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Psychological treatment for social anxiety disorder (SAD) has been found to be less effective than for other anxiety disorders. Targeting the vivid and distressing negative mental images typically experienced by individuals with social anxiety could possibly enhance treatment effectiveness. To provide both clinicians and researchers with an overview of current applications, this systematic review and meta‐analysis aimed to evaluate the possibilities and effects of imagery‐based interventions that explicitly target negative images in (sub)clinical social anxiety. Based on a prespecified literature search, we included 21 studies, of which 12 studies included individuals with a clinical diagnosis of SAD. Imagery interventions (k = 28 intervention groups; only in adults) generally lasted one or two sessions and mostly used imagery rescripting with negative memories. Others used eye movement desensitization and reprocessing and imagery exposure with diverse intrusive images. Noncontrolled effects on social anxiety, imagery distress and imagery vividness were mostly large or medium. Meta‐analyses with studies with control groups resulted in significant medium controlled effects on social anxiety (d = −0.50, k = 10) and imagery distress (d = −0.64, k = 8) and a nonsignificant effect on imagery vividness. Significant controlled effects were most evident in individuals with clinically diagnosed versus subclinical social anxiety. Overall, findings suggest promising effects of sessions targeting negative mental images. Limitations of the included studies and the analyses need to be considered. Future research should examine the addition to current SAD treatments and determine the relevance of specific imagery interventions. Studies involving children and adolescents are warranted. [ABSTRACT FROM AUTHOR]

Healthcare workers exposed to emergencies and chronic stressors are at high risk of developing mental health problems. This review synthesized existing studies of group psychological therapy to reduce distress symptoms in healthcare workers (i.e., as complex and heterogeneous emotional states, characterized by the presence of symptoms associated with post‐traumatic stress disorder, burnout, anxiety, depression and moral injury). Searches were conducted using PRISMA guidelines and databases such as PubMed, PsycINFO, Medline and Web of Science, along with manual searches of reference lists of relevant articles. The search returned a total of 1071 randomized trials, of which 23 met the inclusion criteria. Of the total studies, nine were mindfulness interventions, seven were cognitive behavioural programmes, one was a programme based on acceptance and commitment therapy, one was an EMDR protocol and two focused on systemic and art therapy. Most studies aimed to reduce burnout, anxiety and depression; only three focused on post‐traumatic stress disorder, and no studies were found that addressed moral injury. The results suggested that group interventions could be an effective tool to improve the mental health of healthcare workers and reduce their symptoms of distress, although many of the studies have methodological deficiencies. Limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Sudden gains, defined as large and stable improvements in symptom severity during psychological treatment, have consistently been found to be associated with better outcomes across treatments and diagnoses. Yet, insights on coherent predictors of sudden gains and on emotional changes around sudden gains in post‐traumatic stress disorder (PTSD) are lacking. We aimed at replicating a measure of intraindividual variability as a predictor for sudden gains and testing its independence from change during treatment. Furthermore, we expected changes in emotions of guilt, shame and disgust prior to sudden gains to predict sudden gains. Data from a pre‐registered randomized controlled trial (RCT) of eye‐movement desensitization and reprocessing (emdr) and Imagery Rescripting (ImRs) for PTSD in 155 adult survivors of childhood abuse were used. Intraindividual variability of PTSD symptoms in both treatments did not predict sudden gains status and was not independent of change during treatment. In the EMDR condition, levels of shame during treatment predicted sudden gains and shame decreased shortly before a sudden gain in both treatments. Reductions in all emotions during sudden gains were significantly higher for participants with sudden gains than for comparable intervals in non‐sudden gainers. Our findings do not support the predictive validity of intraindividual variability for sudden gains. The decrease of guilt, shame and disgust during sudden gains warrants further research on their role as a mechanism of treatment change for PTSD. