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EMDR Research

Eye movement desensitization and reprocessing (EMDR), though it has been in use for decades, has only recently been publically recognized as one of the premier treatments for PTSD and other anxiety-related disorders.

Research Findings

  • EMDR has been listed as an effective treatment by the American Psychiatric Association, Departments of Defense and Veterans Affairs, International Society for Traumatic Stress Studies, and numerous international agencies.
  • The sheer number of EMDR studies performed makes a statement about the technique's impact. According to UCLA Neuropsychiatric Institute child psychiatry fellow Gary Peterson, M.D. EMDR has had “more double-blind, placebo-controlled studies published in peer-reviewed journals than any other psychotherapy method” for the treatment of PTSD.
  • Controlled clinical trials support the use of EMDR for trauma symptoms resulting from natural disasters and other near death experiences, and EMDR has been used successfully to treat war- and terrorism-related trauma.
  • EMDR has been used successfully in response to a variety of mass-casualty events, and can be integrated with educational formats.
  • EMDR has been shown to reduce or eliminate intrusive imagery (such as nightmares and flashbacks), numbing, and hyperarousal symptoms of PTSD, as well as associated grief and depression.
  • In several direct comparisons with cognitive-behavioral therapy, EMDR offers equivalent effects using fewer sessions and no homework. Process analyses indicate less distress for individuals undergoing EMDR treatment versus CBT.

Review of the Literature

Compared to modified flooding - The first EMDR study was conducted in 1989 by Shapiro (1989) who randomly assigned 22 combat veterans and civilians to one session of EMDR or a modified flooding procedure. The subjects were diagnosed with PTSD by referral sources. The measures used consisted of SUD and VOC ratings and a behavioral measure which documented the frequency and severity of the primary presenting complaint (e.g. flashbacks) with corroboration by significant others. Subjects in the EMDR group showed significant positive treatment effects compared to the control procedure at post-test. Because the modified flooding control subjects showed no improvement, they were provided with EMDR treatment for ethical reasons. Their response to treatment replicated the results of the first group.

These results were independently corroborated at 1- and 3-month follow-up. Shapiro's study (1989) had many limitations. There was no independent blind assessor. The lack of standardized measures prevents the comparison of results with other samples. Provision of EMDR treatment to the control group eliminated their use as controls for the follow-up measures. Because of the multiple roles played by Shapiro as treatment originator, therapist, and author, experimenter bias cannot be ruled out.

Since 1989, dozens of controlled randomized studies have investigated the use of EMDR with PTSD subjects. The methodology has improved and to a greater or lesser extent, later studies have addressed these problems; providing a more rigorous examination of EMDR. A number of these empirical studies have demonstrated that EMDR is effective as a treatment for PTSD.

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Treatment Efficacy Studies with Civilian Participants

Compared to No Treatment After 3 Sessions - Rothbaum (1997) randomly assigned 18 adult female rape victims with PTSD to three sessions of EMDR or a wait-list control group. Results were evaluated by a blind independent assessor using structured interviews and self-report measures. The self-report scores of the EMDR participants on PTSD and depression scales showed a mean decrease of more than two standard deviations at post-treatment, which was a significant improvement compared to wait-list controls. Although decreases on other self-report measures were not significant, mean scores of the EMDR group decreased to within normal limits range. At post-treatment, 90% of the subjects in the EMDR group no longer met full criteria for PTSD compared to 12% of the wait list group. The wait list design is limited: No comparison is made to other treatments and there is no control for nonspecific factors such as therapeutic alliance, expectations, or placebo effects.

Compared to No Treatment After 15 Months - Wilson, Becker, and Tinker (1995) randomly assigned a sample of 80 traumatized individuals, 46% of whom were diagnosed with PTSD, to EMDR treatment or Wait List conditions. Each subject received three 90-min sessions of EMDR. A blind independent assessor administered all self-report measures at pre and post treatment and at three month follow-up. Significant differences were found between EMDR and Wait List groups on standardized measures of PTSD symptoms, depression, and anxiety at post-treatment and 3 month follow-up. This improvement was also clinically significant, with the means for all measures moving into a normal range. Treatment gains were strongest for those measures specifically related to trauma. When treatment was provided to the Wait List group, treatment effects were replicated, with significant effects for all measures. A linear regression analysis indicated that treatment gains did not vary as a function of symptom severity or PTSD diagnosis at pre-treatment. This study is limited by its wait list design which does not control for nonspecific treatment factors.

