Therapists’ Experiences With the Effectiveness and Feasibility of Videoconference-Based Eye Movement Desensitization and Reprocessing

Research on the effectiveness and applicability of eye movement desensitization and reprocessing (EMDR) via videoconference is sparse. Considering the emerging use of internet-based psychotherapy during the COVID-19 pandemic, information on videoconference-based EMDR (eEMDR) would be beneficial for many therapists. In this study, 23 therapists from the EMDR-Institute in Germany provided information about their experiences with eEMDR in a questionnaire-based survey. Information on the effectiveness and the course of 102 eEMDR sessions was recorded. Results showed the potential of eEMDR as an effective and viable method. The decrease in the subjective unit of disturbance (SUD), which is an important indicator of treatment outcome, was found to be at a similar level compared to that of previous EMDR studies that were not administered in eEMDR format. The most important predictor of the SUD decrease was the type of bilateral stimulation used in eEMDR sessions. Eye movements resulted in significantly greater SUD reductions than tapping. Perceived disadvantages and impediments for the implementation of eEMDR were mainly of bureaucratic and technical concerns. In addition, about one-third of the therapists stated that some patients were not willing to engage in eEMDR. In our study, eEMDR proved to be a practically applicable therapy method and therefore, therapists can consider using eEMDR. These findings will hopefully encourage EMDR therapists and their patients to use eEMDR due to its effectiveness and viability as an online treatment approach.

Immersive Rehearsal in a Simulated Environment

ABSTRACT Introduction Recent advancements in virtual environment (VE) technology and the increasing use of VEs for treatment are opening up possibilities for rehearsal in safe and rich environments. Research has shown that VEs can be used to treat individuals with posttraumatic stress disorder (PTSD), but little research has been done to suggest guidelines for creating an effective environment. The aim of this study was to determine the design of systems that would allow military veterans to rehearse potentially stressful events in a VE before having to step into the actual environment. This research evaluated the responses to six stimuli: startle sound, direct eye contact, horizontal movement across the visual field, social conflict, an abandoned item, and a crowded auditorium. Measures used included change in heart rate (ΔHR), change in subjective unit of discomfort scores, and participant behavior. Materials and Methods Thirty-eight participants, both with and without PTSD, experienced two VEs in first person using an Oculus Rift device. The first VE consisted of a tranquil garden, which allowed the participants to practice in the system, whereas baseline data were collected. The second VE was the experimental condition where the participant completed tasks within the VE and encountered stimuli designed to evoke responses from those with PTSD. Results There was a significant difference in ΔHR between the PTSD and non-PTSD groups (P = .008), and the PTSD group had a higher mean ΔHR for all stimuli. The stimulus type was also significant for all participants (P < .001). Crowded auditorium and startle sound had the largest impact on the participants’ ΔHR. Change in subjective unit of discomfort showed a significant interaction between the group factor (PTSD, non-PTSD) and stimulus (P = .043). Individuals with PTSD also presented more avoidance behavior than those without PTSD. Conclusions Findings imply that VEs other than virtual combat zones can elicit behavioral, emotional, and physiological responses in individuals with PTSD, and these types of environments should be further studied for use with veterans suffering from PTSD. In future studies, systems should include initial stimuli that can be configured to allow focus on specific past traumatic experiences. Stimuli should also include both a crowded room and a startle noise scenario.

TECHNOLOGY REDUCES DISTRESS IN A GERIATRIC COHORT WITH DEPRESSION AND NEUROCOGNITIVE IMPAIRMENTS

Many older adult Veterans with Depression and superimposed Neurocognitive Impairments may demonstrate behavioral agitation. To buffer patient agitation seen within a Veteran’s Affairs residential extended care facility, psychological services were expanded to include the use of mobile technologies. To evaluate the effectiveness of adding technology supported psychological services, outcomes were gathered as part of continuous process improvement efforts. 28 Veterans with Depression and NCI who received technology enhanced services were rated by staff on observed agitation behaviors prior and following clinical encounters. In addition, a subset of 17 Veterans also provided subjective unit of distress (SUD’s) ratings based on the Brief Interview for Mental Status inclusion criteria. Paired sample T-Tests were completed to assess if technology-enhanced interventions resulted in average reductions of clinician rated observations of Veteran agitation behaviors. Significant differences were found in observations of Veteran facial tension (t(27)=3.722, p=.001), agitated body movement (t(14)=2.020, p=.053), and threatening posture (t(27)=2.243, p=.044). Evaluation of a subset of those residents who also provided SUD’s ratings show a significant change in self-reported distress after intervention (t(16)=4.3, p=.001). Effect size for this difference was large (d=1.042). These results suggest that mobile technologies can help reduce agitation and Veteran self-reported distress among older Veterans with Depression and superimposed Neurocognitive Impairments.

