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Research on EMDR
Since Dr. Francine Shapiro first developed EMDR, quite a bit of research has appeared in scientific journals about its effectiveness. The EMDR Institute (emdr.com), EMDRIA (www.emdria.org), and David Baldwin's Trauma Information Pages are excellent web sites for finding up-to-date information about this research. Some of the reference lists on these sites include:EMDR Institute References: The EMDR Institute web site has several lists of references devoted to controlled studies, efficacy of EMDR, and research on EMDR and trauma. You can also find a research overview.Now that news about the effectiveness of EMDR is appearing in the media, a few professionals as well as other skeptics have raised questions about it. Discussion and debate is always important in better understanding and improving a new psychotherapy approach - and CenterPoint welcomes such challenging explorations. However, criticisms too often are based on misconceptions about the theory, technique, and research on EMDR. Here we'd like to address some of those common misconceptions:
Books at the EMDR Institute site that review the theory, technique, and research
Recent Research Articles on EMDR. Also check out the Journal of EMDR Practice and Research.
Special Issue of Journal of Clinical Psychology which is devoted to EMDR research.
A recent book by Francine Shapiro, the originator of EMDR, highlights it's use as a self-help tool: Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy, 2012
How strong is the scientific evidence to support EMDR?
One solid indicator of the effectiveness of new form of psychotherapy is the quantity and quality of scientific research published about it. If you click on the links above and peruse the list of scientific articles about EMDR, you'll see that there are many such articles. The majority of these journals are very reputable and "peer-reviewed," which means a panel of experts in the field must read, analyze, and approve a submitted article before it is published. Higher quality research studies involve "control groups" in which a psychotherapy technique is compared to other interventions or no interventions at all. In her books and articles in which she reviewed the research on EMDR, Francine Shapiro (1995, 1996) notes that there were more controlled studies on EMDR than on any other method used in the treatment of post-traumatic stress disorders.
Is there a placebo effect?
A "placebo effect" is when people improve from an intervention simply because they EXPECT to improve, not because the intervention is truly effective. According to Susan Rogers, an EMDR clinician and researcher at the Coatesville VA Hospital and co-author of a book on EMDR (2001), there have been five studies which examined expectancy effects in EMDR (Bauman & Melnyk, 1994; Devilly& Spence, 1999; Gosselin & Matthews, 1995; Hekmat, Groth & Rogers, 1994). None of them have shown any relationships between clients' expectancies and treatment outcome.
Is EMDR any better than other interventions?
Another well-researched treatment is Cognitive Behavioral Therapy (CBT) which includes such techniques as prolonged exposure, stress inoculation treatment, and cognitive restructuring. According to Susan Rogers, there have been four studies directly comparing EMDR and CBT. In one (Devilly & Spence, 1999), CBT was found to be more effective than EMDR. In the other three (Lee et al., in press; Ironson et al., in press; Powell McGoldrick & Brown, 2000), EMDR was found to have either superior effects, or equal effects in less treatment time. The three positive studies were more rigorous than the negative one.
Are eye movements really an effective component of the treatment?
Since Francine Shapiro first coined the term "Eye Movement Desensitization and Reprocessing," a great deal of debate has ensued about the role of eye movements in the treatment. Other types of bilateral stimulation also may work well (sounds alternating from ear to ear, tapping alternating on the left and right side of the body). Exactly what types of stimulation work best is still an unanswered question in research studies. The studies conducted so far that examine this issue used samples of people which were too small to be scientifically significant. It's also very possible that specific types of bilateral stimulation work well for some people, but not for others. Each person may have his/her own preference.
Does the improvement from EMDR last?
It's not uncommon for many types of psychotherapy interventions to result in initial improvement that then fades over time after the psychotherapy ends. However, controlled studies with follow-ups of nine or fifteen months (which is quite long in psychotherapy research) have shown that EMDR's treatment effects do last.
It's important to note that scientific research on psychotherapy is a very complex process that cannot be explained easily in any one article. Highly knowledgeable researchers continue to debate how and why EMDR works just as they continue to debate the merits of all the other types of psychotherapy. This is what science is all about. In fact, heated debates about a new therapy often indicate that it has gained attention as an important and powerful new intervention.