In a 15 month follow-up study (Wilson, Becker & Tinker, 1997), 32 of the original 37 subjects with PTSD were interviewed by an independent assessor. The assessment was not blind as all subjects had received EMDR treatment by this time, and there was no longer a control group. EMDR produced an 84% reduction in PTSD diagnosis compared to pre-treatment. Because this design does not control for influences during the 15 month period, such as other treatment or spontaneous remission, it is not possible to conclude that the maintenance of post-treatment outcome resulted solely from EMDR treatment effects.

Seven controlled civilian studies investigated the efficacy of EMDR with civilian PTSD subjects. The aggregate evidence of the results demonstrates that EMDR is an effective treatment for civilian PTSD. Six of these studies (Lee & Gavriel, 1998; Marcus et al., 1998; Rothbaum, 1997; Scheck et al. 1998; Vaughan et al., 1994; Wilson et al., 1995) found EMDR very effective. These studies indicated that EMDR was superior to active listening, standard Kaiser care, and no treatment, and as effective as CBT. Five of these six studies calculated the decrease in PTSD diagnosis which was substantial, ranging from 70% to 90%. The seventh study (Devilly & Spence) had poor results with EMDR, with only 18% of persons no longer meeting PTSD diagnostic criteria. Although Vaughan et al. and Lee and Gavriel found EMDR and CBT exposure therapies to be relatively equivalent, this was not the finding of Devilly and Spence who found CBT superior. The wide variation in the outcome of these three studies makes apparent the need for further studies to compare EMDR and CBT.

EMDR Compared to Other Treatments

Compared to Standard Kaiser Care: cognitive, psychodynamic and behavioral therapies - Marcus, Marquis, and Sakai (1997) compared EMDR to Standard Kaiser Care (SKC) in an outpatient HMO. SKC consisted of individual therapy (cognitive, psychodynamic, or behavioral therapy). Sixty-seven individuals with PTSD were randomly assigned to EMDR or SKC treatment. An unspecified number in each group had medication related supervision appointments. Participants received an unlimited number of 50-min treatment sessions; the average number of sessions was not reported. The independent assessor was not blind to treatment condition.

EMDR participants attained symptom reduction with significantly greater rapidity and had significantly fewer treatment sessions and fewer medication related appointments than SKC participants. EMDR produced significantly lower scores than SKC, after 3 sessions and at post-treatment, on measures of PTSD symptoms, depression, and anxiety. After three sessions, 50% of the EMDR participants no longer met the criteria for PTSD, compared to 20% of the SKC group. At post-treatment, 77% of the EMDR group (including 100% of the single trauma victims) no longer met criteria for PTSD compared to 50% of the SKC group. Limitations of this study include the numerous statistical analyses without Bonferroni corrections. Even though the wide variety of treatments used in the control group accurately represents standard care in an HMO setting, their unstandardized heterogeneous nature precludes specific knowledge of their effectiveness for PTSD treatment; this limits the conclusions that can be drawn.

Compared to active listening (AL) - Scheck, Schaeffer, and Gillette (1998) compared EMDR to an active listening(AL) control with a group of 60 traumatized young women who were engagingin high risk behavior such as sexual promiscuity, runaway behavior, or substance abuse. Seventy-seven percent were diagnosed with PTSD using a structured interview. The women received two 90-minute treatment sessions, and had a homework assignment of journal writing. Post treatment measures were collected by an independent blind assessor. No treatment integrity ratings were done.

Both AL and EMDR resulted in significant improvement on all measures, which included measures of PTSD, depression, anxiety, and self-concept. The effects of EMDR were significantly greater than that of AL on all measures except self-concept. This difference was most evident for the most trauma specific measure. Treatment gains were maintained at 3 month follow-up for both groups. Because no assessment was made at post-treatment of the PTSD status of the subjects, it is not known if treatment resulted in a change in PTSD diagnosis. There is no established evidence that active listening is an effective treatment for PTSD, so this study does not compare EMDR to an established effective treatment. The results indicate that EMDR is superior to a condition that controls for some of the nonspecific effects of treatment such as attention, therapeutic rapport, and active listening.

