Its efficacious -- but is it exposure or exposure plus?

Well, skepticism is a virtue, but don't miss the point of the article please. The article did NOT find that EMDR was not efficacious or valid, but rather, questioned whether it was different in efficacy from exposure treatment. That is, can the effect be explained by exposure alone, and is the bilateral stimulation necessary or irrelevant.

Let me repeat. This article found that EMDR is efficacious (as is exposure treatment). The article didn't find an effect for bilateral stimulation.

I'm still not done reading and studying the article and its methodology or limitations of same. However, a couple things stick out in my reading of the early pages.

The first is that the metaanalysis doesn't look at two important things that EMDR practitioners (if they used to do traditional exposure therapy) note on a daily basis, namely, that clients find EMDR more pallatable than exposure therapy. Exposure therapy is noxious, painful, and requires jump starting that is painful for all concerned. EMDR is easier on both client and therapist, because the bilateral stimulation seems to titrate the intensity of affect to a pallatable level. Therefore, clients don't drop out as much. This is a clinician impression, and few studies have looked at it. The ones that have, as I recall, find the drop out rate for EMDR to be less than the drop out rate for exposure therapy. In one study, the EMDR group had a higher drop out rate BEFORE treatment started, but that hardly counts against EMDR.

More later.....

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