Trauma and Post-Traumatic Stress Disorder
David B. Cooper, Jo Cooper in Palliative Care Within Mental Health, 2018
Eye Movement Desensitization and Reprocessing (EMDR) is a therapy that helps people process their trauma-related thoughts, memories, and feelings. A variety of different EMDR protocols exist and there is no consensus about the right approach. Some recommend that the individual focuses their attention on a back-and-forth movement made by the therapist’s fingers or a light bar. Another approach suggests use of a sound that beeps in one ear at a time. Both require that the individual recalls the traumatic event until the way the memory is recalled shifts and becomes less distressing. Most people report that they benefit from the experience and that the effort and discomfort is minimal. For select individuals, this might be a good approach because it requires minimal times (i.e. no homework or practice between sessions) and only involves thinking and not speaking about the trauma. Although the demands are less than other types of therapy, it still requires weekly visits for one to three months.
The Relaxation SystemTherapeutic Modalities
Len Wisneski in The Scientific Basis of Integrative Health, 2017
Eye movement desensitization and reprocessing (EMDR) uses a combination of clinician-directed physical stimuli (primarily a set of specific eye movements, but also hand tapping and finger clicking) coupled with mental focus. The mental focus begins first on a trauma, painful memory, or negative belief and then shifts to a positive sentiment. Francine Shapiro, who developed the technique, felt that the physical stimulation (e.g., eye movement) somehow triggers the portion of the brain involved in information processing and thus activates an inherent adaptive response that has gone awry, possibly as a result of the intensity of the trauma (Shapiro, 1995). I would speculate that the mechanism underlying EMDR involves neural pathways that connect the extraocular muscles (i.e., the muscles responsible for eye movement) with the limbic system (i.e., the area most central in processing emotion). The release of traumatic memories may be a positive therapeutic ramification of the programmed movements of EMDR. Ideally, both desensitization to the negative issue and an adaptive resolution can occur.
Post-traumatic stress disorder
MS Thambirajah in Case Studies in Child and Adolescent Mental Health, 2018
Despite the high prevalence of childhood trauma, studies regarding psychotherapy for children suffering from PTSD are scarce, especially regarding the treatment for paediatric PTSD following single-incident trauma. Treatment practices for this population rely mainly on the paradigms of therapy for adult PTSD and paediatric PTSD following sexual abuse. No evidence exists that a particular treatment approach (e.g. individual, group or family) of delivery of the therapeutic treatment is superior. The best available evidence supports outpatient trauma-focused psychotherapy containing cognitive-behavioural components, including exposure strategies, stress management, cognitive/narrative re-structuring and parental treatment components. While psychotropic medication has been found to be helpful in reducing symptoms of PTSD in adults, in children and adolescents, their use has little to add to psychological management. The National Institute for Health and Clinical Excellence (NICE) has recently reviewed the evidence base for the treatment of PTSD in adults and children and recommends trauma-focused cognitive behavioural therapy (TFCBT) and eye movement desensitisation and reprocessing (EMDR) as the two first-line treatments for PTSD (NICE, 2005).
Interventions for addressing trauma among people with HIV: a narrative review
Published in AIDS Care, 2022
Hilary Goldhammer, Linda G. Marc, Nicole S. Chavis, Demetrios Psihopaidas, Massah Massaquoi, Sean Cahill, Erin Nortrup, Carol Dawson Rose, Janet Meyers, Kenneth H. Mayer, Stacy M. Cohen, Alex S. Keuroghlian
Previously published reviews have found a limited number of intervention studies demonstrating efficacy for improving trauma-related stress or HIV outcomes among people with HIV (Applebaum et al., 2015; LeGrand et al., 2015; McLean & Fitzgerald, 2016; Sales et al., 2016; Seedat, 2012). A large body of evidence, however, supports the efficacy of trauma-focused treatments in other populations (Watkins et al., 2018). Interventions include expressive writing, (Nyssen et al., 2016) prolonged exposure therapy (Powers et al., 2010), cognitive–behavioral therapy (Watkins et al., 2018), and cognitive-processing therapy (Asmundson et al., 2019). Eye movement desensitization and reprocessing (EMDR) (Novo Navarro et al., 2018) has also been recommended for treating PTSD, although its status as an evidence-based treatment is debated (Watkins et al., 2018).
Borderline Personality Disorder: A Case for the Right Treatment, at the Right Dose, at the Right Time
Published in Issues in Mental Health Nursing, 2021
Katrina Campbell, Richard Lakeman
Primary prevention of BPD and C-PTSD may also entail an effective therapeutic response to trauma close to the time it occurred. There is a consistent and linear relationship between the number of childhood adverse experiences and the likelihood of dropping out of treatment as adults and those that do not receive treatment do not appear to spontaneously remit or get well without assistance (Mahon et al., 2001). Even in childhood those with the most severe trauma and greatest severity of symptoms are most likely to ‘drop-out’ of treatment (Wamser-Nanney & Steinzor, 2017) which in part may be explained by problems with attachment and caregiver capacity to facilitate access to treatment. However, these facts do suggest that those with the most experience of trauma are the least likely to receive an adequate dose of therapy (or a sustained containing and safe relationship with a therapist to build a working alliance and mitigate the effects of trauma). An adequate treatment of PTSD symptoms in both children and adults with prominent symptoms would seem like a logical start to psychotherapy. Presently, at least for adults, focussed treatment for PTSD symptoms includes eye movement desensitisation and reprocessing (EMDR), exposure therapy and cognitive behavioural therapy. These have been found to be effective in reducing symptoms of C-PTSD (Karatzias et al., 2019). Non randomised controlled trials of these programmes with people with BPD and comorbid PTSD have demonstrated reductions in symptoms of both conditions (De Jongh et al., 2020).
Enhancing Connections between Clinicians and Research in Hypnosis Practice: Strategies for Practice and Training
Published in International Journal of Clinical and Experimental Hypnosis, 2023
Lindsey C. McKernan, Elizabeth G. Walsh
For a novice practitioner, competency development may include seeking ongoing consultation and supervision beyond introductory training to ensure responsible hypnosis practice. For example, all approved trainings in eye movement desensitization and reprocessing (EMDR) require the completion of 10 hours of consultation in the year following initial training to achieve competence (EMDR International Association, n.d.) While ASCH and SCEH have certification systems for practitioners, certification is not required for the practice of clinical hypnosis. Outside of these optional certification processes, no standard is set for competency development, meaning this standard is individually driven and informed by the ethical guidelines of a clinician’s discipline. Furthermore, there is no system for approving clinical hypnosis trainings the way that EMDR trainings are approved by EMDRIA (EMDR International Association), which acts as an accrediting body. With the rapid uptake of telemedicine in recent years, seeking consultation from advanced practitioners may prove more accessible. As well as practitioners new to hypnosis pursuing consultation individually, societies providing systems for online consultation and supervision could further increase consultation accessibility and uptake.
Related Knowledge Centers
- Cognitive Behavioral Therapy
- Eye
- Observer Bias
- Psychotherapy
- Traumatic Memories
- Post-Traumatic Stress Disorder
- Exposure Therapy
- Thought Field Therapy
- Emotional Freedom Techniques
- Complex Post-Traumatic Stress Disorder