EMDR intervention after a disaster: The Morandi Bridge collapse

Survivors involved in natural or man-made disasters can develop a range of psychological problems including Post-Traumatic Stress Disorder (PTSD), depression, other forms of psychological distress, and a poor quality of life. Therefore, the principal focus of early psychological interventions, according to World Health Organization, is to provide a rapid and effective therapeutical approach like EMDR therapy. The EMDR approach enables the assimilation and integration of the various aspects of a traumatic experience at a somatic, sensorial, cognitive, behavioral and emotional level. In this article will be presented data of 47 patients collected after the partial collapse of Morandi bridge, in Genoa, in August 2018. Survivors were treated applying the Recent Traumatic Episode Protocol (R-TEP); in order to evaluate the effect of the traumatic event and to monitor the intervention outcome, the Impact of Event Scale- Revised (IES-R) was administered to each person pre and after EMDR treatment. Results show that regardless the number of sessions and the time elapsed after the disaster in which they were performed, EMDR significantly reduced participants’ IES-R scores from pre-treatment to posttreatment. Clinical implications and limits of the study will be discussed.

Anorexie mentale et EMDR : un cas clinique

De nombreuses études ont identifié des liens entre la psychopathologie et des antécédents d’événement de vie traumatiques et de relations d’attachement dysfonctionnelles. Compte tenu des origines traumatiques possibles de cette pathologie, il pourrait être utile d’apporter une intervention centrée sur le trauma comme la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires). Cet article s’appuie sur un cas clinique pour décrire les résultats positifs de la thérapie EMDR dans le rétablissement d’une anorexie mentale résistante chez une patiente de 17 ans en hospitalisation. Elle avait déjà été hospitalisée à quatre reprises au cours des quatre dernières années et avait suivi des thérapies psychodynamique et cognitive comportementale. Au début de la prise en charge, la patiente pesait 28 kg et son indice de masse corporelle était 14. Elle s’est vu attribuer un style d’attachement désengagé/évitant sur l’entretien de l’attachement adulte (Adult Attachment Interview). La thérapie EMDR lui a été proposée à l’hôpital sur une durée de six mois sous la forme de séances de 50 minutes, deux fois par semaine, correspondant aux procédures standard qui se centraient principalement sur ses traumas relationnels ; elle était combinée à des séances de psychoéducation et intégrée à la thérapie des états du moi. À la fin de la prise en charge, la patiente pesait 55 kg et son indice de masse corporelle était 21,5. Elle ne remplissait plus les critères diagnostiques de l’anorexie mentale et son style d’attachement s’était modifié en faveur d’un état d’esprit libre-autonome acquis. Elle décrivait une confiance en soi accrue et une plus grande capacité à gérer différentes situations sociales. Les résultats étaient maintenus lors du suivi après 12 et 24 mois. Les implications de cette étude de cas pour la prise en charge sont examinées.

Early Eye Movement Desensitisation and Reprocessing (EMDR) intervention in a disaster mental health care context

'Early psychological intervention' is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012. This study is based on a retrospective review of medical records collected during the activities of psychological and psychosocial unit in the immediate aftermath of earthquake. In total, 529 participants completed the Impact of Event Scale Revised (IES-R) (pre e post treatment). In order to provide a comparison similar to a waitlist-like control group, a method of cohort analysis was applied. In addition, possible time dependent effect was tested. ET (early-treated sample, participants treated within one month after the earthquake) and LT (late-treated sample, participants treated after the first month from the earthquake) reported at post-treatment an improvement to a level below the IES-R cutoff (65.8% of the ET sample and 64.02% of the LT sample). Control group analogue and time-outcome correlation suggest that positive changes in symptoms were likely due to the treatment provided and not merely to the time lapse from the traumatic event. The results of this study suggest that EMDR is a viable treatment option in response to a disaster crisis and in reducing psychological distress of acutely traumatized individuals within the context of a natural disaster.

EMDR Europe Humanitarian Programs: Development, Current Status, and Future Challenges

The efficacy of eye movement desensitization and reprocessing (EMDR) therapy has been well established by numerous scientific studies over the past 25 years. The ability to achieve a rapid resolution of trauma symptoms often after only a few EMDR sessions allows clinicians to treat many survivors in a very short period of time. This makes EMDR an ideal intervention after a catastrophic event. The main objective of this article is to describe how European EMDR Associations have provided interventions in emergency situations. Natural and man-made disaster relief projects in Italy, Greenland, and the Netherlands are highlighted. EMDR Europe Humanitarian Assistance Program (HAP) projects sponsored by Austria and Sweden in the Ukraine and Estonia have provided trainings for clinicians. National EMDR Europe associations have developed initiatives in many other areas of the world, such as in Vietnam (EMDR Italy), Cuba (EMDR Spain and Italy), in Pakistan (EMDR United Kingdom and Ireland), in China (EMDR Germany), and in Kenya (EMDR Germany). These projects illustrate the resilience of the populations affected and the generosity of the EMDR Europe community.