EMDR PROTOCOLS AND ASSYST TREATMENT PROCEDURES FOR EARLY INTERVENTION AND PROLONGED ADVERSE EXPERIENCES BIBLIOGRAPHY PAPERS.
Abstract
In this report, you will find the 71 peer-reviewed published papers on the Jarero, Artigas, and Smyth-Dent EMDR Protocols, ASSYST treatment procedures, and the Butterfly Hug EMDR therapy method for self-administer bilateral stimulation. No posters, conference presentations, in-press, or Newsletter publications are included in this bibliography.Updated on November 6, 2023.
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Background:
During the COVID-19 pandemic, psychological support was provided to healthcare workers in Nephrology and Dialysis Operative Unit of the Azienda Ospedaliera Bassini using an EMDR group protocol to decrease posttraumatic stress symptoms in the medium and long term. The aim of this study was to demonstrate the effectiveness of EMDR treatment to reduce post-traumatic stress symptoms at the end of the first pandemic wave and its progress over time in the subsequent phases of the health emergency.
Methods:
The sample of study consisted of 43 healthcare workers from the Nephrology and Dialysis Service who spontaneously decided to take part in the Brief EMDR treatment. Statistical analyses were carried out to compare the data collected with the IES-R, the Emotion Thermometer and the Post-Traumatic Growth Scale. The comparisons covered pre-treatment, post-treatment and follow-up.
Results:
The results show a significant clinical improvement in reducing PTSD symptoms following the Brief EMDR group treatment. The comparison between PRE and POST treatment (DELTA1) regarding the scores from IES-R and Emotion Thermometer, highlighted the important statistically change that occurred in terms of symptomatology reduction (p < 0.001). By comparing POST and FU (DELTA2), it was observed that all variables except avoidance show a significant weakening of the effect with time (p < 0.001), but the magnitude of this effect is much smaller than the improvement found in DELTA1. DELTA 3 analysis finally made it possible to highlight how the treatment effect is maintained almost intact at follow-up. In fact, the maintenance of a better situation at follow-up was observed, in the course of re-traumatization linked to the new wave, compared to the initial data (p < 0.001).
Conclusion:
The COVID-19 health emergency has significantly impacted hospital healthcare workers, leading to a high risk of developing PTSD symptoms. A psychological intervention aimed at the operators themselves is therefore of great importance.
Residential nursing homes were particularly badly affected by the first wave of COVID-19, with large numbers of their frail person getting infected with COVID-19 and dying. The staff in these structures were catapulted into a reality very different from what they were used to. They had to adapt the way they used to take care of their patients in a very short space of time and in a scenario that was continually changing. In this manuscript we describe the subjective experience of staff in a number of Italian nursing homes during the first wave of the COVID-19 pandemic; and we report data showing the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) treatment provided to support them during this Pandemic.
Adverse childhood experiences (ACEs, i.e., abuse, neglect, household dysfunction) represent a potential risk factor for a wide range of long-lasting diseases and shorter life expectancy. We recently described a 1-week residential group program, based on mindfulness training, artistic expression and EMDR group therapy, that significantly reduced PTSD-related symptoms and increased attention/awareness-related outcomes in adolescent girls with multiple ACEs in a randomized controlled study. Since epigenetic mechanisms (i.e., DNA methylation) have been associated with the long-lasting effects of ACEs, the present report extends these prior findings by exploring genome-wide DNA methylation changes following the program. Saliva samples from all participants (n = 44) were collected and genomic DNA was extracted prior (T1) and following (T2) the intervention. Genome-wide DNA methylation analysis using the MethylationEPIC beadchip array (Illumina) revealed 49 differentially methylated loci (DML; p value < 0.001; methylation change > 10%) that were annotated to genes with roles in biological processes linked to early childhood adversity (i.e., neural, immune, and endocrine pathways, cancer and cardiovascular disease). DNA sequences flanking these DML showed significant enrichment of transcription factor binding sites involved in inflammation, cancer, cardiovascular disease, and brain development. Methylation changes in SIRT5 and TRAPPC2L genes showed associations with changes in trauma-related psychological measures. Results presented here suggest that this multimodal group program for adolescents with multiple victimization modulates the DNA methylome at sites of potential relevance for health and behavioral disorders associated with ACEs.
