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Science and pseudoscience in the development of Eye Movement Desensitization and Reprocessing: Implications for clinical psychology
Abstract
The enormous popularity recently achieved by Eye Movement Desensitization and Reprocessing (EMDR) as a treatment for anxiety disorders appears to have greatly outstripped the evidence for its efficacy from controlled research studies. The disparity raises disturbing questions concerning EMDR's aggressive commercial promotion and its rapid acceptance among practitioners. In this article, we: (1) summarize the evidence concerning EMDR's efficacy; (2) describe the dissemination and promotion of EMDR; (3) delineate the features of pseudoscience and explicate their relevance to EMDR; (4) describe the pseudoscientific marketing practices used to promote EMDR; (5) analyze factors contributing to the acceptance of EMDR by professional psychologists; and (6) discuss practical considerations for professional psychologists regarding the adoption of EMDR into professional practice. We argue that EMDR provides an excellent vehicle for illustrating the differences between scientific and pseudoscientific therapeutic techniques. Such distinctions are of critical importance for clinical psychologists who intend to base their practice on the best available research.
... The attention it has gained from the field of psychology at large comes not only from the often dramatic and immediate positive results demonstrated by this treatment in many empirical outcome studies, but from the fact that not all studies replicate these findings. In addition, it is no longer used only to treat Post-traumatic Stress Disorder (PTSD), but also Panic Disorder, Obsessive-Compulsive Disorder, Dissociative Disorders, and Dysmorphic Body Disorder, as well as depression, grief, addictions, eating disorders, body image disturbances, issues of self-esteem, morbid jealousy, chronic pain, test anxiety, personality disorders, public-speaking anxiety, somatoform disorders, substance abuse, and some aspects of Attention-Deficit/Hyperactivity Disorder (processing condition-related distressing experiences and learning self-management skills) Herbert et al., 2000;MacCluskie, 1998;Parnell, 1997;Shapiro, 1999Shapiro, , 2002. ...
... These conflicting perspectives raise issues about research and empirical validation, providing the opportunity to define our expectations for treatment research. Herbert et al. (2000) list some of the non treatment-specific factors that often affect outcome and make treatment research so complicated: "treatment credibility, expectation for improvement, experimental demand, therapist-experimenter enthusiasm, therapistexperimenter allegiance, [and] effort justification" ( 950). The fervor expressed in the literature from writers, both critics and proponents, seems to reflect unusual personal investment in one side of the debate or the other, possibly increasing the likelihood that unintentional bias in findings and interpretations also plays a role in varied research findings. ...
... In a less extreme example, Muris and Merckelbach (1999), in a criticism of Shapiro for discovering EMDR by chance rather than from a preconceived theory, use the term "lively" to describe Shapiro's description of EMDR's discovery. The scientific context which makes the term "lively" appear condescending highlights the seemingly unfounded description of EMDR by some opponents as "pseudoscience" (Herbert et al., 2000). Instances such as these make believable comment that EMDR proponents "regularly" receive "overt bias and downright rudeness" in "otherwise civilized professional settings" (306). ...
Eye-movement Desensitization and Reprocessing (EMDR) has been widely supported in the literature for its effectiveness in treating Post-traumatic Stress Disorder (PTSD) and a variety of other diagnoses and symptoms. The variable findings regarding whether its effects are for reasons unique to this treatment, however, have become the focus of extensive discussion and debate. The following article reviews the studies targeting this question, and proceeds to consider why these studies’ findings, and other findings in the EMDR literature, vary so vastly. Implications of the EMDR controversy for the process of psychological research at large are considered.
... exposure, cognitive reframing); Shapiro's implausible theories, changing methods, and dismissal of negative results (e.g. DeBell & Jones, 1997;Devilly, 2002;Herbert et al., 2000;Lohr et al., 2015;Rosen, 1999); the confound of allegiance effects impacting randomized controlled trials (RCTs; Cuijpers et al., 2020); and the method's trademarked status, proprietary workshops and other promotional efforts (Herbert et al., 2000). Despite these concerns a set of positive findings took precedence and EMDR obtained recognition as an empirically supported treatment (EST). ...
... exposure, cognitive reframing); Shapiro's implausible theories, changing methods, and dismissal of negative results (e.g. DeBell & Jones, 1997;Devilly, 2002;Herbert et al., 2000;Lohr et al., 2015;Rosen, 1999); the confound of allegiance effects impacting randomized controlled trials (RCTs; Cuijpers et al., 2020); and the method's trademarked status, proprietary workshops and other promotional efforts (Herbert et al., 2000). Despite these concerns a set of positive findings took precedence and EMDR obtained recognition as an empirically supported treatment (EST). ...
Eye Movement Desensitization and Reprocessing (EMDR), while recognized as evidence-based, continues to be viewed as a novel and controversial treatment. At the same time, numerous alternative eye movement therapies have been introduced, each of which requires its own set of randomized controlled trials (RCTs) to assess remarkable claims of cure. The present situation is untenable in our opinion because any clever entrepreneur can claim a new method and trademark a new acronym. Recommendations are made for more stringent criteria to establish science-based methods that guide clinical practice.
... The mechanisms of action of EMDR have been widely debated (Lohr et al., 1998;Herbert et al., 2000;Rogers and Silver, 2002;Lee et al., 2006;Pagani et al., 2017;de Voogd et al., 2018;Landin-Romero et al., 2018;Baek et al., 2019;Holmes, 2019). During EMDR sessions, the patient is instructed to keep the most disturbing image, the negative feelings, beliefs, emotions, and the body sensations associated with the trauma in mind, while following an alternating bilateral stimulation (e.g., right-left hand movements, bilateral fingers tapping, or bilateral auditory stimuli) from the therapist (Gainer et al., 2020). ...
... Despite initial skepticism, due to the discussion about underlying neurobiological mechanisms (Lohr et al., 1998;Herbert et al., 2000), several meta-analyses and international guidelines show that EMDR is an effective treatment for PTSD (INSERM Collective Expertise Centre, 2004;Ursano et al., 2004;Bisson et al., 2007Bisson et al., , 2019World Health Organization, 2013;de Roos et al., 2017;Khan et al., 2018;Lewey et al., 2018;Navarro et al., 2018;Wilson et al., 2018;Karatzias et al., 2019;Bastien et al., 2020;Mavranezouli et al., 2020). Our model allowed us to analyze patients' data in search of the most suitable parameter set that explains the experimental findings. ...
Eye movement desensitization and reprocessing (EMDR) therapy is a well-established therapeutic method to treat post-traumatic stress disorder (PTSD). However, how EMDR exerts its therapeutic action has been studied in many types of research but still needs to be completely understood. This is in part due to limited knowledge of the neurobiological mechanisms underlying EMDR, and in part to our incomplete understanding of PTSD. In order to model PTSD, we used a biologically inspired computational model based on firing rate units, encompassing the cortex, hippocampus, and amygdala. Through the modulation of its parameters, we fitted real data from patients treated with EMDR or classical exposure therapy. This allowed us to gain insights into PTSD mechanisms and to investigate how EMDR achieves trauma remission.
... Simultaneously, the therapist guides the patient to move their eyes horizontally, either following the therapist's finger or a moving electronic dot (Houben et al., 2020). However, the technique gained popularity far quicker than it was validated for its efficacy, leading to criticism in the field (Herbert et al., 2000). Early critics argued that EMDR was developed without a solid theoretical foundation, highlighting the lack of support for the unique contribution of the eye movements (the "EM" component of EMDR; Leer et al., 2014). ...
... Further, there is currently no evidence that trauma symptom reduction is linked to the decreases in vividness and emotionality due to EM (van Schie et al., 2019). Evidence also exists suggesting that reprocessing (R) does not bear additional therapeutic benefits (Herbert et al., 2000). Thus, the desensitisation component of EMDR, which closely resembles beneficial components of existing exposure therapies, such as cognitive behavioural therapy (CBT), may be the only efficacious part of the treatment, leading critics to suggest that EMDR is merely another brand of exposure therapy (Lohr et al., 1998). ...
