Eye Movement Desensitization and Reprocessing (EMDR) Therapy 3rd Edition by Francine Shapiro, ISBN-13: 978-1462532766
[PDF eBook eTextbook] – Available Instantly
- Publisher: The Guilford Press; Third edition (December 29, 2017)
- Language: English
- 568 pages
- ISBN-10: 1462532764
- ISBN-13: 978-1462532766
The authoritative presentation of Eye Movement Desensitization and Reprocessing (EMDR) therapy, this groundbreaking book–now revised and expanded–has been translated into 10 languages. Originally developed for treatment of posttraumatic stress disorder (PTSD), this evidence-based approach is now also used to treat adults and children with complex trauma, anxiety disorders, depression, addictive behavior problems, and other clinical problems. EMDR originator Francine Shapiro reviews the therapy’s theoretical and empirical underpinnings, details the eight phases of treatment, and provides training materials and resources. Vivid vignettes, transcripts, and reproducible forms are included. Purchasers get access to a webpage where they can download and print the reproducible materials in a convenient 8 1/2″ x 11″ size.
New to This Edition:
– Over 15 years of important advances in therapy and research, including findings from clinical and neurophysiological studies.
– New and revised protocols and procedures.
– Discusses additional applications, including the treatment of complex trauma, addictions, pain, depression, and moral injury, as well as post-disaster response.
– Appendices with session transcripts, clinical aids, and tools for assessing treatment fidelity and outcomes.
EMDR therapy is recognized as a best practice for the treatment of PTSD by the U.S. Departments of Veterans Affairs and Defense, the International Society for Traumatic Stress Studies, the World Health Organization, the U.K. National Institute for Health and Care Excellence (NICE), the Australian National Health and Medical Research Council, the Association of the Scientific Medical Societies in Germany, and other health care associations/institutes around the world.
Table of Contents:
Cover
Title Page
Copyright Page
Dedication Page
About the Author
Preface
Acknowledgments
Contents
1. Background
A Chance Discovery
The First Controlled Study
Further Clinical and Experimental Observations
Shift in Paradigm
Adaptive Information Processing
Theoretical Convergences
Posttraumatic Stress Disorder
Psychodynamic Approaches
Cognitive-Behavioral Approaches
Integrative Approach
Summary and Conclusions
2. Adaptive Information Processing: The Model as a Working Hypothesis
Information Processing
Bilateral Dual Attention Stimulation
Memory Networks
A Sample EMDR Session
Partial Transcript of the Sample Session
Evaluation of the Sample Session
Dysfunctional to Functional
Disparate Neural Networks
Applications of EMDR Therapy to Other Disorders
Static Experience: Affect and Belief Statements
Resolution
Frozen in Childhood
“Time-Free” Psychotherapy
Targets
Access Restricted to Negative Material
Memory Lapses
Dissociation
Integrated Psychotherapy
Summary and Conclusions
3. Components of EMDR Therapy and Basic Treatment Effects
Basic Components of the EMDR Processing Targets
The Image
The Negative Cognition
The Positive Cognition
The Emotions and Their Level of Disturbance
The Physical Sensations
Activating the Information-Processing System
Eye Movements
Alternative Forms of Stimulation
The Eight Phases of EMDR Therapy
Phase One: Client History and Treatment Planning
Phase Two: Preparation
Phase Three: Assessment
Phase Four: Desensitization
Phase Five: Installation
Phase Six: Body Scan
Phase Seven: Closure
Phase Eight: Reevaluation
Standard Three-Pronged EMDR Therapy Protocol
Choosing a Target
Patterns of Response
Multimemory Associative Processing
The Belief Inherent in the Trauma
The Major Participant or Perpetrator
The Pronounced Stimuli
The Specific Event
The Dominant Physical Sensations
The Dominant Emotions
Single-Memory Processing Effects
Changes in Image
Changes in Sounds
Changes in Cognitions
Changes in Emotions
Changes in Physical Sensation
Differential Effects
Supervised Practice
Summary and Conclusions
4. Phase One: Client History
Client Readiness
Client Safety Factors
Level of Rapport
Emotional Disturbance
Stability
Life Supports
General Physical Health
Office Consultation versus Inpatient Treatment
Neurological Impairment
Epilepsy
Eye Problems
Drug and Alcohol Abuse
Legal Requirements
Systems Control
Secondary Gains
Timing
Medication Needs
Dissociative Disorders
Treatment Planning
History-Taking Transcript
Supervised Practice
Summary and Conclusions
5. Phases Two and Three: Preparation and Assessment
Phase Two: Preparation
Adopting a Clinical Stance
Forming a Bond with the Client
Explaining the Theory
Testing the Eye Movements
Creating a Safe/Calm Place
Describing the Model
