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View this email in your browser Clinical Newsletter Volume 7, Issue 6 | November 2019 With the volatile world situation resulting in an increasing number of victims of politically related trauma, in this edition of our Clinical Newsletter, we focus on recent studies applying EMDR therapy to terror victims, refugees, and asylum seekers. As the EMDR Research Foundation Board of Directors work to create more research opportunities for our community, we hope you join the conversation with your suggestions for upcoming newsletters. Click here to offer your suggestions.

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Page 1: With the volatile world situation resulting in an ... · Evaluating the EMDR Group Traumatic Episode Protocol with Refugees: A Field Study ... M., Shapiro, E., Schreiber, M., & Hofmann,

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Clinical Newsletter

Volume 7, Issue 6 | November 2019

With the volatile world situation resulting in an increasing number of victims of politicallyrelated trauma, in this edition of our Clinical Newsletter, we focus on recent studies

applying EMDR therapy to terror victims, refugees, and asylum seekers.

As the EMDR Research Foundation Board of Directors work to create more researchopportunities for our community, we hope you join the conversation with your suggestions forupcoming newsletters. Click here to offer your suggestions.

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Immediate Treatment Following the November 13Attacks: Use of an EMDR Emergency Protocol

Brennstuhl, M.J., Bassan, F., Fayard, A.M., Fisselbrand, M., Guth, A., Hassler, M.,Tarquinio, C. (2019). Immediate treatment following the November 13 attacks: Useof an EMDR emergency protocol. European Journal of Trauma & Dissociation, 3(1),17-21. doi:10.1016/j.ejtd.2018.09.004.

ABSTRACTOBJECTIVE: The objective of this article is to report on an emergency posttraumatictreatment following the November 13, 2015 attacks in Paris.

METHOD: Thirty-six children and 20 adults were treated with EMDR therapy ordebriefing within 48 hours after the attacks. Quantitative assessments wereperformed pre- and post-treatment and at a 3-month follow-up.

RESULTS: The EMDR treatment administered to the children and the debriefingused with the adults both showed their efficacy through the reduction on allquantitative measures.

DISCUSSION: Our results indicate that the EMDR approach and emergencytreatment strategies may be promising treatment strategies that are non-invasive

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and preventive. Although these results should be completed by studies on largersamples with a control group, they remain promising in that they suggest that anemergency psychological treatment based on EMDR procedures may prove effectivein preventing the installation of a post-attack posttraumatic stress disorder. Learn more.

Evaluating the EMDR Group Traumatic Episode Protocolwith Refugees: A Field Study

Lehnung, M., Shapiro, E., Schreiber, M., & Hofmann, A. (2017). Evaluating theEMDR group traumatic episode protocol with refugees: A field study. Journal ofEMDR Practice and Research, 11(3), 129-138. | doi:10.1891/1933-3196.11.3.129

ABSTRACTIn 2015, more than 1.5 million refugees arrived in Germany, many severely traumatized.Eye movement desensitization and reprocessing (EMDR) therapy has been proven to bean effective treatment for acute and chronic traumatic stress symptoms. A modification forprovision in group settings was developed by E. Shapiro: the EMDR Group TraumaticEpisode Protocol (G-TEP). In this field study, we investigated the effectiveness of 2sessions of EMDR G-TEP in treating traumatized refugees. After receiving a psycho-education session, 18 Arabic-speaking refugees from Syria and Iraq who had come toGermany during the previous 5 months were assigned to treatment and/or waitlist.

The Impact of Event Scale-Revised (IES-R) and Beck Depression Inventory (BDI) wereadministered at pre- and post-treatment. Analysis was conducted using the Mann-WhitneyU test and planned Kolmogorov-Smirnov tests. Results showed significant differencesbetween the treatment and the waitlist groups, indicating a significant decline in IES-Rscores (p < .05). Although differences in BDI scores did not reach significance (p = .06), alarge decline in BDI scores was seen in the treatment group. These results providepreliminary evidence that it might be effective to treat groups of traumatized refugees withEMDR G-TEP. Learn more.

An Eye Movement Desensitization and Reprocessing(EMDR) Group Intervention for Syrian Refugees with

Post-Traumatic Stress Symptoms: Results of a

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Randomized Controlled Trial

Yurtsever, A., Konuk, E., Akyüz, T., Zat, Z., Tükel, F., Çetinkaya, M. et al. (2018). An EyeMovement Desensitization and Re- processing (EMDR) Group Intervention for SyrianRefugees With Post-traumatic Stress Symptoms: Results of a Randomized Con- trolledTrial. Front Psychol, 9, 493.