Eye-Movement Desensitisation and Reprocessing (EMDR) therapy is a common treatment for PTSD. However, skeptics like James Ost question the theoretical underpinnings, highlight inconsistency of empirical findings surrounding the efficacy of such therapy, and warn against unknown drawbacks. Little is known about the impact of the eye movements, a critical component in EMDR, on susceptibility to false memories, and the existing literature is contradictory. We review the literature and present new findings to help tell the story of the effects of eye movements on memory. Taken as a whole, this small body of work suggests that eye movements do not reliably affect susceptibility to misinformation, nor do they appear to enhance memory, but they do seem to increase spontaneous false memories.
... Other researchers, however, have critiqued the evidence base for EMDR (e.g., Herbert et al., 2000;McNally, 1999). These scholars are concerned by the aggressive marketing and dissemination strategies by EMDR's developers and have argued that EMDR may simply be a variant of exposure therapy (Herbert et al., 2000;McNally, 1999). ...
... Other researchers, however, have critiqued the evidence base for EMDR (e.g., Herbert et al., 2000;McNally, 1999). These scholars are concerned by the aggressive marketing and dissemination strategies by EMDR's developers and have argued that EMDR may simply be a variant of exposure therapy (Herbert et al., 2000;McNally, 1999). Nevertheless, EMDR is one of the "treatments of choice" recommended by NICE (Bisson et al., 2013, p. 2). ...
The chapter discusses the application of various treatment models under the cognitive-behavioral therapy umbrella to treat trauma. The chapter presents an overview of the key theoretical assumptions, treatment process, practice strategies, and a review of the research behind each of the models addressed.
... In EMDR patients are instructed to make horizontal eye movements (EM) by following a therapist's finger while simultaneously recalling their traumatic memory (Shapiro, 2017). Since its inception, the necessity of the EM has been heavily debated and the intervention's general effectiveness was then frequently attributed to mere exposure (e.g., Herbert et al., 2000;McNally, 1999). Initial reviews and meta-analyses supported this idea (Cahill, Carrigan, & Frueh, 1999;Davidson & Parker, 2001), but a later more encompassing meta-analysis of lab analogue and full protocol studies showed that EM are essential and that EMDR is different from exposure-based therapies (Lee & Cuijpers, 2013). ...
... In the last thirty years, the use of EM in EMDR has been heavily disputed (e.g., Herbert et al., 2000;McNally, 1999). The largest randomized clinical trial thus far showed that there is no evidence for a difference between eyes moving and eyes fixated in the reduction of PTSD symptoms (Sack et al., 2016), while both conditions outperformed a control condition (i.e., eyes unfocused/closed). ...
Background and objective:
A recent, large randomized controlled trial employing different forms of eye (non-)movements in eye movement desensitization and reprocessing (EMDR) showed that fixating the eyes either on a therapist's moving or non-moving hand led to equal reductions in symptoms of post-traumatic stress disorder (PTSD). However, numerous EMDR lab analogue studies found that eye movements produce larger memory effects than eyes stationary. These beneficial effects are typically explained by differences in working memory (WM) taxation. We tested the degree of WM taxation of several eye (non-)movement conditions used in the clinical trial.
Methods:
All participants (N = 40) performed: (1) eyes moving by following the experimenter's moving finger, (2) eyes fixed on the experimenter's stationary finger, (3) eyes closed, or (4) looking unfocused into the room. Simultaneously they performed a simple reaction time task. Reaction times are an objective index of the extent to which different dual attention tasks tax WM.
Results:
Eyes moving is more taxing than eyes fixed, while eyes fixed did not differ from eyes unfocused. All conditions were more taxing than eyes closed.
Limitations:
We studied WM taxation in a laboratory setting; no clinical interventions were applied.
Conclusions:
In line with previous lab studies, making eye movements was more taxing than eyes fixed. We discuss why this effect was not observed for reductions in PTSD symptoms in the clinical trial (e.g., differences in dependent variables, sample population, and intervention duration). For more comprehensive future insights, we recommend integration of mechanistically focused lab analogue studies and patient-oriented clinical studies.
... EMDR has been widely researched, with several meta-analyses showing it offers similar or higher efficacy for supporting people with PTSD compared to pharmacological or other psychological interventions (Bisson et al., 2007(Bisson et al., , 2013Chen et al., 2014). Despite the initial skepticism from the scientific community (Herbert et al., 2000;McNally, 2013), EMDR has since been recognized as an effective treatment for trauma by various global and country-specific (e.g., the United States and United Kingdom) health organizations, including the World Health Organization (WHO, 2013), the American Psychological Association (APA, 2017), and the National Institute for Clinical Excellence (NICE; Ost & Easton, 2006). While other Western countries like Australia have recently started to see its value in reducing posttraumatic stress symptoms (APS, 2019). ...
There is growing research interest in examining how cultivating autistic adults’ self-compassion may improve their mental health and overall well-being. However, caution is needed in applying compassion-based therapies to autistic adults due to the phenomenon of backdraft, which is an intense, distressing reaction that can occur during self-compassion practices. Autistic individuals, often burdened with trauma and past adverse experiences, may be particularly vulnerable to backdraft. Preliminary research indicates that a large proportion of autistic adults report experiences of backdraft, indicating a significant potential for adverse short-term effects. This Perspective piece provides a brief overview of self-compassion and backdraft, highlights why backdraft is particularly relevant to self-compassion research involving autistic adults, and offers recommendations on how to study backdraft and clinically support autistic adults through their backdraft experiences. We advocate for research into the mechanisms of backdraft in autistic adults and stress the importance of trauma-sensitive therapeutic approaches. We also recommend that clinicians proactively address backdraft and provide the necessary support to ensure these therapies remain beneficial. This perspective underscores the importance of understanding the unique challenges autistic individuals face during self-compassion and compassion-based therapies and calls for rigorous research and clinical strategies to mitigate the risks associated with backdraft.
... A pesar de las modificaciones realizadas sobre el protocolo original a lo largo del tiempo (Hase, 2021;Novo Navarro et al., 2018;Shapiro, 2001Shapiro, , 2017, y del relativo respaldo de ciertos organismos como la Asociación Americana de Psicología (APA; American Psychological Association, 2017) o la Organización Mundial de la Salud (OMS; World Health Organization, 2013), el EMDR sigue mostrando algunas debilidades (Fasce, 2018;Herbert et al., 2000). ...
... Three of the strong pairs compared PE or CBT to EMDR for treating PTSD. Many believe that EMDR is based on pseudoscience (e.g., Herbert et al. 2000), and the Journal of EMDR Practice and Research, where two of the three EMDR-allied studies were published, appears to be dedicated to promoting EMDR, which may explain why these comparisons yielded strong evidence of bias or spin. In Pairs 6 and 7, the researcherpreferred treatment outperformed the alternative on all three outcomes (author conclusions, effect sizes and significance levels). ...
Researchers who conduct studies comparing the efficacy of two treatments often find that their preferred treatment outperforms the comparison treatment. This finding has been labelled the allegiance association. Although this association is robust, it is unclear whether it reflects an allegiance bias on the part of the researchers or whether it is noncausal, with researchers being allied to the more effective treatments. This study applied a quasi‐experimental method proposed by a previous study to 19 pairs of treatment comparison studies. Each member of a pair had used the same two psychotherapies to treat clients with the same disorder, but the researchers in each of the two studies had opposing allegiances. If the authors of one study in the pair concluded that their preferred treatment was superior and the authors of the other study concluded that their preferred treatment was superior or that the two treatments were equivalent, these patterns would suggest allegiance bias. In 10 of the 19 pairs, the patterns were consistent with the operation of an allegiance bias, indicating that although allegiance biases are not inevitable, they are ubiquitous. Practitioners and other psychotherapy research consumers should use caution when interpreting the findings from treatment comparison studies.