Efficacy of behaviour modification techniques to reduce stage fright: A study

Fright or performance anxiety. Stage fright and anxiety in the students were developed due to various causes and Students were selected for the study on the basis of their Subjective Unit of Distress Scale developed by Wolpe (1992). The students were assessed pre and post intervention. we used the questionnaire Personal Report of Public Speaking Anxiety - 34 (PRPSA) developed by McCroskey (2013) and Rosenberg Self Esteem Scale developed by Rosenberg (1965) in order to determine the level of anxiety, that a student experiences while performing a speech and measures global self-worth by measuring both positive and negative feelings about the self respectively. This is the study of forty student of IX standard, Kendriya Vidyalaya, they were very diffident to present themselves on the stage. The students were assessed pre intervention and intervened with Behaviour Modification techniques for the period of Six weeks. The student's stage fright and self esteem were reassessed after the period of six weeks. The results of the study reflected that the students experienced significantly less anxiety / stage fright, decreased in their Subjective Unit of Distress Scale and increase in the self esteem. This shows that Behaviour Modification techniques are efficient in reducing stage fright, performance anxiety and increase in self esteem.

PENERAPAN ART THERAPY DALAM MENGATASI FOBIA KUCING PADA INDIVIDU DEWASA

Fobia kucing merupakan specific phobia yang ditandai dengan kecemasan berlebihan saat dihadapkan dengan kucing. Umumnya, fobia diatasi dengan intervensi yang berpendekatan behavioristik dan kognitif. Namun, art therapy merupakan pendekatan lain yang juga dapat digunakan untuk mengatasi fobia. Art therapy bermanfaat membantu individu menghadapi tekanan melalui media seni. Individu merasa aman dengan mengekspresikan pemikiran dan perasaan melalui media seni. Dengan demikian, penelitian ini bertujuan untuk mengetahui seperti apakah penerapan art therapy dalam mengatasi fobia kucing pada individu dewasa. Desain dalam penelitian ini adalah kuasi-eksperimen. Pemeriksaan terkait pengalaman-pengalaman tiap partisipan didapatkan dari wawancara. Setelah itu, art therapy dilakukan lima sampai enam sesi untuk mengatasi fobia kucing. Terdapat tiga partisipan yang terlibat dalam penelitian ini. Kondisi fobia ketiga partisipan sesuai dengan kriteria DSM-IV-TR. Salah satu partisipan mengundurkan diri setelah pemeriksaan, karena kediamannya sangat jauh dan jadwal intervensi dapat berpengaruh pada jam kerjanya. Kedua partisipan lainnya dihadapkan dengan kucing di awal, tengah, dan akhir sesi untuk mengetahui penurunan tingkat fobia. Evaluasi dilakukan dengan menggunakan pulse oximeter, kuesioner Severity Measure for Specific Phobia – Adult, dan Subjective Unit of Discomfort Scale (SUDS). Hasil intervensi menunjukkan partisipan pertama (UK) mengalami penurunan tingkat fobia dari kategori severe hingga mild. Setelah intervensi, UK mampu berjalan di dekat kucing. Sementara itu, partisipan kedua (CF) mengalami penurunan tingkat fobia dari kategori severe hingga moderate. Setelah diberi intervensi, CF sudah mampu mengusir kucing dengan menggunakan sapu dan lebih tenang. Hasil penurunan tingkat fobia antar kedua partisipan tidak signifikan, karena jumlah partisipan yang kurang mencukupi dan kurangnya sikap kooperatif dari salah satu partisipan.

Reducing Public Speaking Anxiety with Behavior Modification Techniques among School Students: A Study

The purpose of this study was to investigate whether the behavior modification techniques helps the students to reduce public speaking anxiety and enhancement in the Self-esteem. The fifty Students were selected purposively for the study on the basis of their Subjective Unit of Distress Scale (SUDS) developed by Wolpe (1990). The questionnaire Personal Report of Public Speaking Anxiety – 34 developed by McCroskey (2013) was adapted to determine the level of public speaking anxiety while holding the speech. Another instrument was Rosenberg Self Esteem Scale (Rosenberg, 1965) in order to measures global self-worth by measuring both positive and negative feelings about the self, before and after intervention. This is the study of fifty student of IX standard, Kendriya Vidyalaya. The students were assessed pre intervention and intervened with Behaviour Modification techniques for the period of Six weeks. The interventions used for the study were: (i) Public speaking with similar problem in the presence of similar group (Ganesan, 2008) (ii) Establishing dialogues with audience in a graded manner in groups one to twenty members (Ganesan, 2009) (iii) Purposeful faltering, while speaking to overcome fear of failure while speaking (Ganesan, 2010) and (iv) Perform voice and breathing exercises (Ganesan, 2012). The student’s SUDS, PRPSA-34 and RSE were reassessed after the period of six weeks interventions phase of how to manage their distress and results of the study indicate that the students experienced significantly less anxiety. The study reflected that the students experienced significantly less public speaking anxiety, decreased in their Subjective Unit of Distress Scale and increase in the self esteem. This shows that Behaviour Modification techniques are efficient in reducing public speaking anxiety.

