Abstract
Literature points to cognitive-behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR) as evidence-based therapies for trauma-related disorders. Treatments are typically administered in a vis-à-vis setting with patients reporting symptoms of a previously experienced trauma. Conversely, online-therapies and ongoing trauma have not received adequate attention. This study aimed to compare the efficacy of two brief treatments for health professionals and individuals suffering from the circumstances imposed by the coronavirus disease 2019 (COVID-19) pandemic. The EMDR and the trauma focused-CBT were administered online during the earliest stage of distress to manage the ongoing trauma associated to quarantine or disease. Thirty-eight patients satisfying the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for acute stress disorder were randomly assigned to the EMDR or CBT treatment. Both groups received a 7-session therapy, and psychometric tests were administered before, after the treatment and at one-month follow-up to assess traumatic symptoms, depression and anxiety. Results revealed that both treatments reduced anxiety by 30%, and traumatic and depressive symptoms by 55%. Present findings indicate the internet-based EMDR and CBT as equally effective brief treatments, also suggesting a maintenance of the effects as indicated by the follow-up evaluation. The EMDR and CBT might be considered as first line therapies to treat the ongoing trauma and to prevent the sensitization and accumulation of trauma memories.
Highlights
In the last few decades, an extensive literature has recommended eye movement desensitization and reprocessing (EMDR) therapy as a psychotherapeutic intervention for anxiety disorders
EMDR is mostly provided for post-traumatic stress disorder (PTSD; see [4] for a review), for which the trauma-focused cognitive-behavioural therapy (TF-CBT) has been proven to be a first-line treatment as well [5]
It is noteworthy that a few recent meta-analyses have directly addressed this issue suggesting that TF-CBT produces the strongest evidence for recent trauma [13], while CBT and EMDR are efficacious for PTSD [14,15] and complex PTSD symptoms in the adult population [16]
Summary
In the last few decades, an extensive literature has recommended eye movement desensitization and reprocessing (EMDR) therapy as a psychotherapeutic intervention for anxiety disorders (for reviews see [1,2,3]). EMDR is mostly provided for post-traumatic stress disorder (PTSD; see [4] for a review), for which the trauma-focused cognitive-behavioural therapy (TF-CBT) has been proven to be a first-line treatment as well [5]. It needs to be recognized that ongoing trauma could sometimes hinder patients’ access to care making the psychotherapeutic intervention even more problematic. In such situations, internet-based therapies might reflect the only way to treat trauma-exposed patients: this was the case of the strict Italian lockdown during the initial and more dramatic phase of the coronavirus disease 2019 (COVID-19) pandemic. As for the online modality, it is worth noting that an extensive meta-analysis revealed that its effectiveness is quite similar to traditional face-to-face psychological interventions [26]
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