Trauma-focused CBT or EMDR – does having a choice matter?
When people seek therapy for post-traumatic stress disorder (PTSD), they may be offered different evidence-based treatments. Two of the main approaches recommended by NICE are trauma-focused Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). A new study from a South London NHS Talking Therapies service has looked at how these two approaches compare in everyday clinical practice.
The researchers found that both EMDR and trauma-focused CBT produced similarly good outcomes across different types of trauma and different groups of clients. There was no clear indication that one treatment was consistently better than the other. This supports the idea that, when both treatments are suitable and available, the individual’s own preference can reasonably play an important part in deciding which approach to use.
The study also highlighted something equally important: some people stopped therapy around the point at which treatment began to focus more directly on traumatic memories. Trauma therapy can understandably feel daunting, and the researchers suggest that careful preparation and discussion about what memory-focused work involves may help people remain engaged with treatment. Sarah has found over many years of clinical work that good preparation often makes a real difference, helping people feel more able to engage with trauma-focused therapy when they are ready to do so.
For someone considering therapy for trauma, the question therefore may not simply be “Which treatment is best?” A more useful discussion may be about how the different therapies work, what feels acceptable to the individual, and which approach they feel most able to engage with. Good trauma therapy should be collaborative rather than something that is simply done to a person.
At Symmetry CBT, Sarah works with both CBT and EMDR when helping people with traumatic experiences and PTSD. Having experience in more than one trauma-focused therapy allows the treatment discussion to take account of the individual person, their difficulties and their preferences, rather than starting from the assumption that one approach will suit everybody.