ABSTRACTThe number of refugees has increased significantly over the past few years. PTSD anddepression are among the most common mental health problems among refugees. EyeMovement Desensitization and Reprocessing (EMDR), an effective treatment for PTSD, isusually administered individually. The availability of mental health resources would begreatly enhanced when EMDR can be delivered to groups. The EMDR G-TEP is a groupprotocol based on EMDR Early Intervention protocols. There is clinical evidence and onefield study published on the effect of EMDR G- TEP and there is only one RCT publishedon the treatment of PTSD and depression in a refugee camp. The aim of our study was toinvestigate the efficacy of EMDR G-TEP in treating post-trauma symptoms and depressionand preventing the development of chronic PTSD among refugees living in a refugeecamp. 47 adult participants with PTSD symptoms were randomly allocated to experimental(n = 18) and control (n = 29) groups. We measured Impact of Event Scale (IES-R), BeckDepression Inventory-II (BDI-II) and International Neuropsychiatric Interview (MINI) atpre-, post- and 4-week follow-up. Analysis of the results showed that the EMDR G-TEPgroup had significantly lower PTSD and depression symptoms after intervention. Thepercentage of PTSD diagnosis decreased from 100 to 38.9% in the EMDR G-TEP groupand was unchanged in the control group. Following the EMDR G-TEP intervention 61.1%of the experimental group no longer had a PTSD diagnosis; this decrease was maintainedat 4 weeks follow-up. In the control group the percentage of people who no longer met thediagnostic criteria for PTSD was 10.3% post-test and 6.9% at 4 weeks follow-up. Asignificant decrease in depression symptoms from pre-test levels was found in EMDRgroup but not in the control group follow up-test. This study indicated that EMDR G-TEP effectively reduced PTSD symptoms among refugees living in a camp, aftertwo treatment sessions conducted over a period of 3 days. Further studies need tobe performed using a larger number of participants, followed for a longer period of timeand given more treatment sessions to strengthen our findings. Learn more.

The Use of EMDR with Refugees and Asylum Seekers: A

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Review of Research Studies

Gattinara, P. C., & Pallini, S. (2017). The use of EMDR with refugees and asylum seekers:A review of research studies. Clinical Neuropsychiatry, 14(5), 341-344.

ABSTRACTEye Movement Desensitization and Reprocessing (EMDR) (Shapiro 2001), is an evidencebased therapy for PTSD and could be effective in the treatment of the traumatized andtherefore, has been endorsed as a treatment of choice in many national and internationalhealth organizations including the world health organization. This article reviews thecurrent state of knowledge regarding the use of EMDR in the refugees and asylum seekerstreatment of PTSD. Recently there is a growing interest in implementing EMDR as atrauma-focused intervention. On reviewing nine studies, authors found that EMDR wasmore efficacious against waitlist, and was equally efficacious against stabilization. Learnmore.

Efficacy and Acceptability of Psychosocial Interventionsin Asylum Seekers and Refugees: Systematic Review

and Meta-Analysis

* The study below is not limited to EMDR

Turrini, G., Purgato, M., Acarturk, C., Anttila, M., Au, T., Ballette, F., Barbui, C.(2019). Efficacy and acceptability of psychosocial interventions in asylum seekersand refugees: systematic review and meta-analysis. Epidemiol Psychiatr Sci, 1-13. doi:10.1017/ S2045796019000027

ABSTRACTAIMS: In the past few years, there has been an unprecedented increase in the number offorcibly displaced migrants worldwide, of which a substantial proportion is refugees andasylum seekers. Refugees and asylum seekers may experience high levels ofpsychological distress, and show high rates of mental health conditions. It is thereforetimely and particularly relevant to assess whether current evidence supports the provisionof psychosocial interventions for this population. We conducted a systematic review andmeta-analysis of randomized controlled trials (RCTs) assessing the efficacy andacceptability of psychosocial interventions compared with control conditions (treatment as

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usual/no treatment, waiting list, psychological placebo) aimed at reducing mental healthproblems in distressed refugees and asylum seekers.