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic, which has affected a significant number of individuals worldwide, is generating serious mental health issues. Recovered COVID‐19 patients have experienced traumatic events related to their symptoms, isolation, possible hospitalization, bereavement, fear of infecting loved ones and the physical consequences of COVID‐19. One effective psychological treatment for these patients is Eye Movement Desensitization and Reprocessing (EMDR). The aim of this paper is to describe the therapeutic intervention and effects of EMDR in a pool of COVID‐19 survivors referred to an integrated psychological/psychiatric outpatient service. Twelve patients, comprising of nine males and three females, underwent EMDR psychotherapy from October 2020 to February 2022. Each patient received 8–16 weekly treatment sessions. The standard EMDR protocol of eight stages was administered to enable desensitization and reprocessing of four main targets: first positive swab, hospitalization, isolation and fear for relatives' health. Efficacy of EMDR was demonstrated by the significant improvement at clinical scale for subjective distress caused by traumatic events. For the therapists, carrying out these treatments was an intense and challenging experience. In fact, the perceived distance between therapist and patient was less defined than in other hospital settings because the pandemic affects everyone equally. However, with the widespread availability of vaccines and although the pandemic is still ongoing with the emergence of new variants, a window of improvement in the mental health landscape is starting to open up. [ABSTRACT FROM AUTHOR]

This review systematically synthesized existing literature on group protocols of eye movement desensitization and reprocessing (EMDR) therapy for treating a range of mental health difficulties in adults and children. We conducted database searches on PsychINFO, EMBASE, MEDLINE, Web of Science, The Cochrane Library and Francine Shapiro Library up to May 2020, using PRISMA guidelines. Studies were included if they used at least one standardized outcome measure, if they present a quantitative data on the effect of group EMDR protocols on mental health difficulties and if they were published in English. Twenty‐two studies with 1739 participants were included. Thirteen studies examined EMDR Integrative Group Treatment Protocol (IGTP), four studies examined EMDR Group Traumatic Episode Protocol (G‐TEP), four studies EMDR Integrative Group Treatment Protocol for Ongoing Traumatic Stress and one study considered EMDR Group Protocol with Children. Of the 22 studies included, 12 were one‐arm trials and 10 were two‐arm trials. We assessed risk of bias using a revised Tool to Assess Risk of Bias in Randomized Trials (ROB 2) and Risk of Bias in Nonrandomized Studies of Interventions (ROBINS‐I). Overall, the results suggested that Group EMDR protocols might be an effective tool in improving a wide range of mental health‐related outcomes including posttraumatic stress disorder (PTSD), depression and anxiety. However, the included studies are limited to methodological challenges. The limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Homicidally bereaved individuals may experience symptoms of Complicated Grief (CG) and Posttraumatic Stress Disorder (PTSD). This Randomized Controlled Trial examined the effectiveness of an 8‐session treatment encompassing Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) to reduce self‐rated CG and PTSD symptoms in 85 Dutch adult homicidally bereaved men and women. We compared changes in symptoms of CG (assessed using the Inventory of Complicated Grief) and PTSD (assessed using the Impact of Event Scale) between an intervention group and a waitlist control group. The treatment was effective in reducing CG and PTSD symptoms, from pretreatment to posttreatment. It can be concluded that EMDR and CBT seem promising treatments for homicidally bereaved individuals for both men and women, and regardless of the time since the loss. Further research is needed to examine whether a combined treatment of EMDR and CBT together is of added value in situations where grief and trauma are intertwined over offering only one of the two treatment modalities. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive–compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention. Method: This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale‐Brown obsessive–compulsive scale was completed at baseline, after treatment and at 6 months follow‐up. Treatment completion and response rates were compared using chi‐square tests. Effect size was examined using Cohen's d and multilevel modelling. Results: Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale‐Brown obsessive–compulsive scale severity post‐treatment (d = −0.24, p = .38) or at 6 months follow‐up (d = −0.03, p = .90). Conclusions: EMDR and CBT had comparable completion rates and clinical outcomes. [ABSTRACT FROM AUTHOR]

