Differential Treatment Effects

• Predicting Who Will Respond to EMDR by Peter M. Barach, Ph.D., 7/22/97
  
  

I think the differences in treatment effects are often a question of the specific protocol used, specific client characteristics, and whether or not the problem is primarily experientially based. For instance, I believe that there is a need to explicitly educate all panic disorder clients about the meaning of the physical sensations. It is part of attending to the *fear of the fear.* That education process alone is often enough to do the trick for many clients. Along with the education process, the EMDR client is also given relaxation techniques to deal with that issue. The processing of the contributing experiences then can proceed more easily. However, other panic disorder patients have had negative results because they spontaneously use their relaxation techniques during targetting which interrupts the processing effects. Another issue that might differentiate treatment effects is if the problem is primarily organic, or primarily experientially-based. If the problem is an organic predisposition to hyperarousal then the processing might not be successful or superior to education alone. All in all, we will need more research on the different clinical protocols before we can make the predictions in each category.

For single-trauma victims the controlled research says that 84-90% no longer have PTSD after three 90-minute sessions. However, that is misleading because an examination of the 10-16% left over indicates that they are either multiple trauma victims who need more processing time, or presently under systems or litigation pressures. Nevertheless, I would not want to say that all single trauma clients not presently being traumatized or vested in secondary gains are guaranteed a cure. I would say those not able to get in touch with their affect--not willing to -let whatever happens, happen- are not good candidates for EMDR. The most emotionally suppressed--and those without sufficient ego-strength to withstand emotion-- need special preparation for EMDR treatments, and perhaps other methods are preferrable.

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