Eye Movement Desensitization and Reprocessing (EMDR) Therapy · 3rd Edition by Shapiro, Francine -- Read -- Imperial Library of Trantor

Index

Title Page Copyright Page Dedication Page About the Author Preface Acknowledgments Contents 1. Background

A Chance Discovery The First Controlled Study Further Clinical and Experimental Observations Shift in Paradigm Adaptive Information Processing Theoretical Convergences

Posttraumatic Stress Disorder Psychodynamic Approaches Cognitive-Behavioral Approaches Integrative Approach

Summary and Conclusions

2. Adaptive Information Processing: The Model as a Working Hypothesis

Information Processing

Bilateral Dual Attention Stimulation

Memory Networks A Sample EMDR Session

Partial Transcript of the Sample Session Evaluation of the Sample Session

Dysfunctional to Functional Disparate Neural Networks Applications of EMDR Therapy to Other Disorders Static Experience: Affect and Belief Statements Resolution Frozen in Childhood “Time-Free” Psychotherapy Targets

Access Restricted to Negative Material Memory Lapses Dissociation

Integrated Psychotherapy Summary and Conclusions

3. Components of EMDR Therapy and Basic Treatment Effects

Basic Components of the EMDR Processing Targets

The Image The Negative Cognition The Positive Cognition The Emotions and Their Level of Disturbance The Physical Sensations

Activating the Information-Processing System

Eye Movements Alternative Forms of Stimulation

The Eight Phases of EMDR Therapy

Phase One: Client History and Treatment Planning Phase Two: Preparation Phase Three: Assessment Phase Four: Desensitization Phase Five: Installation Phase Six: Body Scan Phase Seven: Closure Phase Eight: Reevaluation

Standard Three-Pronged EMDR Therapy Protocol Choosing a Target Patterns of Response

Multimemory Associative Processing

The Belief Inherent in the Trauma The Major Participant or Perpetrator The Pronounced Stimuli The Specific Event The Dominant Physical Sensations The Dominant Emotions

Single-Memory Processing Effects

Changes in Image Changes in Sounds Changes in Cognitions Changes in Emotions Changes in Physical Sensation

Differential Effects Supervised Practice Summary and Conclusions

4. Phase One: Client History

Client Readiness Client Safety Factors

Level of Rapport Emotional Disturbance Stability Life Supports General Physical Health Office Consultation versus Inpatient Treatment Neurological Impairment Epilepsy Eye Problems Drug and Alcohol Abuse Legal Requirements Systems Control Secondary Gains Timing Medication Needs Dissociative Disorders

Treatment Planning History-Taking Transcript Supervised Practice Summary and Conclusions

5. Phases Two and Three: Preparation and Assessment

Phase Two: Preparation

Adopting a Clinical Stance Forming a Bond with the Client Explaining the Theory Testing the Eye Movements Creating a Safe/Calm Place Describing the Model Setting Expectations Addressing Client Fears

Phase Three: Assessment

Selecting the Picture Identifying the Negative Cognition Developing a Positive Cognition Rating the Validity of Cognition Naming the Emotion Estimating the Subjective Units of Disturbance Identifying Body Sensations

Importance of the Components Supervised Practice Summary and Conclusions

6. Phases Four to Seven: Desensitization, Installation, Body Scan, and Closure

Accelerated Reprocessing of the Memory Phase Four: Desensitization

Associative Processing

Imagery

New Memory Image Changes Incident Unfolds Appearance Changes

Sounds and Thoughts

Negative Statements Mismatches Positive Thoughts Insights

Sensation and Affect

New Emotions Shifting Sensations

Assessment

Phase Five: Installation Phase Six: Body Scan Phase Seven: Closure

Visualization Safety Assessment Debriefing and Log

Supervised Practice Summary and Conclusions

7. Working with Abreaction and Blocks

Abreaction

Guidelines for Facilitating Abreaction If Abreaction Persists

Strategies for Blocked Processing

Primary Target

Altering the Eye Movement Focusing on Body Sensation

All Sensation The Primary Sensation Unspoken Words Using Movement Pressing the Location

Scanning

Visual Cues Sound Effects Dialogue

Alterations

Appearance of Image No Action Hierarchy Redirecting to Image Redirecting to Negative Cognition Adding a Positive Statement Checking the Positive Cognition

Return to Target

Ancillary Targets

Feeder Memories Blocking Beliefs Fears

Fear of Going Crazy Fear of Losing the Good Memories Fear of Change

Wellsprings of Disturbance

Supervised Practice Summary and Conclusions

8. Phase Eight: Reevaluation and Use of the EMDR Therapy Standard Three-Pronged Protocol

Phase Eight: Reevaluation The Standard Three-Pronged EMDR Therapy Protocol

Working on the Past

Single-Target Outcome Recycling through Multiple Targets

Primary Events Past Events Progressions Clusters Participants

Working on the Present

Using the Log to Report Systems Issues

Working on the Future

Significant People Significant Situations Incorporating a Future Template

Concluding Therapy

Follow-Up Terminating Therapy

Supervised Practice Summary and Conclusions

9. Standardized Protocols and Procedures for Special Situations

The Standard Procedures Three-Pronged Protocol Protocol for a Single Traumatic Event Disorder-Based Protocol Symptom-Based Protocol Protocol for Current Anxiety Eye Movement Desensitization

Procedural Steps

Protocols for Recent Traumatic Events

Recent Event Protocol EMDR Protocol for Recent Critical Incidents Recent Traumatic Episode Protocol

Protocol for Phobias Protocol for Complicated Grief Protocol for Illness and Somatic Disorders Pain Conditions Self-Directed Use of Bilateral Stimulation for Stress Reduction

