Is EMDR a one-session cure?

No. When Shapiro (1989a) first introduced EMDR into the professional literature, she included the following caveat: “It must be emphasized that the EMD procedure, as presented here, serves to desensitize the anxiety related to traumatic memories, not to eliminate all PTSD-symptomology and complications, nor to provide coping strategies to victims” (p 221). In this first study, the focus was on one memory, with effects measured by changes in the Subjective Units of Disturbance (SUD) scale. The literature consistently reports similar effects for EMDR with SUD measures of in-session anxiety. Since that time, EMDR has evolved into an integrative approach that addresses the full clinical picture.

Two studies (Lee, Gavriel, Drummond, Richards, & Greenwald, 2002; Rothbaum, 1997) have indicated an elimination of diagnosis of posttraumatic stress disorder (PTSD) in 83-90% of civilian participants after four to seven sessions. Other studies using participants with PTSD (e.g. Ironson, Freund, Strauss, & Williams, 2002; Scheck, Schaeffer, & Gillette, 1998; S. A. Wilson, Becker, & Tinker, 1995) have found significant decreases in a wide range of symptoms after three-four sessions.

The only study (Carlson, Chemtob, Rusnak, Hedlund, & Muraoka, 1998) of combat veterans to address the multiple traumas of this population reported that 12 sessions of treatment resulted in a 77% elimination of PTSD. Clients with multiple traumas and/or complex histories of childhood abuse, neglect, and poor attachment may require more extensive therapy, including substantial preparatory work in phase two of EMDR (Korn & Leeds, 2002; Maxfield & Hyer, 2002; Shapiro, 2001).

Suggested research.
It is recommended that outcome studies compare EMDR to other PTSD treatments using the complete three pronged protocol (described above) and 12 or more sessions, with a session by session evaluation of recovery patterns. A wide range of psychometrics should be used to evaluate the process of change in overt symptoms, quality of life, and personal development parameters. An evaluation of client factors, such as trauma history, should be analyzed to determine their possible effect on treatment length and course.

Are treatment effects maintained over time?
Twelve studies with PTSD populations assessed treatment maintenance by analyzing differences in outcome between post-treatment and follow-up. Follow-up times have varied and include periods of 3, 4, 9, 15 months, and 5 years after treatment. Treatment effects were maintained in eight of the nine studies with civilian participants; one study (Devilly & Spence, 1999) reported a trend for deterioration. Of the three studies with combat veteran participants only one (Carlson et al., 1998) provided a full course of treatment (12 sessions). This study found that treatment effects were maintained at 9 months. The other two studies provided limited treatment: Devilly, Spence and Rapee (1998) provided two sessions and moderate effects at post-test were not maintained at follow-up. Pitman et al. (1996) treated only two of multiple traumatic memories, and treatment effects were not maintained at 5 year follow-up (Macklin et al., 2000). It appears that the provision of limited treatment may be inadequate to fully treat the disorder, resulting in remission of the partial effects originally achieved.