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EMDR Compared to Behavioral and Cognitive Behavioral Therapies

Compared to imaginal exposure (IHT), applied muscle relaxation training (AMR), and wait list - Vaughan et al. (1994) assigned 36 participants, 78% of whom were diagnosed with PTSD, to EMDR, imaginal exposure (IHT), applied muscle relaxation training (AMR), and wait list conditions. The exposure group (IHT) used a procedure in which subjects listened daily for 60-mins to an audiotaped description of their trauma, and recorded thoughts and feelings. Three to five treatment sessions were administered, with daily homework assigned to the IHT and AMR groups only. Blind independent assessments were conducted at pretreatment, post-treatment and at three month follow-up. There were no reported checks on treatment fidelity.

All treatments led to significant decreases in depression and PTSD symptoms for subjects in the treatment groups as compared to those on the wait list. A comparison between treatment groups found a significantly greater reduction at post-treatment for the EMDR group on PTSD intrusive symptoms (IES), and at follow-up for the relaxation group on the BDI. At follow-up, 70% of the PTSD subjects no longer met PTSD diagnostic criteria. Limitations include the limited number of treatment sessions, and different amounts of treatment received by the groups with additional daily homework time in the AMR and IHT groups.

Compared to Trauma Treatment Protocol (TTP): CBT, Stress Inoculation Training, and Prolonged Exposure - Devilly & Spence (1999) compared EMDR to a treatment developed by Devilly, "Trauma Treatment Protocol" (TTP). TTP has never been examined before, and is a treatment package combining elements of CBT, Stress Inoculation Training, and Prolonged Exposure. Twenty-three civilian subjects with PTSD were randomly assigned to eight sessions of either EMDR or TTP. There was no independent blind assessor. Although treatment integrity was rated as high by an independent EMDR therapist, their description of the technique (Devilly, Spence & Rapee, 1998) indicated a lack of conformity to standardized procedures, with errors such as inaccurate instructions, rating the negative cognition, repeating the negative cognition during treatment, and frequent SUD ratings (see Shapiro, 1995). After the initial information session, 31% of the EMDR participants dropped out before receiving any EMDR treatment.

Both EMDR and TTP were significantly effective on all measures. TTP was significantly more effective than EMDR on combined PTSD measures, and a scale of global function. At three month follow-up, scores on a mailed-in self-report PTSD measure indicated that 58% of the TTP subjects no longer met PTSD criteria compared to only 18% of the EMDR group. Follow-up showed that improvement was maintained with TTP, but worsened with EMDR. Limitations of this study include the large number of statistical analyses done with no Bonferroni correction for Type I error.

Compared to Stress Inoculation Training with Prolonged Exposure (SITPE) - Lee and Gavriel (1998) randomly assigned 22 civilian subjects with PTSD to Stress Inoculation Training with Prolonged Exposure (SITPE) or EMDR. They also served as their own controls during a wait list period. Participants were provided with seven 60-min treatment sessions. Measures were collected at pre and post-treatment and at three month follow-up. Assessment was not blind nor independent. Fidelity checks were satisfactory for both treatments.

Both EMDR and SITPE were found to be highly effective, with significant decreases of scores on a PTSD scale and a depression measure. At follow-up 83% of the EMDR subjects and 75% of the SITPE subjects no longer met PTSD criteria. The only difference found between groups was on measures of the Intrusion subscales of the PTSD measures with the EMDR group showing significantly greater improvement. This study indicates that EMDR and SITPE are fairly equivalent in treatment effectiveness. The authors point out that EMDR may be more efficient by not requiring homework assignments. EMDR required an average of 3 hours homework, SITPE required 28 hours.

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Combat Studies Providing Limited Treatment

EMDR using two treatment sessions - Jensen (1994) randomly assigned 25 Vietnam combat veterans suffering from PTSD to a wait list condition or two sessions of EMDR. No difference was found between groups. Instead of improvement, the condition of the veterans actually deteriorated. Limitations include the use of global measures, lack of blind independent assessment, poor treatment fidelity, insufficient number of sessions and participants receiving concurrent mental health services. The wait list condition was confounded by informing participants that no treatment would be provided and encouraging them to seek treatment elsewhere.

