Is Eye Movement Desensitization and Reprocessing Worth it? A Pragmatic Analysis For Clinicians

Eye movement desensitization and reprocessing is a treatment developed for post-traumatic stress disorder (PTSD) that combines the cognitive processing of trauma with bilateral eye movements (EMs). Research has demonstrated that EMDR can be an efficacious treatment for PTSD. Other common treatments for PTSD include cognitive behavioral therapy (CBT) and exposure therapy (ET). Research has demonstrated that both CBT and ET are efficacious in the treatment of PTSD. EMDR is a controversial treatment, with critics stating that it is very similar to ET and that the novel component, EMs, are irrelevant to treatment outcomes. EMDR has additional time and financial costs, including mandatory training sessions and certification to be allowed to administer the treatment. These factors make it difficult for a clinician to decide if investing in EMDR is worth it. While EMDR has demonstrated that it is efficacious to use with adults, the research on children and other populations is significantly more limited, making the use of EMDR in such populations questionable. Research demonstrates that the role of EMs in EMDR is poorly understood, with many competing explanations needing more investigation. The highest quality evidence indicates that the EMs in EMDR are irrelevant to treatment outcomes, with EMDR without any EMs performing just as well as EMDR with EMs in the treatment of PTSD. CBT and ET do not have the additional costs of EMDR, requiring only standard mental health provider licensing to administer. CBT and ET have more ample, higher quality evidence for their efficacy than EMDR. CBT and ET have also demonstrated that they are efficacious to use with children and other populations. These factors make it difficult to recommend a clinician invest in and administer EMDR. Overall, CBT and ET can be more easily administered and have greater evidence for their use than EMDR