... Initially, critics argued that EMDR did not demonstrate efficacy above and beyond nonspecific treatment effects and that there was insufficient evidence that the eye movements, which are so central to EMDR that they are part of its name, contributed significantly to the treatment's effectiveness (e.g., Herbert et al., 2000). Support for the differential effectiveness of EMDR with and without eye movements came more than 20 years after the first published outcome studies through both laboratory and dismantling studies (Günter & Bodner, 2008;Lee & Cuijpers, 2013;van den Hout & Engelhard, 2012). ...
Eye movement desensitization and reprocessing (EMDR) therapy is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD), with support from more than 30 published randomized controlled trials (RCTs) demonstrating its effectiveness in both adults and children. Most international clinical practice guidelines recommend EMDR therapy as a first-line treatment for PTSD. This paper describes the current state of the evidence for EMDR therapy. We begin with a brief description of EMDR therapy and its theoretical framework. Next, we summarize the scientific support for its efficacy, effectiveness, and safety and discuss its applicability across cultures and with diverse populations. We conclude with suggestions for future directions to develop the research base and applications of EMDR therapy.
... Some of EMDR's harshest critics argue that the benefits of the EMDR procedure are due exclusively to its incorporation of certain aspects of exposure therapy and that the eye movement component of EMDR is just an unnecessary gimmick that aids in the marketing of EMDR as something new (Herbert et al., 2000;Lohr et al., 1998). Some of the randomized experiments on this issue have been conducted in relation to combat PTSD, and thus were mentioned above. ...
A literature review was conducted to examine whether EMDR should be considered an empirically-supported treatment for PTSD. Relying largely but not exclusively on electronic data bases such as Medline and PsychInfo, journal articles published through April 2003 were identified which reported a randomized experimental evaluation of the effectiveness of EMDR in treating PTSD. EMDR appears to be an empirically supported treatment for adults with single-trauma civilian PTSD. However, the evidence supporting the effectiveness of EMDR is much less compelling when we focus on children, combat PTSD, multiple-trauma PTSD, and whether EMDR is more effective than exposure therapies. Proponents of EMDR hotly debate proponents of exposure therapy regarding methodological issues, with each side in the debate frequently employing a double standard. Clinicians are advised to use either EMDR, exposure therapy, or stress-inoculation therapy when treating civilian adults with single-trauma PTSD. They may also want to employ EMDR when treating children with PTSD or clients with multiple-trauma or chronic PTSD. But if they do, they should do so in light of the inadequate evidence base, be guided by future evaluations of EMDR with these populations, and recognize that many more sessions of EMDR, with less robust effects, may be required than what they might currently expect.
... Shapiro (1995) explained (preface, p. vi): "The eventful walk in the park that led to the discovery of the effects of the Eye Movement Desensitization and Reprocessing (EMDR) is a widely recognized set of procedures that originally was based on the novel idea that eye movements could facilitate the desensitization of traumatic memories by accelerating information processing (Shapiro, 1989). Despite controversy surrounding EMDR at most every turn (DeBell & Jones, 1997;Devilly, 2002;Herbert et al., 2000;Lohr et al., 2015, Rosen, 1999, a set of positive findings eventually took precedence (Lee & Cuijpers, 2013) and EMDR came to be listed as an evidence-based treatment. Still, debates continue as to whether eye movements and other forms of bilateral stimulation meaningfully contribute to treatment outcomes beyond allegiance and placebo effects (e.g., Cuijpers et al., 2020). ...
Francine Shapiro, the founder of Eye Movement Desensitization and Reprocessing (EMDR), reported that the therapeutic use of eye movement patterns was discovered by chance while walking in a park. An alternative accounting for the origins of EMDR comes from research that demonstrates individuals are unable to perceive their own eye movements and from historical sources that document Shapiro’s acceptance of Neuro-Linguistic Programming theory on eye movement patterns and super-achievers. The present paper brings together this diverse set of findings to provide a more accurate context within which Shapiro’s purported discoveries and subsequent claims can best be viewed.
... Evaluated by 12 indicators of a scientific programme, the PS research programme is a degenerating programme. The PS has directly engaged with the pseudoscientific pyramid cult of the Lightning Process thereby crossing the final threshold of an egregious clinical practice [193]. ...
The psychosomatic approach to medically unexplained symptoms, myalgic encephalomyelitis and chronic fatigue syndrome (MUS/ME/CFS) is critically reviewed using scientific criteria. Based on the 'Biopsychosocial Model', the psychosomatic theory proposes that patients' dysfunctional beliefs, deconditioning and attentional biases cause or make illness worse, disrupt therapies, and lead to preventable deaths. The evidence reviewed suggests that none of these psychosomatic hypotheses is empirically supported. The lack of robust supportive evidence together with the use of fal-lacious causal assumptions, inappropriate and harmful therapies, broken scientific principles, repeated methodological flaws and an unwillingness to share data all give the appearance of cargo cult science. The psychosomatic approach needs to be replaced by a scientific, biologically grounded approach to MUS/ME/CFS that can be expected to provide patients with appropriate care and treatments. Patients with MUS/ME/CFS and their families have not been treated with the dignity, respect and care that is their human right. Patients with MUS/ME/CFS and their families could consider a class action legal case against the injuring parties.
... These markers are presented in online supplement Table A3. Interested readers are also encouraged to consult Herbert et al. (2000) for further elaboration of the above referenced indicators within marketing practices that have been used to promote eye movement desensitization therapy (EMDR) as but one salient example of the marketing of a questionable practice in professional psychology. ...
Although the field of school psychology has made progress toward the use of tests and assessment practices with empirical support over the past 20 years, many school psychology practitioners still engage in what can be described as low-value value assessment practices that lack compelling scientific support potentially taking time and resources away from practices that have a demonstrated evidence-base. Why do school psychologists engage in questionable assessment and interpretive practices despite decades of discrediting scientific evidence? This article critically examines several plausible explanations for the perpetuation of low-value practices in school psychology assessment. It also underscores the importance of critical thinking when evaluating assessment and interpretation practices, and discusses practical recommendations to assist in advancing evidence-based assessment in school psychology training and practice as the field progresses well-into the 21st century.
Impact Statement
Many school psychologists engage in assessment practices that lack compelling scientific support potentially taking time, resources, and energy away from more effective practices. This article critically reviews reasons why these questionable assessment practices persist long after discrediting scientific evidence has been aptly presented. Recommendations are offered to promote the use of evidence-based practices and discourage the use of assessment methods lacking compelling empirical support in training and clinical practice.
... We excluded interventions: (a) found only in unpublished or non-peer-reviewed work (e.g., dissertations, chapters); (b) focused on preventing or reviewing the event (e.g., homicide prevention, death review); (c) for populations outside the paper's scope (e.g., adult survivors, first responders, child perpetrators); and (d) for other forms of loss or stress (e.g., divorce). We opted to exclude interventions with only case study support; mixed findings (e.g., Eye Movement Desensitization and Reprocessing; Herbert et al., 2000); or potentially iatrogenic effects (e.g., Critical Incident Stress Debriefing; World Health Organization, 2012). Considering the need for practical, timely, and feasibly disseminated interventions, we also excluded therapies that typically use unstructured or non-directive methods (e.g., psychodynamic, counseling, art, yoga) and broad-based therapeutic models without specified protocols. ...
The nature of intrafamilial homicide is complex and traumatic. Child survivors are at significant risk for maladjustment, including negative psychological sequela, grief complications, and contextual challenges associated with the homicide. Thus, children may benefit from services addressing specific psychosocial challenges following intrafamilial homicide. In this paper, we review the literature to identify trauma- and grief-informed interventions implemented for youth following violent bereavement. Given limited research on this vulnerable population, we discuss interventions that show promise for child survivors, exploring specific needs, challenges, and potential implications of these interventions for treating children and families experiencing intrafamilial homicide bereavement.
