The Green Will Conservancy hosts EMDR Psycho-Therapy Trainings and Consultation for Clinicians and Local Agencies ongoing: Participants have included Private Practitioners, Hawaii DOE, DHS, CFS, QLCC, Hawaii Island Recovery, DOH-CAMHD-Contract Agencies, Bay Clinic and Others.
EMDR Therapy Hawaii
(Eye Movement Desensitization and Reprocessing) Presentation
Eye movement desensitization and reprocessing (EMDR) Psycho-Therapy PTSD is a psychotherapy developed by Francine Shapiro that emphasizes disturbing memories as the cause of psychopathology. It is used to help with the symptoms of post traumatic stress disorder (PTSD). According to Shapiro, when a traumatic or distressing experience occurs, it may overwhelm normal coping mechanisms. The memory and associated stimuli are inadequately processed and stored in an isolated memory network.
The goal of EMDR Therapy PTSD is to reduce the long-lasting effects of distressing memories by developing more adaptive coping mechanisms. The therapy uses an eight-phase approach that includes having the patient recall distressing images while receiving one of several types of bilateral sensory input, such as side to side eye movements. EMDR was originally developed to treat adults with PTSD; however, it is also used to treat other conditions and children.
In 1999, EMDR was a controversial therapy within the psychological community, and in 2000, its efficacy compared to other treatments and underlying mechanism was the subject of debate.However, since 2004, EMDR was recommended as an effective treatment for trauma in the Practice Guidelines of the American Psychiatric Association, the Departments of Veterans Affairs and Defense, SAMHSA, the International Society for Traumatic Stress Studies, and the World Health Organization.
EMDR therapy PTSD consists of eight phases and each phase has its precise intentions.
Phase I History and Treatment Planning
- The therapist conducts an initial evaluation of the client’s history and develops a general plan for treatment. This includes the problems which are the primary complaint of the client and a history of distressing memories which will become the targets for reprocessing.
Phase II Preparation
- The therapist helps the client develop ways to cope with distressing emotions so that they are able to calm down and help themselves in between therapy sessions. Commonly this is done with guided imagery or other relaxation techniques.
Phase III Assessment
- The therapist asks the client to visualize an image that represents the disturbing event. Along with it, the client describes a thought or negative cognition (NC) associated with the image. The client is asked to develop a positive cognition (PC) to be associated with the same image that is desired in place of the negative one. The client is asked how strongly he or she believes the PCs to be true using a 1-7 scale (completely false to completely true) called the Validity of Cognition (VOC) scale. The client is also asked to identify what emotions he or she feels. The client is then asked to rate his or her level of distress on a scale from 0-10, with 0 being no distress and 10 being the most distress they can imagine. This is the same as a Subjective Units of Distress scale (SUD) that is commonly used in cognitive behavioral therapy (CBT). Finally the client is asked to identify where in the body he or she is sensing the feelings.
Phase IV Desensitization
- During the reprocessing phases of EMDR therapy, the client focuses on the disturbing memory in multiple brief sets of about 15–30 seconds. Simultaneously, the client focuses on the dual attention stimulus, which consists of focusing on the trauma while the clinician initiates lateral eye movement or another stimulus such as a pulsing light held in each hand, or tapping on the knees. Following each set, the client is asked what associative information was elicited during the procedure. This new material usually becomes the focus of the next set or another aspect of the memory may be guided by the clinician. This process of personal association is repeated many times during the session. This process continues until the client no longer feels as distressed when thinking of the target memory.
Phase V Installation
- The therapist asks the client to focus on the event along with the PC developed in phase III. The client is asked to hold in mind the memory with the positive thought as the therapist continues with the bilateral stimulation. When the client feels he or she is certain the PC is fully believed and that belief is as strong as possible, the installation phase is complete.
Phase VI Body Scan
- At this phase the goal of the therapist is to identify any uncomfortable sensations that could be lingering in the body when thinking about the target memory and the PC. While thinking about the event and the positive belief the client is asked to scan over his or her body entirely, searching for tension, tightness or other unusual physical sensation. Any negative sensations are targeted and then diminished, using the same bilateral stimulation technique from phases IV and V. The PCs should be incorporated emotionally as well as intellectually. Phase VI is complete when the client is able to think and speak about the event along with the PC without feeling any physical or emotional discomfort.
Phase VII Closure
- Not all traumatic events will be resolved completely within one session. If the client is significantly distressed the therapist will guide the client through relaxation techniques that are designed to bring about emotional stability and tranquility. The client will also be asked to use these same techniques for experiences that might arise between sessions such as strong emotions, unwanted imagery, and negative thoughts. The client may be encouraged to keep a brief log of these experiences, allowing for easy recall and processing during the next session.
Phase VIII Reevaluation
With every new session, the therapist will reevaluate the work done in the prior session. The therapist will also assess how well the client managed on his or her own in between visits. At this point, the therapist will decide whether it is best to continue working on previous targets or continue to newer ones.
Wikipedia contributors. “Eye movement desensitization and reprocessing.” Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 6 Sep. 2015. Web. 6 Sep. 2015.