A critique of the 2025 American Psychological Association Clinical Practice Guideline for the treatment of posttraumatic stress disorder in adults: Underrating EMDR effectiveness

This article explores the APA’s PTSD guidelines, which list EMDR therapy as a second-line treatment. It argues the recommendation was based on outdated, lower-quality evidence and inconsistent interpretations of research, noting inconsistencies and a divergence from other international and national clinical practice guidelines.

Resource Abstract

“The American Psychological Association’s (APA’s) most recent guidelines for the treatment of posttraumatic stress disorder in adults recommend cognitive processing therapy, prolonged exposure, and trauma-focused cognitive behavioral therapy as first-line psychological treatment approaches. Eye movement desensitization and reprocessing (EMDR) therapy is listed as a second-line treatment. This position contrasts with 5 international and national clinical practice guidelines published in the past decade, making the APA’s guidance an outlier. Reasons for this discrepancy are explored, including that the APA utilized outdated reviews, relied on lower-quality meta-analytic evidence, applied a conservative approach to what constitutes evidence, and provided limited transparency into how specific decisions about EMDR were made. The guidelines comment negatively on EMDR in 4 domains: long-term treatment gains, adverse effects, outcomes for comorbid conditions such as depression, and the acceptability of EMDR therapy across cultures. Yet the APA panel’s documented commentary on each of these issues is inconsistent with published research. The paper concludes with recommendations for enhancing future guideline development.”

—Description from publisher

Resource Access

Open Access

Lee, C. W., Jongh, A., Farrell, D., Meysener, L., Dominguez, S., & El-Leithy, S. (2026). A critique of the 2025 American Psychological Association Clinical Practice Guideline for the treatment of posttraumatic stress disorder in adults: Underrating EMDR effectiveness. Journal of EMDR Practice and Research, 20, Article 34. https://doi.org/10.34133/jemdr.0034