Why do I Have to Die Twice? EMDR Treatment After Experience of Clinical Death

BackgroundClinical death is etiologically non-specific state of reversible cessation of blood circulation and breathing, the two necessary criteria to sustain life. Serious consequences in form of anxiety and/or depression can remains after recovery.Case reportMale patient 55 y/o with no prior history of psychiatric difficulties, who experienced clinical death after cardiac infarction. Reanimation was successful and he was discharged with minimal if any cardiac consequences. During the hospitalization in Coronar unit he reacted with major depression, and aftermath with disabilitating anxiety and panic attacks followed by avoidant behavior, obsessive thoughts, social withdrawal, and consequently, very poor quality of life, regardless of the favorable outcome of somatic (cardiac) illness. The patient did not wanted psychiatric medications, so EMDR treatment was introduced. We assess negative cognition: why do I have to die twice? “Subjective unit of disturbance regarding the traumatic event (SUD) was 9”. Adhering to the EMDR protocol, the therapist helped the patient to re-process the traumatic event (the very moment when he was told that “he was died”). Complete desensitization and reprocessing were accomplished, SUD was 0, VoC was 7. Patient reached pre-morbid level of psychosocial functioning, doing his demanding job, and enjoying his social life.ConclusionNear death experience has high traumatic potential with serious psychological consequences. EMDR is efficious treatment for variety of anxiety disorders caused by psychologic trauma due to physical illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Design of Intervention among Survivors of Disaster

Indonesia is a region that is frequently hit by disasters, especially the earthquake because of geological factors. Earthquake in 2006 in the region of Yogyakarta and Central Java still has problems to this day, the basics of the economy has not fully recovered , disabled people coud not work as usual, people experience a variety of stressors such as income and material stress and emotional stress. The aimed of this study was to find out the effect of cognitive and religious intervention to cope with stress of disaster. The subjects of this study were people in Bantul who exposed to stress due to disasters such as disability and individuals who have low self-confidence because of disabilty. The method of the study was a responsive action research. Data were collected through observation, interviews, focus group discussions, psychoeducation and training. The study found that cognitive and religious intervention has positive impact on recovery of the subject, for example increase on self-confidence of individual and decrease in the mean of SUD (subjective unit disturbances) score of familie’s subject member. The interventions were usefull to improve the future intervention of disabled persons and people who experience stress of family member’s disability.

The Design of Intervention among Survivors of Disaster

Indonesia is a region that is frequently hit by disasters, especially the earthquake because of geological factors. Earthquake in 2006 in the region of Yogyakarta and Central Java still has problems to this day, the basics of the economy has not fully recovered , disabled people coud not work as usual, people experience a variety of stressors such as income and material stress and emotional stress. The aimed of this study was to find out the effect of cognitive and religious intervention to cope with stress of disaster. The subjects of this study were people in Bantul who exposed to stress due to disasters such as disability and individuals who have low self-confidence because of disabilty. The method of the study was a responsive action research. Data were collected through observation, interviews, focus group discussions, psychoeducation and training. The study found that cognitive and religious intervention has positive impact on recovery of the subject, for example increase on self-confidence of individual and decrease in the mean of SUD (subjective unit disturbances) score of familie’s subject member. The interventions were usefull to improve the future intervention of disabled persons and people who experience stress of family member’s disability.

Hypochondriacal and Persecutory Ideas in A Man with Obsessive Compulsive Disorder Managed via Cognitive Behavioural Hypnotherapy

This case report illustrates the management of a patient with Obsessive Compulsive Disorder who presented with hypochondriacal and persecutory ideas. Cognitive behavioural hypnotherapy approaches were applied in the management as the patient not keen for pharmacological treatment. Obsessive thoughts were managed via distraction technique, thought stopping and modified it to a more helpful compulsive behavior via direct suggestion during hypnotic state. The compulsive behavior was managed via hypno-behavioural approaches, reinforced by direct suggestion and pseudo-orientation in time. The Subjective Unit of Distress Scale (SUDS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scales were used to measure the progress of anxiety and depressive symptoms. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18308 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.221-223