Setting Expectations
Addressing Client Fears
Phase Three: Assessment
Selecting the Picture
Identifying the Negative Cognition
Developing a Positive Cognition
Rating the Validity of Cognition
Naming the Emotion
Estimating the Subjective Units of Disturbance
Identifying Body Sensations
Importance of the Components
Supervised Practice
Summary and Conclusions
6. Phases Four to Seven: Desensitization, Installation, Body Scan, and Closure
Accelerated Reprocessing of the Memory
Phase Four: Desensitization
Associative Processing
Imagery
New Memory
Image Changes
Incident Unfolds
Appearance Changes
Sounds and Thoughts
Negative Statements
Mismatches
Positive Thoughts
Insights
Sensation and Affect
New Emotions
Shifting Sensations
Assessment
Phase Five: Installation
Phase Six: Body Scan
Phase Seven: Closure
Visualization
Safety Assessment
Debriefing and Log
Supervised Practice
Summary and Conclusions
7. Working with Abreaction and Blocks
Abreaction
Guidelines for Facilitating Abreaction
If Abreaction Persists
Strategies for Blocked Processing
Primary Target
Altering the Eye Movement
Focusing on Body Sensation
All Sensation
The Primary Sensation
Unspoken Words
Using Movement
Pressing the Location
Scanning
Visual Cues
Sound Effects
Dialogue
Alterations
Appearance of Image
No Action
Hierarchy
Redirecting to Image
Redirecting to Negative Cognition
Adding a Positive Statement
Checking the Positive Cognition
Return to Target
Ancillary Targets
Feeder Memories
Blocking Beliefs
Fears
Fear of Going Crazy
Fear of Losing the Good Memories
Fear of Change
Wellsprings of Disturbance
Supervised Practice
Summary and Conclusions
8. Phase Eight: Reevaluation and Use of the EMDR Therapy Standard Three-Pronged Protocol
Phase Eight: Reevaluation
The Standard Three-Pronged EMDR Therapy Protocol
Working on the Past
Single-Target Outcome
Recycling through Multiple Targets
Primary Events
Past Events
Progressions
Clusters
Participants
Working on the Present
Using the Log to Report Systems Issues
Working on the Future
Significant People
Significant Situations
Incorporating a Future Template
Concluding Therapy
Follow-Up
Terminating Therapy
Supervised Practice
Summary and Conclusions
9. Standardized Protocols and Procedures for Special Situations
The Standard Procedures
Three-Pronged Protocol
Protocol for a Single Traumatic Event
Disorder-Based Protocol
Symptom-Based Protocol
Protocol for Current Anxiety
Eye Movement Desensitization
Procedural Steps
Protocols for Recent Traumatic Events
Recent Event Protocol
EMDR Protocol for Recent Critical Incidents
Recent Traumatic Episode Protocol
Protocol for Phobias
Protocol for Complicated Grief
Protocol for Illness and Somatic Disorders
Pain Conditions
Self-Directed Use of Bilateral Stimulation for Stress Reduction
Eye Movement Sets: Caveats and Suggestions
Technical Considerations
Butterfly Hug
Self-Control/Closure Procedures
Safe/Calm Place Imagery
EMDR Resource Development and Installation
Client Instructions for RDI
Recorded Visualizations
The Light Stream Technique
Breathing Shift
Vertical Eye Movements
Debriefing and Safety Assessment
Summary and Conclusions
10. The Cognitive Interweave: A Proactive Strategy for Working with Challenging Clients
Foundation of the Interweave
Responsibility, Safety, and Choices
Fitting the Intervention to the Client
Interweave Choices
New Information
“I’m Confused”
“What If It Were Your Child?”
Metaphor/Analogy
“Let’s Pretend”
Socratic Method
Assimilation
Verbalizations and Actions
Education
Supervised Practice
Summary and Conclusions
11. Selected Populations
Issues of Noncompliance
Complex PTSD
Sexual Abuse Victims
Appropriate Goals
Client Readiness
Structure
Integration
Information Plateaus
Emotional Stages
False Memory
Cautions Regarding Memory Work
Hypnosis
The Fallibility of Memory
Combat Veterans
Dealing with Feelings of Lack of Control
Secondary Gain Issues
Affiliation and the Fear of Forgetting
Dealing with Denial, Moral Injury, and Transition States
Dealing with Anger
Military Sexual Trauma
Using the Cognitive Interweave
Anniversary Dates
Complicated Grief
Postdisaster Response
Special Considerations
EMDR Intervention at the Time of the Event or within the First 48 Hours
EMDR Interventions 48 Hours or More Postdisaster
Phases of Treatment
Vicarious Trauma
Couples
Partner Providing Support
Marital Therapy
Infidelity
Children
History Taking
Preparation Phase
Holding the Child’s Attention
Assessment Phase
Desensitization and Installation Phases
Cognitive Interweaves
Closure and Reevaluation
Working with Caregivers
Generalizing Treatment Effects
Intellectual Disability
Autism Spectrum Disorder
Complex Trauma in Children
Addictions
Addiction through the Lens of the AIP
Client Readiness and Stages of Change
Safety and Stabilization
Timing of Treatment
Suggested Targets for Reprocessing
