Abstract
Although low self-esteem has been found to be an important factor in the development and maintenance of psychopathology, surprisingly little is known about its treatment. This study investigated the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy and Cognitive Behavioural Therapy (CBT), regarding their capacities in enhancing self-esteem in a general psychiatric secondary health care population. A randomized controlled trial with two parallel groups was used. Participants were randomly allocated to either 10 weekly sessions of EMDR (n = 15) or CBT (n = 15). They were assessed pre-treatment, after each session, post treatment and at 3 months follow-up on self-esteem (Rosenberg Self-esteem Scale and Credibility of Core Beliefs), psychological symptoms (Brief Symptom Inventory), social anxiety, and social interaction (Inventory of Interpersonal Situations) (IIS). The data were analyzed using repeated measures ANOVA for the complete cases (n = 19) and intention-to-treat (n = 30) to examine differences over time and between conditions. Both groups, EMDR as well as CBT, showed significant improvements on self-esteem, increasing two standard deviations on the main parameter (RSES). Furthermore, the results showed significant reductions in general psychiatric symptoms. The effects were maintained at 3 months follow-up. No between-group differences could be detected. Although the small sample requires to exercise caution in the interpretation of the findings, the results suggest that, when offering an adequate number of sessions, both EMDR and CBT have the potential to be effective treatments for patients with low self-esteem and a wide range of comorbid psychiatric conditions. This study was registered at www.trialregister.nl with identifier NTR4611.
Highlights
Self-esteem has been defined as a person’s overall evaluation of his or her own worth (Hewitt, 2009)
Low self-esteem is involved in a wide range of psychiatric conditions, including depression (Brown et al, 1990), anxiety disorders (Sowislo and Orth, 2013), personality disorders (Lynum et al, 2008) obsessive compulsive disorder (Ehntholt et al, 1999), eating disorders (Gual et al, 2002), chronic pain (Soares and Grossi, 2000), substance abuse (Silverstone and Salsali, 2003), The Effect of Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavioural Therapy (CBT) on Low Self-esteem and psychosis (Barrowclough et al, 2003)
The results of the present study suggest that both EMDR therapy and CBT have the potential to be an effective treatment alternative for patients who suffer from low self-esteem in cooccurrence with a wide range of psychiatric disorders
Summary
Self-esteem has been defined as a person’s overall evaluation of his or her own worth (Hewitt, 2009). Over the past several years a variety of therapeutic interventions has been developed for changing low self-esteem, predominantly with a cognitive behavioral background. Another study found a positive effect of CBT being significantly more effective in changing self-esteem in comparison to a waitlist control condition (Waite et al, 2012). Some studies have addressed the effectiveness of group CBT on individuals’ selfesteem, mostly using protocols designed by Fennell (1998), showing significantly positive treatment effects, including a reduction of symptoms of depression and anxiety (Rigby and Waite, 2006; Morton et al, 2012; Pack and Condren, 2014). Research far found support for the effectiveness of CBT for individuals suffering from low self-esteem
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