EMDR works in the same way that a doctor works if you saw them and they waved a rubber chicken over your infected leg, then gave you some antibiotics. It still works but doesnt exactly inspire confidence that the practitioner has really grasped the scientific method.
The study cited involved 16 weeks of EMDR at 90 minutes a week, vs 16 weeks of CBT at 45-60 minutes a week.
Despite almost double the resources, it also ends up no better in longer term outcomes. You kind of have to wonder how much the initial improvement in outcomes is simply a result of a greater time involvement with the therapist.
Hmm. You mean the scientific method that actually looks at the evidence, whether or not it conform to your preconceived expectation? Oh. No. You mean the one that tells you what fits with what you think you know and if it does not can be dismissed. The one that actually is not really the scientific method. That one.
Been there done that with this discussion before, and you are taking the same position Hentor did there. Except that, as noted at the end of that thread, CBT usually involves more time investment including “homework” that EMDR does not require. “Homework” that the tested form of CBT also requires. Seems to me that if they are otherwise the same then CBT’s use of “homework” is the rubber chicken.
The scientific method I know is not one that requires that I can explain why a finding is. It instead forces me to deal explaining what is observed. CBT works with a requirement of “homework” and used as designed will be as effective as EMDR at 16 weeks. EMDR works as prescribed faster and without the requirement of “homework.” Both are safe as well as effective. Anecdotally individuals I know who have done EMDR and CBT report more vivid visual imagery evoked during EMDR; I have no good explanation that I believe to explain why that would be but it is consistent with the Cochrane report that endorsed both CBT and EMDR as effective.
To call that “quack-ish” is completely inaccurate.
“Been there done that with this discussion before, and you are taking the same position Hentor did there.”
Pretty much, ie the copious cites he provides showing the central claimed mechanism AKA rubber chicken seems to do squat, and ultimately has no scientific basis to date.
No matter how much window dressing is added on, its fundamental theoretical core is based on quackery. Your argument boils down to ‘it doesnt matter as long as it works’ and in my view, thats not science.
It might make its own decent thread, and it is a huge hijack, but our basic concepts of what is and is not science are very different.
Yours seems to be that it does not matter if it works if it does not have an understood “theoretical core.” Mine is that the reproducible observation is the lynchpin, being able to make a prediction about the future. The theory bases are in service of making better predictions about other future observations and if a theory does not fit the reproducible observation the problem aint with the observation.
And yes, from a practitioner POV, what matters to me is what works, whether I am able to comprehend how or not. In that regard I will share a little bit of history - way back in medical school we learned about theophylline, a drug used commonly back then to treat asthma. We were taught that its effects were due to a phosphodiesterase cascade leading to bronchodilation, which made sense. Would it have been less effective if we did not have a good explanation for its working? When we later discovered that it was actually effective in asthma for completely other reasons (both a CNS effect and one on diaphragmatic muscles), did that mean that because our theoretical core was false that using it was not based on science?
It worked. And it was used even though we did not really understand why it worked. And it only stopped being used when other approaches to asthma were developed that had less risk with greater efficacy. Understanding why it works was important because doing so helps us understand the system well enough to make other predictions and potentially to develop other therapeutics, but the decision to use it or not was not contingent on an accurate understanding. It was contingent merely on the fact that it was shown to work.
From another thread this post helps illustrate a difference between CBT and EMDR. EMDR has the sessions with no required work at home; CBT has the sort of homework described here as well. Both get to the same place at the end of treatment.
Again both EMDR and CBT have the same results. One does not require the homework. Both have advantages and disadvantages. Neither are the same exact thing even though they overlap.
I guess they are. Its one thing to have an initial theory and correct it as new data presents. It is not science once new data is presented and they keep clinging to the old one regardless. There is no evidence that the eye movement aspect of EMDR has any effect in itself.
CBT can modify over time, eg if homework does turn out to be superfluous and that exposure in session is the only effective part of the intervention it will change to that. It doesnt have any ideological need to keep the intervention in question or even to use any particular intervention, its major goal is to use evidence based interventions to improve wellbeing.
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… you take the recorded disc home and listen to it for an hour every day, recording your anxiety levels. At first it’s horrible, and you hyperventilate and cry and hurt, but the more you go through the memory the less you fear it and the less it upsets you. You keep listening, over and over, and reliving the memory, until it’s kind of tedious and boring. … you identify common triggers and deliberately approach them. This was done at home. First you create a trigger hierarchy, starting small and building up.
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[QUOTE=Dseid]
Again both EMDR and CBT have the same results. One does not require the homework. Both have advantages and disadvantages. Neither are the same exact thing even though they overlap.
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Whoa whoa whoa. Let me be very clear - **the treatment I described in that quote is homework for prolonged exposure therapy, a highly intensive and specialized version of CBT designed for sufferers of PTSD. ** Regular CBT does involve homework, but it’s not anywhere near the same thing, and requires nowhere near the same level of time investment. When I did exposure therapy I was spending two hours a day in severe distress. CBT is maybe 15 minutes a day filling out charts and thought records, and is nowhere near as distressing. My god, man, you’re going to scare people off from CBT if they think it’s like that!