EMDR FORUM ARCHIVE, 2000
Re: Research Standards
Sandra Paulsen Inobe PhD · 10/17/02 at 1:50 PM ET
Specious hardly. My point was not that adding an R to a name changes the protocol, rather that, and it was Ricky Greenwald's point initially, which I endorse, that it belies the fact that the current research protocol was not used. It is the standard of research to do a lit search, right? and take adopt in ones research a design that takes into account the results of that research. In no way does it make sense to base a research design on an article from 15 years ago when there have been dozens of studies and two books and calls for a standard of research since that time. EMDR research should meet those standards. From Shapiro's 2nd edition: Suggested Criteria for Clinical Outcome Research, which draws upon Foa and Meadows, among others: 1) clearly defined target symptoms, 2) reliable and valid measures, 3) blind evaluators, 4) assessor training with interrater reliability, 5) manualized, replicable, specific treatment programs, 6) random or unbiased assignment to treatment, and 7) treatment adherence. Also, 8) no confounding concurrent treatment,2) multimodal measures, 3) an adequate course of treatment. Shapiro adds the following: 1) researchers should be trained int he entire approach being evaluated and should implement the protocols actually used in clinical practice (fidelity checks),2) the researcher's competence with the procedure should be assessed in regard to an agreed upon standard, such as that used to assess the application of cognitive behavioral therapy to depression. Clearly, methods used incorrectly or incompetently by researchers contribute little or nothing to the knowledge base and can lead to false conclusions. I'm going to continue this piece from Shapiro's book in an additional postingn, and continue below with my own thoughts. With clinical research it is a commonly reported phenomenon that the originator of a procedure underestimated how much s/he was actually doing in addition to what s/he originally thought was necessary. Both Novaca and Wolpe, as I recall, made comments about how they wish they had required more training instead of assuming a procedure could be just published in an article and then faithfully replicated for subsequent research. The original EMD article did not include everything that is currently done. I'll repeat my main point though which you didn't address, namely that there needs to be a dose/response sensibility in the research. Any study purporting to test EMDR has to either measure pre and post EMDR on a specific trauma only, that EMDR addressed, or has to provide sufficient dosage to address multiple traumas, which may require not only multiple EMDR sessions but also other ego strengthening procedures. You also didn't address my point about dosage in terms of length of sessions. 45 minute sessions are not enough - that's like filling half a cavity. A single 90 minute session is often enough to address a single trauma - but it isn't enough to address a PTSD condition if that condition is related to multiple traumas.
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