The Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder (PTSD) recommend two therapies which have the best evidence. These are EMDR (Eye Movement Desensitization & Reprocessing) and trauma focused Cognitive Behaviour Therapy (CBT).


EMDR faster than CBT
While I am trained in both CBT and EMDR, when it comes to treating trauma, I prefer EMDR as it more rapidly resolves symptoms. Clients also prefer EMDR as it has no real homework attached to it. 

My preference for using EMDR has also been supported by a study that was recently published in the British Journal of Psychiatry. This study compared EMDR with a trauma based CBT to treat 140 patients diagnosed with Post Traumatic Stress Disorder. It found that while both therapies were effective, EMDR worked faster and had less people who drop out of therapy. You can read the full study here. 

EMDR better than Aropax
Another recent study compared EMDR with an antidepressant (Aropax) to treat male survivors of war trauma who had moderate to severe PTSD. This study was presented at the 2013 International Congress of the Royal College of Psychiatrists. It found that 90% of the patients treated with EMDR improved while only 36% of those treated with Aropax improved. More importantly, those treated with EMDR had a significantly greater reduction in symptoms and without the side effects of medication.

EMDR is Well Researched
When EMDR first came out (In the early 1990’s) there was a lot of scepticism about it as it seemed a bit weird (involving moving one’s eyes back and forth while recalling upsetting memories) and seemed to work much faster than other trauma therapies. This has meant that a great deal of research has been done to demonstrate its effectiveness.  For more information on EMDR research see this website 

Understanding, Coping skills and Safety First
Treatment of PTSD begins with understanding exactly how the trauma has affected a person as similar events can hold very different meanings to different people. Next, a range of coping skills (like relaxation strategies) are taught to assist with the high levels of distress that may occur while reprocessing traumatic memories and between sessions. 

Once the client feels safe, therapy would move on to working through the trauma and reprocessing it in an atmosphere of support so the client is able to process the traumatic memories and finally put them behind them.

Medication may also play a role in treatment, particularly if psychological therapy is not available, or the client has not benefited from therapy. Either way, if insomnia is a problem, this should be treated, as sleep deprivation aggravates the condition.

Feelings, Thoughts and Body sensations
Trauma has many components that need to be targeted in therapy. Along with intrusive traumatic memories and images, and high levels of emotional distress, people often have negative beliefs about themselves and strong bodily sensations.  Sometimes they cannot put into words what has happened so a therapy that involves more than just talking about it is needed. In fact, just talking about major traumas can make things worse as it may get the person in touch with painful emotions but does not help them process them at an emotional level.

EMDR
EMDR (Eye Movement Desensitization & Reprocessing) is one of the two evidenced- based therapies recommended in the Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder. In addition, the World Health Organisation (WHO) recommends EMDR for treating trauma-related conditions in adults and children.

EMDR provides the therapist with a structure that guides the client through their trauma and helps them to reprocess what happened, learn from it and put it behind them. Read this article to see why I prefer EMDR over other treatments for trauma.