Additional Precautions and Guidelines
Dissociative Disorders
Overall Evaluations
Summary and Conclusions
12. Theory, Research, and Clinical Implications
Procedural Elements
Exposure
Perceived Mastery
Attention to Physical Sensation
Cognitive Reframing
Alignment of Memory Components
Free Association
Mindfulness
Eye Movements and Alternative Bilateral Stimuli
Orienting Response
Working Memory
Distraction
Hypnosis
Neural Network Changes
Dream Sleep
Relaxation Response
Integrative Effect
Working Memory Account of EMDR
Orienting Response
REM Sleep
Summary of Recommendations for Component Research
Treatment of PTSD
Trauma and PTSD
Children
Adults with PTSD
Treatment of Military Personnel
Complex PTSD
Elderly Adults
Disaster Response Research
Individual Protocols
EMDR Standard Protocol
Recent Traumatic Events Protocol
EMDR Protocol for Recent Critical Incidents
Recent Traumatic Episode Protocol
Group Protocols
EMDR Integrative Group Treatment Protocol
Group Traumatic Episode Protocol
Protocols for Disaster-Response Teams
Future Research
Diverse Clinical Applications
Anxiety Disorders
Phobias
Panic Disorder
Obsessive–Compulsive Disorder
Mood Disorders
Addictions
Pain Conditions
Diverse Somatic Conditions
Treatment-Resistant Populations
Suggested Criteria for Clinical Outcome Research
Method Validity
Selection of Psychometrics
Participant Selection
Comparative Research
Recommended Clinical Parameters for Comparative Outcome Studies
Additional Future Research
The Adaptive Information Processing Model
Broader Clinical and Professional Concerns
Clinical Responsibility
Global Responsibility
Summary and Conclusions
Appendix A. Clinical Aids
Adverse Childhood Experiences Questionnaire
Recommended Format for Weekly Log (TICES) Report
Negative and Positive Cognitions
Examples of Negative and Positive Cognitions
Form and Sequence for Techniques to Identify Past Event
Affect Scan (Shapiro, 1995)
Floatback Technique (Young, Zangwill, & Behary, 2002)
EMDR Therapy Procedural Outline
Explanation of EMDR
Specific Instructions
Appendix B. Client Transcripts
Three-Pronged Protocol with a Combat Veteran
Cognitive Interweave Case Session with a Molestation Survivor
Appendix C. Clinical and Outcome Assessments
EMDR Fidelity Rating Scale (EFRS)
Empirically Evaluating EMDR without a Control Group: A Step-by-Step Guide for EMDR Therapists
Purpose of This Guide
Part I: Single-Case Designs
Overview and Logic of Single-Case Evaluation
Step-by-Step Guide
Step 1. Specify the Target
Step 2. Operationally Define the Target
Step 3. Devise a Data Collection Plan
Step 4. The Baseline Phase
Step 5. The Basic Single-Case Design
Step 6. Data Analysis
Step 7. Replication
Part II. Within-Group Effect Size Benchmarks
Appendix D. Research Lists
Psychophysiological and Neurobiological Evaluations
Appendix E. Client Safety
EMDR Dissociative Disorders Task Force Recommended Guidelines: A General Guide to EMDR’s Use in the Dissociative Disorders
Purpose
Assumptions
Screening
Clarifying the Diagnosis
When a Dissociative Disorder Is Present
Embedding EMDR in the Treatment Plan
Preparing for EMDR
Early Treatment Phases
Caution
Middle Treatment Phases
Final Treatment Phases
Task Force Members
Additional Training
Suggested Reading
Professional Standards and Training Committee of the EMDR International Association
Appendix F. EMDR Therapy Training Resources
North and South America
Europe
Asia
References
Index
About Guilford Press
Discover Related Guilford Books
Francine Shapiro, PhD, until her death in 2019, was Senior Research Fellow Emeritus at the Mental Research Institute in Palo Alto, California; Executive Director of the EMDR Institute in Watsonville, California; and founder and President Emeritus of the Trauma Recovery/EMDR Humanitarian Assistance Programs, a nonprofit organization that coordinates disaster response and pro bono trainings worldwide. The originator and developer of EMDR therapy, Dr. Shapiro was a recipient of the International Sigmund Freud Award for distinguished contribution to psychotherapy, presented by the City of Vienna in conjunction with the World Council for Psychotherapy; the Award for Outstanding Contributions to Practice in Trauma Psychology from Division 56 of the American Psychological Association; and the Distinguished Scientific Achievement in Psychology Award from the California Psychological Association. Dr. Shapiro was designated as one of the “Cadre of Experts” of the American Psychological Association and the Canadian Psychological Association Joint Initiative on Ethnopolitical Warfare and served as advisor to a wide variety of trauma treatment and outreach organizations and journals. She was an invited speaker at psychology conferences worldwide and published more than 90 articles, chapters, and books about EMDR.
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