In the 1996 article I argued that EMDR has been shown to be quite effective, particularly as a treatment for specific traumatic memories; and that contrary results can be explained by substandard practice (i.e., that EMDR per se was not being tested). It would follow that well-designed studies, involving therapists who are careful to use the EMDR protocol correctly, should yield positive results. In the case of EMDR, these results should be not merely equal to other established treatments, but far superior, as in other, similar studies.

Since that article went to press, several important studies have been reported (but not yet published), which I will summarize here. In this informal update I select only the few studies which I consider most pertinent to the issues addressed in the previous article. I have omitted many interesting studies. No well-designed study (that I know of) has reflected poorly on EMDR. I am pleased to report that, in general, as the quality of the studies has improved, so also have the results favored EMDR.

First of all, Wilson, Becker, and Tinker (1996b) reported 15 month follow-up data to their original study (1996a), including 82 percent of participants, most of the rest having moved away. For those who had not been retraumatized since the initial 3 session treatment and 3 month follow-up, their gains maintained quite well. However, 51 percent of the participants had been retraumatized in the intervening period. For those whose new trauma was unrelated to the index (initially treated) trauma, gains were still, in general, maintained. However, when the new trauma was basically a repeat of the index trauma, the symptoms returned to the initial high presenting levels. In my opinion, these findings suggest a) that the benefits of EMDR are "real" and may last indefinitely, even following a very brief treatment; and b) that even successful treatment of a traumatic memory (whether EMDR or otherwise) does not eliminate vulnerability to subsequent trauma.

Another Colorado Springs group (Scheck, Schaeffer, & Gillette, 1996) compared 2 sessions of EMDR with 2 sessions of Active Listening (AL), treating 60 females between the ages of 16 and 24, who were actively pursuing high-risk behaviors (substance abuse, unsafe sex, criminal acts, suicide attempts, etc.) and who had histories of trauma. This well-designed study included random assignment, 24 well-trained therapists, independent blind assessment, and multiple standardized measures. Although both groups improved post-treatment, EMDR outperformed AL on all five measures, with significant differences on four of the five. The EMDR group's post-treatment gains were also clinically significant, with mean scores falling within one standard deviation of the non-clinical norms on all measures, whereas for the AL group, only one of the measures was in the normal range. Two measures readministered at 90 day follow-up showed maintenance of gains. In addition to providing additional support for EMDR, this study found no differences in the responses of the young adults compared to the older adolescents (J. Schaeffer, personal communication, 11/96).

Another study (Marcus, Marquis, & Sakai, 1996) is expected to have special impact in the managed care world, since it was conducted by Kaiser Permanente, one of the largest US health care companies. Sixty-seven Kaiser clients with post-traumatic stress disorder (PTSD) were randomly assigned to standard care or to treatment featuring EMDR. This study also featured multiple objective measures, and a blind independent evaluator who also conducted PTSD-oriented clinical interviews. Although both groups improved, the EMDR group showed much greater symptom reduction (also statistically significant differences on all measures) while using only 55% of the total visits (including individual, group, and medication) used by the control group.

Edmond and Rubin (1996) studied 59 adult female survivors of childhood sexual abuse, comparing EMDR with eclectic treatment (a variety of techniques organized to treat the focal issues) and to a delay-treatment control group. Several objective and subjective measures were used. Although the same four therapists conducted the treatment for both treatment groups, three of the therapists had not heard of EMDR before being trained for the study; and indicated varying degrees of skepticism - which controlled somewhat for bias, and turned out to be unrelated to their effectiveness. The EMDR sessions were subject to independent fidelity ratings, and found acceptable. After the 6 sessions, both treatment groups showed improvement, with the EMDR group's gains being more than double the eclectic group's (comparing effect sizes), whereas the delay group showed no change at all. At three month follow-up, the EMDR group continued to improve, whereas the eclectic group's gains deteriorated somewhat.

There is less in the way of controlled studies featuring children and adolescents. In the first reported study (Puffer, Greenwald, & Elrod, 1996), twenty children & adolescents were non-randomly assigned to EMDR treatment or 1m delayed treatment groups. Treatment was a single session; focus was a single trauma or loss. The first author conducted all treatment and assessment, using several measures, at pre, post, and 1-2 m follow-up. There was no change in the delay condition, and significant improvement between the first and last scores on all measures. On the best measure of trauma symptoms (Impact of Events Scale), of the 17 participants starting in the clinical range, 11 moved to normal levels, and 3 others dropped 12 or more points, while the other 3 stayed the same. The lack of independent assessment (although most measures were objectively scored) and use of a therapist with only Level I training make this study a bit shaky. Also, 3 participants had ongoing sources of distress, making "recovery" unlikely. Still, the results were quite positive, although somewhat more variable than in other studies.

Chemtob & Nakashima (1996) reported very positive results in using EMDR with 32 children and adolescents traumatized by Hurricane Iniki in Kauai, who did not respond to a generally effective previous treatment program. The design featured a delay control group, independent assessment with several standardized measures, and five therapists with varying levels of EMDR training and experience. The treatment protocol was clearly specified, and a number of efforts were made to ensure fidelity. The participants averaged a 58% reduction on the primary trauma measure following three sessions, with results holding several months later.

These studies provide increasingly solid support for EMDR's superiority to traditional methods in the treatment of a wide variety of traumatic memories. As expected, careful adherence to the EMDR protocol is yielding much more reliable results than in past years, when the treatment approaches varied considerably among studies. Also as expected, the first studies including children and adolescents are entirely consistent with earlier case studies, and with comparable adult studies; it appears likely that that EMDR is at least as effective with children and adolescents as with adults.

Chemtob, C. & Nakashima, J. (1996, November). Eye movement desensitization and rereprocessing (EMDR) treatment for children with treatment resistant disaster related distress. Presented at the annual meeting of the International Society for Traumatic Stress Studies, San Francisco.

Edmond, T. & Rubin, A. (1996, June). Evaluating the effectiveness of EMDR in reducing trauma symptoms in adult survivors of childhood sexual abuse. Presented at the annual conference of the EMDR International Association, Denver.

Greenwald, R. (1996). The information gap in the EMDR controversy. Professional Psychology: Research and Practice, 27, 67-72.

Puffer, M. K., Greenwald, R., & Elrod, D. E. (1996, June). A treatment outcome study of eye movement desensitization and reprocessing (EMDR) with traumatized children and adolescents. Presented at the annual conference of the EMDR International Association, Denver.

Marcus, S., Marquis, P., & Sakai, C. (1996, June). A controlled study for post-traumatic stress disorder using EMDR in an HMO setting. Presented at the annual conference of the EMDR International Association, Denver.

Scheck, M. M., Schaeffer, J. A., & Gilette, C. S. (1996, June). Brief psychological intervention with young high-risk females: A comparison of eye movement desensitization and reprocessing with active reflective listening. Presented at the annual conference of the EMDR International Association, Denver.

Wilson, S. A., Becker, L. A., & Tinker, R. H. (1996, November). Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for psychological trauma. Presented at the annual meeting of the International Society for Traumatic Stress Studies, San Francisco.