Eye Movement Sets: Caveats and Suggestions Technical Considerations Butterfly Hug

Self-Control/Closure Procedures Safe/Calm Place Imagery EMDR Resource Development and Installation

Client Instructions for RDI

Recorded Visualizations The Light Stream Technique Breathing Shift Vertical Eye Movements Debriefing and Safety Assessment Summary and Conclusions

10. The Cognitive Interweave: A Proactive Strategy for Working with Challenging Clients

Foundation of the Interweave Responsibility, Safety, and Choices Fitting the Intervention to the Client Interweave Choices

New Information “I’m Confused” “What If It Were Your Child?” Metaphor/Analogy “Let’s Pretend” Socratic Method

Assimilation Verbalizations and Actions Education Supervised Practice Summary and Conclusions

11. Selected Populations

Issues of Noncompliance Complex PTSD Sexual Abuse Victims

Appropriate Goals Client Readiness Structure Integration Information Plateaus Emotional Stages False Memory Cautions Regarding Memory Work

Hypnosis The Fallibility of Memory

Combat Veterans

Dealing with Feelings of Lack of Control Secondary Gain Issues Affiliation and the Fear of Forgetting Dealing with Denial, Moral Injury, and Transition States Dealing with Anger Military Sexual Trauma Using the Cognitive Interweave Anniversary Dates Complicated Grief

Postdisaster Response

Special Considerations EMDR Intervention at the Time of the Event or within the First 48 Hours EMDR Interventions 48 Hours or More Postdisaster Phases of Treatment Vicarious Trauma

Couples

Partner Providing Support Marital Therapy Infidelity

Children

History Taking Preparation Phase Holding the Child’s Attention Assessment Phase Desensitization and Installation Phases Cognitive Interweaves Closure and Reevaluation Working with Caregivers Generalizing Treatment Effects

Intellectual Disability Autism Spectrum Disorder

Complex Trauma in Children

Addictions

Addiction through the Lens of the AIP Client Readiness and Stages of Change Safety and Stabilization Timing of Treatment Suggested Targets for Reprocessing Additional Precautions and Guidelines

Dissociative Disorders Overall Evaluations Summary and Conclusions

12. Theory, Research, and Clinical Implications

Procedural Elements

Exposure Perceived Mastery Attention to Physical Sensation Cognitive Reframing Alignment of Memory Components Free Association Mindfulness Eye Movements and Alternative Bilateral Stimuli

Orienting Response Working Memory Distraction Hypnosis Neural Network Changes Dream Sleep Relaxation Response Integrative Effect Working Memory Account of EMDR Orienting Response REM Sleep Summary of Recommendations for Component Research Treatment of PTSD

Trauma and PTSD Children Adults with PTSD Treatment of Military Personnel Complex PTSD Elderly Adults Disaster Response Research

Individual Protocols

EMDR Standard Protocol Recent Traumatic Events Protocol EMDR Protocol for Recent Critical Incidents Recent Traumatic Episode Protocol Group Protocols

EMDR Integrative Group Treatment Protocol Group Traumatic Episode Protocol

Protocols for Disaster-Response Teams

Future Research Diverse Clinical Applications

Anxiety Disorders

Phobias Panic Disorder

Obsessive–Compulsive Disorder Mood Disorders Addictions Pain Conditions Diverse Somatic Conditions

Treatment-Resistant Populations Suggested Criteria for Clinical Outcome Research

Method Validity Selection of Psychometrics Participant Selection Comparative Research Recommended Clinical Parameters for Comparative Outcome Studies

Additional Future Research

The Adaptive Information Processing Model

Broader Clinical and Professional Concerns

Clinical Responsibility Global Responsibility

Summary and Conclusions

Appendix A. Clinical Aids

Adverse Childhood Experiences Questionnaire Recommended Format for Weekly Log (TICES) Report Negative and Positive Cognitions Examples of Negative and Positive Cognitions Form and Sequence for Techniques to Identify Past Event

Affect Scan (Shapiro, 1995) Floatback Technique (Young, Zangwill, & Behary, 2002)

EMDR Therapy Procedural Outline

Explanation of EMDR Specific Instructions

Appendix B. Client Transcripts

Three-Pronged Protocol with a Combat Veteran Cognitive Interweave Case Session with a Molestation Survivor

Appendix C. Clinical and Outcome Assessments

EMDR Fidelity Rating Scale (EFRS) Empirically Evaluating EMDR without a Control Group: A Step-by-Step Guide for EMDR Therapists

Purpose of This Guide Part I: Single-Case Designs

Overview and Logic of Single-Case Evaluation Step-by-Step Guide

Step 1. Specify the Target Step 2. Operationally Define the Target Step 3. Devise a Data Collection Plan Step 4. The Baseline Phase Step 5. The Basic Single-Case Design Step 6. Data Analysis Step 7. Replication

Part II. Within-Group Effect Size Benchmarks

Appendix D. Research Lists

Psychophysiological and Neurobiological Evaluations

Appendix E. Client Safety

EMDR Dissociative Disorders Task Force Recommended Guidelines: A General Guide to EMDR’s Use in the Dissociative Disorders

Purpose Assumptions Screening Clarifying the Diagnosis When a Dissociative Disorder Is Present Embedding EMDR in the Treatment Plan Preparing for EMDR Early Treatment Phases Caution Middle Treatment Phases Final Treatment Phases Task Force Members Additional Training Suggested Reading

Professional Standards and Training Committee of the EMDR International Association

Appendix F. EMDR Therapy Training Resources

North and South America Europe Asia

References Index About Guilford Press Discover Related Guilford Books

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