Compared to Standard Psychiatric Support (SPS) and an EMDR variant (REDDR) -Devilly et al. (1998) assigned 51 combat veterans with PTSD, to one of three conditions: Standard Psychiatric Support (SPS), EMDR, or an EMDR variant (REDDR) in which subjects concentrated on a stationary flashing light. Forty-six percent of the veterans did not mail back their follow-up measures, and the authors note a diminishing of treatment effect over time. Limitations of this study include no blind independent assessment, treatment delivery not according to standard, only one treatment provider, participants receiving concurrent mental health treatment, insufficient number of sessions, and the use of global measures. At post treatment all groups showed significant improvement on measures of PTSD, depression, anxiety, and problem coping. Measures of reliable improvement occurred in 67% of the EMDR group, 42% of the REDDR group, and 10% of the SPS group.

Compared to an EMDR analogue with eyes closed (EC), or standard group therapy - Boudewyns and Hyer (1996) sought to evaluate the addition of EMDR to standard group therapy in the treatment of 61 combat veterans with chronic PTSD who were considered multiply disabled and most of whom were receiving disability pensions. Subjects were randomly assigned to one of three conditions: EMDR, an EMDR analogue with eyes closed (EC), or standard group therapy. Every participant received 8 sessions of group therapy, with the EMDR and EC conditions also receiving 5 to 7 treatment sessions of either EMDR or EC. Participants in all three conditions improved significantly on a structured interview measuring PTSD symptoms, with no group differences. Subjects in the EMDR analogue (EC) and EMDR conditions showed superior improvement on a mood and physiological measures compared to group therapy controls. This study indicates that the addition of EMDR or EC to group treatment may improve outcome. Boudewyns and Hyer report that both therapists and clients preferred EMDR to the more direct exposure condition (EC). Limitations include the treatment of only one or two memories, use of global measures, variable treatment fidelity, and subjects receiving concurrent group treatment.

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Combat Studies Providing Full Treatment

Full EMDR Course of Therapy Compared to Biofeedback Relaxation - Only one EMDR study has provided a full course of treatment for combat veterans with PTSD. Carlson et al. (1998) randomly assigned 35 Vietnam combat veterans to a wait list control, or to 12 treatment sessions of biofeedback relaxation, or EMDR. At post-treatment, the EMDR group had significantly lower symptom scores on instruments measuring PTSD and depression than the wait list. At 3-month follow-up, EMDR had significantly lower scores than the biofeedback relaxation group on measures of PTSD and self-reported symptoms. Both treatment groups and the wait list control showed significant improvement on physiological measures with no differences between groups. This decrease in physiological arousal was maintained at 3 month follow-up. Nine of the ten EMDR subjects completed the 9 month follow-up which confirmed the maintenance of treatment effects. Seventy-eight percent of the EMDR subjects no longer met the diagnostic criteria for PTSD. This study controls for the often neglected variable of therapist allegiance (Hollon, 1999), as the non-EMDR subjects received the treatment to which the therapist had allegiance. Because biofeedback relaxation therapy has not been designated an efficacious treatment for PTSD, it could be argued that this study does not compare EMDR to another acknowledged effective treatment, but only controls for some of the nonspecific effects of treatment.

Summary of EMDR Studies with Combat Veteran Participants

Five controlled studies have examined the efficacy of EMDR with combat veterans. This research area has suffered from poor methodology. In four studies (Boudewyns et al.,1993; Boudewyns & Hyer, 1996; Devilly, et al., 1998; Jenson, 1994), subjects were provided with only two or three treatment sessions, or addressed only one or two of multiple traumatic memories. Treatment outcome was assessed by determining if there was change in PTSD diagnosis. Also the participants in these four studies were all receiving adjunctive concurrent treatments, confounding the effect of the experimental conditions, and making it impossible to determine unique effects. Although some changes in diagnostic status were found (Boudewyns & Hyer, 1996; Devilly et al, 1998) because of the methodological limitations, these four studies provide no clear evidence of the effectiveness of EMDR with combat PTSD. In the fifth study (Carlson et al., 1998) an adequate number of treatment sessions was provided, the methodology was sound, and EMDR resulted in positive treatment effects with indication of superiority to a wait list condition and to biofeedback relaxation. Carlson et al. (1998) found that 78% of the EMDR subjects no longer met the diagnostic criteria for PTSD at follow-up. This study, and the process study by Rogers et al. (1999), provide preliminary evidence that EMDR may be efficacious in the treatment of combat veterans with PTSD. More research is needed with this population.