METHODS: We used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacyand acceptability of psychosocial interventions in adults and children asylum seekers andrefugees with psychological distress. Post-traumatic stress disorder (PTSD), depressiveand anxiety symptoms at post-intervention were the primary outcomes. Secondaryoutcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning,quality of life and dropouts due to any reason.

RESULTS: We included 26 studies with 1959 participants. Meta-analysis of RCTs revealedthat psychosocial interventions have a clinically significant beneficial effect on PTSD(standardized mean difference [SMD] = -0.71; 95% confidence interval [CI] -1.01 to -0.41;I2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence),depression (SMD = -1.02; 95% CI -1.52 to -0.51; I2 = 89%; 95% CI 82-93; 12 studies, 844participants; moderate quality evidence) and anxiety outcomes (SMD = -1.05; 95% CI-1.55 to -0.56; I2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate qualityevidence). This beneficial effect was maintained at 1 month or longer follow-up, which isextremely important for populations exposed to ongoing post-migration stressors. For theother secondary outcomes, we identified a non-significant trend in favor of psychosocialinterventions. Most evidence supported interventions based on cognitive behavioraltherapies with a trauma-focused component. Limitations of this review include the limitednumber of studies collected, with a relatively low total number of participants, andthe limited available data for positive outcomes like functioning and quality of life.

CONCLUSIONS: Considering the epidemiological relevance of psychological distress andmental health conditions in refugees and asylum seekers, and in view of the existing dataon the effectiveness of psychosocial interventions, these interventions should be routinelymade available as part of the health care of distressed refugees and asylum seekers.Evidence-based guidelines and implementation packagesshould be developed accordingly. Learn more.

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Announcing a $50,000 Grant Award

In honor of the legacy of Dr. Francine Shapiro, the EMDR Research Foundation is pleasedto announce a $50,000 grant to be awarded and funded by the Francine Shapiro MemorialFund. It was her dedication to research that inspired and motivated us to form the EMDRResearch Foundation. Her mantra was Research, Research, Research! She would oftensay to clinicians making a verbal report of success, “Will you write that up? That needs tobe published!” Whatever is claimed in your clinical practice, must be validated in research.We hope to be able to carry that legacy forward in our work together. Learn more.

Grants & Awards

Our next grant application deadline is February 1, 2020 and canbe submitted through our website.

RESEARCH AWARD GRANTSResearchers, if you are interested in doing research thataddresses EMDR topics related to the military and you needadditional funding, consider applying for a $25,000 researchaward through the EMDR Research Foundation.

RESEARCH CONSULTATION AWARDSUp to $1,000 may be available to facilitate access to requiredexpertise that would advance the development of an EMDRTherapy research project, to support the completion of anEMDR Therapy research project underway, or the writing of anarticle on EMDR Therapy for publication in a professionaljournal. Applications for these awards are accepted at any timeduring the year.

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Learn more.

Revised Fidelity Rating Scale

NEW for Clinicians, Consultants, and Researchers! The EMDRFidelity Rating Scale (EFRS) has been significantly revisedsince it was originally published, making it more precise anduser-friendly.

Learn more.

New ISTSS Prevention and TreatmentGuidelines

The new International Society for Traumatic Stress Studies'(ISTSS) guidelines on the prevention and treatment of post-traumatic stress disorder (PTSD), and position papers oncomplex PTSD, have recently been published. An internationalcommittee of experts was established in 2015 to updateguidelines published in 2009 by reviewing the latest evidencefrom clinical research trials. The guidelines and position papersare intended to assist clinicians providing prevention andtreatment interventions for children, adolescents and adultswith, or at risk of, developing PTSD and Complex PTSD.Professor Julian Ford, ISTSS President, said, "The excellentwork of the ISTSS Treatment Guidelines Committee will make areal difference to people affected by traumatic events" The newguidelines and position papers are available to download fromthe ISTSS website.

Learn more.

Create a Fundraising Page

You have the opportunity to create a fundraising page in which

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your network can easily donate to the EMDR ResearchFoundation in honor of a family member, friend, colleague,yourself, or through a special event or occasion like a wedding,graduation, or running in a 5K race!

Learn more.

See Our Updated Toolkit

Whether humanity inflicting harm on itself or due to naturaldisasters, left untreated, traumatic life experiences can lead tomore harm. The EMDR Research Foundation has created theEMDR Early Intervention (EEI) Toolkit as a research toclinicians and researchers in times of need.

Learn more.