EMDR has been compared to numerous exposure therapy protocols, with and without CT techniques. It should be noted that exposure therapy uses one to two hours of daily homework and EMDR uses none. The most recent meta-analyses are listed here.
· Bisson, J., & Andrew, M.(2007).Psychological treatment of post-traumatic stress disorder (PTSD).Cochrane Database of Systematic Reviews2007, Issue 3. Art. No.: CD003388. DOI: 10.1002/14651858.CD003388.pub3.
“Trauma focused cognitive behavioural therapy and eye movement desensitisation and reprocessing have the best evidence for efficacy at present and should be made available to PTSD sufferers.”
· Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005).A multidimensional meta-analysis of psychotherapy for PTSD.American Journal of Psychiatry, 162,214-227.
EMDR is equivalent to exposure and other cognitive behavioral treatments and all “are highly efficacious in reducing PTSD symptoms.”
· Davidson, P.R., & Parker, K.C.H. (2001). Eye movement desensitization and reprocessing (EMDR): A meta-analysis. Journal of Consulting and Clinical Psychology, 69, 305-316.
EMDR is equivalent to exposure and other cognitive behavioral treatments.
· Maxfield, L., & Hyer, L.A. (2002).The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD.Journal of Clinical Psychology, 58, 23-41.
A comprehensive meta-analysis reported the more rigorous the study, the larger the effect.
· Rodenburg, R., Benjamin, A., de Roos, C, Meijer, A.M., & Stams, G.J. (in press).Efficacy of EMDR in children: A meta – analysis.Clinical Psychology Review.
“Results indicate efficacy of EMDR when effect sizes are based on comparisons between EMDR and non-established trauma treatment or no-treatment control groups, and incremental efficacy when effect sizes are based on comparisons between EMDR and established (CBT) trauma treatment.”
· Seidler, G.H., & Wagner, F.E. (2006).Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study.Psychological Medicine, 36,1515-1522.
Results suggest that in the treatment of PTSD, both therapy methods tend to be equally efficacious.”
Randomized Clinical Trials
· Carlson, J., Chemtob, C.M., Rusnak, K., Hedlund, N.L, & Muraoka, M.Y. (1998).Eye movement desensitization and reprocessing (EMDR): Treatment for combat-related post-traumatic stress disorder.Journal of Traumatic Stress, 11,3-24.
Twelve sessions of EMDR eliminated post-traumatic stress disorder in 77.7% of the multiply traumatized combat veterans studied. There was 100% retention in the EMDR condition. Effects were maintained at follow-up. This is the only randomized study to provide a full course of treatment with combat veterans. Other studies (e.g., Boudewyns/Devilly/Jensen/Pitman et al./Macklin et al.) evaluated treatment of only one or two memories, which, according to the International Society for Traumatic Stress Studies Practice Guidelines (2000), is inappropriate for multiple-trauma survivors. The VA/DoD Practice Guideline (2004) also indicates these studies (often with only two sessions) offered insufficient treatment doses for veterans.
· Abbasnejad, M., Mahani, K. N., & Zamyad, A. (2007).Efficacy of "eye movement desensitization and reprocessing" in reducing anxiety and unpleasant feelings due to earthquake experience.Psychological Research, 9(3-4), 104-117.
“EMDR is effective in reducing earthquake anxiety and negative emotions (e.g. PTSD, grief, fear, intrusive thoughts, depression, etc) resulting from earthquake experience. Furthermore, results show that, improvement due to EMDR was maintained at a one month follow up.”
· Ahmad A, Larsson B, & Sundelin-Wahlsten V. (2007).EMDR treatment for children with PTSD: Results of a randomized controlled trial.Nord J Psychiatry, 61,349-54.
Thirty-three 6-16-year-old children with a DSM-IV diagnosis of PTSD were randomly assigned to eight weekly EMDR sessions or the WLC group. EMDR was found to be an effective treatment in children with PTSD from various sources and who were suffering from a variety of co-morbid conditions.