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The Aggregate Evidence for EMDR's Efficacy in the Treatment of PTSD

The results of six of the civilian studies and one of the combat veteran studies suggest that EMDR is an effective therapy for PTSD. It appears to be more effective than active listening, standard Kaiser care, relaxation therapy and no treatment. There are preliminary indications that it may be equivalent in effectiveness to CBT exposure therapies.

EMDR had the largest influence on measures of PTSD symptoms, with fairly consistent improvement across the civilian studies. Improvement on measures of other types of symptoms such as depression were not as robust, and varied within and between studies. Most studies offered only a few treatment sessions and it may be that more distressed clients would have benefitted from additional sessions. More distressed clients may also have more comorbid disorders. Wilson et al. (1997) found that those clients reporting higher levels of distress at 3-month follow-up were the most likely to seek further treatment over the next year.

Persons who have suffered multiple traumas, such as combat veterans, may require more extensive therapy. Marcus et al. (1997) reported that EMDR resolved PTSD more rapidly for those clients with a single trauma. The only combat veteran study which provided extensive treatment was the only one that achieved positive treatment outcome (Carlson et al., 1998). This suggests that research evaluating EMDR treatment of chronic PTSD must provide a full course of therapy to adequately assess efficacy.

Another issue that may explain the range of outcomes across studies is methodological rigor. The civilian study which reported a poor outcome (Devilly & Spence, 1999) and several of the combat veteran studies were limited by various methodological flaws, which may have obscured true treatment effects. It appears that differences in outcome are related to differences in methodology, and that higher ratings of methodological rigor predict treatment effect sizes (Maxfield & Hyer, in press).

Further research is required to examine the responses of different PTSD populations to EMDR treatment. At present the research indicates that EMDR is effective for civilian PTSD. Only tentative conclusions can be reached concerning EMDRs effectiveness for combat PTSD until further research replicates studies like Carlson et al. (1998) and compares EMDR with other effective treatments for combat PTSD. Research should evaluate individual response to EMDR to determine if there are differential effects for persons with comorbid disorders, multiple traumas, or with chronic PTSD.

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References

Bohart, A. C. (in press). EMDR And Experiential Psychotherapy.

Blank, A. S. (1993). Vet centers: A new paradigm in delivery of services for victims and survivors of traumatic stress. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 915-924). Plenum: New York.

Boudewyns, P. A., & Hyer, L. A. (1996). Eye movement desensitization and reprocessing (EMDR) as treatment for post-traumatic stress disorder (PTSD). Clinical Psychology and Psychotherapy, 3 (3), 185-195.

Boudewyns, P. A., Stwertka, S. A., Hyer, L. A., Albrecht, J. W., & Sperr, E. V. (1993). Eye movement desensitization and reprocessing: A pilot study. Behavior Therapist, 16, 30-33. Brown, L. S. (in press). Feminist therapy and EMDR: a practice meets a theory. In F. Shapiro (Ed.) EMDR and the Paradigm Prism. Washington D.C.: American Psychological Association Press.

Carlson, J. G., Chemtob, C. M., Rusnak, K., Hedlund, N. L., & Muraoka, M. Y. (1998). Eye movement desensitization and reprocessing for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 11, 3-24.

Devilly, G. J., & Spence, S. H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive behavioral trauma treatment protocol in the amelioration of post traumatic stress disorder. Journal of Anxiety Disorders, 13 (1-2), 131-157.

Devilly, G. J., Spence, S. H., & Rapee, R. M. (1998). Statistical and reliable change with eye movement desensitization and reprocessing :Treating trauma with a veteran population. Behavior Therapy, 29, 435-455.

Fensterheim, H. (1994). Eye movement desensitization and reprocessing with complex personality patterns: An integrative therapy. Journal of Psychotherapy Integration, 6 (1), 27-38.

Hollon, S. D. (1999). Allegiance effects in treatment research: A commentary. Clinical Psychology, 6 (107-112).

Hyer, L. A. (in press). The relationship between efficacy and methodology in EMDR treatment of PTSD. Journal of Clinical Psychology.

Hyer, L., & Brandsma, J. M. (1997). EMDR minus eye movements equals good psychotherapy. Journal of Traumatic Stress, 10 (3), 515-522.

Lazarus, C. N. & Lazarus, A. A. (in press). EMDR: An elegantly concentrated multimodal procedure. In F. Shapiro (Ed.) EMDR and the Paradigm Prism. Washington D.C.: American Psychological Association Press.