... In Fasce (2018) I developed a demarcation criterion that fulfils the requirements of this discriminant metacriterion, where pseudoscience radically differs from science regarding domain, method, and evidence. So, it can be identified by being uncontroversially outside the domain of science, particularly due to untestable contentsuch as reiki, morphic fields, acupuncture's qi, and vertebral subluxationsand through the use of radically flawed methodsfor example research on EMDR without controlling exposure (Herbert et al. 2000), the use of projective tests (Lilienfeld, Wood, and Garb 2000), pendulum diagnosis, and unspecific cases, such as illusions of causality (Torres, Barberia, and Rodríguez-Ferreiro 2020). Some others are characterised by a complete lack of evidencee.g. ...
In this article, I develop a philosophical framework, or “metacriterion”, for the demarcation of pseudoscience. Firstly, “gradualist demarcation” is discussed in depth, considering an approach to the demarcation problem that presupposes the existence of a spectrum between science and pseudoscience; six general problems are found by means of this analysis. Secondly, based on the subsequent discussion of these problems, a discriminant metacriterion composed of four philosophical requirements is proposed. Lastly, it is shown that this metacriterion is able to guide the development of a workable and well-founded demarcation criterion for pseudoscience.
... EMDR is not a neutral intervention; it has quick and often profound effects on clients. Unlike what was argued by EMDR's earlier critics, it is not simply a placebo caused by the waving of the clinician's hands (Herbert et al., 2000) Thus, all phases of the treatmentreprocessing old trauma, addressing trauma responses, and preparing for and practicing more effective behaviors-are crucial both to client safety and to successful outcomes. Francine Shapiro's (2001) amended standard protocol is described in the following section of this article and is adapted with modifications from the first author's Trauma Treatment Handbook (R. Shapiro, 2010). ...
Eye movement desensitization and reprocessing (EMDR) therapy is a very useful and innovative evidence-based treatment for posttraumatic stress disorder (PTSD), complex trauma, dissociative disorders, and many other conditions. It has received a strong recommendation in all of the recently published treatment guidelines for PTSD, with the exception of the American Psychological Association, Guideline Development Panel for the Treatment of PTSD in Adults (2017), which gave it a conditional recommendation, largely due to the limited research reviewed. This article describes the development of EMDR therapy and its method, outlines its 8-stage protocol, provides an overview of literature on the topic and research that supports its efficacy, and describes various clinical offshoots utilizing bilateral stimulation. EMDR therapy is an integrative treatment that incorporates methods from other treatment modalities while focusing on a number of elements involved in the traumatic response—such as emotions, cognitions, and somatosensory responses. EMDR therapy directs the client to imagine elements of the trauma memory while engaging in saccadic (back and forth) eye movements (or other bilateral stimuli) to create a condition of dual-awareness that assists in the processing of the traumatic material. It follows an 8-stage protocol starting with engagement in treatment and assessment of the client and the trauma memory, to processing of the trauma with bilateral stimulation conducted in sets, to evaluation of the ratings of positive and negative cognitions and somatosensory scanning until they are reported by the client to be “cleared” (i.e., resolved, with no residual distress). EMDR therapy is now often used in integrative ways with other therapies (relational psychoanalysis, ego state therapy, somatic therapies). Several of EMDR’s better known and more frequently practiced offshoots, include brainspotting (Grand, 2013) and life span integration (Pace, 2003) are discussed.
This book sheds light on the translation of current mechanistic research on placebo effects to develop comprehensive and adequate strategies for better symptom management and treatment. This book identifies three core aspects to bridge state-of-the-art concepts with day-to-day clinical practice. First, lessons from mechanistic placebo research indicate a neurobiological basis underlying placebo effects. Second, placebo research can improve the design of clinical trials to advance drug development. Third, placebo effects can be exploited in daily clinical practice to optimize patient-clinician communication and relationships and clinical outcomes. Together, these three core aspects provide a new perspective with which to appraise the implications of Placebo Research for healthcare systems, clinicians, patients, and caregivers. New patient-centered approaches, mental health, and pain-related issues are discussed while describing technologically advanced and novel research applications that will shift current clinical practice to improve treatment outcomes.
The Maxfield, Lake, and Hyer acerbic attack on my review is filled with fallacies and inaccurate and unwarranted accusations that deflect attention away from the main issue pertaining to the insufficient evidence base for current claims that EMDR is more effective than exposure therapies and is an empirically-supported treatment for children, combat PTSD, and multiple trauma PTSD. More research is needed before such claims can be called evidence-based.
Posttraumatic stress disorder (PTSD) can develop after exposure to a traumatic event and impacts roughly 5–8% of trauma-exposed individuals. Individuals with PTSD develop distressing intrusions, trauma-related avoidance, alterations in mood and cognition, and hyperarousal. There are both social and neurobiological factors that appear to confer risk for PTSD. There are high rates of psychiatric comorbidity, particularly with respect to mood disorders and substance use disorders. PTSD is associated with significant functional impairment and is likely to persist when untreated. Cognitive-behavioral psychotherapies, specifically prolonged exposure and cognitive processing therapy, have the most research supporting their use as frontline treatments for PTSD. Although effect sizes are not as robust as with psychotherapy, some of the selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) medications are associated with benefits. Psychological debriefing methods are not recommended for the treatment of PTSD. With successful treatment, PTSD can remit, and individuals return to their premorbid level of functioning.KeywordsPosttraumatic stress disorderTraumaCognitive-behavioral therapyProlonged exposureCognitive processing therapy
L’EMDR est une thérapie qui a été développée pour traiter les souvenirs traumatiques, puis proposée pour traiter une variété de troubles psychologiques. Ce texte est le premier à recenser en français les études qui ont évalué l’efficacité de cette forme de thérapie. L’efficacité de l’EMDR est d’abord démontrée à l’aide d’études de cas qui comportent des limites importantes. Les études de cas basées sur un protocole expérimental donnent des résultats plus mitigés. Les études contrôlées qui examinent l’efficacité de l’EMDR sont ensuite décrites en fonction du type de contrôle exercé et du type de trouble traité. L’EMDR est aussi efficace que la thérapie cognitivo-comportementale pour traiter le trouble de stress post-traumatique, mais pas pour le traitement de la phobie spécifique ni du trouble panique. De plus, les études montrent de façon répétée que l’absence des mouvements oculaires ne modifie pas l’efficacité de l’EMDR. Une analyse des différences et des similitudes entre l’EMDR et l’approche cognitivo-comportementale est présentée. Les caractéristiques pseudo-scientifiques qui ont marquées le développement et la diffusion de l’EMDR sont aussi abordées.
When experiencing mental health challenges, we all deserve treatments that actually work. Whether you are a healthcare consumer, student, or mental health professional, this book will help you recognize implausible, ineffective, and even harmful therapy practices while also considering recent controversies. Research-supported interventions are identified in this book and expanded upon in a companion volume. Chapters cover every major mental disorder and are written by experts in their respective fields. Pseudoscience in Therapy is of interest to students taking courses in psychotherapy, counseling, clinical psychology, and behavior therapy, as well as practitioners looking for a guide to proven therapeutic techniques.
In this chapter, I offer my perspective on Scott Lilienfeld’s contributions to the field of psychology and on his formative influences, through the lens of our 40-year friendship and 30-year collaboration. In doing so, I hope to illuminate some aspects of Scott’s developmental trajectory that contributed to him becoming the person that so many came to know and respect. Describing our developmental trajectories toward becoming clinical psychologists and clinical scientists highlights some of the important themes facing our field. These include the classification of psychopathology and the comorbidity among disorders; the validity of psychological measures, assessment tools, and treatment techniques; and the use of Questionable Research Practices (QRPs) and the reproducibility and replication of findings across studies. In many ways, our professional journey reflects important trends in the field of psychology over the past 40 years, which continue to the present day.
Science is the preferred method of knowledge acquisition in clinical science; however, science has limitations and these limitations and their implications have not been recognized in clinical science. This paper explicates major limitations to science and proposes that progress in these domains can be addressed through critical rationalism. Consistent with the philosopher of science Sir Karl Popper, science is seen as a subspecies of rationalism. A failure to properly recognize the limitations of science is called scientism, and the problems associated with this have also not been properly dealt with in clinical science.