· Chemtob, C.M., Nakashima, J., & Carlson, J.G. (2002).Brief-treatment for elementary school children with disaster-related PTSD: A field study. Journalof Clinical Psychology, 58,99-112.
EMDR was found to be an effective treatment for children with disaster-related PTSD who had not responded to another intervention.
· Cvetek, R. (2008).EMDR treatment of distressful experiences that fail to meet the criteria for PTSD.Journal of EMDR Practice and Research, 2,2-14.
EMDR treatment of disturbing life events (small “t” trauma) was compared to active listening, and wait list. EMDR produced significantly lower scores on the Impact of Event Scale (mean reduced from “moderate” to “subclinical”) and a significantly smaller increase on the STAI after memory recall.
· Edmond, T., Rubin, A., & Wambach, K. (1999).The effectiveness of EMDR with adult female survivors of childhood sexual abuse.Social Work Research,23, 103-116.
EMDR treatment resulted in lower scores (fewer clinical symptoms) on all four of the outcome measures at the three-month follow-up, compared to those in the routine treatment condition. The EMDR group also improved on all standardized measures at 18 months follow up (Edmond & Rubin, 2004, Journal of Child Sexual Abuse).
· Edmond, T., Sloan, L., & McCarty, D. (2004). Sexual abuse survivors’ perceptions of the effectiveness of EMDR and eclectic therapy: A mixed-methods study.Research on Social Work Practice, 14, 259-272.
Combination of qualitative and quantitative analyses of treatment outcomes with important implications for future rigorous research. Survivors’ narratives indicate that EMDR produces greater trauma resolution, while within eclectic therapy, survivors more highly value their relationship with their therapist, through whom they learn effective coping strategies.
· Hogberg, G. et al., (2007).On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers: A randomized controlled study.Nordic Journal of Psychiatry, 61,54-61.
Employees who had experienced “person-under-train accident or had been assaulted at work were recruited.” Six sessions of EMDR resulted in remission of PTSD in 67% compared to 11% in the wait list control. Significant effects were documented in Global Assessment of Function (GAF) and Hamilton Depression (HAM-D) score.Follow-up:Högberg, G. et al. (2008).Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up. Psychiatry Research. 159,101-108.
· Ironson, G.I., Freund, B., Strauss, J.L., & Williams, J. (2002). Comparison of two treatments for traumatic stress: A community-based study of EMDR and prolonged exposure.Journal of Clinical Psychology, 58,113-128.
Both EMDR and prolonged exposure produced a significant reduction in PTSD and depression symptoms. This is the only research comparing EMDR and exposure therapy that equalized homework. The study found that 70% of EMDR participants achieved a good outcome in three active treatment sessions, compared to 29% of persons in the prolonged exposure condition. EMDR also had fewer dropouts.
· Jaberghaderi, N., Greenwald, R., Rubin, A., Dolatabadim S., & Zand, S.O. (2004). A comparison of CBT and EMDR for sexually abused Iranian girls.Clinical Psychology and Psychotherapy, 11,358-368.
Both EMDR and CBT produced significant reduction in PTSD and behavior problems. EMDR was significantly more efficient, using approximately half the number of sessions to achieve results.
· Lee, C., Gavriel, H., Drummond, P., Richards, J. & Greenwald, R. (2002).Treatment of post-traumatic stress disorder: A comparison of stress inoculation training with prolonged exposure and eye movement desensitization and reprocessing.Journal of Clinical Psychology, 58,1071-1089.
Both EMDR and stress inoculation therapy plus prolonged exposure (SITPE) produced significant improvement, with EMDR achieving greater improvement on PTSD intrusive symptoms. Participants in the EMDR condition showed greater gains at three-month follow-up. EMDR required three hours of homework compared to 28 hours for SITPE.
· Marcus, S., Marquis, P. & Sakai, C. (1997).Controlled study of treatment of PTSD using EMDR in an HMO setting.Psychotherapy, 34,307-315
Funded by Kaiser Permanent. Results show that 100% of single-trauma and 77% of multiple-trauma survivors were no longer diagnosed with post-traumatic stress disorder after six 50-minute sessions.
