EMDR & CBT work equally well for psychological trauma – Why?

The use of EMDR, CBT or a combination of the two, in managing psychological ill health following road Traffic Accidents (RTA): The Results and analysis of 1100 consecutive referrals. This paper determines the role of trauma-focused psychological treatment in the management of psychological ill health following road traffic accidents in the UK. RTA’s are the biggest cause of PTSD in this country. All consecutively referred patients with possible psychological ill-health following a RTA were offered a comprehensive psychological assessment by an established provider of trauma services in the UK. Those with significant psychological ill health were offered trauma-focused psychological treatment, EMDR and/or CBT, in line with NICE (National Institute for Health and Clinical Excellence) guidelines. During the psychological assessment a clinical diagnosis was made and a number of psychometric scores were used. These comprised 1 DSM IV criteria for PTSD and illness severity, 2 General Health Questionnaire, 3 Impact of Event Scale, 4 Hospital Anxiety and Depression Scale. Similar subjective and objective measurements were made after every fourth session of therapy and on discharge. The results offer a breakdown of diagnoses, the number of patients who proceeded to treatment and the type of treatment and outcome of such treatment. Of the 658 patients who proceeded to Trauma-focused psychological treatment, patients had either EMDR by itself (31%), CBT by itself (36%) or a Combination of EMDR and CBT (33%). Subjectively and objectively three out of four patients were completely relieved of their symptoms or were much better. There was no significant difference between CBT and EMDR in terms of treatment results. Closer analysis of the three subgroups revealed a number of variables which seemed to be associated with failure of EMDR treatment and failure of CBT treatment. These variables will be discussed against the background of the trauma focused CBT model of Clarke, D and Ehlers A, 2002. Recommendations will be made of ways to improve the outcome of EMDR Therapy and improving EMDR training.

Conference

English

Manda Holmshaw

Holmshaw, M. (2008, June). EMDR & CBT work equally well for psychological trauma - Why? Presentation at the 9th EMDR Europe Association Conference, London, England