Eye movement desentitization and reprocessing in the treatment of post-traumatic stress disorder: a review of an emerging therapy

Background. Eye Movement Desensitization and Reprocessing (EMDR) is a:relat ively new form of psychotherapy for post-traumatic stress disorder. We crit ically reviewed randomized controlled trials of EMDR. Methods. A wide range of electronic databases and reference lists of articl es obtained were searched and relevant experts were consulted. Studies were critically appraised according to established criteria. Results. We found 16 published randomized controlled trials (RCTs) comparin g EMDR with alternative psychotherapy treatments, variants of EMDR and with delayed treatment groups. Studies were generally small (mean number of pat ients = 35) and of variable methodological quality, with only five reportin g blinding of outcome assessors to treatment allocation, and in some cases with high loss to follow-up. In most cases EMDR was shown to be effective at reducing symptoms up to 3 m onths after treatment. In one case benefit was maintained up to 9 months an d in another (:uncontrolled) followup treatment effect was present at 15 mo nths. Two studies suggest that EMDR is as effective as exposure therapies, three claim greater effectiveness in comparison to relaxation training, and three claim superiority over delayed treatment groups. Of the studies exam ining specific treatment components, two found that treatment with eyes mov ing was more effective than eyes fixed, while three studies found the two p rocedures to be of equal effectiveness. Conclusion. The evidence in support of EMDR is of limited quality but resul ts are encouraging for this inexpensive, simple therapy. Further research i s warranted in larger samples with longer periods of follow-up.