· Marcus, S., Marquis, P. & Sakai, C. (2004).Three- and 6-month follow-up of EMDR treatment of PTSD in an HMO setting.International Journal of Stress Management, 11,195-208.
Funded by Kaiser Permanent, follow-up evaluation indicates that a relatively small number of EMDR sessions result in substantial benefits that are maintained over time.
· Power, K.G., McGoldrick, T., Brown, K., et al. (2002).A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring, versus waiting list in the treatment of post-traumatic stress disorder.Journal of Clinical Psychology and Psychotherapy, 9,299-318.
Both EMDR and exposure therapy plus cognitive restructuring (with daily homework) produced significant improvement. EMDR was more beneficial for depression, and social functioning, and required fewer treatment sessions. Subsequent reevaluation of the data indicated that“For pre- to post-treatment IES mean change score, EMDR patients also appeared to have had better treatment outcome than E+CR patients” and EMDR therapy was a predictor of positive outcome:Karatzias, A.,Power, K.McGoldrick, T., Brown, K., Buchanan, R., Sharp, D. & Swanson, V. (2006).Predicting treatment outcome on three measures for post-traumatic stress disorder. Eur Arch Psychiatry Clin Neuroscience, 20, 1-7.
· Rothbaum, B. (1997).A controlled study of eye movement desensitization and reprocessing in the treatment of post-traumatic stress disordered sexual assault victims.Bulletin of the Menninger Clinic, 61,317-334.
Three 90-minute sessions of EMDR eliminated post-traumatic stress disorder in 90% of rape victims.
· Rothbaum, B.O., Astin, M.C., & Marsteller, F. (2005).Prolonged exposure versus eye movement desensitization (EMDR) for PTSD rape victims.Journal of Traumatic Stress, 18,607-616.
In this NIMH funded study both treatments were effective:“An interesting potential clinical implication is that EMDR seemed to do equally well in the main despite less exposure and no homework. It will be important for future research to explore these issues.”
· Scheck, M., Schaeffer, J.A., & Gillette, C. (1998).Brief psychological intervention with traumatized young women: The efficacy of eye movement desensitization and reprocessing.Journal of Traumatic Stress, 11,25-44.
Two sessions of EMDR reduced psychological distress in traumatized adolescents/ young women and brought scores within one standard deviation of the norm.
· Shapiro, F. (1989).Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories.Journal of Traumatic Stress, 2, 199–223.
Seminal study appeared the same year as first controlled studies of CBT treatments. Three-month follow-up indicated substantial effects on distress and behavioral reports. Marred by lack of standardized measures and the originator serving as sole therapist.
· Soberman, G. B., Greenwald, R., & Rule, D. L. (2002).A controlled study of eye movement desensitization and reprocessing (EMDR) for boys with conduct problems.Journal of Aggression, Maltreatment, and Trauma, 6,217-236.
The addition of three sessions of EMDR resulted in large and significant reductions of memory-related distress, and problem behaviors by 2-month follow-up.
· Taylor, S. et al. (2003).Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training.Journal of Consulting and Clinical Psychology, 71, 330-338.
The only randomized study to show exposure statistically superior to EMDR on two subscales (out of 10). This study used therapist assisted “in vivo” exposure, where the therapist takes the person to previously avoided areas, in addition to imaginal exposure and one hour of daily homework (@ 50 hours). The EMDR group used only standard sessions and no homework.
· Vaughan, K., Armstrong, M.F., Gold, R., O'Connor, N., Jenneke, W., & Tarrier, N. (1994). A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder.Journal of Behavior Therapy & Experimental Psychiatry, 25,283-291.
All treatments led to significant decreases in PTSD symptoms for subjects in the treatment groups as compared to those on a waiting list, with a greater reduction in the EMDR group, particularly with respect to intrusive symptoms. In the 2-3 weeks of the study, 40-60 additional minutes of daily homework were part of the treatment in the other two conditions.
