Tuesday, June 25, 2013

Evidence-Based Medicine is Not the Same as Science-Based Medicine

EMDR is controversial not because it works, but why it works...

A thread at the Association of Threat Assessment Professionals (ATAP) LinkedIn group asking about research supporting the use of EMDR gave me a chance to practice my Google-fu.

I know people who have benefited from Eye Movement Desensitization and Reprocessing (EMDR) and several health care professionals who recommend it for the treatment of Post-Traumatic Stress Disorder (PTSD).

The VA/DoD Clinical Practice Guideline for the Management of Post Traumatic Stress lists EMDR as an effective treatment for PTSD, while expressing the usual reservations about it's mechanism of action. It's a thorough piece of scholarship that addresses many current PTSD treatments. It's bibliography is 30 pages long. I forwarded it on to my friends and associates in the field.

A search for the terms Eye Movement Desensitization and Reprocessing EMDR at Google Scholar returns 6,880 hits.  PubMed serves up 247 hits for eye movement desensitization and reprocessing.  Here's an interesting discussion by an insurance company (Aetna) that pays for EMDR.  The analysis is supported by a strong bibliography.

Less un-biased resources include an EMDR International Association (EMDRIA) response to the Institute of Medicine (IOM) report on “Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment.”  Many of the papers in past issues of "Journal of EMDR Practice and Research" are open access.

Except for knowing people who have benefited from EMDR I have no dog in this fight, but the controversy is a fascinating example of the difference between evidence-based medicine and science-based medicine.  Again, most everyone agrees it works.  The disagreement is about understanding how it might work.

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