The treatment eye movement, desensitisation and reprocessing (EMDR) continues to court controversy despite its adoption by the National Institute for Health and Clinical Excellence (2005) as a preferred treatment for post-traumatic stress disorder. This article critically reviews the two issues at the heart of the controversy. First, is EMDR effective for unique reasons or is it a disguised treatment such as exposure therapy? Second, is evidence-based practice an appropriate framework within which to assess psychological therapies or are its criteria too narrow and inflexible? The article proposes practice-based evidence as a potential way forward in EMDR research and describes an appropriate model within an EMDR treatment framework.
Functional Neurological Disorder (FND) results in altered motor, sensory and cognitive function in the absence of evident organic disease. It often co-occurs alongside dissociative disorders and dissociation has been found to be high in patients across FND subtypes (particularly in those with Non-Epileptic Attack Disorder; NEADs). However, the presence of dissociation in FND is varied and there are contradictory definitions and suggestions for elevated levels. Here, three studies show that dissociation is a prominent, defining feature of people with FND compared to those who are healthy or have other, similar long-term health conditions, and that this heightened dissociation is not explained by a history of trauma (study 1, N = 121), mood (study 2, N = 589) and is not associated with social isolation/social exclusion (study 3, N = 542). As dissociation appeared to occur in FND in the absence of the usual contributing factors, and as higher levels of dissociation were associated with increased disability and illness impacts, understanding its role is of fundamental importance to developing our understanding of FND. These findings have further applications, beyond the theoretical, in clinical settings and in research; the implications for further research are discussed.
Psychotherapies are popular complementary treatments. These treatments include behavioral activation therapy (BA), cognitive behavior therapy (CBT), problem-solving therapies (PST), and self-examination therapy (SET); “third-wave” therapies such as acceptance and commitment therapy (ACT), mindfulness-based CBT (MBCT), cognitive behavioral analysis system of psychotherapy (CBASP), and dialectic therapy (DBT); as well as interpersonal psychotherapy (IPT), psychodynamic therapy, non-directive supportive therapy, life review therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR). This chapter presents the results of recent meta-analyses investigating the evidence for the efficacy of 15 psychotherapies for depression. Progress in the field is hampered by methodological problems including the abundance of studies with small sample sizes and insufficient power to detect differences between treatments. Several sources of bias have been reported, including strong researcher allegiance to the therapy, non-blinding of raters, improper randomization, selective outcome reporting, publication bias, waiting list control groups, problems with meta-analysis, and the placebo effect. The “Dodo bird verdict” contends that meta-analyses have been unable, so far, to find any significant difference between psychotherapeutic techniques, suggesting that they are all equally effective. The common factors theory proposes that treatment differences, the therapist’s competence, specific ingredients, and protocol adherence are not responsible for the outcome of psychotherapies. But factors common to all psychotherapies: foremost are the personality traits of the psychiatrist or psychotherapist such as genuineness and empathy. Further commonalities include goal consensus, collaboration, alliance, positive regard, and affirmation.
Cognitive behavior therapy (CBT) has been the dominant psychotherapeutic paradigm in the Western world, enjoying this status for a few decades. To date, managed care and third-party payers have favored its emphasis on scientific validation, short-term efficient treatment, and relatively easy to learn techniques (often in treatment manuals). In practice, CBT also attained a wide range of applicability: from childhood problems, such as functional enuresis and oppositional defiant disorder, to problems of adults, such as depression, anxiety disorders, chronic pain and so on. As such, it is important to understand CBT paradigm, particularly for those entering the field. To understand CBT and to make intelligent therapeutic choices as well as research questions, one needs to understand waves of CBT as well as their relative strengths and weaknesses. While taking the agnotology of CBT into consideration, this volume will help readers do this by having experts in the field of CBT write key chapters on the key component issues in CBT.
This chapter will argue that the three waves of behavior therapy have been influenced by three distinct sets of meta-scientific ideas, and thus for the most part these have adopted distinct views of science and the scientific method. In addition, other key positions have influenced some waves but not others. The ideas of the Stoics, which do not deal with science or the philosophy of science but rather a pragmatic philosophy of life, have influenced second wave cognitive therapies, while Buddhism, again obviously not a philosophy of science, has influenced some third wave therapies; and neither of these had any significant influence on first wave behavior therapy. Understanding the strengths and weaknesses of each of these views of science can perhaps shed light on important issues, such as improving the problem-solving progress of behavior therapy. We will argue that the evolutionary epistemology (a naturalized scientific approach to understanding knowledge) of the first wave has held up to criticism well over time, as has the second wave’s (possible) adoption of Bartley’s (The retreat to commitment. Open Court, London, 1984) pan-critical rationalism although there are legitimate questions of this wave’s fidelity to Bartley’s epistemology. However, the third wave’s embrace of a rather obscure philosopher, Stephen Pepper (World hypotheses: A study in evidence. University of California Press, Berkeley, 1942), is most concerning as it is so outside the critical dialogue in mainstream meta-science/philosophy of science. Once again, we believe that an increased understanding of distinct views of science and the scientific method followed by the three waves of behavior therapy improves future scientific progress more efficiently in part by identifying weaknesses that can be addressed.
A meta‐analysis was conducted to evaluate the comparative effectiveness of eye movement desensitization and reprocessing (EMDR) in the treatment of symptoms of over‐arousal and comparing effectiveness in the treatment of anxiety and posttraumatic stress disorder (PTSD). Thirty‐two effect sizes from randomized controlled trials were included in the analysis. Findings were mixed, indicating that EMDR was more effective than alternative viable treatments in the treatment of over‐arousal, but that true effect may range from 210% of a standard deviation favoring EMDR to 66% of a standard deviation favoring alternative viable treatments. No statistically significant differences for effectiveness were noted in the use of EMDR when treating anxiety versus trauma. Our findings indicate that on average, EMDR may be beneficial, but there is an equivalent chance that future applications with similar samples could result in findings regarded as considerably or categorically ineffective.
Eye movement desensitization and reprocessing (EMDR) is a widely used treatment for posttraumatic stress disorder. The idea behind EMDR is that lateral eye movements may mitigate the emotional impact of traumatic memories. Given the focus on changing patients’ memories, it is important that EMDR practitioners have detailed knowledge about human memory. We explored beliefs and ideas about memory in samples of EMDR practitioners (Study 1: n = 12; Study 2: n = 41), students (Study 1: n = 35; Study 2: n = 24), and researchers (Study 2: n = 30). All groups seemed to be aware of the fallibility of memory. However, a majority of the surveyed EMDR practitioners (70–90%), students (around 90%), and researchers (66.7%) endorsed the controversial idea of repressed memories. Skepticism and endorsement of problematic ideas about memory-related topics may coexist within the same group. In clinical settings, this might be problematic, because a strong belief in repressed memories might lead therapists to suggestively seek for such memories in patients.
