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Eye Movement Desensitization and Reprocessing – EMDRA Brief Description of EMDR Eye Movement Desensitization and Reprocessing (EMDR) integrate elements of several forms of effective psychotherapies in structured protocols in order to maximize the effects of treatment. Some of the therapies that may be used in building this structure are psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies. Eye Movement Desensitization and Reprocessing is considered an information processing therapy and uses an eight-phase approach. With EMDR, the client focuses simultaneously on past and present experiences in sequential doses and on an external stimulus. The client is then instructed to allow this new material to become the focus of the next set of dual attention. The sequence of dual attention and personal association is repeated many times throughout the EMDR session. Eight Phases of Treatment PHASE 1 The first phase of treatment is a history taking session where the therapist assesses the client’s readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for Eye Movement Desensitization and Reprocessing processing. This information might include recent distressing situations, current situations which result in emotional disturbances, related incidents of a historical nature, and the development of specific skills and behaviors the client will need in handling future situations. PHASE 2 During the second phase of treatment, the therapist will assure that the client has adequate means for handling emotional distress and coping skills for those situations. In addition, during this phase the therapist will ensure that the client is in a reasonably stable state. If it is determined, that further stabilization is needed or additional skills are necessary, the therapy will focus on providing those. The client will then be able to use stress-reducing techniques both during and in between sessions as needed with the goal being to elimination of this need once therapy is completed. PHASE 3 THROUGH PHASE 6 In phases three through six, using Eye Movement Desensitization and Reprocessing procedures, a target is identified and processed. This requires the client to identify the most vivid visual image related to the memory, something negative about himself or herself, related emotions, and sensations of the body. The client will also be asked to identify a favorite positive belief he has with the validity of this positive belief being rated along with the intensity of the negative belief. The client is then instructed to focus his attention on the image, negative thought, and body sensations while at the same time moving his or her eyes back and forth in order to follow the therapists’ fingers that will be moving across his or her field of vision for 20-30 seconds dependent upon the need of the client. These eye movements are the most commonly used external stimulus used, but they are not the only ones that therapists use. Other possibilities include auditory tones, tapping, or any other type of tactile stimulation. There is no set length of kind of dual attention used, but rather these items are customized to the needs of each client. The client is told nothing more than to just notice whatever happens. The clinician then instructs the client to let his or her mind go blank and to notice whatever comes to mind. Based on the information given by the client, the clinician will make a decision concerning the next focus of attention. A client directed association process is encouraged in most cases and is repeated numerous times throughout the session. Should the client become distressed or have difficult with the process, the therapist will initiate established procedures in order to help the client resume processing. When the client reaches the point where he reports no distress related to the targeted memory, he is asked to think of the positive belief that was identified at the beginning of the session and to focus on that while at the same time engaging in the eye movements. Increased confidence in the positive belief is usually reported after several sets, which tends to be further enhanced as the session continues. PHASE 7 In phase seven, which is the closure, the therapist requests that the client keep a journal during the week. The purpose of this is to document any related material that may come to mind and to remind the client of activities that were mastered in phase two such as self-calming techniques. PHASE 8 Phase eight is actually the start of the next session, which is a re-evaluation of the previous work and any progress that has been made since the previous session. EMDR treatment ensures processing of all related events and other incidents that will require different responses. The goal with this type of treatment is to produce the most comprehensive treatment effects in the shortest period while at the same time maintaining a stable client. After EMDR processing, clients usually report the elimination or large decrease in the emotional distress that was related to the memory. |
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