The same thing is done after the end of treatment to measure maintenance of treatment effects. What you end up with is a graph with 3 sections, Pre, During, and Post treatment. Each section of the graph has a line with several data points measuring symptom severity. For example:

 

Pre

During

Post

Week

1

2

3

4

5

6

7

8

9

10

11

12

Scores

78

60

76

54

49

35

42

26

20

23

22

18


Just collecting the data during and post treatment is not considered scientifically compelling, because it is possible that the person may have had a similar improvement without treatment. The pre-score baseline demonstrates that this is probably not the case. Published studies generally show a series of clients with the same disorder, using the same measures. The simplest single case designs (pre, during and post) are called A-B-C designs (A for baseline, B for intervention phase, C for follow-up). These designs are easy to implement, but aren’t as rigorous as more complex single case designs which can establish an intervention’s effectiveness more convincingly.

Many practitioners may choose to collect "During" and "Post" data in their own practice to document the effectiveness of the therapy they provide. This is also very useful, but has a different goal. Therapists can use this type of information to help them to identify any patterns of response among their own client group, the advantages of changing or modifying the protocol, etc.

The second type of design that could be used is the waitlist design. This involves randomly assigning clients to either receive treatment, or wait for treatment. All clients requesting treatment complete measures at Time 1; half get treatment right away, half wait for treatment. For example:

Time-1

Time-2

Time-3

Time-4

Time-5

1   Test

EMDR

Test

Test

 

2   Test

waitlist

Test

EMDR

Test


This is a more rigorous design than the A-B-C single-case design. The total time depends on the length of treatment, and the time for follow-up tests. For example, there could be 8 weeks between Time 1 and Time 2, to accommodate 8 treatment sessions; then another 2 months, until Time 3, for follow-up measures for the treatment group. In other words, the waitlist group might wait 4 months for treatment. In some designs, the waitlist starts treatment after Time 2. Such studies usually require at least 10 persons per condition, ideally 20.

The third type of design compares EMDR to another treatment. This could be standard care provided in the agency, relaxation, or another treatment known to be effective, and in which the therapist is trained and competent. This is a more rigorous design than the waitlist design. Although some studies are published with about 10 persons per condition, having 20 or more per condition gives more statistical power to analyze differences in outcome.
For example,

Time-1

Time-2

Time-3

Time-4

1 Test

treatment

Test

Test

2 Test


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