The effectiveness of EMDR with adult female survivors of childhood sexual abuse

Abstract

A randomized experimental evaluation found support for the effectiveness of eye movement desensitization and reprocessing (EMDR)in reducing trauma symptoms among adult female survivors of childhood sexual abuse. Fifty-nine women were assigned randomly one of three groups: (1) individual EMDR treatment (six sessions); (2)routine individual treatment (six sessions); or(3) delayed treatment control group. A MANOVA was statistically significant at both posttest and follow-up. In univariate ANOVAs for each of four standardized outcome measures EMDR group members scored significantly better than controls at posttest. In a three-month follow-up, EMDR participants scored significantly better than routine individual treatment participants on two of the four measures, with large effect sizes suggestive of clinical significance. Key words: childhood sexual abuse; EMDR (eye movement desensitization and reprocessing); practice effectiveness; trauma This article reports the results of a randomized experimental evaluation of the effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse. These survivors, who suffer a variety of symptoms that are persistent and at times debilitating, comprise a large target population for social workers. Although the literature is replete with information on the prevalence and effects of childhood sexual abuse and on practice wisdom about its treatment, very little information is available that examines treatment efficacy. Numerous clinical accounts of treatment with adult survivors of childhood sexual abuse have been published, but controlled treatment research rarely has been conducted with this population (Gordon & Alexander, 1993). Of the studies found that examine treatment efficacy exclusively with this population, none involved the use of random assignment (Alexander, Neimyer, Follette, Moore, & Hatter, 1989; Apolinsky & Wilcoxon, 1991; Jehu, 1988, 1989; Roberts & Lie, 1989). EMDR is a relatively new treatment approach that has from its beginning been fraught with controversy, largely because of its unusual use of eye movements and dramatic claims of rapid efficacy with severely traumatized individuals. According Shapiro (1995), EMDR is interactive, intrapsychic, cognitive, behavioral, body-oriented therapy whose goal is to rapidly metabolize the dysfunctional residue from the past and transform it into something useful (pp. 52-53). Given its claims of dramatic successes within relatively few treatment sessions in this era of managed care, given the promise of the early experimental studies of its effectiveness with traumatized individuals, and given its compatibility with existing practice wisdom about trauma work, testing the effectiveness of EMDR with adult survivors of childhood sexual abuse is both important and timely. EMDR consists of an eight-phase treatment approach accompanied by specific protocols for different treatment issues. The eight phases involve (1) obtaining a thorough client history and from that developing a sound treatment plan; (2) preparing the client for using EMDR; (3) assessing the target issue components be addressed; (4) desensitizing the target material with eye movements or an alternate form of stimulation; (5) installing the desired positive cognition; (6) conducting a body scan determine if any residual material from the target issue remains; (7) closure; and (8) re-evaluation (Shapiro, 1995). Phase three is particularly important in that it is when the components of the treatment target are identified. The components of the target include the presenting problem, the memory connected the presenting problem, a picture or image of the memory be held in mind (both the negative and desired positive self-assessments associated with the memory), the emotions connected the memory, as well as any accompanying physical sensations. …