Not Convincing Evidence. [Was: Re:EMDR v EXPOSURE]

Ricky:

It is a start, but only a start. The use of a WL control group for this purpose is wholey inadequate because it is entirely possible that the children who were "none-responders" to 4 sessions of CBT would have been responders to 8 sessions. There is published evidence of this with medication. Longborg et al. followed a group of people who had been treated with sertraline in a placebo controlled study. Everyone in the Longborg study had received sertraline during 12 weeks of the RCT and these people continued on sertraline for another 24 weeks. About 60% of the subjects were med responders during the initial 12-week phase. Over the course of the continuation phase, 92% of the initial responders remained responders (i.e., little relapse as long as the med was continued), and about 50% of the former non-reponders became responders.

Our Center now has similar data with CBT. It's not yet published, so I can't go into detail. In brief, we had a group of patients who showed limited benefits after 8 weeks of treatment. They were given an additional 4 weeks of treatment and showed as much improvement during the last 4 weeks as they had during the first 8 weeks. By the end, they had a good treatment response, it was just delayed.

Thus, to show that EMDR worked where CBT did not, they would have had to either show that EMDR was superior to CBT during the ealier treatment phase, OR they would have had to show the switching to EMDR was superior to continuing with CBT. They study did neither, so we can't draw and strong conclusions about whether EMDR worked where CBT failed.

Replies:

Not Convincing Evidence. [Was: Re:EMDR v EXPOSURE], by Ricky Greenwald, 04/23/03

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