· Van der Kolk, B., Spinazzola, J. Blaustein, M., Hopper, J. Hopper, E., Korn, D., & Simpson, W. (2007).A randomized clinical trial of EMDR, fluoxetine and pill placebo in the treatment of PTSD: Treatment effects and long-term maintenance.Journal of Clinical Psychiatry, 68,37-46.
EMDR was superior to both control conditions in the amelioration of both PTSD symptoms and depression. Upon termination of therapy, the EMDR group continued to improve while the Fluoxetine participants again became symptomatic.
· Wanders, F., Serra, M., & de Jongh, A. (2008).EMDR Versus CBT for Children With Self-Esteem and Behavioral Problems: A Randomized Controlled Trial.Journal of EMDR Practice and Research, 2,180-189.
Twenty-six children (average age 10.4 years) with behavioral problems were randomly assigned to receive either 4 sessions of EMDR or CBT. Both were found to have significant positive effects on behavioral and self-esteem problems, with the EMDR group showing significantly larger changes in target behaviors.
· Wilson, S., Becker, L.A., & Tinker, R.H. (1995).Eye movement desensitization and reprocessing (EMDR): Treatment for psychologically traumatized individuals.Journal of Consulting and Clinical Psychology, 63,928-937.
Three sessions of EMDR produced clinically significant change in traumatized civilians on multiple measures.
· Wilson, S., Becker, L.A., & Tinker, R.H. (1997).Fifteen-month follow-up ofeye movement desensitization and reprocessing (EMDR) treatment of post-traumatic stress disorder and psychological trauma.Journal of Consulting and Clinical Psychology, 65, 1047-1056.
Follow-up at 15 months showed maintenance of positive treatment effects with 84% remission of PTSD diagnosis.
· Aduriz, M.E., Bluthgen, C. & Knopfler, C. (2009).Helping child flood victims using group EMDR intervention in Argentina: Treatment outcome and gender differences.International Journal of Stress Management. 16,138-153.
A comprehensive group intervention with 124 children, who experienced disaster related trauma during a massive flood utilizing a one session group protocol. Significant differences were obtained and maintained at 3-month follow up.
· Devilly, G.J., & Spence, S.H. (1999).The relative efficacy and treatment distress of EMDR and a cognitive behavioral trauma treatment protocol in the amelioration of post-traumatic stress disorder.Journal of Anxiety Disorders,13, 131-157.
This study found CBT superior to EMDR. The research is marred by higher expectations in the CBT condition: Treatment was delivered in both conditions by the developer of the CBT protocol.
· Fernandez, I. (2007).EMDR as treatment of post-traumatic reactions: A field study on child victims of an earthquake.Educational and Child Psychology. Special Issue: Therapy,24, 65-72.
This field study explores the effectiveness of EMDR and the level of post-traumatic reactions in a post-emergency context on 22 children victims of an earthquake. The results show that EMDR contributed to the reduction or remission of PTSD symptoms and facilitated the processing of the traumatic experience
· Fernandez, I., Gallinari, E., & Lorenzetti, A. (2004). A school- based EMDR intervention for children who witnessed the Pirelli building airplane crash in Milan, Italy.Journal of Brief Therapy, 2, 129-136.
A group intervention of EMDR was provided to 236 schoolchildren exhibiting PTSD symptoms 30 days post-incident. At four-month follow up, teachers reported that all but two children evinced a return to normal functioning after treatment.
· Grainger, R.D., Levin, C., Allen-Byrd, L., Doctor, R.M. & Lee, H. (1997).An empirical evaluation of eye movement desensitization and reprocessing (EMDR) with survivors of a natural catastrophe.Journal of Traumatic Stress, 10,665-671.
A study of Hurricane Andrew survivors found significant differences on the Impact of Event Scale and subjective distress in a comparison of EMDR and non-treatment condition.
· Hensel, T. (2009).EMDR with children and adolescents after single-incident trauma an intervention study.Journal of EMDR Practice and Research, 3, 2-9.