Aim
The Coronavirus 2019 (COVID-19) pandemic represents one of the most catastrophic events of recent times. Due to the hospitals’ emergency situation, the population of healthcare workers was the most affected. Healthcare workers who were exposed to COVID-19 patients are most likely to develop psychological distress and post-traumatic stress disorder (PTSD). The present study aimed at investigating PTSD in a sample of Italian healthcare workers during this outbreak and to evaluate the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) Therapy with this population.
Methods
A total of 744 healthcare workers were included. 587 healthcare workers were treated with EMDR, while the other 157 were not treated. Participants were asked to provide sociodemographic information; the post-traumatic symptomatology was evaluated through Impact of Event Scale-Revised (IES-R) and to investigate the level of intensity of emotional activation was used The Emotion Thermometer (THERMO) at two time points (pre-post treatment).
Results
The results obtained between EMDR treatment and non-EMDR treatment were evaluated on only 2 hospitals. Treatment group n = 68 vs. waitlist non-treatment group n = 15 7. All scores pre- and post-EMDR decreased significantly ( p < 0.001) showing an evident effect of EMDR. The differences between pre- and post-treatment of the IES-R scores of subjects in which EMDR was performed as compared to the scores pre- and post-12 weeks of waiting list subjects in which it was not performed were significantly different ( p < 0.001).
Limitation
The emergency situation did not provide an opportunity to explore further aspects that would have been important for research. One limitation is the use and analysis of only two standardized tests. In addition, other psychopathologies were not investigated as outcome measures. A limitation is the comparison of subjects treated online and de visu . Although the protocol used was the same, the mode of intervention may have influenced the results. In addition, the effectiveness of EMDR treatment was only evaluated at two time points (pre-post) with no possibility of follow-up and the lack of a control group.
Discussion/conclusion
The findings of the present study suggest that healthcare workers were at high risk of developing PTSD when confronted with COVID-19 outbreak and suggest the importance of psychological support during this humanitarian emergency.
We report the results of a pilot study regarding the adaptation of the group eye movement desensitization and reprocessing (EMDR) protocol for the treatment online, for the management of trauma associated with the COVID-19 Pandemic in Italy. The target group were healthcare workers in a nursing home (Residenza sanitaria assistita, RSA) who decided to live and stay on site during the most acute phase of the Pandemic in order to protect the residents of the home. Scores for perceived post traumatic stress disorder (PTSD) symptoms and quality of emotional experience improved significantly following participation in the therapy programme. These preliminary results confirm the innovative potential of the EMDR protocol when used online on early intervention, to prevent the development of later psychological disturbances.
Background
Adverse childhood experiences (ACEs) are associated with a wide range of diseases, unsafe behavior and shorter life expectancy. However, there is scarce evidence on effective interventions for children or adolescents who report multiple ACEs, including abuse, neglect and household dysfunction.
Objective
The aim of this study was to evaluate the mental health outcomes of a multimodal program designed for adolescents with multiple ACEs.
Participants
Forty-four girls (aged 13–16 years, mean ACE score > 5) were randomized to an intervention group or a care-as-usual control group.
Methods
The intervention included mindfulness-based practices, expressive arts and EMDR (Eye Movement Desensitization and Reprocessing Integrative) group treatment. We used questionnaires for adolescents to assess trauma (SPRINT, CPSS) and attention/awareness-related outcomes (MAAS-A) at baseline (T1), post-intervention (T2) and two-months post-discharge (T3).
Results
Linear mixed effects model analyses showed significant Group by Time interactions on all the scales (F = 11.0, p = 0.015; F = 12.5 p < 0.001; and F = 6.4, p = 0.001, for SPRINT, CPSS and MAAS-A, respectively). After completing the program, the intervention group showed significant reduction in trauma-related outcomes (SPRINT, Δ%(T2-T1) = −73%, p < 0.001; CPSS, Δ%(T2-T1) = −26%, p < 0.001) while attention/awareness-related outcomes were improved by 57% (p < 0.001). These changes remained stable two months after discharge. SPRINT and CPSS scales were highly correlated (r = 0.833, p < 0.001) and outcomes from both trauma-related scales negatively correlated with mindfulness scores (MAAS-A/SPRINT, r = −0.515, p = 0.007; MAAS-A/CPSS, r = −0.553, p < 0.001).
