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News Article: "errors in the 2017 apa clinical practice guideline for the treatment of ptsd...."

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Tornadic Thoughts

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I haven't had time/mind space to read this thoroughly and attempt to translate, digest, and innerstand it as much as I'd like to, but wanted to share as I felt it would be of interest to many here.

I've not experienced EMDR or CBT/CPT/CT in a professional setting, so it's a bit foreign to me at times, especially in the terminology.

I thought it would be interesting to hear from others who may wish to read it, especially those with minds that allow them to more easily translate the scientific terminology and such, and those who have, or are currently, trying the methods they speak of.

The full title of the article is:

"Errors in the 2017 APA Clinical Practice Guideline for the Treatment of PTSD: What the Data Actually Says"

Errors in the 2017 APA Clinical Practice Guideline for the Treatment of PTSD: What the Data Actually Says
 
I think it's going to be hard to get too much out of the article without having access to every item referenced. I disagree with them about including studies of people that do not fit the DSM's criteria for PTSD, because you can't toss out construct validity. If it's for the treatment of PTSD, studies of people that don't have PTSD shouldn't be included.

It does make me curious as to why some of the articles that they mentioned were excluded, though.
 
After just having read the first three lines of the article, I balked at what was said about EMDR as in WTF? I've had 16 sessions of EMDR and attribute the abatement of most of my ptsd triggers/flashbacks and SI to EMDR! However the article says that the APA (American Psychological Association) in their practice guidelines concluded weak evidence utilizing EMDR. Oh f*cking really! Tell that to my brain and mind now that have greatly benefited from the EMDR therapy. Hmmm.

Afterthought, perhaps the APA has realized that EMDR is working too well in the treatment of ptsd. Again, just an afterthought.

Just read or tried to read (too difficult to understand for me) the rest of the above article...and all I have to conclude is...that the proof is in the pudding. And EMDR Therapy worked in spades for me. That's it.
 
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WOW!! This is heavy and lengthy stuff. I tread research articles and synopsis all the time, but breaking all this stuff would take me a few days.

However, even if broken down, I am not sure how it could be communicated in a clear way.

Here are my views.

*IMHO, EMDR is more of another type of CBT and strictly speaking, you will always have CBT as well.

*EMDR is very new therapy, relatively speaking compared to CBT.

*It is very hard for me to accept the "evidence-based" rigors as being accurate here compared to (for example) evidence that a drug lowers blood pressure.

*We think we know so much about the brain, but I don't think we even know 1% to the extent that we do with organic issues.

*My personal experience has at least convinced me that this stuff works. I know this is not a terribly scientific argument, but when you see and hear enough success and little adverse effects, I am willing to accept a lot of leeway.

*You can overdose on medications, but NOT on EMDR. If an experience is too strong you can just abandon.

Finally, (and some cynical and conspiratorial view), drug companies and other groups who know nothing or have little interest in letting other avenues on the scene will endorse less encouraging views of EMDR. There are tons of medications in medical use that have little efficacy as well, but it is easier to knock complex cognitive treatments that cannot be as rigorously "proven" as a drug given to 400 and a sugar pill to another 400 and even the sugar pill will have effect upon many.
 
My brain has tried a few times, and it just isn't wrapping around it. I've heard more good things about both emdr and cbt than I've heard bad, but as with everything, there's at least two sides. I know for my journey, I've found much more help in things that aren't, as you say @ParalyzedMind , rigorously "proven" than those I was lead to that have piles of documentation stating they are. Thanks for everyone's input.
 
The APA Guidelines that the article refers to is more about the available research than if EMDR is an effective treatment. This is a tricky article because it is only in conversation really with one document, and it doesn't make much of an effort to describe what that document is. I'm not entirely sure, but I think that they are almost entirely referring to the contents of the second part of it, which is primarily intended to be a research review. In the part that is more focused on giving actual guidelines, EMDR is given fairly equal billing with CBT.

In the actual guidelines, they pretty much say to try a variety of approaches and see what sticks for each individual patient, because they don't have the kind of research that would have them advocating for a specific treatment plan. For the purposes of the second part of the document, EMDR needs to be defined as a treatment different from any other treatment that includes emotional reprocessing and those differences need to be tested to see if it has an effect. That isn't something that is going to be too relevant to most patients or even to a lot of professionals.
 
Seems like gilding the lily, to me.

They're still Tier 1 treatments, even using the more conservative numbers & studies the APA chose, rather than the ones the authors want them to use. If the more conservative interpretations downgraded the results, I might could see getting knickers in a twist over the data interpretation, but they don't.

In essence? They appear to be miffed because "These are fantastic and highly effective evidence based protocols." doesn't read "These are really fantastic and very highly effective evidence based protocols." :bored: Which makes my jaded self think they're selling something. Wow??? Wow isn't enough! We need BIG WOW! Umm...
 
Most clinicians are not researchers and most researchers are not clinicians.

I have gotten very discouraged by the academic elite who do so many "studies" in a vacuum and tell clinicians what to do.

Healing is an art as well as science, but I feel more and more that big science is taking over the arena and would prefer to ignore anything outside of it. Science is today also so bothered by big money that unless something can be "randomized" it is automatically lower tier to many.
 
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