36 children and adolescents ranging in age from 1 year 9 months to 18 years 1 month were assessed at intake, post-waitlist/pretreatment, and at follow up. EMDR treatment resulted in significant improvement, demonstrating that children younger than 4 years of age showed the same benefit as the school-age children.
· Jarero, I., Artigas, L., & Hartung, J. (2006).EMDR integrative group treatment protocol: A post-disaster trauma intervention for children and adults. Traumatology, 12,121-129.
A study of 200 children treated with a group protocol after a flood in Mexico indicates that one session of treatment reduced trauma symptoms from the severe range to low (subclinical) levels of distress. Data from successful treatment at other disaster sites are also reported.
· Konuk, E., Knipe, J., Eke, I., Yuksek, H., Yurtsever, A., & Ostep, S. (2006). The effects of EMDR therapy on post-traumatic stress disorder in survivors of the 1999 Marmara, Turkey, earthquake.International Journal of Stress Management, 13,291-308.
Data reported on a representative sample of 1500 earthquake victims indicated that five sessions of EMDR successfully eliminated PTSD in 92.7% of those treated, with a reduction of symptoms in the remaining participants.
· Puffer, M.; Greenwald, R. & Elrod,D. (1997).A single session EMDR study with twenty traumatized children and adolescents.Traumatology-e, 3(2), Article 6.
In this delayed treatment comparison, over half of the participants moved from clinical to normal levels on the Impact of Events Scale, and all but 3 showed at least partial symptom relief on several measures at 1-3 m following a single EMDR session.
· Silver, S.M., Brooks, A., & Obenchain, J. (1995).Eye movement desensitization and reprocessing treatment of Vietnam war veterans with PTSD: Comparative effects with biofeedback and relaxation training.Journal of Traumatic Stress, 8, 337-342.
One of only two EMDR research studies that evaluated a clinically relevant course of EMDR treatment with combat veterans (e.g., more than one or two memories; see Carlson et al., above). The analysis of an inpatient veterans’ PTSD program (n=100) found EMDR to be superior to biofeedback and relaxation training on seven of eight measures.
· Silver, S.M., Rogers, S., Knipe, J., & Colelli, G. (2005).EMDR therapy following the 9/11 terrorist attacks: A community-based intervention project in New York City.International Journal of Stress Management,12, 29-42.
Clients made highly significant positive gains on a range of outcome variables, including validated psychometrics and self-report scales. Analyses of the data indicate that EMDR is a useful treatment intervention both in the immediate aftermath of disaster as well as later.
· Solomon, R.M. & Kaufman, T.E. (2002).A peer support workshop for the treatment of traumatic stress of railroad personnel: Contributions of eye movement desensitization and reprocessing (EMDR).Journal of Brief Therapy, 2,27-33,
60 railroad employees who had experienced fatal grade crossing accidents were evaluated for workshop outcomes, and for the additive effects of EMDR treatment. Although the workshop was successful, in this setting, the addition of a short session of EMDR (5-40 minutes) led to significantly lower, sub clinical, scores which further decreased at follow up.
· Sprang, G. (2001).The use of eye movement desensitization and reprocessing (EMDR) in the treatment of traumatic stress and complicated mourning: Psychological and behavioral outcomes.Research on Social Work Practice,11, 300-320.
In a multi-site study, EMDR significantly reduced symptoms more often than the CBT treatment on behavioral measures, and on four of five psychosocial measures. EMDR was more efficient, inducing change at an earlier stage and requiring fewer sessions. Positive recall of the deceased was significantly greater post treatment in the EMDR condition.
· Zaghrout-Hodali, M., Alissa, F. & Dodgson, P.W. (2008).Building resilience and dismantling fear: EMDR group protocol with children in an area of ongoing trauma.Journal of EMDR Practice and Research, 2,106-113.
Results indicate that the EMDR approach can be effective in a group setting, and in an acute situation, both in reducing symptoms of posttraumatic and peritraumatic stress and in “inoculation” or building resilience in a setting of ongoing conflict and trauma.
Material from the EMDR Institute, Inc.