Empirically supported principles of change

[ClinPsycMasters]

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The authors of this paper cite studies that suggest EMDR is no more effective than the traditional exposure therapies. However, since studies show that this trademarked therapy is more effective than no treatment, EMDR is listed as an empirically supported therapy. They suggest focus on empirically supported principles of change instead.

The authors use a humorous example to drive their point home: assume a therapist instructs her patients--who have driving phobia--to drive, wearing a purple hat equipped with magnets, in addition to using relaxation and cognitive coping techniques. Any improvement can then be attributed to the psychologist's unique form of therapy:

"When properly placed, so the practitioner claims, the magnets reorient energy fields, accelerate information processing, improve interhemispheric coherence, and eliminate phobic avoidance. The inventor might call his method "purple hat therapy" (PHT) or "electro Magnetic Desensitization and Remobilization" (eMDR)...."

What do you think?

Rosen GM, Davidson GC. Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behav Modif. 2003;27:300–12.

 

[Therapist4Chnge]

Until I see a study that can actually prove the eye movement does anything, I'll keep using my magic rocks and moon beams example as a comparison for EMDR treatment.

 

[Neuropsych2be]

Until I see a study that can actually prove the eye movement does anything, I'll keep using my magic rocks and moon beams example as a comparison for EMDR treatment.

CBT has been critiqued because some mediational studies have indicated that altered cognition is not the causal factor responsible for the observed therapeutic response. Simply because CBT outcome research shows an effect, it does not follow that the purported causal mechanism actually works. EMDR is exactly the same critter. The theory behind EMDR seems very very fishy to me. I remember when Shapiro came up with this nutty idea, thinking it could not possibly work for the reasons she claims. I'd love to see psychophysiological data comparing participant responses after graded exposure coupled and deep relaxation versus EMDR. I suspect that exposure is a vastly superior. However,, one can not overlook the placebo effect.

 

[aagman01]

The eye movements are only a part of EMDR treatment, which i would think makes differentiation of txs difficult. There are relaxation techniques and numerous other cognitive elements infused into the tx. On another note, I met one masters level clinician who got certified in EMDR----she seemed to use it WAY too often in working with clients....

CBT has been critiqued because some mediational studies have indicated that altered cognition is not the causal factor responsible for the observed therapeutic response. Simply because CBT outcome research shows an effect, it does not follow that the purported causal mechanism actually works. EMDR is exactly the same critter. The theory behind EMDR seems very very fishy to me. I remember when Shapiro came up with this nutty idea, thinking it could not possibly work for the reasons she claims. I'd love to see psychophysiological data comparing participant responses after graded exposure coupled and deep relaxation versus EMDR. I suspect that exposure is a vastly superior. However,, one can not overlook the placebo effect.

 

[ClinPsycMasters]

That's why some criticize psychotherapy for being a pseudoscience. I do agree that sometimes one's training is closer to enculturation of the dubious practices of the particular field, than to true scientific education. Values will always exist and guide us whether we like it or now. However, therapeutic treatment itself should be--and yes I'm "shoulding"--based on results of scientific inquiry of highest standards. And it seems the field is moving in that direction more recently.

 

[TenaciousGirl]

Until I see a study that can actually prove the eye movement does anything, I'll keep using my magic rocks and moon beams example as a comparison for EMDR treatment.

If EMDR wasn't useful why would major hospitals use it? Why would insurance companies compensate for it?

(I know you're into the business side of the profession, that's why I'm asking you this. To see what you think about that side of EMDR being called effective)

 

[Psiguy]

If EMDR wasn't useful why would major hospitals use it? Why would insurance companies compensate for it?

(I know you're into the business side of the profession, that's why I'm asking you this. To see what you think about that side of EMDR being called effective)

For the same reason that major hospitals use the "newest" medications, which are often nothing more than combinations of old medications or old medications with a single, and questionably effective, new ingredient.

 

[TenaciousGirl]

For the same reason that major hospitals use the "newest" medications, which are often nothing more than combinations of old medications or old medications with a single, and questionably effective, new ingredient.

and what do you think about the second part of my question? the insurance compensation component?

 

[Therapist4Chnge]

and what do you think about the second part of my question? the insurance compensation component?

Much like BigPharma....strong marketing and mediocre "cooked" research. EMDR is basically taking a proven ingredient (exposure tx) and adding a few new molecules (eye movement), and then calling it the new wonder drug....err...treatment. It would be considered a "brand name" because to do it you have to pay for the training, even though the active ingredient is fair use information. Insurance companies pay for it because the EMDR people were able to prop up enough "new" research to get it recognized. Much like BigPharma, a few years down the road someone will pull the curtain away and show that it isn't really what they said, but by then the $$ has been made.

 

[TenaciousGirl]

interesting. thanks for your perspective.