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Quality substance abuse treatment is needed to help fight the battle against drug addiction. This qualitative study was designed to explore some of the approaches to eye movement desensitization (EMDR) therapy that therapists trained in Parnell's adapted EMDR model use in conjunction with treatment for addictions. The purpose of this narrative inquiry was to investigate the experience of therapists who incorporate substance abuse treatment with Parnell's adapted EMDR model when treating trauma and substance use disorders. The population studied comprised licensed mental health therapists who had completed Parnell's EMDR training and implemented Parnell's modified EMDR protocol in their professional practice. The data from 9 participant interviews were coded and NVIVO data analysis software was used to identify key concepts and themes including deviations from Parnell's modified protocol, incorporating addiction treatment within the modified protocol, and the importance of the resourcing phase in the modified protocol. The study findings provided a deeper understanding of the types of addiction therapies that therapists are using in conjunction with Parnell's EMDR model. The results also showed that that participants perceived Parnell's EMDR model, combined with addiction therapeutic techniques and approaches, as beneficial in treating those with trauma and substance use disorders. By integrating addiction therapies with Parnell's EMDR protocol, EMDR certified trainers may better educate EMDR trainees about useful strategies for treating dual diagnosed clients. The strategies may shorten the client's time in treatment and provide a strong foundation for therapists as they conduct therapy for dual diagnosed people.

Si l’efficacité des psychothérapies semble maintenant faire consensus, la recherche vient aujourd’hui interroger directement le processus psychothérapeutique. Notre travail s’inscrit dans cette démarche et se fonde sur l’étude de l’interaction verbale issue d’une psychothérapie émergente, la psychothérapie EMDR, Eyes Movement Desensitization and Reprocessing. La traduction française est désensibilisation et retraitement par les mouvements oculaires. Ce dispositif thérapeutique s’avère prometteur dans le champ du soin psychique, et est principalement identifié parmi les pratiques psychothérapeutiques comme étant celle où le thérapeute exerce une action physique sur son patient et ce, au moyen de stimulations bilatérales alternées (notamment par le biais de mouvements oculaires). L’EMDR bénéficie dans le champ de la recherche majoritairement d’études s’intéressant aux effets physiologiques en lien principalement avec les mouvements des yeux pendant le traitement. Or, en vertu du fait que l’EMDR s’agence aussi autour d’un protocole verbal, nous nous inscrivons dans le champ des études qui considèrent que la psychothérapie est avant tout un « événement de parole » (Labov et Fanshel, 1977). Ainsi, en nous appuyant sur l’étude du langage, à la fois tel qu’il est prévu par le protocole et tel qu’il est dispensé par le thérapeute en séance, nous venons compléter ces travaux en nous plaçant à un niveau de description clinique, à hauteur du sujet. Dans une première partie, nous nous situons sur le plan théorique, nous éclairons les phases 3 et 4, prototypes du protocole EMDR à la lumière de théories issues du champ de la pragmatique mais aussi à la lumière des théories issues de la psychanalyse. Dans une seconde partie de recherche empirique, nous examinons un corpus constitué de trois suivis psychothérapeutiques filmés et retranscrits. En nous inscrivant dans le réel de la pratique telle qu’elle se donne à entendre, nous mettons en œuvre une méthodologie d’analyse exploratoire et qualitative issue du paradigme de la pragmatique. Pour ce faire, nous nous référons aux travaux menés au sein de l’analyse linguistico-pragmatique des interventions du thérapeute et de la Logique Interlocutoire. Nous dégageons certaines caractéristiques de la matrice langagière qui viennent souligner son importance, son rôle et ses effets dans l’instauration d’un processus de changement qui apparaît bénéfique pour le patient / As the efficiency of psychotherapies is now widely recognized, research questions the psychotherapeutic process. In this vein, we review and study the verbal interactions resulting from an emerging psychotherapy, the Eyes Movement Desensitization and Reprocessing (EMDR) psychotherapy. This therapy is very promising in the field of psychic care. It is a psychotherapeutic practice in which the therapist exercises a physical action on his patient by means of alternating bilateral stimulations – notably by ocular movements. Thus far, research on EMDR has primarily examined the physiological effects related mainly to eye movements during treatment. Because EMDR also has a verbal protocol, we review it in the framework of studies that consider psychotherapy as a "speech event" above all (Labov and Fanshel, 1977). Based on a study of language, both as provided for in the protocol and as used by the therapist in session, we attempt to pursue these works by placing ourselves at a level of clinical description, at the level of the subject. In a first part, we follow a theoretical approach, and review phases 3 and 4 and prototypes of the EMDR protocol, in light of theories in the field of pragmatics and theories stemming from psychoanalysis. In a second part of empirical research, we examine a corpus consisting of three psychotherapeutic follow-ups, which have been filmed and transcribed. By placing ourselves into the reality of the practice, as it is commonly understood, we implement a methodology of exploratory and qualitative analysis emerging from the paradigm of pragmatics. To do this, we refer to the works carried out within the linguistic-pragmatic analysis of the interventions of the therapist as well as to interlocutory logic. We highlight some characteristics of the language matrix that demonstrate its importance, its role and its effects in the implementation of a process of change that appears to be beneficial for the patient

