Preliminary evidence for the acceptability, safety, and efficacy of the flash technique.

Objectives: This study reports on four similar studies intended to explore the acceptability, safety, and efficacy of the flash technique (FT), a method of rapidly reducing the intensity of a disturbing memory or image, with minimal subjective disturbance for subjects during the process. Of the four studies, two were conducted during FT trainings in the United States, one in Australia, and one in Uganda. Methods: The studies involve pre-, post-, and follow-up repeated-measures design to determine the effectiveness of a 15-min FT intervention. A total of 654 subjects were asked to think of a disturbing memory and then participate in a structured experience of an FT. The purpose of this investigation was to determine whether a brief application of an FT would be safe and effective in significantly reducing their disturbance. In each study, subjects rated their disturbing memories on a 0-to-10 scale, with zero representing no disturbance at all and 10 representing the worst they could imagine. Then, they took part in a 15-min group practicum where they were guided in a self-administering FT with no individual supervision or support. Results: In all four studies, the mean reduction in disturbance exceeded two-thirds, the results were significant (p < 0.001), and the effect size was very large. Of the 813 sessions (654 subjects) represented in these studies, only two subjects reported slight increases in disturbances, and both of these subjects reported reductions in disturbance in their second FT experiences 2 h later. At a 4-week follow-up, mean disturbance levels in all four studies indicated maintenance of benefit or slightly further reduction of mean disturbance levels. An 18-month follow-up study with a subgroup of subjects who initially reported a high level of memory-related distress found similar maintenance of gains as well as symptom reduction. Conclusion: These findings provide preliminary evidence of acceptability, safety, and efficacy of FT; therefore, further study is warranted.

A pragmatic randomized comparison of intensive EMDR and intensive PC for victims of crime.

OBJECTIVE: The intensive therapy format offers clients the opportunity to reduce time to treatment benefit, compared with conventional weekly therapy. Eye movement desensitization and reprocessing (EMDR) has been identified as the most efficient of the leading trauma therapies. Progressive counting (PC) is less resource-intensive for therapists to master and may be at least as efficient as EMDR. Our objective was to evaluate and compare intensive EMDR and intensive PC. METHOD: We randomized 96 treatment-seeking victims of crime to intensive EMDR or intensive PC. RESULTS: Participants experienced statistically and clinically significant improvements on measures of posttraumatic stress, presenting problems, level of functioning, and quality of life from pretreatment to posttreatment and follow-up, with large to very large effect sizes on all measures. There were no significant differences between EMDR on PC any outcome, including treatment efficiency, and dropout was minimal. CONCLUSIONS: These results support previous findings regarding the value of intensive trauma-focused therapy and indicate that PC may be comparable to EMDR in the intensive therapy format. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A randomised comparison of cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) in disaster-exposed children.

BACKGROUND: Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. OBJECTIVE: The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). DESIGN: Children (n=52, aged 4-18) were randomly allocated to either CBT (n=26) or EMDR (n=26) in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4-8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures) were conducted on the intention-to-treat sample and the completers. RESULTS: Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. CONCLUSION: Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children.

Treatment of PTSD: stress inoculation training with prolonged exposure compared to EMDR.

The effectiveness of Stress Inoculation Training with Prolonged Exposure (SITPE) was compared to Eye Movement Desensitization and Reprocessing (EMDR). Twenty-four participants who had a diagnosis of Post Traumatic Stress Disorder (PTSD) were randomly assigned to one of the treatment conditions. Participants were also their own wait-list control. Outcome measures included self-report and observer-rated measures of PTSD, and self-report measures of depression. On global PTSD measures, there were no significant differences between the treatments at the end of therapy. However on the subscale measures of the degree of intrusion symptoms, EMDR did significantly better than SITPE. At follow-up EMDR was found to lead to greater gains on all measures.