Lęk przed wystąpieniami publicznymi jest odczuwany przez większość ludzi. Dla znacznej części osób lęk ten ma tak dużą intensywność, że nie tylko czyni przemawianie nieprzyjemnym dla nich doświadczeniem, ale także może utrudniać i ograniczać ich funkcjonowanie w trakcie zajęć edukacyjnych, w miejscu pracy czy w życiu społecznym. Naukowcy od ponad 50 lat testują skuteczność różnych metod redukujących ten typ lęku. Brakuje jednak w języku polskim pozycji, które przedstawiałyby podsumowanie efektów ich starań. Dlatego celem tego opracowania jest omówienie metod redukcji lęku przed wystąpieniami publicznymi o potwierdzonej empirycznie skuteczności. W pracy opisano podstawowe mechanizmy działania lęku przed wystąpieniami publicznymi i przedstawiono kategoryzację metod redukujących lęk przed wystąpieniami publicznymi z podziałem na metody ekspozycyjne, terapie poznawcze i inne formy terapii. Praca adresowana jest do naukowców, praktyków (terapeutów, trenerów) oraz do osób chcących obniżyć swój lęk przed wystąpieniami publicznymi. Starano się na tyle szczegółowo opisać metodologię najważniejszych badań testujących skuteczność metod redukujących lęk przed wystąpieniami publicznymi, by z jednej strony pomóc naukowcom w projektowaniu własnych tego typu badań, a z drugiej strony by możliwe było zastosowanie części z opisanych metod przez praktyków lub samodzielnie przez osoby zmagające się z wysokim lękiem przed wystąpieniami publicznymi. We wnioskach z opracowania wskazano kierunki przyszłych badań, omówiono ograniczenia w łączeniu poszczególnych metod oraz wskazano możliwości samodzielnego zastosowania (przy zachowaniu należytej ostrożności) metod opisanych w tej pracy w ramach działań samopomocowych.
Potem ko sem v predhodnem članku opisal Dodova zgodnja leta, to je razvoj teorije skupnih dejavnikov od Rosenzweiga do Frankovega kontekstualnega modela, tokrat nadaljujem s pregledom Dodovih mladostniških in odraslih let, ki se raztezajo od prvih metaanalitičnih raziskav o učinkovitosti psihoterapije do Schiepkovega nelinearnega dinamičnega modela. Tretja faza raziskovanja psihoterapije (med letoma 1970 in 1983) je prinesla velike izboljšave raziskovalne metodologije, ki so omogočile kakovostnejše preučevanje terapevtskega odnosa in razvoj metaanaliz, ki so potrdile visoko splošno učinkovitost psihoterapije. Po eni strani so se intenzivirala prizadevanja za standardizacijo psihoterapevtskih intervencij, po drugi strani pa je Dodo spodbudil prizadevanja za integracijo psihoterapevtskih pristopov in razvoj transteoretičnih modelov. V četrti fazi (od leta 1984 do danes) je tako v psihoterapevtski znanosti kot tudi klinični praksi prišlo do paradigmatskih premikov, npr. do prehoda od empirično podprtih terapij k na izsledkih temelječi praksi in na praksi temelječih izsledkov ter do razcveta integrativnih in transdiagnostičnih pristopov. Razvoj različnih konceptualizacij skupnih dejavnikov in njihovo empirično potrjevanje je Dodu omogočilo vstop v odrasla leta, tako da je v okviru Wampoldovega kontekstualnega modela prispeval k preseganju dihotomije med terapevtskim odnosom in tehnikami. Schiepkov sinergetični nelinearni dinamični model pa omogoča vpogled v dinamiko interakcij med skupnimi in specifičnimi dejavniki. Psihoterapevtska znanost in klinična praksa sta od svojih začetkov do danes, tudi zahvaljujoč Dodovi pomoči, dosegli visoko stopnjo razvoja. Na osnovi obilja kliničnih in raziskovalnih izsledkov psihoterapevtom različnih pristopov ponuja možnost paradigmatskega preskoka v novo, bolj integrirano razumevanje psihoterapevtske stroke kot samostojnega poklica, v učinkovitejše in uspešnejše oblike klinične prakse in preventive ter v celovitejše, didaktično naprednejše oblike izobraževanja. Hkrati pa Dodo onkraj različnih psihoterapevtskih šol kot meta integrator ponuja vizijo širše integracije znanosti in prakse (model znanstvenika praktika), biološkega, psihološkega in socialnega, kvantitativne in kvalitativne metodologije, nomotetičnosti in idiografičnosti, teoretičnih razlag in kliničnega razumevanja, personalizirane medicine in psihoterapije ter medicinskega in kontekstualnega modela.
EMDR was originally developed to address traumatic memories. In teaching patients who have had a traumatic experience to repetitively move their eyes in a conjugate manner while contemplating that memory, EMDR therapy attempts to copy the conjugate eye movements occurring in rapid eye movement sleep (REMS). EMDR was consciously based on the theoretically proposed role for REMS in emotional processing during sleep, particularly in the case of negative emotions and trauma. Unfortunately for this theoretical construct, despite intensive research, no clear evidence has been discovered suggesting that the processing of emotional memories is confined to REMS. However, from the very first, remarkable results have been obtained using EMDR to treat patients diagnosed with PTSD. EMDR therapy consistently demonstrates large effects in treating subjective distress and moderate effects in treating PTSD and depression. There are a plethora of trained therapists, and since EMDR is non-aversive and not known to induce negative side effects, it is apparently ideal for use in at-risk populations. EMDR is equally effective to prolonged exposure when used immediately post-trauma. More studies document the effectiveness of EMDR therapy in treating PTSD than support any other form of PTSD therapy. A typical EMDR treatment protocol is described.
desde tiempos inmemorables el hombre ha cuestionado el mundo que lo rodea y el porqué de los fenómenos que diariamente observa en la naturaleza, al igual que se ha interesado por estudiar el comportamiento humano y la explicación de las interacciones humanas. En la búsqueda por explicar lo que le rodea, el hombre ha propuesto hipótesis que con el paso del tiempo se han podido verificar o falsear, ese conjunto de conocimientos que se ha logrado confirmar o refutar es lo que se conoce como ciencia y el conjunto de pasos que se siguen para poder confirmarlos es lo que se conoce como método científico. Este artículo busca hacer un análisis de las distintas definiciones de ciencia que se han conocido provenientes de pensadores y filósofos a lo largo de la historia; se realiza un análisis de la categorización de métodos científicos aplicados para la generación de conocimiento y cómo la filosofía aporta para la generación de este
Background and objectives
Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for posttraumatic stress disorder. It uses a dual-task approach, in which patients recall an aversive memory while making lateral eye movements. Research has shown that this ‘eye movements’ intervention reduces subjective memory vividness and emotionality. This study examined whether it also reduces memory accuracy on a visual discrimination task.
Methods
Participants (68 undergraduates) underwent an aversive conditioning phase, in which two pictures of male faces were followed by shock. Then they recalled one face with (experimental condition) and one without (control condition) making lateral eye movements. Finally, they completed a stimulus discrimination test with slightly different faces shortly after the intervention and one day later.
Results
Results showed that the eye movements intervention led to increased false-positive rates one day later.
Limitations
Our intervention targeted newly formed memory rather than consolidated memory.
Conclusions
The results inform theory about EMDR's mechanisms of change and suggest that the treatment may have side effects regarding memory accuracy.
There is no comprehensive meta-analysis of randomised trials examining the effects of Eye Movement Desensitization and Reprocessing (EMDR) on post-traumatic stress disorder (PTSD) and no systematic review at all of the effects of EMDR on other mental health problems. We conducted a systematic review and meta-analysis of 76 trials. Most trials examined the effects on PTSD (62%). The effect size of EMDR compared to control conditions was g = 0.93 (95% CI: 0.67–.18), with high heterogeneity (I²= 72%). Only four of 27 studies had low risk of bias, and there were indications for publication bias. EMDR was more effective than other therapies (g = 0.36; 95% CI: 0.14–0.57), but not in studies with low risk of bias. Significant results were also found for EMDR in phobias and test anxiety, but the number of studies was small and risk of bias was high. EMDR was examined in several other mental health problems, but for none of these problems, sufficient studies were available to pool outcomes. EMDR may be effective in the treatment of PTSD in the short term, but the quality of studies is too low to draw definite conclusions. There is not enough evidence to advise it for the use in other mental health problems.
Fraudulent health claims have become an inescapable fixture of the contemporary information (or misinformation) landscape. MacFarlane, Hurlstone, and Ecker (2020) provided a five-fold framework for conceptualizing susceptibility to fraudulent health claims, and proposed potential remedies for each driver of these claims. We build on their analysis by arguing that a complete account of fraudulent health claim susceptibility additionally requires a thoroughgoing consideration of (a) individual differences in cognitive styles and personality traits, (b) innumeracy and statistical illiteracy, and (c) persuasive appeals involving logical fallacies and commonplaces. We further contend that dual processing models of cognition may help to synthesize a variety of psychological variables relevant to fraudulent health claim vulnerability. In conjunction with our commentary, MacFarlane's framework underscores the broader point that complex, multifactorial psychological phenomena demand complex, multifactorial psychological explanations and solutions.
