Adaptations culturelles du protocole EMDR standard dans cinq pays d'AfriqueCultural adaptations of the standard EMDR protocol in five African countries
Description
Depuis 2007, des professionnels de santé mentale en Afrique sub-saharienne ont été formés à la thérapie de désensibilisation et de retraitement par les mouvements oculaires (EMDR). Cette étude qualitative a recouru à un dispositif afrocentré avec analyse thématique pour explorer les adaptations apportées au protocole standard EMDR, visant à le rendre culturellement pertinent pour des patients africains. Les participants étaient 25 thérapeutes EMDR (dont trois hommes, tranche d’âge 32-60 ans, x = 44) de cinq pays africains, qui pratiquaient l’EMDR depuis 1 à 11 ans (x = 7). Tous ont répondu à un questionnaire d’enquête, huit ont participé à une discussion de groupe, et deux ont fourni une analyse de notes de supervision. Les participants estimaient que l’EMDR était une thérapie utile et bénéfique et la préféraient aux autres thérapies en raison de sa nature non narrative et de ses résultats rapides. Nous avons identifié quatre domaines dans lesquels les thérapeutes africains ont régulièrement adapté le protocole standard : la formulation du texte du protocole, l’expression culturelle des pensées et des émotions, le choix des stimulations et la simplification des échelles quantitatives. Sur la base des résultats de cette étude, nous formulons de nombreuses recommandations pour des adaptations culturelles du protocole EMDR. Celles-ci comprennent des changements de langage pour prendre en compte la communication « orientée vers le nous » des patients ; des interprétations culturelles des pensées et des événements positifs et négatifs ; l’ajout d’activités culturelles telles que la danse, la musique et les pratiques religieuses comme exercices de ressourcement ; l’utilisation de gestes des mains ou de l’échelle picturale avec des visages au lieu d’échelles numériques ; et l’utilisation de tapotements pour les stimulations bilatérales au lieu de mouvements oculaires, parfois considérés comme de la « sorcellerie ». Nous abordons la pertinence de ces résultats pour la pratique et la formation EMDR. Nous recommandons aux chercheurs africains d’étudier plus avant l’acceptabilité, l’utilisation et l’efficacité de l’EMDR dans leur pays.
Since 2007, mental health workers in sub-Saharan Africa have been trained in eye movement desensitization and reprocessing (EMDR) therapy. This qualitative study used an Afrocentric design with thematic analysis to investigate adaptations to the EMDR standard protocol that make it culturally relevant for African clients. Participants were 25 EMDR therapists (three male, age range 32–60 years, x̄ = 44) from five African countries, who practiced EMDR for 1–11 years (x̄ = 7). All answered a survey questionnaire, eight participated in a focus group discussion, and two provided a supervision notes analysis. Participants found EMDR a useful and beneficial therapy and preferred it over other therapies because of its nonnarrative nature and quick results. We identified four areas in which African therapists consistently made adaptations to the standard protocol: wording of the protocol text, cultural expression of thoughts and emotions, stimulation choice, and simplification of quantitative scales. Based on the study results, we make numerous recommendations for cultural adaptions to the EMDR protocol. These include language changes to take into account the clients’ “we oriented” communication; cultural interpretations of positive and negative thoughts and events; adding cultural activities such as dance, music, and religious practices as resourcing exercises; using hand gestures or the pictorial faces scale instead of ordinal scales; and using tapping for bilateral stimulation instead of eye movements, which were sometimes seen as “witchcraft.” The relevance of the findings for EMDR practice and training are discussed. We recommend that African researchers further study the acceptability, use, and effectiveness of EMDR in their countries.
Since 2007, mental health workers in sub-Saharan Africa have been trained in eye movement desensitization and reprocessing (EMDR) therapy. This qualitative study used an Afrocentric design with thematic analysis to investigate adaptations to the EMDR standard protocol that make it culturally relevant for African clients. Participants were 25 EMDR therapists (three male, age range 32–60 years, x̄ = 44) from five African countries, who practiced EMDR for 1–11 years (x̄ = 7). All answered a survey questionnaire, eight participated in a focus group discussion, and two provided a supervision notes analysis. Participants found EMDR a useful and beneficial therapy and preferred it over other therapies because of its nonnarrative nature and quick results. We identified four areas in which African therapists consistently made adaptations to the standard protocol: wording of the protocol text, cultural expression of thoughts and emotions, stimulation choice, and simplification of quantitative scales. Based on the study results, we make numerous recommendations for cultural adaptions to the EMDR protocol. These include language changes to take into account the clients’ “we oriented” communication; cultural interpretations of positive and negative thoughts and events; adding cultural activities such as dance, music, and religious practices as resourcing exercises; using hand gestures or the pictorial faces scale instead of ordinal scales; and using tapping for bilateral stimulation instead of eye movements, which were sometimes seen as “witchcraft.” The relevance of the findings for EMDR practice and training are discussed. We recommend that African researchers further study the acceptability, use, and effectiveness of EMDR in their countries.
Format
Journal
Language
French
Original Work Citation
Bannink, F., Dewailly, A., Admasu, K., Wamala, K., Vera, A., Bwesigye, D., & Roth, G. (2023). [Cultural adaptations of the standard EMDR protocol in five African countries]. Journal of EMDR Practice and Research, 17(2), e1121-e138. doi: 10.1891/EMDR-2022-0062. French
Citation
“Adaptations culturelles du protocole EMDR standard dans cinq pays d'AfriqueCultural adaptations of the standard EMDR protocol in five African countries,” Francine Shapiro Library, accessed May 7, 2024, https://francineshapirolibrary.omeka.net/items/show/28361.