Sequence matters : Combining Prolonged Exposure and EMDR therapy for PTSD

Objective
Investigating the influence of the sequence in which two evidence-based trauma-focused treatments are offered to PTSD-patients.

Methods
PTSD-patients were treated using an intensive eight-day treatment program, combining Prolonged Exposure (PE) and EMDR therapy. Forty-four patients received a PE session in the morning and an EMDR session in the afternoon, while 62 patients received the reversed sequence (EMDR followed by PE). Outcome measures were PTSD symptom severity and subjective experiences.

Results
Patients who received PE first and EMDR second showed a significantly greater reduction in PTSD symptoms. Patients preferred this sequence and valued the treatment sessions as significantly more helpful compared to patients in the EMDR-first condition.

Conclusion
The results of this explorative study are supportive of the notion that PE and EMDR therapy can be successfully combined, and that sequence matters. First applying PE sessions before EMDR sessions resulted in better treatment outcome, and better subjective patient's evaluations in terms of treatment helpfulness and preference.



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Reference: 
Agnes Van Minnen, Eline M. Voorendonk, Linda Rozendaal, Ad de Jongh | 2020
In: Psychiatry Research ; ISSN: 0165-1781 | 290 | augustus | 113032
https://doi.org/10.1016/j.psychres.2020.113032
Keywords: 
Comorbidity, EMDR, EMDR (Eye Movement Desensitization and Reprocessing), Exposure Therapy (en), Posttraumatic Stress Disorder, Prolonged Exposure Therapy, Psychotrauma, PTSD (DSM-5), PTSD (DSM-IV), PTSD (en), Research, Treatment