Can Eye Movement Desensitization and Reprocessing (EMDR) Help People with Early Psychosis?

What you need to know

• Eye Movement Desensitization and Reprocessing for psychosis (EMDRp) appears to be a feasible and potentially effective treatment for individuals with early psychosis who have experienced trauma.
• The study found promising results for EMDRp in reducing psychotic symptoms, improving recovery, and decreasing post-traumatic stress symptoms.
• A larger, multi-center trial is warranted to further evaluate the efficacy of EMDRp for early psychosis.

Understanding Psychosis and Trauma

Psychosis is a mental health condition that affects about 0.7% of the population. It can cause significant personal and societal burden, often leading to poor recovery outcomes. Current treatments for psychosis, including medication and psychological therapies, often have modest and variable effects. This highlights the need for improved treatments, especially for individuals experiencing early or first-episode psychosis.

Research has shown a strong link between trauma exposure and the risk of developing psychosis. Trauma is particularly common in people with early psychosis and is associated with more severe symptoms and poorer outcomes. Despite this connection, most trauma-focused treatments have traditionally excluded people with psychotic symptoms.

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a type of therapy recommended for treating trauma. It involves the patient focusing on a traumatic memory while simultaneously engaging in eye movements or other forms of bilateral stimulation. EMDR has been gaining attention as a potential treatment for complex mental health issues beyond post-traumatic stress disorder (PTSD).

The EMDR for Psychosis (EMDRp) Study

This study aimed to determine if it would be feasible to conduct a large-scale trial of EMDR adapted for people with early psychosis, called EMDRp. The researchers wanted to know if they could recruit and retain participants, if therapists could deliver the treatment effectively, and if there were early signs that the treatment might be helpful.

How the Study Was Conducted

The study involved 60 participants who were receiving care from Early Intervention services for psychosis. These participants were randomly assigned to one of two groups:

1. EMDRp plus treatment as usual (31 participants)
2. Treatment as usual only (29 participants)

The EMDRp group received up to 16 sessions of therapy over 6 months. All participants were assessed at the start of the study, after 6 months, and after 12 months.

Key Findings

1. Feasibility: The study met all its feasibility criteria. They were able to recruit the target number of participants, retain most of them throughout the study, and deliver the EMDRp treatment effectively.

2. Promise of Effectiveness: At the 6-month assessment, there were promising signs that EMDRp might be helpful for:

   • Reducing overall psychotic symptoms
   • Improving subjective recovery from psychosis
   • Decreasing post-traumatic stress symptoms
   • Reducing symptoms of depression and anxiety
   • Improving general health status

3. Longer-term Effects: At the 12-month assessment, the benefits were less pronounced but still notable for post-traumatic stress symptoms and general health status.

4. Safety: The treatment appeared to have a good safety profile, with no serious adverse events related to the EMDRp therapy.

Adapting to COVID-19

It’s worth noting that this study was conducted during the COVID-19 pandemic, which led to some changes in how the research was carried out. For example, some therapy sessions and assessments had to be done remotely via video calls. Interestingly, this showed that it’s possible to safely deliver trauma-focused therapy remotely for people with complex mental health problems.

What This Means for Patients and Families

For individuals with early psychosis who have experienced trauma, this study offers hope for a potentially effective new treatment option. EMDRp appears to be safe and may help improve a range of symptoms, including psychotic symptoms, post-traumatic stress, and overall mental health.

However, it’s important to remember that this was a small, initial study. While the results are promising, larger studies are needed to confirm the effectiveness of EMDRp for early psychosis. Patients and families should discuss all treatment options with their healthcare providers to determine the best approach for their individual situation.

Future Research

Based on these promising results, the researchers recommend conducting a larger, multi-center trial to further evaluate the effectiveness of EMDRp for early psychosis. Future studies may also look into how EMDRp works and for whom it might be most beneficial.

Conclusions

• EMDRp appears to be a feasible treatment for individuals with early psychosis who have experienced trauma.
• The study found promising signs that EMDRp might help improve various symptoms, including psychotic symptoms and post-traumatic stress.
• While these results are encouraging, larger studies are needed to confirm the effectiveness of EMDRp for early psychosis.