Primary, integrative, or adjunctive

• Various clinical applications by Francine Shapiro, 8/20/97
  
  

Perhaps I should clarify that the manner in which EMDR is used is based upon the specific complaint. For instance, EMDR is used as a primary treatment for some anxiety disorders, such as posttraumatic stress disorder and phobias. However, an integrative approach would be taken if it is applied to panic disorders or obsessive compulsive disorder. For specialty populations, EMDR must be combined with the traditional approaches. For instance, a clinician trained in EMDR should not then attempt to find and treat his or her first dissociative disordered client. There is a great deal of specialty knowledge necessary to deal with this population. The use of EMDR may accelerate the processing of the traumatic memories and may assist in resource development, but mapping the system and stability issues must be appropriately addressed.

Basically, every specialty population, such as veterans, sexual abuse victims, children, adolescents, substance abusers, etc., are best treated by clinicians knowledgeable in that area. EMDR is a comprehensive approach that integrates and incorporates aspects of most of the major modalities, but it always dovetails with clinical skill, and a comprehensive understanding of specific clinical populations. This holds true for the use of EMDR with personality disorders as well. As with any clinical method, EMDR should not be used unless a clinician feels comfortable with and knowledgeable about a given population. The EMDR protocols for different populations have been developed by clinicians who have previous expertise with the pertinent specialty knowledge base. While comparatively few controlled clinical outcomes studies exist throughout the field of psychology, the 14 controlled PTSD studies have set a strong empirical base for EMDR. Other specialty protocols are currently being subjected to controlled research. However, the way in which pathology is viewed, and the eight treatment phases described in a previous post provide a basic framework for the conceptualization of treatment.

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