EMDR FORUM ARCHIVE, 2000
Re:Exposure Therapy better than EMDR for PTSD
Ricky Greenwald · 04/21/03 at 9:31 ET
Landry wrote in part, "But you do do your best to defend EMDR in light of this study" EMDR did rather well in this study. Effect size of 2.41 for EMDR, compared to 2.54 for exposure, and 1.66 for relaxation. This with an hour/day of homework for the Exposure for the Relaxation conditions, and none for EMDR. What is striking to me in this study is how well Exposure and Relaxation did, not how poorly EMDR did. PE did "win" this time, but the differences were not great. I wouldn't make too much of it, just as I haven't made too much of it when EMDR has "won" by a similarly small margin. Landry: "Your only real defense here is that not all studies have reached these conclusions. But this is weak at best as you gloss over a very important point: not all studies are created equal. This is one of the most solid RCTs done to date, that has the advantange of including vocal EMDR proponents, and completely fails to support the "evidence" from less rigorous studies and those from folks who have a strong conflict of interest. For example, compare the methodology of this study to the ones that you co-authored that support EMDR and you will find a marked discrepancy." The Lee et al study (that I co-authored) has excellent methodology, as do the Power et al, McGoldrick et al, and Ironson et al studies. Vaughan et al isn't so bad either. These are all controlled comparison studies with most of the bells and whistles, most of the Foa & Meadows "gold standards." All favor EMDR, though not by a lot, so it's no big deal. Like I said, neither treatment has won yet. Incidentally, I think it's wise to be careful about these "conflict of interest" comments, they risk being uninformed and appearing self-serving. On the one hand, you may be unaware that many of those who report data favorable to EMDR did not wish to do so, and in fact had a vested interest in the competing treatment (or still do). On the other hand, you may be unaware of the prevalence of scholars with a bias (conflict of interest?) against EMDR and how they have influenced decisions on publication, funding, and provision of services. I have even heard of investigators (yes, plural) refusing to report data that could make EMDR look better (I am not in a position to disclose details on these, sorry). I am not suggesting that those reporting data that favors EMDR are conflict-free; only that it would be naive to assume that so-called EMDR proponents have sole ownership of this problem. I would support a discussion on the merits of the Taylor et al study as well as the others. For example, anyone have an idea why the exposure treatment did so well here? A very large effect size, compared to other studies. The sample wasn't an easy one, participants often had multiple trauma histories. I wonder what they did to make the PE treatment work so well?
Replies:
|
| Behavior OnLine Home Page | Disclaimer |
Copyright © 1996-2004 Behavior OnLine, Inc. All rights reserved.