Among the explorations of psychotherapy integration, attempts to integrate the cognitive behavioral and psychodynamic approaches are receiving much attention. Eye movement desensitization and reprocessing (EMDR) is one newly developed method that appears to have successfully achieved such integration. Presented here are two cases of patients with complex personality problems that illustrate how EMDR does achieve this integration. The cases demonstrate the formulation of dynamic hypotheses based first on a thoughtful clinical understanding of the patient and then reformulated as new information emerges from the free associations elicited by this method. Treatment based on these formulations is through the cognitive and behavioral aspects of the EMDR procedures. Unlike many other integrative methods that have been proposed, the different aspects of this method are not applied separately but form a cohesive whole.
Methodological weaknesses, a lack of controls, or the failure to fully report data and methods in the few TFT studies that have been conducted limit their interpretability. Clinical reports are suggestive, but careful research has yet to confirm whether or not TFT interventions cause a rapid decrease in subjective distress. Research published to date provides neither sure conclusions nor insight into any of the many other questions surrounding TFT. Current TFT theory is highly elaborated, but too speculative to be helpful in understanding the potential therapeutic mechanisms of TFT.
Forty college students suffering from public speaking anxiety and having experienced a specific traumatic speech-related event were exposed to either a standard EMD protocol with eye movements; a moving audio stimulus in place of the eye movements; a protocol with eyes resting on the hands in place of the eye movement, or a no-treatment control condition. The results revealed that EMD is comparable in limited effectiveness to the other procedures and that the eye movements are not a crucial component of the treatment with this population.
This meta-analysis tested the Dodo bird conjecture, which states that when psychotherapies intended to be therapeutic are compared, the true differences among all such treatments are 0. Based on comparisons between treatments culled from 6 journals, it was found that the effect sizes were homogeneously distributed about 0, as was expected under the Dodo bird conjecture, and that under the most liberal assumptions, the upper bound of the true effect was about .20. Moreover, the effect sizes (a) were not related positively to publication date, indicating that improving research methods were not detecting effects, and (b) were not related to the similarity of the treatments, indicating that more dissimilar treatments did not produce larger effects, as would be expected if the Dodo bird conjecture was false. The evidence from these analyses supports the conjecture that the efficacy of bona fide treatments are roughly equivalent. In 1936, Rosenzweig proposed that common factors were responsible for the efficacy of psychotherapy and used the con- clusion of the Dodo bird from Alice in Wonderland (Carroll, 1865/1962) to emphasize this point: "At last the Dodo said, 'Everybody has won, and all must have prizes' " (p. 412). Later, Luborsky, Singer, and Luborsky (1975) reviewed the psy- chotherapy outcome literature, found that the psychotherapies reviewed were generally equivalent in terms of their outcomes, and decreed that the Dodo bird was correct. Since Luborsky et al.'s seminal review, the equivalence of outcome in psychother- apy has been called the Dodo bird effect. To many interested in the technical aspects of particular psy- chotherapies, the Dodo bird effect was distasteful and, on the face of it, unbelievable:
Research, quantification, and verification of treatment approaches are vital to any treatment field. This paper reviews the problems and challenges to testing new psychotherapy treatment procedures and suggests an innovative way to deal with the problems associated with researching new and innovative treatments. It is suggested that innovative practitioners be assisted in the demonstration and evaluation of their approaches by researchers, allowing the clinicians to demonstrate their method while researchers evaluate the effectiveness of the approach. This approach, the Systematic Clinical Demonstration (SCD) which combines the skills of clinicians and researchers, is described and discussed.
Facilitated communication (FC) is a method of assisting people with severe developmental disabilities to communicate. Before its adoption as a teaching–treatment technique, the only research evidence in support of its validity consisted of a small number of descriptive reports in the professional literature and anecdotal reports in the popular press and disability media. In use, this technique, which involves providing physical support to people with disabilities as they type out messages on a keyboard or letterboard, appears to result in unexpected literacy and to disclose normative or superior intellectual skills among people with lifelong histories of severe developmental delay. Controlled research using single and double blind procedures in laboratory and natural settings with a range of clinical populations with which FC is used have determined that, not only are the people with disabilities unable to respond accurately to label or describe stimuli unseen by their assistants, but that the responses are controlled by the assistants.
Within the constraints imposed by philosophy of science and the limitations of scientific methodology, experiments are basically attempts to identify causes and to evaluate their effects. All experiments involve a comparison of dependent variable values in the presence of different values of another variable. This comparison is usually accomplished by one of two basic experimental strategies: within-subject designs and between-subject designs. The 12 most common designs are outlined and discussed in the present article. Much of the discussion focuses on the importance of internal, external, and theoretical validity in experimentation and data interpretation. To illustrate the most common threats to these three forms of validity, various components in a hypothetical experimental manuscript are discussed. This discussion is followed by an acknowledgement of the continuum of fallibility along which all experiments fall. It is argued that in the final analysis, our goals should be to strive toward conducting the least fallible inquiries, to cautiously interpret our experiments in accord with their logical warrant, and to guard against the paralysis of complacency regarding the adequacy of current research methods.
Commit it then to the flames: for it can contain nothing but sophistry and illusion.' Thus ends David Hume's Enquiry concerning Human Understanding, the definitive statement of the greatest philosopher in the English language. His arguments in support of reasoning from experience, and against the 'sophistry and illusion' of religiously inspired philosophical fantasies, caused controversy in the eighteenth century and are strikingly relevant today, when faith and science continue to clash. The Enquiry considers the origin and processes of human thought, reaching the stark conclusion that we can have no ultimate understanding of the physical world, or indeed our own minds. In either sphere we must depend on instinctive learning from experience, recognizing our animal nature and the limits of reason. Hume's calm and open-minded scepticism thus aims to provide a new basis for science, liberating us from the 'superstition' of false metaphysics and religion. His Enquiry remains one of the best introductions to the study of philosophy, and this edition places it in its historical and philosophical context.
Objective.
—The purpose of this article is to review the empirical evidence for the efficacy of a range of treatments for posttraumatic stress disorder (PTSD). Reviewed studies focused on rape victims, combat veterans, the tragically bereaved, torture victims, accident victims, victims of physical assault, and child abuse victims.Data Sources.
—Peer-reviewed journals (Psych-Info, MEDLINE), book chapters (PILOTS database), active investigators, abstracts from the 1990 and 1991 International Society for Traumatic Stress Studies.Study Selection.
—We identified 255 English-language reports of treatment for PTSD. We restricted our focus to randomized, clinical trials that included a systematic assessment of PTSD using DSM-III or DSM-III-R criteria (N=11).Data Extraction.
—Studies were assessed according to methodological strength: random assignment to the treatment of interest, and either an alternative treatment or control group; sample selection; and inclusion of statistical tests of significance.Data Synthesis.
—Drug studies show a modest but clinically meaningful effect on PTSD. Stronger effects were found for behavioral techniques involving direct therapeutic exposure, particularly in terms of reducing PTSD intrusive symptoms. However, severe complications have also been reported from the use of these techniques in patients suffering from other psychiatric disorders. Studies of cognitive therapy, psychodynamic therapy, and hypnosis suggest that these approaches may also hold promise. However, further research is needed before any of these approaches can be pronounced effective as lasting treatment of PTSD.Conclusions.
