La thérapie EMDR en contexte interculturel

Abstract

IntroductionEye movement desensitisation and reprocessing (EMDR) therapy represents a significant progress in the treatment of post-traumatic disorders. Since the creation of EMDR in 1989 in the United States, in the cultural context of the Western world, its practice has spread to other cultures for the treatment of migrant and refugee populations and within humanitarian projects abroad. ObjectiveThe issue raised is that of the extent to which EMDR may be “transported” and adapted to non-Western cultures. The associated challenges must be assessed and fully comprehended—since psychological trauma is a global burden, efficient solutions should be built that are adaptable to various cultural contexts, to limit the adverse effects of trauma on health. MethodThe author reviews the questions raised by focusing on 3 types of studies. After an overview of current clinical practices that have merged from EMDR humanitarian efforts across the world, general factors that are crucial to intercultural clinical situations are presented. Adaptations to the 8 phases of the protocol, as applied by Western EMDR clinicians in intercultural contexts and by non-Western EMDR clinicians, are then presented. ResultsOutcomes in humanitarian situations underscore the remarkable adaptability of EMDR therapy, based on the swiftness and ease of its implementation and its non-intrusive nature. Some of the factors that are crucial to the intercultural context already appear to have been integrated to the specific approach of EMDR clinicians in the field, which invite the co-construction, with the individual, of a therapeutic framework that focuses explicitly on the traumatic events that will be processed, while building on and prioritising their cultural resources. The administration of the protocol is flexible enough to enable the unfolding of relevant cultural adaptations. DiscussionThe structured consideration of cultural factors in the diagnosis should be included more systematically, as should the community dimension in the impact of trauma. Key points concern the necessity of defining a more structured manner of adapting the protocol and the development of various educational formats for training local therapists in EMDR. ConclusionEMDR therapy shows excellent potential for being adapted to intercultural contexts. These outcomes need to be consolidated, extended, and enriched by research on the relevance of a systematic inclusion of cultural factors for diagnosis and treatment as well as in training programmes.