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Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures

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The therapist offers an explanation for the treatment, and introduces the client to the procedures, practicing the eye movement and/or other BLS components. The therapist ensures that the client has adequate resources for affect management, leading the client through the Safe/Calm Place exercise. Assessment

After the client has named the emotion he or she is feeling, the clinician asks, "On a scale of 0-10, where 0 is no disturbance or neutral and 10 is the highest disturbance you can imagine, how disturbing does it feel now?" Archer, D. (2021). Anti-racist psychotherapy: Confronting systemic racism and healing racial trauma. Montreal: Each One Teach One Publications. Marich, J. & Dansiger, S. (2018). EMDR Therapy and Mindfulness for Trauma-focused Care. New York: Springer Publishing Company Parnell, L. (2008). Tapping In: A Step-by-Step Guide to Activating your Healing Resources Through Bilateral Stimulation. Boulder, CO: Sounds True Books. EMDR revolutionized the treatment of PTSD and has emerged as a front-line therapy for multiple forms of psychological trauma. The third edition of this foundational work underscores EMDR's integrative nature, research support, and sensitive adaptations to diverse populations. The clinical aids, client transcripts, and fidelity scales will prove a boon to practitioners and researchers alike."--John C. Norcross, PhD, ABPP, Distinguished Professor of Psychology, University of ScrantonAn excellent resource on an important evidence-based treatment for traumatic stress. This book is relevant for all practitioners interested in EMDR therapy, including novices as well as those who already use the approach. The third edition offers a wealth of detail to guide the reader in applying EMDR across a range of clinical presentations. Highly recommended."--David Forbes, PhD, Professor, Department of Psychiatry, University of Melbourne; Director, Phoenix Australia--Centre for Posttraumatic Mental Health Two measures are used during EMDR therapy sessions to evaluate changes in emotion and cognition: the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale. Both measures are used again during the treatment process, in accordance with the standardized procedures: Validity of Cognition (VOC) scale Mark C. Russell, PhD, ABPP, is a core faculty member at Antioch University, Seattle, and the establishing director of the Institute of War Stress Injury, Recovery, and Social Justice. As a graduate student, Dr. Russell became Francine Shapiro's research assistant and was primarily responsible for developing the theory underlying EMDR. Shapiro, F., & Forrest, M. (1997). EMDR: The Breakthrough “Eye Movement” Therapy for Overcoming Stress, Anxiety, and Trauma. New York: Basic Books. Marich, J. (2011). EMDR Made Simple: Four Approaches to Using EMDR with Every Client. Eau Claire, WI: PESI Publishing (Premiere)

Dworkin, M. (2005). EMDR and the Relational Imperative: The Therapeutic Relationship in EMDR Treatment. New York: Brunner-Routledge. Marich, J. & Dansiger, S. (2021). Healing addiction with EMDR therapy: a trauma-focused guide. New York: Springer Publishing Company. Baldwin, M. & Korn, D. (2021). Every memory deserves respect: EMDR, the proven trauma therapy with the power to heal. New York: Workman Publishing Company. Menakem, R. (2017). My grandmother’s hands: Racialized trauma and the path to mending our hearts and bodies. Las Vegas: Central Recovery Press. Closure is used to end the session. If the targeted memory was not fully processed in the session, specific instructions and techniques are used to provide containment and ensure safety until the next session. Re-evaluationDr. Russell has authored more than 13 articles and 6 book chapters on EMDR. He was awarded the Distinguished Psychologist Award by the Washington State Psychological Association for his sustained effort to transform military mental healthcare including advocating for EMDR trainings and treatment access, as well as the 2018 Outstanding Service in the Field of Trauma Psychology by APA Division 56 Trauma Psychology. The clinician asks, "When you think of the incident, how true do those words (repeat the positive cognition) feel to you now on a scale of 1-7, where 1 feels completely false and 7 feels totally true?" Appendices with session transcripts, clinical aids, and tools for assessing treatment fidelity and outcomes.

The sixth phase of EMDR is the body scan, in which clients are asked to observe their physical response while thinking of the incident and the positive cognition, and identify any residual somatic distress. If the client reports any disturbance, standardized procedures involving the BLS are used to process it. Closure Dr. Russell is a retired Navy commander and military psychologist, who became the first certified military EMDR trainer in the Department of Defense, and organized a series of just-in-time EMDR trainings for more than 265 mental health providers in response to a growing military mental health crisis. The fifth phase of EMDR is installation, which strengthens the preferred positive cognition. Body Scan Those little buzzers had worked some kind of Robin Williams magic. I didn't just understand the weight of my abuse logically. I felt it, like a blade through flesh, a bone popping out of place. I felt it like a lover saying it's not going to work: sharp, immediate, and terrifying. I actually felt, with searing clarity, the horror of what happened to me -- maybe for the first time ever. I felt how tremendously sad it was that I was forced to make my parents feel loved at such a young age. I felt how courageous I must have been to endure that torture, day after day for so many years, by the people I trusted most in this world. I felt a sense of love and adoration for my childhood self that I'd never been able to summon before.Francine Shapiro, PhD, the originator and developer of EMDR therapy, was senior research fellow emeritus at the Mental Research Institute in Palo Alto, California, and executive director of the EMDR Institute in Watsonville, California. She founded and was president emeritus of the Trauma Recovery/EMDR Humanitarian Assistance Programs, a non-profit organization that coordinates disaster response and pro bono trainings worldwide. Over 15 years of important advances in therapy and research, including findings from clinical and neurophysiological studies. It's not easy to take a classic and improve on it, but that's what Shapiro has done in this third edition, with her usual combination of incisive writing, scientific rigor, and deep compassion for human suffering. The strength of EMDR's research base is now available in one easily accessible place, a testament to Shapiro's decades of insistence that no matter how clinically useful EMDR therapy might be, it needs to be supported by empirical data. The book clearly describes applications to the range of posttraumatic responses as well as other clinical problems. It is truly a gift for clinicians--and our clients."--Laura S. Brown, PhD, ABPP, past president, Division of Trauma Psychology, American Psychological Association; private practice, Seattle, Washington Bannit, S.P. (2012). The Trauma Toolkit: Healing trauma from the inside out. Wheaton, IL: Quest Books.

The next session starts with phase eight, re-evaluation, during which the therapist evaluates the client's current psychological state, whether treatment effects have maintained, what memories may have emerged since the last session, and works with the client to identify targets for the current session. Burke Harris, N. (2019). The deepest well: Healing the long-term effect of childhood adversity. London: Pan McMillan. In addition to getting a full history and conducting appropriate assessment, the therapist and client work together to identify targets for treatment. Targets include past memories, current triggers and future goals. Preparation During this phase, the client focuses on the memory, while engaging in eye movements or other BLS. Then the client reports whatever new thoughts have emerged. The therapist determines the focus of each set of BLS using standardized procedures. Usually the associated material becomes the focus of the next set of brief BLS. This process continues until the client reports that the memory is no longer distressing. InstallationDuring EMDR therapy, clinical observations suggest that an accelerated learning process is stimulated by EMDR’s standardized procedures, which incorporate the use of eye movements and other forms of rhythmic left-right (bilateral) stimulation (e.g., tones or taps). While clients briefly focus on the trauma memory and simultaneously experience bilateral stimulation (BLS), the vividness and emotion of the memory are reduced. Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.

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