One particular challenge in substance abuse treatment is co-occurring post-traumatic stress disorder, or PTSD.
A number of people who become addicted to drugs or alcohol have had traumatic experiences that contribute to the substance use disorder. In many cases, it can be difficult to treat these people because of the person’s struggle to process and recover from the trauma. This, in turn, makes it difficult to work on resolution of the issues behind the associated substance use disorder.
One form of treatment that has been used to overcome this challenge is Eye Movement Desensitization and Reprocessing, or EMDR. This therapy is purported to help people process trauma in a way that is less time-consuming and less expensive than other forms of therapy. It can also benefit the substance abuse recovery process.
Description of EMDR Treatment
According to the EMDR Institute, Inc., EMDR was developed as a psychological treatment to help diminish the distress caused by traumatic experiences. The therapist first instructs the person to think about the traumatic event. Then, the therapist directs certain eye movements that are thought to be related to the rapid eye movements that occur during deep sleep and that may be part of the brain’s cognitive processing functions. This helps the person access the internal associations made with the traumatic event, enabling the event and the person’s reactions and responses to be processed over additional follow-up sessions.
Through this process, the person is able to cognitively work through the feelings and issues brought up by the event. In sessions, the person can transform those negative associations. The therapist emphasizes the person’s ability to overcome the event, making the trauma easier to manage.
Who Benefits from EMDR Treatment?
People struggling with substance abuse who have also experienced trauma or who have PTSD are most likely to benefit from EMDR treatment during rehab. A recent study in the Journal of Psychoactive Drugs showed that people who received traditional substance abuse treatment along with EMDR were able to reduce symptoms of PTSD during treatment. While the substance abuse symptoms were not directly changed by this method, the relief from PTSD symptoms may be helpful in enabling other substance abuse treatment to work better.
Another study from the Journal of EMDR Practice and Research shows that this treatment may also be able to help people struggling with addiction reprocess their addiction memories. In this study, people who received two sessions of EMDR along with traditional substance abuse treatment for alcohol abuse reported significantly decreased cravings for alcohol after treatment and in the month following treatment, compared with those who received traditional treatment alone.
Pros and Cons of EMDR
The pros of EMDR therapy include the following:
- Shorter period of treatment than traditional therapies
- Lower cost of treatment due to shortened treatment timeline
- Ability to process traumatic experiences that may be difficult to talk about
- Potential to improve both PTSD and substance abuse treatment outcomes
- Safety, as EMDR is deemed to be a safe treatment type
There is some controversy as to the actual effectiveness of this treatment type. A relatively low number of studies exist that explore the reasons it seems to be effective. The studies that do exist are generally case studies and do not involve large numbers of subjects. For this reason, further research is being done.
At present, there does seem to be positive therapeutic effect. The American Psychological Association includes this treatment as an accepted therapy that demonstrates positive outcomes.
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Qualifications to Administer EMDR Therapy
According to the EMDR International Association, a professional qualified to administer EMDR therapy must be certified in the professional’s field of practice, in addition to having completed an approved EMDR training program, conducted a certain number of sessions, and received consulting education. Continuing education is also required.
For this person to perform EMDR in a substance abuse treatment setting, it is important that the professional has also completed training in substance abuse treatment and is certified and licensed by the appropriate governing body in the state of practice. Working through a reputable, accredited substance abuse treatment center can provide verification that the practitioner is adequately certified.
Duration of Treatment
Generally, EMDR treatment takes place over eight phases, during which the person is assessed, the trauma is accessed, and the feelings associated with memories of the event are transformed into more positive reactions. The assessment phase generally takes 1-2 sessions, and the remaining phases depend on the progress of the individual client. According to the EMDR International Association, each session takes 60-90 minutes to complete.
As a part of a more robust, comprehensive substance abuse treatment program including detox, therapy, medical treatment (if necessary), group therapy, education, and aftercare, EMDR treatment may provide additional positive outcomes for people struggling with PTSD, trauma, and substance abuse disorders.