Post-traumatic stress disorder study casts doubt on popular treatment

Post-traumatic stress disorder study casts doubt on popular treatment

World-first research at the University of Queensland has proved the efficacy of a popular, internationally-marketed psychological treatment for post-traumatic stress disorder (PTSD) is relatively poor.

The PhD study by Dr Grant Devilly of the School of Psychology has shown that eye movements, the central feature of Eye Movement Desensitisation and Reprocessing (EMDR) treatment, offers no long-term benefit to PTSD sufferers. It is the first study to compare a Trauma Treatment Protocol (TTP) and EMDR over time. The results have appeared in the Journal of Anxiety Disorders.

"PTSD is intrusive and very distressing, not only for the person but for their families," said Dr Devilly. "It causes a lot of pain and some people are willing to take advantage of that with new treatment techniques."

Dr Devilly, a clinician in private practice and University lecturer, was trained in exposure techniques (on which TTP is based) by PTSD expert Dr Edna Foa. He was also trained in EMDR by Californian psychologist Dr Francine Shapiro, who developed the technique in the late 1980s and has created a highly successful business around it.

In Dr Devilly's study, one group of PTSD sufferers received typical EMDR treatment, in which they imagined a traumatic scene while moving their eyes to follow a psychologist's bilateral hand movements. The other group received TTP, which used exposure principles and advanced cognitive therapy. TTP also provided psycho-education about the disorder and taught coping strategies.

Under TTP's exposure principles, PTSD sufferers returned to the situations which triggered their fears, so that they could gain ?corrective information'. "For instance, a woman suffering PTSD after being attacked in a park might believe parks were dangerous. Our corrective message would be that the park itself wasn't dangerous; the person was dangerous." Dr Devilly said.

The results of the study showed that, both in the short and long term, TTP was statistically and clinically more effective on all measures than EMDR. EMDR seemed to help a little in the short term, but was nowhere near as effective. "At the end of treatment, 85-92 percent of those who had received TTP treatment no longer met criteria for PTSD. This is among the best return rates in the world," Dr Devilly said.

"Later follow-ups showed TTP maintained these results and on some measures continued improving, while some of those who were treated successfully with EMDR returned to base-line - back to how they had been at the beginning of treatment. EMDR is effective to a degree because it does involve some exposure treatment. But it is the exposure that is effective - not the eye movements. We know that for a fact now."

For more information, contact Dr Grant Devilly (telephone 0412 157 951).