Eye Movement Desensitization and Reprocessing (EMDR)

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Eye Movement Desensitization and Reprocessing
(EMDR)
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• ??????? ?????
• www.riverside.tw
• 98.12.18

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??EMDR?(I)

• ??????(?????)
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??EMDR?(II)

• ?????????????,?????(??)??
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• EMDR ?????
• (1)?????
• (2)?????
• (3)???????

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EMDR???(1)

• Francine Shapiro ?????
• 1987?,??EMD
• 1989?,EMD for PTSD
• 1991?,EMD?EMDR
• 1995?,Shapiro??Eye Movement Desensitization and
  Reprocessing Basic Principles, Protocols, and
  Procesures (2001????)
• ??www.amazon.com ????48?EMDR ??

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EMDR???(2)

• 1987?EMDR ??
• 1989????EMDR????
• ??medline?????164???
• ??52??,??????????????????????

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EMDR ???????

• Victims of Vietnam combat, rape, molestation,
  accident, catastrophic loss and natural disaster
  (???????,??? ?????)
• PTSD, Panic disorder with/out agoraphobia,
  Specific phobia(spider phobia), Performance
  anxiety(public speaking, test), Eating disorder,
  Chronic pain, Couple therapy, Adjustment
  disorder,
• Dental Phobia, Dermatological Disorder

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Efficacy/Validation

• American Psychiatric Association (2004). Practice
  Guideline for the Treatment of Patients with
  Acute Stress Disorder and Posttraumatic Stress
  Disorder. Arlington, VA American Psychiatric
  Association Practice GuidelinesEMDR given the
  same status as CBT as an effective treatment of
  ameliorating symptoms of both acute and chronic
  PTSD.

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EMDR ????????

• Client history
• Client preparation
• Assessment
• Desensitization
• Installation
• Body scan
• Closure
• Reevaluation

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Phase One Client History(1)

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• ( Symptoms, Specific Internal picture /
  cognition / feeling, Duration, Initial course or
  incident, Past occurrences, Alternative
  Complaints, How presently affected, Parallels and
  connections in past and present history, Desired
  behavior, Skill needed)

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Phase One Client History(2)????

• ????(secondary gain)
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• ???(??????????????)
• ???? (Readiness)
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• ??(???????????????)

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Phase Two Client Preparation(1)

• ?????? (Rapport)
• ?? EMDR ???????? ( ?? ???? )
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• ?? ????? ( ?????? )
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Phase Two Client Preparation(2) Eight-step Safe
Place Exercise

• Image (??)
• Emotions and sensations (?????)
• Enhancement ( ??????? )
• Eye Movement ( 4-6??? )
• Cue Word (?????)
• Self-cuing ( ??????? )
• Cuing with disturbance ( ??????,????? )
• Self-cuing with disturbance (??????,????)

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Phase Three Assessment(1)

• What picture represents the incident?
• What picture represents the worst past of the
  incident?
• If no picture when you think of the incident
  what do you get?
• Negative cognition what negative words go best
  with that picture that express your belief about
  yourself now?

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Phase Three Assessment(2)

• Positive cognition when you bring up that
  picture (or incident) what would you like to
  believe about yourself now?
• VOC (Validity of Cognition) How true does that
  statement feels to you now on a scale of 1 to7?
• Emotion when you bring up that picture (or
  incident) what emotion do you feel now?

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Phase Three Assessment(3)

• SUDs(Subjective Unit of Disturbance Scale) On a
  scale of 0 to 10, how disturbing does the picture
  ( or incident) feel to you now?
• Location of body sensation Where in your body do
  you feel it?

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Phase Four Desensitization

• ???????????? ? EM (Eye Movement, hand tapping,
  alternating sound)
• ?????
• ??????????????(???)
• ?? EM?
• ? SUDs(??0-1)

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Phase Five Installation

• ???????VOC (??6-7)
• ??????

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Phase Six Body Scan

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• ?????????????

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Phase Seven Closure

• ??? EMDR ?????
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• ?????,?????????, EMDR?????????? (Remind the
  client that the disturbing images, thoughts, or
  emotions may arise between sessions.)
• ????????EMDR?,????????,?????????

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Phase Eight Reevaluation

• ??EMDR?????????????
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??EMDR????

• 28???????,?????? (1 EMDR with Mindfulness
  Meditation training)
• 31??????,????????(BDI 24?3?1, BAI 34?0?0) (2
  EMDR)
• 47??????,?????(2 EMDR)
• 73??????,??????????(2 EMDR/MM)
• 38????????,?????,???????(1 EMDR ?????)
• 52??????,?????????,??????(2 EMDR)
• 21????,??????????? (1 EMDR)
• 56????,???????????????(3 EMDR)
• 47???,?????????,?????????????,????????(1 EMDR)

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??????

• Mindfulness Meditation Training Combined with Eye
  Movement Desensitization and Reprocessing in
  Psychotherapy of an Elder Patient.????????????????
  ?????????(Chang Gung Medical Journal. June 2004)
• Synergism Between Mindfulness Meditation Training
  and Eye Movement Desensitization and Reprocessing
  in Psychotherapy of Social Phobia?????????????????
  ???????? (CGMJ, Dec 2005)