Institutional and Professional Support for EMDR
An important indication of the effectiveness of a new psychotherapy are the institutions and professional organizations that endorse it. Few organizations will officially endorse a therapy unless they feel the scientific research behind it is solid.
- There are more than a dozen University graduate programs that offer courses in how to use EMDR.
- EMDR advanced training programs have been sponsored by the Menninger Clinic.
- EMDR treatment is advocated by the FBI and other sensitive government security agencies for their EAP programs.
- EMDR HAP programs have been funded by the United Nations High Commission for Refugees in Bangladesh.
- EMDR has been accepted and given a high rating as an effective treatment for PTSD by the International Society for Traumatic Stress Studies (November, 1999).
- EMDR has been explicitly identified as a approved method of treatment by a number of the largest national HMO and PPO payers in the United States.
- EMDR has been highly endorsed by Lenore Walker, Ed.D. ABPP, Diplomate in Clinical Psychology and Executive Director of the Domestic Violence Institute, as well as by Jeffrey T. Mitchell, Ph.D., President, of the International Critical Incident Stress Foundation and Clinical Associate Professor of Emergency Health Services at the University of Maryland.
- The Treatment Guidelines published by the International Society for Traumatic Stress Studies, the premier professional trauma organization, gives EMDR an "A" rating for effectiveness based on the highest scientific standard and a review of seven published, randomized, controlled studies with overall large effect sizes.
- EMDR trainings have been co-sponsored by the Dutch government.
- The British Department of Health Guide "Treatment Choice in Psychological Therapies and Counselling: Evidence Based Clinical Practice Guidelines" (developed by the British Psychological Society Centre for Outcomes Research and Effectiveness in coordination with the Royal College of General Practitioners, Royal College of Psychiatris) endorses EMDR.
Bauman, W. & Melnyk, W.T. (1994) A controlled comparison of eye movements and finger tapping in the treatment of test anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 25, 29-33.
Chambless, D.L., Baker, M.J., Baucom, D.H., Beutler, L.E., Calhoun, K.S., Crits-Christoph, Daiuto, A., Derubeis, R., Detweiler, J., Haaga, D.A.F., Bennett Johnson, S., McCurry, S., Mueser, K.T., Pope, K.S., Sanderson, W.C., Shoham, V., Stickle, T., Williams, D.A., Woody, S.R. (1998) Update on empirically validated therapies II. The Clinical Psychologist, 51, 3-16.
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 posttraumatic stress disorder. Journal of Anxiety Disorders, 13, 131-157.
Feske, U. & Goldstein, A. (1997) Eye movement desensitization and reprocessing for panic disorder: a controlled outcome and partial dismantling study. Journal of Consulting and Clinical Psychology, 65, 1026 1035.
Gosselin, P & Matthews, W. (1995). Eye movement desensitization and reprocessing in the treatment of test anxiety: a study of the effects of expectancy and eye movement. Journal of Behavior Therapy and Experimental Psychiatry, 26, 331-337.
Hekmat, H., Groth, S. & Rogers, D. (1994) Pain ameliorating effect of eye movement desensitization. Journal of Behavior Therapy and Experimental Psychiatry, 25, 121-130.
Ironson, G.L., Freund, B., Strauss, J.L., & Williams (in press). A comparison of two treatments for traumatic stress: A pilot study of EMDR and prolonged exposure. Journal of Clinical Psychology.
Lee, C., Gavriel, H., Drummond, P., Richards, J. & Greenwald, R. (in press) 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.
Pitman, R.,K., Orr, S.P., Altman, B, Longpre, R.E., Poire, R.E. & Macklin, M.L. (1996). Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder. Comprehensive Psychiatry, 37, 419-429.
Powell, K.G., McGoldrick, T. & Brown, K.W. (2000). 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. Poster presented at the Annual Meeting of the EMDR International Association, Toronto.
Silver, S.M. & Rogers, S. (2001). Light in the heart of darkness: EMDR and the treatment of war and terrorism survivors. New York: W.W. Norton