Lee, C. and Gavriel, H. (1998). Treatment of post-traumatic stress disorder: A comparison of stress inoculation training with prolonged exposure and eye movement desensitization and reprocessing. Proceedings of the World Congress of Behavioral and Cognitive Therapies, Acapulco.

Lohr, J. M., Tolin, D. F., & Lilienfeld, S. O. (1998). Efficacy of eye movement desensitization and reprocessing: Implications for behavior therapy. Behavior Therapy, 29, 123-156.

Maxfield, L., & Hyer, L. (in press). The relationship between efficacy and methodology in the treatment of PTSD with EMDR. Journal of Clinical Psychology.

Manfield, P. (Ed.). (1998) Extending EMDR. New York: Norton.

Marcus, S.V., Marquis, P., & Sakai, C. (1997). Controlled study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy, 34, 307-315.

Pitman, R. K., Orr, S. P., Altman, B., Longpre, R. E., Poire, R. E., & Macklin, M. L. (1996). Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder. Comprehensive Psychiatry, 37 (6), 419-429.

Rogers, S., Silver, S., Goss, J., Obenchain, J., Willis, A., & Whitney, R. (in press). A single session, controlled group study of flooding and eye movement desensitization and reprocessing in treating posttraumatic stress disorder among Vietnam war veterans: Preliminary data. Journal of Anxiety Disorders.

Rothbaum, B. O. (1997). A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims. Bulletin of the Menninger Clinic, 61, 317-334.

Scheck, M. M., Schaeffer, J. A. & Gillette, C. S. (1998). Brief psychological intervention with traumatized young women: The efficacy of eye movement desensitization and reprocessing. Journal of Traumatic Stress, 11, 25-44.

Scurfield, R. M. (1993). Treatment of posttraumatic stress disorder among Vietnam veterans. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 879-888). Plenum: New York.

Shapiro F. (1989). Efficacy of the eye movement desensitization procedure: A new treatment for post-traumatic stress disorder. Journal of Traumatic Stress, 2 (2), 199-223.

Shapiro, F. (1991). Stray thoughts. EMDR Network Newsletter, 1-3.

Shapiro, F. (1994a). Alternative stimuli in the use of EMD(R). Journal of Behavior Therapy and Experimental Psychiatry, 25, 89.

Shapiro, F. (1994b). EMDR: In the eye of a paradigm shift. Behavior Therapist, 17 (7), 153-156.

Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols and procedures. New York: Guilford Press.

Shapiro, F. (1999). EMDR and the anxiety disorders: Clinical and research implications of an integrated psychotherapy treatment. Journal of Anxiety Disorders.

Shapiro, F., & Silk Forrest, M. (1997). EMDR: The breakthrough therapy for overcoming anxiety, stress, and trauma. New York: Basic Books.

Vaughan, K., Armstrong, M.S., Gold, R., O'Connor, N., Jenneke, W., & Tarrier, N. (1994). A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 25 (4), 283-291.

Wachtel, P. L. (in press) EMDR and psychoanalysis. In F. Shapiro (Ed.) EMDR and the Paradigm Prism. Washington D.C.: American Psychological Association Press.

Wilson, S. A., Becker, L. A., & Tinker, R. H. (1995). Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals. Journal of Consulting and Clinical Psychology, 63 (6), 928-937.

Wilson, S. A., Becker, L. A., & Tinker, R. H. (1997). 15-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for psychological trauma. Journal of Consulting and Clinical Psychology, 65 (6), 1047-1056.

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Clay Watkins is a licensed marriage and family therapist specializing in the use of EMDR in the treatment of PTSD, childhood or adult trauma, anxiety, panic and phobias, with offices located in San Luis Obispo, Arroyo Grande, and Santa Maria, California.

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Our director, Clay Watkins, M.A. LMFT, a licensed Marriage & Family Therapist. Our director, Clay Watkins, LMFT, is a licensed Marriage and Family Therapist. He provides individual, couples and family counseling. He specializes in anxiety-related difficulties including panic attacks, post-traumatic stress (PTSD) and phobias. He has advanced training and a decade of experience utilizing EMDR to treat trauma, and his unique brand of counseling integrates a solution-focused perspective that often speeds up the therapy process compared to more traditional forms of counseling. (BBS License #: MFC 37239)
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