Hockenbury Discovering Psychology 5th txtbk

Evaluating the Effectiveness of Psychotherapy605cognitive techniques, exposure therapy has a high rate of successin the treatment of anxiety disorders (Foa & Meadows, 1997).Is EMDR more effective than exposure therapy or other cognitivebehavioraltreatments? No. When Davidson and Parker (2001)compared the effectiveness of EMDR to other exposure treatments,no difference was found. EMDR was no more effectivethan standard treatments for anxiety disorders, including PTSD.Other researchers have found that EMDR is less effective thanexposure therapy for PTSD (Taylor & others, 2003).Are the Eye Movements Necessary?Several research studies have compared standard EMDR withother treatments that duplicate all aspects of the treatmentexcept the eye-movement component. For example, some studieshave compared treatment effects between an eye-movementcondition (EMDR) and “sham” EMDR, a kind of placebo conditionin which the participants fixed their eyes on a bright light thatdid not move or engaged in finger tapping with alternate hands.All these studies found no difference between “real” EMDR and“sham” EMDR (DeBell & Jones, 1997; Feske & Goldstein, 1997;Goldstein & others, 2000). In their meta-analysis, Davidson andParker (2001) agreed with other researchers: There was nodifference in outcome between treatments that incorporatedeye movements and the “sham” EMDR that did not.So if you remove the eye movements from the EMDR treatmentprotocol, what is left? Harvard psychologist Richard McNally(1998), an expert in the treatment of anxiety disorders, puts itsuccinctly: “What is effective in EMDR is not new, and what isnew is not effective.” Psychologists Gerald Rosen and JeffreyLohr (1997) are more blunt:Shapiro took existing elements from cognitive-behavior therapies,added the unnecessary ingredient of finger waving, and thentook the technique on the road before science could catch up.Is EMDR a Pseudoscience?Some psychologists argue that EMDR is just that—a pseudoscience(Devilly, 2005; Lilienfeld, 1998; Rosen & others, 1999).Psychologist James D. Herbert and his colleagues (2000) note severalways in which EMDR displays the fundamental characteristicsof a pseudoscience, which were discussed in Chapter 1:EMDR appears to possess the outward form of science but littleof its substance. The appearance of science, such as case studiesreported in peer reviewed journals, selective publicity of weaktests of effectiveness, [and] scientific-sounding jargon . . . servesto obscure EMDR’s lack of scientific substance and have persuadedmany of its scientific legitimacy. Although there is littleevidence to support the strong claims of EMDR’s proponents, thistreatment has resulted in a significant financial return.The case of EMDR highlights an ongoing problem in contemporarypsychotherapy. Too often, “revolutionary” new therapies aredeveloped, advertised, and marketed directly to the public—and totherapists—before controlled scientific studies of their effectivenesshave been conducted (Lazarus, 2000). Many of the untested therapiesare ineffective or, as in the case of EMDR, no more effectivethan established therapies (Lilienfeld & others, 2003; Lohr & others,2003). Others are downright dangerous, such as the “rebirthing”technique that resulted in the death of a young girl in Colorado inApril 2000. Ten-year-old Candace Newmaker suffocated after beingwrapped in a blanket, covered with pillows, and restrained byfour adult “therapists” who taunted her when she cried, pleadedfor air, and repeatedly told them she could not breathe.Like many pseudosciences, such fringe therapies rely on anecdotesand testimonials to persuade others of their efficacy. Theirproponents often resort to vague, scientific-sounding explanationsof their mechanisms rather than established—and testable—scientificprinciples (Lilienfeld, 1998). James Herbert and his colleagues(2000) argue that new therapeutic techniques should be tested beforethey are put into widespread use, not after. The conditions thatnew therapies should meet are summarized in the table at left.The Burden of ProofPsychologist James D. Herbert and his colleagues (2000) arguethat before being put into widespread use, new therapies shouldprovide empirically based answers to the following questions:• Does the treatment work better than no treatment?• Does the treatment work better than a placebo?• Does the treatment work better than standard treatments?• Does the treatment work through the processes that itsproponents claim?Source: Herbert & others (2000).eye movement desensitization reprocessing (EMDR)Therapy technique in which the client holds a vivid mental imageof a troubling event or situation while rapidly moving his or hereyes back and forth in response to the therapist’s waving finger orwhile the therapist administers some other form of bilateral stimulation,such as sounding tones in alternate ears.exposure therapyBehavioral therapy for phobias, panic disorder, post-traumaticstress disorder, or related anxiety disorders in which the person isrepeatedly exposed to the disturbing object or situation under controlledconditions.day, therapists identify themselves as eclectic more often than any other orientation(Norcross, Lambert & Ogles, 2004; Karpiak, & others, 2005). Eclectic psychotherapistscarefully tailor the therapy approach to the problems and characteristics ofthe person seeking help. For example, an eclectic therapist might integrate insightorientedtechniques with specific behavioral techniques to help someone sufferingfrom extreme shyness. A related approach is integrative psychotherapy. Integrativepsychotherapists also use multiple approaches to therapy, but they tend to blendthem together rather than choosing different approaches for different clients(Lazarus, 2008; Stricker & Gold, 2008).