Can Eye Movement Desensitisation and Reprocessing (EMDR) therapy work in public mental health services? A pilot study

EMDR is a structured, Level 1 evidence-based treatment for PTSD and Complex PTSD (Australian Psychological Association, 2024). It follows an 8-phase standard protocol including assessment, resource building, memory mapping, and stabilisation, followed by trauma memory desensitisation and reprocessing. Resource building involves teaching distress tolerance and anxiety management skills, and is also referred to as the stabilisation phase in the trauma therapy research. Memory mapping the process of mapping a participant's traumatic memory networks chronologically to identify appropriate memories for processing. During the processing phase of EMDR therapy, participants will focus on an emotionally disturbing memory while simultaneously also focussing on a bilateral stimulus (such as lateral eye movements, tapping, or other cognitive tasks) until the level of disturbance is reduced. EMDR therapy appears to work by exposure to distressing memories paired with memory taxation which results in memory degradation. In this context, the participant learns to associate more adaptive memories and safety in the present, reduce emotional distress and promote adaptive learning. Participants will receive up to 16 weekly individual sessions of EMDR to focus on one traumatic memory, and will be asked not to engage with other psychological therapies for trauma for the duration of their EMDR therapy. They will continue to receive treatment as usual during the study including medication and case management. EMDR treatment and protocol selection will be tailored to each participant by their assigned therapist. All EMDR therapists are mental health clinicians that have completed a minimum of approved accredited basic EMDR training (including 20 hours of didactic training, 20 hours of skills training and 10 hours of consultation with an Accredited Consultant) with the EMDR Association of Australia (EMDRAA) or the EMDR International Association (EMDRIA). EMDR therapists will attend monthly peer supervision facilitated by an EMDRAA Accredited Consultant. Consistent with previous research, EMDR participants will be offered up to 16 weekly sessions for 60 to 90 minutes duration determined by the clinical needs identified through ongoing therapist assessments (Bates et al, 2024; Gielkens et al, 2024). Sessions will be offered face-to-face or via telehealth, and delivered in a clinic environment or consumer's home (if appropriate). Consumers will be reminded of appointments and monitored weekly.