Re: Thank you Teresa!

The importance of critical thinking is undisputed.

Your citation of the evidence is extraordinarily one-sided and simply continues to spread misinformation. Specifically you are inaccurate in your statements regarding EMDR treatment outcomes as well as evidence regarding the bilateral stimulation:

1) In a comprehensive meta-analysis EMDR has been found to be equivalent in treatment effects to cognitive behavior therapy. However, treatment effects have taken only one third of the time. [Van Etten, M.L. & Taylor, S. (1998) Comparative efficacy of treatments for posttraumatic stress disorder: A meta-analysis. Clinical Psychology & Psychotherapy, 5, 126-144]

If you feel this is untrue: EMDR has numerous controlled and semi-controlled studies indicating remission of PTSD diagnosis in approximately 4.5 treatment hours. If you believe EMDR is simply cognitive behavior therapy: Please name one controlled study of exposure therapy that has produced an 84-100% treatment effect in 4.5 hours of therapy. Until you do that, please refrain from the misinformation that EMDR is simply warmed over CBT. In fact, according to strict exposure therapy terms EMDR should make people worse since it used interrupted exposure and free association.

2) The literature review you cite as "proving the eye movement superfluous" has already been rebutted. In fact, the evidence used against the eye movement in case studies actually unequivocally stated the opposite. If you haven't done so yet I suggest you read the following article which documents that 5 case studies cited in the Lohr et al. review against the eye movement actually stated just the opposite:

Lipke, H. (1999) Comments on "Thirty years of behavior therapy . . ." and the promis of the application of scientific principles. the Behavior Therapist, 22, 11-14.

3) The Lohr et al reviewers you cite have previously been refuted in the following article which documented 4 pages of errors in data citation. These citations of errors have never been corrected or challenged.

Shapiro, F. (1996). Errors of context and review of eye movement desensitization and reprocessing research. Journal of Behavior Therapy and Experimental Psychiatry, 27, 313-317.

4) EMDR is a complex intervention that includes bilateral stimulation. In fact, the Renfrey and Spates (1994) study you cited showed a marginally significant effect on rapidity of treatment with only 8 people to a cell. Component analysis is supposed to be conducted is with 35-50 people in a cell so this article actually has greater suppor for the eye movement than you conveyed. The following article speaks to the many problems with the component analysis research:

Shapiro, F. (1999) Eye movement desensitization and reprocessing (EMDR): Clinical and research implications of an integrated psychotherapy treatment. Journal of Anxiety Disorders, 13, 35-67.

5) You state that the better the study the worse the EMDR outcome. This is unequivocally inaccurate. Two meta-analysis have shown that the better the study, the better the EMDR outcome. One such review was presented last year at the Association for the Advancement of Behavior Therapy.

In sum, please refrain from disseminating misinformation on this list. When you can cite any published controlled research that has indicated imaginal exposure therapy to be 80% effective in 3 treatment sessions I will be happy listen. Until that time, please be more judicious in your statements. At this point, 85% success in PTSD diagnosis remission in 3 sessions is the hallmark of EMDR treatment in repeated studies. In fact, the only controlled research with imaginal plus in vivo exposure has needed 8-10 sessions and daily homework equating to 50-100 hours of exposure to obtain comparable results. For instance, the homework in addition to the 10 sessions was deemed necessary for treatment effects (Marks et al., 1998). All the peer reviewed controlled studies with imaginal exposure alone has never obtained more than a 50% success rate in PTSD remission. And again, if you care to respond, I would be interested in citation of any published controlled research to the contrary.

Replies:

the discussion continues, by Brian G., 2/15/00 Re: the discussion continues, by Sandra Paulsen, Ph.D., 2/16/00

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