Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes
Description
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories (Brown, Scheflin, & Hammond, 1998; Chu, 1998; Courtois, 1999; Hart, Nijenhius, Steele, 2006). Resource Development and Installation (RDI) has been described in a series of published case reports as an effective stabilizing intervention for adult survivors of adverse childhood experiences (Korn & Leeds, 2202; Leeds, 1997, 1998, 2001b; Leeds & Shapiro, 2000; Popky, 2005). These clinical case reports of RDI have been described observed decreases in intense shame, depersonalization, angry outbursts, self-injurious behaviors, compulsive eating, obsessive self-critical thoughts, persistent negative emotional states (misery), sexual acting out, and substance abuse. There are now several published procedural descriptions (Korn & Leeds, 2002; Leeds, 2001; Leeds & Shapiro, 2000) and a summary in the standard reference text on EMDR (Shapiro, 2001).
The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with post traumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been persistently offered RDI without being offered standard EMDR reprocessing. EMDR has been shown to produce stable, enduring treatment effects for symptoms of posttraumatic stress disorder. RDI has not. Until recently (Korn et al, 2004; Leeds, 2005, 2006; Shapiro, 2004) little attention has been given to assuring appropriate use and avoiding misuse of RDI. This presentation will describe serious clinical and professional issues in continuing to offer RDI over repeated treatment sessions to patients with posttraumatic stress syndromes who meet or achieve readiness criteria for standard EMDR reprocessing and in failing to offer or in excessively delaying EMDR reprocessing.
This presentation will clarify and review specific criteria for identifying: for which patients (1) and clinical situations (2) the use of RDI is indicated; for which patients and clinical situations (3) RDI should be offered cautiously, if at al, but alternate stabilization methods should be considered; and for which patients (4) RDI should not be offered but where standard EMDR processing should be offered without delay. An overview of RDI procedural steps will be presented (5) to clarify its clinical application. Strategies will be offered to address technical, clinical and countertransference issues that may b associated with misuse or excessive use of RDI. A series of ten clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with post traumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been persistently offered RDI without being offered standard EMDR reprocessing. EMDR has been shown to produce stable, enduring treatment effects for symptoms of posttraumatic stress disorder. RDI has not. Until recently (Korn et al, 2004; Leeds, 2005, 2006; Shapiro, 2004) little attention has been given to assuring appropriate use and avoiding misuse of RDI. This presentation will describe serious clinical and professional issues in continuing to offer RDI over repeated treatment sessions to patients with posttraumatic stress syndromes who meet or achieve readiness criteria for standard EMDR reprocessing and in failing to offer or in excessively delaying EMDR reprocessing.
This presentation will clarify and review specific criteria for identifying: for which patients (1) and clinical situations (2) the use of RDI is indicated; for which patients and clinical situations (3) RDI should be offered cautiously, if at al, but alternate stabilization methods should be considered; and for which patients (4) RDI should not be offered but where standard EMDR processing should be offered without delay. An overview of RDI procedural steps will be presented (5) to clarify its clinical application. Strategies will be offered to address technical, clinical and countertransference issues that may b associated with misuse or excessive use of RDI. A series of ten clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Format
Conference
Language
English
Original Work Citation
Leeds, A. M. (2007, June). Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes. Presentation at the 8th EMDR Europe Association Conference, Paris, France
Citation
“Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes,” Francine Shapiro Library, accessed May 2, 2024, https://francineshapirolibrary.omeka.net/items/show/18460.