Role of exposure in EMDR treatment of PTSD

A standard treatment for anxiety disorders involves exposing clients to anxiety eliciting stimuli. Some theorists have argued that exposure is an essential element in the successful treatment of post traumatic stress disorder (PTSD). Exposure therapy and Eye Movement Desensitization and Reprocessing (EMDR) are two therapeutic approaches that have been identified as efficacious in the treatment of PTSD. It has been proposed that exposure is the active element in all effective treatments for PTSD, including EMDR. This presentation will address various issues that should be considered in evaluating this proposal. Theories underlying exposure therapies will be summarized and differences between process and mechanism will be discussed. Brief overviews of EMDR and exposure therapies will be provided. Video clips of treatment sessions with exposure therapy and with EMDR will be shown, to illustrate the differences in treatment approaches, clinical focus, and client experience. Shared and unique components will be identified. The use of exposure in EMDR and its possible contribution to treatment outcome will be examined. Unlike prolonged exposure therapy, EMDR uses extremely brief repeated exposures (i.e., 20-50 seconds). Instead of continual and uninterrupted exposure, EMDR repeatedly interrupts the client's focus. Exposure therapy typically maintains a focus on the targeted incident, while EMDR uses a free association process to elicit other related material. Research has shown that high levels of anxiety during sessions of exposure therapy typically predict good outcome with that modality; however in successful EMDR treatment, the client's distress is substantially reduced during the session. Suggestions will be made for future research to identify and investigate mechanisms of action in exposure therapy and EMDR.

Conference

English

Smyth, N. (2003, August). Role of exposure in EMDR treatment of PTSD. Presentation at 111th American Psychological Association Annual Convention, Toronto, ON