What Are Intensive EMDR Programmes, and Do They Work?

EMDR is usually delivered once a week, an hour or so at a time, over a period of weeks or months. But a growing number of clinics now offer intensive programmes, sometimes described as retreats, in which the same therapy is concentrated into a small number of consecutive days, often with several hours of treatment each day. The idea is to help people recover faster, and to reduce the long, sometimes destabilising gaps between weekly sessions during which distress can build. There is a practical logic to this. Research on session frequency has found that longer gaps between trauma-therapy sessions tend to be associated with smaller reductions in PTSD symptoms. Weekly therapy also gives people more time and opportunity to drop out, and dropout is a persistent problem in trauma treatment. Concentrating the work into a short, intensive block may help with both issues at once. What does the evidence say? A case series by Hannelies Bongaerts and colleagues, published in the *Journal of EMDR Practice and Research* (2017), followed seven people with complex PTSD stemming from childhood abuse and other severe trauma. Rather than the usual lengthy preparation, they received massed EMDR over consecutive days, with morning and afternoon sessions interspersed with physical activity and education about trauma. No one dropped out, no adverse events occurred, and four of the seven no longer met the criteria for PTSD by the end, with the gains holding at three-month follow-up. Larger naturalistic studies of intensive programmes, which usually combine EMDR with another trauma therapy called prolonged exposure and with physical exercise, have reported similar patterns: large reductions in PTSD symptoms, low dropout, and benefits that stay stable up to a year later, even in people who had not responded to previous therapy. This also challenges the long-held belief that people with severe or complex trauma must first be "stabilised" over many months before trauma processing can safely begin. Some caution is needed. Much of the evidence comes from case series and open studies rather than large randomised trials, and because these programmes bundle EMDR together with exercise and other elements, it is hard to say how much of the benefit comes from EMDR alone. Intensive treatment is also demanding, both emotionally and physically, and will not suit everyone. Even so, the direction of the research is promising. For people who want to avoid months of weekly appointments, or who have not been helped by them, an intensive EMDR programme appears to be a safe and often highly effective alternative worth discussing with a qualified practitioner. *Source: Bongaerts, H., Van Minnen, A., & de Jongh, A. (2017). Intensive EMDR to Treat Patients With Complex Posttraumatic Stress Disorder: A Case Series. Journal of EMDR Practice and Research, 11(2), 84–95.*