Conclusions
Results presented here support this multimodal group intervention as a feasible and promising program for reducing the psychological burden in adolescents with a history of multiple ACEs.
The aim of this study was to investigate the effect of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP), which was previously used in disaster and war related traumas, on depression and trauma scores in female adolescents with Post-Traumatic Stress Disorder. This is the first study with adolescents in this field. For this purpose, 13 female adolescents underwent 3 sessions of Group EMDR protocol. The cases had history of sexual abuse and had been given standard medical treatment for at least 6 months. The Posttraumatic Stress Index and the Children Depression Inventory were administered to the patients before therapy sessions and then 1 month after the sessions were completed. The mean age of the patients was 16 (min: 14 max: 17). 84.6% (n: 11) of the cases had experienced more than one traumatic event before. The mean Child Depression Inventory scores were 19 (± 6.4) before therapy and 11.4 (± 5.5) at 1-month follow-up, Post-Traumatic Stress Index scores were 53.5 (± 7.5) before therapy, and 39.4 (± 8.6) at 1-month follow-up. There was a statistically significant difference in both depression and trauma scores before and after follow-up. Complicated PTSD is a psychiatric disorder that affects lives of individuals in many ways. Although standard psychotropic medication has a partial effect in reducing post-traumatic stress symptoms, this is insufficient. Group therapy has been used mostly in collective trau-matic events; it has been shown that can use effective in complex PTSD as well with this study.
Objective: We aimed at comparing the efficiency of “Eye Movement Desensitization and Reprocessing Integrative Group Treat-
ment Protocol (EMDR-IGTP)” with “Cognitive and Behavioral Therapy Based Crisis Prevention Program for Children and Adolescents
(CIPCA)” in children who survived the 2020 earthquake in Turkey.
Methods: We randomly divided 56 children and adolescents who were earthquake victims between the ages of 8 and 14 into two
groups. Half of the participants underwent EMDR-IGTP, while the other underwent CIPCA. Outcomes were obtained using clinical
global impression (CGI) and the subjective units of distress (SUDS) scales before and after therapy.
Results: The median age of the participants was 10 years (range: 8–14) and 53.6% of them were male. The median CGI scores of
the EMDR-IGTP group before and after therapy were 7 (3–7) and 1 (1–7), while that of the CIPCA group before and after therapy
were 7 (3–7) and 4 (2–7), respectively (p<0.001). The median SUDS scores of the EMDR-IGTP group before and after therapy were
10 (5–10) and 1 (0–10), while that of the CIPCA group before and after therapy were 9 (5–10) and 5.5 (3–9), respectively (p<0.001).
Conclusion: Both EMDR-IGTP and CIPCA are effective in reducing the acute traumatic stress following the earthquake; however,
EMDR-IGTP is relatively more effective. Thus, both methods can be used as a psychosocial intervention in post-earthquake trau-
matic events.
Eye movement desensitization and reprocessing (EMDR) therapy using the integrative EMDR group treatment protocol was adapted for provision of treatment online during the COVID pandemic. Six parents of special needs children were given assessments before treatment, immediately after and one-month post-treatment. This is an exploratory pilot research study that used quasi-experimental and qualitative designs, with pre-assessments and multiple post-measures and by qualitative data taken after each session of the two-part treatment plan. The results of the pilot study show decreases in anxiety, depression, parenting stresses, and distress about the child’s disability. EMDR seems an effective treatment for the stress experienced by parents of special needs children. Considering the importance of the role these parents play, further and more rigorous research with randomized control studies and large samples is recommended
Objective:
To explore the acceptability and the effectiveness of an Eye Movement Desensitization Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP) for patients with a history of recurrent traumatic episodes of interpersonal nature.
Method:
Seven women were recruited from a Trauma Centre and were offered EMDR-IGTP, consisting of 10 semi-structured group sessions. Participants were assessed through a set of standardised clinical measures before the treatment, at the end of it, and after 1 and 3 months since its conclusion.
Results:
EMDR-IGTP was well accepted by all participants. After the intervention and at 1 and 3 months follow-up, patients showed a significant reduction of dissociative symptoms, traumatic symptoms and improved emotional regulation.
Conclusions:
This study suggests that GITM-EMDR therapy can be a helpful treatment for people who experienced traumatic episodes of interpersonal nature and supports more extensive research in this direction.