A new meta-analysis published in Psychological Medicine finds that Eye Movement Desensitization and Reprocessing (EMDR) therapy is effective in treating post-traumatic stress disorder (PTSD), but offers no significant advantage over other psychological treatments. The study also highlights the role of social factors, specifically employment status and gender, in shaping how individuals respond to therapy.
Despite EMDR being listed among the first-line treatments for PTSD, this individual participant data meta-analysis found no significant differences between EMDR and other therapies in reducing symptom severity, achieving treatment response, attaining remission, or lowering dropout rates. However, the researchers did find that unemployed participants receiving EMDR had higher PTSD symptom severity at post-test, and males were more likely to drop out of treatment.Ā
The review, led by Simonne Lesley Wright of Stellenbosch University in South Africa, pooled individual-level data from eight randomized controlled trials (RCTs), including 346 adult participants with PTSD. The authors compared EMDR to a range of other evidence-based psychological treatments, such as trauma-focused cognitive behavioral therapy (CBT-TF), relaxation therapy, emotional freedom technique, and REM-desensitization.
āTo the best of our knowledge, this is the first IPDMA to explore moderators of EMDR for adults with PTSD using individual participant-level data,ā the authors write. āOne of the strengths of the present study was the statistical power to detect statistically significant moderators compared with study-level MA and published RCTs aimed at investigating the efficacy of EMDR for adults with PTSD. This IPDMA made it possible to investigate available participant-level moderators, such as employment status and gender.ā
The study challenges assumptions about the superiority of any single trauma therapy by showing that diverse psychological treatments yield similar outcomes for PTSD. It also highlights how structural factors like employment status and gender shape treatment effectiveness, underscoring the need to address social context rather than focusing solely on technique.
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Try William M Epstein’s work on the evidence base for therapy – he takes apart the best of the studies and looks in detail at them on methodological grounds for a range of so called evidence based therapies EMDR included – he shoes they are of terrible quality – try this AI summarised from Epstein re EMDR:
1. Questionable Scientific Foundations
Epstein argues that EMDRās mechanismsāsuch as the bilateral stimulation through eye movementsālack a plausible scientific rationale. He sees the theoretical foundation of EMDR as vague or unsubstantiated, especially the claim that eye movements can facilitate the processing of traumatic memories.
2. Flawed Research Methodologies
He critiques the research supporting EMDR as methodologically weak. Specifically, he points to:
Small sample sizes.
Poor controls in experimental design.
Selective reporting of positive outcomes.
Lack of long-term follow-up in many studies.
Epstein contends that the apparent effectiveness of EMDR in trials often reflects these methodological issues rather than true therapeutic efficacy.
3. The Placebo Problem
Epstein suggests that EMDR may function primarily as a placebo, with any effectiveness arising from nonspecific therapeutic factorsālike attention, suggestion, and structured supportārather than from the specific techniques (e.g., eye movements) claimed to be central to EMDR.
4. Ideological and Institutional Interests
He argues that the popularity and institutional acceptance of EMDR (including endorsements by organizations like the APA and WHO) may reflect political and ideological pressures more than scientific validity. Epstein frequently emphasizes that practices often become “evidence-based” through institutional mechanisms rather than through genuinely rigorous testing.
5. Critique of the āEvidence-Basedā Label
In line with his wider critique of evidence-based practice, Epstein sees the validation of EMDR as an example of how the label “evidence-based” can be misleading. He argues that what counts as “evidence” is often defined in ways that support prevailing professional, political, or commercial interests, rather than representing a true scientific consensus.
In Summary:
Epstein views the evidence base for EMDR as methodologically suspect, theoretically weak, and ideologically driven. He uses EMDR as a case study in how unproven or poorly understood treatments can gain legitimacy through flawed science and institutional endorsement, rather than through robust empirical validation.
Let me know if youād like quotes or references from Epsteinās works to support this summary.
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I have always thought the eye movement part to be of no importance. It’s basically a regressive therapy, which has always worked for some folks if done well, but doesn’t work for everyone.
That’s the other silly thing about “Evidence Based Therapy” – we are assuming that a percentage of people saying they benefit from a certain approach makes it most effective for everyone, when it may be only effective for that percentage and better approaches may be better for others. Why do we think one “treatment” is going to “work” for everyone with a certain emotional state? Why wouldn’t it depend on the person and their needs? It’s the “medical model” being forced in where it doesn’t belong.
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