—Further studies should specifically address combined treatment approaches, optimal treatment length and timing, effects of comorbidity, and unstudied traumatized populations.(JAMA. 1992;268:633-638)
This popular study of "psychological healing"treats topics ranging from religious revivalism and magical healing to contemporary psychotherapies, from the role of the shaman in nonindustrialized societies to the traditional mental hospital. Jerome and Julia Frank (who are father and daughter) contend that these therapies share common elements that improve the "morale"of sufferers. And in combating the "demoralizing meaning"that people attach to their experiences, the authors argue, many therapies are surprisingly similar to rhetoric (the art of persuasion) and to hermeneutics (the study of meanings). Highly acclaimed in previous editions, Persuasion and Healing has been completely revised and expanded. In addition to a broadened exploration of the role of demoralization in illness, this latest edition offers updated information on topics including self-help, family therapy, psychopharmacology, psychotherapy for the mentally ill, and techniques such as primal therapy and bioenergetics. As they explore the power of "healing rhetoric"in these activities, the authors strengthen the ties among the various healing profession.
Offering an answer to the anti-rationalist argument that all rational theory rests on an irrational commitment, this book also provides a case study of modern Protestant theology. The author contends that Western philosophical traditions are authoritarian in structure.
The following values have no corresponding Zotero field:
ID - 47
In 1996, Alan Sokal published an essay in the hip intellectual magazine "Social Text" parodying the scientific but impenetrable lingo of contemporary theorists. Here, Sokal teams up with Jean Bricmont to expose the abuse of scientific concepts in the writings of today's most fashionable postmodern thinkers. From Jacques Lacan and Julia Kristeva to Luce Irigaray and Jean Baudrillard, the authors document the errors made by some postmodernists using science to bolster their arguments and theories. Witty and closely reasoned, "Fashionable Nonsense" dispels the notion that scientific theories are mere "narratives" or social constructions, and explored the abilities and the limits of science to describe the conditions of existence.
Certain systematic methods of scientific thinking may produce much more rapid progress than others.
Posttraumatic stress disorder (PTSD) is an important mental health issue in terms of the number of people affected and the morbidity and functional impairment associated with the disorder. The purpose of this study was to examine the efficacy of all treatments for PTSD.
PubMed, MEDLINE, PILOTS, and PsycINFO databases were searched for randomized controlled clinical trials of any treatment for PTSD in adults published between January 1, 1980, and April 1, 2012, and written in the English language. The following search terms were used: post-traumatic stress disorders, posttraumatic stress disorder, PTSD, combat disorders, and stress disorders, post-traumatic.
Articles selected were those in which all subjects were adults with a diagnosis of PTSD based on DSM criteria and a valid PTSD symptom measure was reported. Other study characteristics were systematically collected. The sample consisted of 137 treatment comparisons drawn from 112 studies.
Effective psychotherapies included cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (g = 1.63, 1.08, and 1.01, respectively). Effective pharmacotherapies included paroxetine, sertraline, fluoxetine, risperidone, topiramate, and venlafaxine (g = 0.74, 0.41, 0.43, 0.41, 1.20, and 0.48, respectively). For both psychotherapy and medication, studies with more women had larger effects and studies with more veterans had smaller effects. Psychotherapy studies with wait-list controls had larger effects than studies with active control comparisons.
Our findings suggest that patients and providers have a variety of options for choosing an effective treatment for PTSD. Substantial differences in study design and study participant characteristics make identification of a single best treatment difficult. Not all medications or psychotherapies are effective.
Psychological intervention has grown in little more than a decade from an occasional afterthought in disaster response systems to a thriving enterprise; with that growth, however, have come features that sometimes resemble cottage industries, social movements, or, in extreme cases, evangelical cults. The social history of this evolution is reviewed from the perspective of participant observers, and the issues and implications of recent research are considered in the context of integrated models of theory, research, and application.
Eye movement desensitization and reprocessing (EMDR) is among the fastest growing interventions in the annals of psychotherapy. Although many psychologists have commented on its presumably unusual origins and dissemination, history reveals its many parallels with Mesmerism, a previous therapy that spread rapidly throughout 18th century Europe and America. The purpose of this article is to document the many striking similarities between the history of Mesmerism and the history of EMDR.
In social science, everything is somewhat correlated with everything ("crudfactor"), so whether H0 is refuted depends solely on statistical power. In psychology, the directional counternull of interest, H*, is not equivalent to the substantive theory T, there being many plausible alternative explanations of a mere directional trend (weak use of significance tests). Testing against a predicted point value (the strong use of significant tests) can discorroborate T by refuting H*. If used thus to abandon T forthwith, it is too strong, not allowing for theoretical verisimilitude as distinguished from truth. Defense and amendment of an apparently falsified T are appropriate strategies only when T has accumulated a good track record ("money in the bank") by making successful or near-miss predictions of low prior probability (Salmon's "damn strange coincidences"). Two rough indexes are proposed for numerifying the track record, by considering jointly how intolerant (risky) and how close (accurate) are its predictions.
In the past years, Eye Movement Desensitization and Reprocessing (EMDR) has become increasingly popular as a treatment method for Posttraumatic Stress Disorder (PTSD). The current article critically evaluates three recurring assumptions in EMDR literature: (a) the notion that traumatic memories are fixed and stable and that flashbacks are accurate reproductions of the traumatic incident; (b) the idea that eye movements, or other lateralized rhythmic behaviors have an inhibitory effect on emotional memories; and (c) the assumption that EMDR is not only effective in treating PTSD, but can also be successfully applied to other psychopathological conditions. There is little support for any of these three assumptions. Meanwhile, the expansion of the theoretical underpinnings of EMDR in the absence of a sound empirical basis casts doubts on the massive proliferation of this treatment method.
Popper formulates and explains his non-justificationist theory of knowledge. Science--empirical science--aims at true explanatory theories, yet it can never prove, finally establish, or justify any of its theories as true, not even if it is in fact a true theory. Science must continue to question and criticize all its theories, even those which happen to be true.
Phantom alternatives (unavailable options) can appear in many common decision tasks and can influence a wide variety of everyday behaviors. Although the term phantom is of recent vintage, researchers have investigated psychological reactions to unavailable alternatives for almost 60 years. In this article, we review 13 domains of research on unavailable alternatives to identify seven empirical generalizations about phantoms. These generalizations call into questions some basic assumptions of formal choice theory and suggest new research directions for studying phantom options.
A serious problem with Popperian falsificationism in the presence of auxiliary hypotheses and experimental conditions, in addition to a theory under test, is raised by Meehl. In brief, a negative result endangers both the theory in question, and the auxiliary hypotheses; which should we reject? I discuss how considering series of studies, rather than a single study, helps make this problem somewhat more tractable. I treat situations where negative results are in hand, as well as situations where positive results may be discounted by skeptics who question auxiliary hypotheses.
Three problems are identified that the author believes must be addressed in order for psychology to achieve its full potential as a science and profession: the pretension of some practitioners to more knowledge and skill than they possess (charlatanism), the use of scientism (i.e., the misapplication of restrictive definitions of science) to make unwarranted attacks on the profession, and a general failure of the discipline to use fully its resources to meet its implied contract with society. These problems erode public confidence in both the profession and science of psychology. If not corrected, they may well lead to a public perception that psychology has little to contribute to the problems of greatest concern to today's society. General suggestions for addressing each of the problem areas are discussed.
Eye-Movement Desensitization and Reprocessing (EMDR), a technique that combines imaginai exposure with eye movement, recently has been proposed by its originator, F. Shapiro, as a prescriptive treatment for trauma-related anxiety. To date, several uncontrolled case studies have found EMDR to be effective. However, none employed objective or standardized dependent measures of therapeutic improvement and all combined EMDR with other interventions. In contrast to results obtained from case studies, controlled experiments utilizing objective and standardized dependent measures have failed to support the efficacy of the technique beyond that of its imaginal exposure component. Unfortunately, these experiments employed small samples with a limited range of disorders, indicating the need for further evaluation. However, unbiased replication is impeded by Shapiro's practice of prohibiting individuals not associated with her EMDR Institute from training others in the technique. We articulate our concern that despite its lack of empirical validation clinical application of the technique by behavior therapists is rapidly increasing.