Despite its prevalence and potential impact on functioning, there are surprisingly little data regarding the treatment responsiveness of travel phobia. The purpose of this non-randomized study was to evaluate the usefulness of a trauma-focused treatment approach for travel phobia, or milder travel anxiety arising as a result of a road traffic accident. Trauma-focused Cognitive Behavioural Therapy (TF-CBT), and Eye Movement Desensitization and Reprocessing were used to treat a sample of 184 patients, who were referred to a psychological rehabilitation provider. Patients in both treatment groups were encouraged to encounter their feared objects and situations between sessions. Specific (i.e., travel) phobia was diagnosed in 57% of cases. Patients in both treatment conditions showed equally large, and clinically significant, decreases in symptoms as indexed by three validated measures (Impact of Event Scale, Hospital Anxiety and Depression Scale, and General Health Questionnaire), therapist ratings of treatment outcome, and a return to driving or travelling by car or motorbike. These improvements were obtained within an average course of 7.3 sessions of 1 hour each. Patients with travel phobia responded with a greater reduction of anxiety and post-traumatic stress disorder symptoms than those with milder travel anxiety. Passengers reported higher levels of trauma symptoms than drivers, but no difference in effectiveness of treatment was found between these groups. The results suggest that trauma-focused psychological interventions can be a treatment alternative for patients with travel anxiety. Given the seriousness of the clinical problems related to road traffic accidents more rigorous outcome research is warranted and needed. Copyright © 2010 John Wiley & Sons, Ltd. • As the literature on the treatment of travel phobia is largely limited to small-n studies, this is the largest naturalistic outcome study of the treatment of patients with fear and avoidance of travel, subsequent to a traumatic event, to date. • Travel phobia following road traffic accidents should be regarded as a treatable psychological condition requiring a limited number of sessions. In a significant minority of cases the condition is unlikely to remit spontaneously, potentially disrupting occupational, social and personal adjustment. • Besides a purely exposure, in vivo-based approach, a mainly trauma-focused approach, such as imagery exposure or Eye Movement Desensitization and Reprocessing, can be an effective intervention for both travel phobia and milder forms of travel anxiety, and for both drivers and passengers. [ABSTRACT FROM AUTHOR]

Little is known about the types of mental health treatment that are most effective for psychogenic non-epileptic seizure (PNES) patients who have high rates of comorbid post-traumatic stress disorder (PTSD) and dissociation. Eye movement desensitization and reprocessing (EMDR) has proved to be effective in the treatment of PTSD, anxiety states, dissociative symptoms and somatoform disorders. This study, which utilized a non-controlled qualitative multiple revelatory case design, integrates EMDR into the psychological treatment of PNES patients with confirmed trauma experiences. With EMDR targeting trauma and dissociative symptoms in three patients, PNES were extinguished in two. Those patients have remained seizure-free for 12–18 months. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The task of this paper is to present a message of caution regarding the overgeneralized reliance on the NICE (2005) and CREST (2003) recommendations for the treatment of post-traumatic stress disorder (PTSD) in adults in the United Kingdom. The socio-political and ethnocultural context of Northern Ireland is used as a foundation to explore the generalizibility of guideline recommendations. It is argued that clinicians should be mindful of the degree to which they generalize from the recommendations of these guidelines to their clinical work because (1) questions regarding the heterogeneity of PTSD raise as yet unaddressed empirical questions about the generalizability of treatments to all PTSD presentations and (2) ethnocultural and socio-political factors have not yet played a dominant role in randomized outcome studies of treatment efficacy. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Very little is known about the mechanisms that underlie the therapeutic effectiveness of eye movement desensitization and reprocessing (EMDR). This study tested whether the content of participants' responses during EMDR is similar to that thought to be effective for traditional exposure treatments (reliving), or is more consistent with distancing, which would be expected given Shapiro's proposal of dual process of attention. The responses made by 44 participants with post-traumatic stress disorder (PTSD) were examined during their first EMDR treatment session. An independent rater coded these responses according to whether they were consistent with reliving, distancing or focusing on material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement on a measure of PTSD symptoms occurred when the participant processed the trauma in a more detached manner. Cross-lagged panel correlations suggest that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that covaried with improvement. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Fourteen randomly assigned Iranian girls ages 12–13 years who had been sexually abused received up to 12 sessions of CBT or EMDR treatment. Assessment of post-traumatic stress symptoms and problem behaviours was completed at pre-treatment and 2 weeks post-treatment. Both treatments showed large effect sizes on the post-traumatic symptom outcomes, and a medium effect size on the behaviour outcome, all statistically significant. A non-significant trend on self-reported post-traumatic stress symptoms favoured EMDR over CBT. Treatment efficiency was calculated by dividing change scores by number of sessions; EMDR was significantly more efficient, with large effect sizes on each outcome. Limitations include small N, single therapist for each treatment condition, no independent verification of treatment fidelity, and no long-term follow-up. These findings suggest that both CBT and EMDR can help girls to recover from the effects of sexual abuse, and that structured trauma treatments can be applied to children in Iran. Copyright © 2004 John Wiley & Sons, Ltd [ABSTRACT FROM AUTHOR]

