Review of the validation and dissemination of eye-movement desensitization and reprocessing: A scientific and ethical dilemma

Abstract Eye-Movement Desensitization and Reprocessing (EMDR), a technique that combines imaginai exposure with eye movement, recently has been proposed by its originator, F. Shapiro, as a prescriptive treatment for trauma-related anxiety. To date, several uncontrolled case studies have found EMDR to be effective. However, none employed objective or standardized dependent measures of therapeutic improvement and all combined EMDR with other interventions. In contrast to results obtained from case studies, controlled experiments utilizing objective and standardized dependent measures have failed to support the efficacy of the technique beyond that of its imaginal exposure component. Unfortunately, these experiments employed small samples with a limited range of disorders, indicating the need for further evaluation. However, unbiased replication is impeded by Shapiro's practice of prohibiting individuals not associated with her EMDR Institute from training others in the technique. We articulate our concern that despite its lack of empirical validation clinical application of the technique by behavior therapists is rapidly increasing.