Bien que la plupart des personnes soient exposées à un traumatisme au cours de leur vie, toutes ne développent pas de stress-post traumatique (PTSD). La prévalence de vie du PTSD est en effet estimée à 10%. Il peut survenir à la suite d’un événement traumatique tel un accident, agression, deuil, viol ou incendie, mais aussi un désastre naturel (inondation, tremblement de terre…) ou humain (guerre, terrorisme…). En raison de l’augmentation contemporaine des sources traumatiques, les rapports récents de l'Organisation Mondiale de la Santé décrivent le PTSD comme un problème de santé mondiale croissant, en raison de sa fréquence, sévérité, comorbidité et de son coût élevé. Un corpus de recherche enquête sur divers aspects du PTSD concernés par les pensées intrusives, l'hypervigilance, les déficits émotionnels, les troubles cognitifs et les problèmes de mémoire.Comme d'autres problèmes de santé mentale, le PTSD est à ce jour assez méconnu. Comme d'autres troubles anxieux, il est surtout marqué par une peur excessive. Il n'est donc pas surprenant que l'hypothèse la plus répandue dans le PTSD soit celle d'un déficit du traitement de la peur. S’il est vrai que la conceptualisation du PTSD comme un trouble de la peur parait phénoménologiquement étroite, elle a été néanmoins pragmatique en permettant l’approfondissement de la recherche translationnelle de l'animal à l’humain, en passant par la paillasse. Les études sur le sujet ont suggéré que les déficiences centrales et périphériques du PTSD tourneraient autour d’altérations du réseau neuronal de la peur. Ceci impliquerait un dérèglement des mécanismes qui sous-tendent le conditionnement à la peur, ainsi que le traitement des émotions et de l'attention, qui sont en effet bouleversés dans le PTSD. / Although most people encounter at least one traumatic event over their lifetime, not all of them will develop post-traumatic stress disorder (PTSD). Lifetime prevalence of full-blown PTSD, known as an anxiety disorder, is in fact around 10%. In addition to accidents, aggression, grief, rape, fires, traumatic events can be caused by natural (flooding, earthquake…) or man-made stressors (war, terrorism…). With the contemporary rise in traumatic sources the World Health Organization recent reports describe PTSD as an increasing global health issue, due to its high frequency, severity, comorbidity and cost. A body of research has thus started investigating various aspects of PTSD concerned with intrusive thoughts, hypervigilance, emotional deficits, cognitive disturbances and memory issues. Similarly to other mental health problems, much remains unknown about PTSD, and similarly to other anxiety disorders it is marked by excessive fear. It comes as no surprise that the most prevalent hypothesis in PTSD is that of a fear-processing deficit. Conceptualizing PTSD as a fear disorder can be phenomenologically quite narrow. It has been nonetheless pragmatic in allowing thorough translational research from animal to bench-side and clinical studies. Most studies have suggested that central and peripheral impairments in PTSD revolve around altered neural fear processing network. These alterations involve mechanisms implicated in fear conditioning, as well as emotional and attentional processing, all of which are altered in PTSD.

The current literature on victims of sex trafficking lacks adequate research on effective therapeutic treatments for this population. This study aims to find an effective therapy for female victims of sex trafficking to treat trauma-related symptoms including PTSD, depression, anxiety, self-blame, self-esteem, and overall well-being by testing the effectiveness of eye-movement desensitization reprocessing (EMDR), trauma recovery and empowerment model (TREM), and psychoeducation. In this study, approximately 180-200 female victims of sex trafficking ages 18 or older will be randomly assigned to either the EMDR, TREM, psychoeducation, or a control-wait-list group. Trauma-related symptoms will be assessed pre-treatment (Time 1), post-treatment (Time 2), and 6- months post-treatment (Time 3) to assess the effectiveness of each intervention over time. It is expected that participants in all therapy groups will display significantly improved trauma-related symptoms compared to participants in the control-wait list group at time 2. It is further expected that participants in the TREM group will display significantly reduced self-blame and increased self-esteem and overall well-being at time 2 compared to participants in the EMDR and psychoeducation groups. Lastly, it is expected that improvement in trauma-related symptoms will be maintained from time 2 to time 3. These expected findings suggest that TREM will be the most effective long-term therapy for female victims of trafficking.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which were used to gather data for interpretation. Eight essential themes were identified: (a) chosen field, (b) lack of training, (c) stigma and stereotypes, (d) they're just folks like us, (e) preying on their vulnerabilities, (f) PTSD and trauma symptoms are the same with people with ID, (g) EMDR and the adaptive information processing theory, and (h) mindfulness interventions. The participants dispelled myths such as people with ID do not experience trauma and PTSD, and people with ID cannot participate in trauma therapy such as EMDR. Participants who had experience working with people with ID wanted more training on adaptations for treatment interventions, and participants without this experience welcomed advanced training on trauma treatment for people with ID. This study adds to the research on trauma treatment for people with ID and may affect social change by inspiring more conversations among clinicians on appropriate trauma treatment for people with ID. Clinicians with experience can build stronger relationships with community mental health centers, and continue to educate, clients, families, direct care providers, and agency personnel on trauma-informed care.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Master of Science / School of Family Studies and Human Services / Joyce Baptist / This study examined the efficacy of EMDR therapy as a treatment for unipolar depression. Results provide preliminary evidence for the efficacy of EMDR therapy. Of the 12 participants that received 10 sessions of EMDR therapy, four met the criteria for “Recovered,” six “Improved” and two reported no change in severity of depressive symptoms. Results further indicated that participants who experienced decline in depressive symptoms within the first six sessions of treatment had a higher probability to be meet the criteria for “Recovered.” A small sample comparison between EMDR therapy (n = 4) and CBT (n = 4) did not find any significant difference in terms of treatment outcome. In phase 2, participants in both groups either improved or recovered after 10 sessions of treatment. Sudden gains analysis indicated that 5 out of 12 EMDR therapy participants had sudden gains. Participants in sudden gains group were more likely to meet “Recovered” criteria than participants in no-gains group. Examination of attention bias found that depression was positively related to negative affect fixation duration and negatively related to positive affect fixation duration when only using female affect images. These findings support previous research that used attention bias to differentiate depressed and non-depressed persons. Clinical implication and further research are discussed.

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