Injured Workers are frequently prescribed treatment which is non-traditional or that is a new form of treatment. Eye Movement Desensitization and Reprocessing (EMDR) is relatively new form of psychological treatment (30 years of existence as of 2019.) This article will discuss EMDR and why it may become a popular form of treatment within workers’ compensation.
EMDR is a therapy that is used to treat Post-Traumatic Stress Disorder(PTSD.)
What is EMDR?
“Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories (Shapiro, 1989a, 1989b).” EMDR Institute, Inc.
“EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.” EMDR Institute, Inc.
What Is EMDR Treatment Like?
“EMDR therapy is an eight-phase treatment. Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.” EMDR Institute, Inc.
Why would EMDR become a popular form of treatment in Workers’ ‘Compensation?
Various Labor Code Sections 4600, 5307.27, support the position that Evidence-Based Medical Treatment is an important consideration with respect to whether a form of treatment will be authorized within the workers’ compensation system. Evidence-Based Studies have shown that EMDR is effective. If this is the case, California Workers’ Compensation should accept such treatment as indicated and recommend that it be approved through Utilization Review and Independent Medical Review.
A recent study supports EMDR for treatment for Post-Traumatic Stress Disorder (PTSD.) In Mavranezouli I, Megnin-Viggars O, Grey N, Bhutani G, Leach J, Daly C, et al. (2020) Cost effectiveness of psychological treatments for posttraumatic stress disorder in adults. PLoS ONE 15 (4): e0232245. https://doi.org/10.1371/journal. pone.0232245, the study concludes that “[a] number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long term clinical and cost-effectiveness of a range of treatments for adults with PTSD.”
In the study, “ Eye movement desensitisation and reprocessing (EMDR) appeared to be the most costeffective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base.”
Further, “[m]ore than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years.” EMDR Institute, Inc.
Is There Any Case Law Concerning EMDR?
Yes. There have been some reported cases that discussed EMDR. In Bresler vs. WCAB, 2017 Cal. Wrk. Comp. P.D. LEXIS 95 (writ denied,) it was reported that the Injured Worker testified that they benefited from the treatment services which included EMDR. In Madson vs. Cavaletto 2017 Cal. Wrk. Comp. P.D. Lexis 95(Board Panel Decision, ) the Injured Worker testified that he felt better after EMDR treatment.
What If I Need Legal Advice?
If you would like a “free” consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. for more information.