Re:EMDR vs. Writing

I'm going to try and limit myself to three relatively brief points.

1. "Interested" raises the point of treatment fidelity. This is, of course, a very important issue. In order to have confidence in a set of results, we need to have confidence that the treatments were implemented as intended. One of the weaknesses of the EMDR vs. writing study is that the authors do not report on treatment fidelity. However, I disagree that this issue is of greater interest than the outcome question. Rather, treatment fidelity is an important consideration in the interpretation of the outcome, precisely because it is the outcome question we are most interested in answering. In other words, we are not interested in whether or not the treatment was administered properly, except to the extent that the treatment must have been implemented properly in order to have confidence in conclusions about which condition was better.

2. The comparison between EMDR and writing is most interesting to me because of claims by some supporters of EMDR about the uniqueness of EMDR in terms of its effectiveness and the mechanisms for its effectiveness. According to these claims, EMDR should be far more effective than writing. Yet, the evidence does not support this. Thus, this is another example of when EMDR did not outperform a comparison condition that, theoretically, is should have.

3. "Interested" makes the assumption that eye movements are an active ingredient of EMDR and that eye movements that occur during writing would serve the same function. Thus it would not be surprising that both treatments worked as they both included eye movements. The problem here is that there are no convincing evidence that eye movements play an important role in EMDR. Therefore, the observation of no difference between EMDR and writing cannot logically be interpreted to mean that eye movements are responsible for the improvement observed in both conditions. In fact, the design of this study cannot even rule out the possiblity that the improvements seen in both conditions are simply the result of repeated measurement (i.e., regression to the mean).

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