A total of 105 patients with post-traumatic stress disorder (PTSD) were randomly allocated to eye-movement desensitization and reprocessing (EMDR) (n = 39) versus exposure plus cognitive restructuring (E + CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E + CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E + CR patients were also assessed by therapists at the mid-point of the 10-week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A) and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale was also used. Drop-out rates between the three groups were 12 EMDR, 16 E + CR and five WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction and group effects for all the above measures. In general there were significant and substantial pre–post reductions for EMDR and E + CR groups but no change for the WL patients. Both treatments were effective over WL. The only indication of superiority of either active treatment, in relation to measures of clinically significant change, was a greater reduction in patient self-reported depression ratings and improved social functioning for EMDR in comparison to E + CR at the end of the treatment period and for fewer number of treatment sessions for EMDR (mean 4.2) than E + CR (mean 6.4) patients. At 15 months follow-up treatment gains were generally well-maintained with the only difference, in favour of EMDR over E + CR, occurring in relation to assessor-rated levels of clinically significant change in depression. However, exclusion of patients who had subsequent treatment during the follow-up period diminished the proportion of patients achieving long-term clinically significant change. In summary, at end of treatment and at follow-up, both EMDR and E + CR are effective in the treatment of PTSD with only a slight advantage in favour of EMDR. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Eye movement desensitization and reprocessing therapy (EMDR) has increasingly been proposed as an effective therapeutic procedure for post-traumatic stress disorder and other mental health problems. However, views on EMDR in the research literature have been polarized. Reasons for this are explored as is the nature and theoretical basis of EMDR. Fifteen controlled studies thus far published on EMDR and PTSD are reviewed, and it is concluded that (i) EMDR is an effective psychotherapy, (ii) EMDR's relative efficacy in comparison to behavioural exposure therapies has yet to be established, (iii) the role of eye movements and laterality in attentional focus remains controversial and (iv) a direct link between the theoretical basis of the therapy and observable psychological and neurobiological changes has yet to be established. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Choking phobia is a specific phobia characterized by fear and avoidance of swallowing foods and liquids. It often develops following an episode of choking on food. A prospective case study of a 30-year-old woman with a phobia of choking, acquired after a series of traumatic incidents 5 years previously, demonstrates the usefulness of an approach that is aimed at processing the disturbing memories of a traumatic event. Two therapy sessions of Eye Movement Desensitization and Reprocessing (EMDR) produced a lasting decrease in symptomatology. Copyright © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Eye Movement Desensitization and Reprocessing is a new and controversial cognitive-behavioural treatment technique that combines cognitive processing and exposure methodology to treat conditioned emotional responding and other trauma-related symptoms. EMDR is controversial in part due to initial excessive claims by its originator, Francine Shapiro, and also because of what many believe to be Shapiro's proprietary emphasis in controlling who may use the technique with patients. In this paper our aim is to take an objective look at the process and effectiveness of this technique. The purpose here is to (1) offer a brief objective review of the outcome literature to date on EMDR; (2) present a short summary of results of an 'early look' at an ongoing controlled study of this method that we are presently conducting; (3) speculate on the merits of this approach based on both scientific and clinical experience with EMDR and (4) offer a brief description of the evolved process of EMDR along with a commentary on that process. [ABSTRACT FROM AUTHOR]