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Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial

  • Mirjam J. Nijdam (a1), Berthold P. R. Gersons (a2), Johannes B. Reitsma (a3), Ad de Jongh (a4) and Miranda Olff (a2)...

Trauma-focused cognitive–behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) are efficacious treatments for post-traumatic stress disorder (PTSD), but few studies have directly compared them using well-powered designs and few have investigated response patterns.


To compare the efficacy and response pattern of a trauma-focused CBT modality, brief eclectic psychotherapy for PTSD, with EMDR (trial registration: ISRCTN64872147).


Out-patients with PTSD were randomly assigned to brief eclectic psychotherapy (n = 70) or EMDR (n = 70) and assessed at all sessions on self-reported PTSD (Impact of Event Scale – Revised). Other outcomes were clinician-rated PTSD, anxiety and depression.


Both treatments were equally effective in reducing PTSD symptom severity, but the response pattern indicated that EMDR led to a significantly sharper decline in PTSD symptoms than brief eclectic psychotherapy, with similar drop-out rates (EMDR: n = 20 (29%), brief eclectic psychotherapy: n = 25 (36%)). Other outcome measures confirmed this pattern of results.


Although both treatments are effective, EMDR results in a faster recovery compared with the more gradual improvement with brief eclectic psychotherapy.

Corresponding author
Mirjam J. Nijdam, MSc, Centre for Psychological Trauma, Department of Psychiatry, Academic Medical Centre at the University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. Email:
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This study was supported by the Academic Medical Centre, Amsterdam, The Netherlands.

Declaration of interest

A.d.J. teaches and supervises clinical psychologists and psychiatrists in psychological trauma and its treatment by means of seminars, workshops and conferences, for which the participants pay a fee. He is also director and shareholder of a trauma treatment unit. For both activities he has the formal permission of the executive board of the University of Amsterdam to which he is affiliated.

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Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial

  • Mirjam J. Nijdam (a1), Berthold P. R. Gersons (a2), Johannes B. Reitsma (a3), Ad de Jongh (a4) and Miranda Olff (a2)...
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Going Further on Post-Traumatic Stress Disorder

Itoro I. Udo, Specialty Registrar
20 April 2012

The study presented has been appraised with interest. (1) It is a well designed study that does what it sets out to do. This study incorporated clinical effectiveness data which makes it valuable to clinicians. I write to comment further as follows:

1.It would have been beneficial to have had further explanation of how mastery of Dutch language was determined in the study participants.

2.Trauma was characterised in the study as "complex" without a definition of what this subjective term is used to denote in the study.

3.It may have been beneficial to provide more information on the types of "comorbid psychiatric disorders" that participants had, for purposes of the readers' evaluation of clinical applicability of results. I am wondering whether any participant was diagnosed with Dissociative Identity Disorder (DID).(2) Knowing the spread of Personality Disorders and Bipolar Affective Disorder would have been particularly beneficial.

4.As to psychotropic medication use, one wonders what percentages ofparticipants were on mood stabilisers and its types which may have affected their trauma processing.

The bottom line results of this study substantiate what we do observeclinically. Further research needs to consider whether faster recovery does also occur with multiple trauma survivors. Increasingly, in liaison psychiatry settings, we are confronted with persons with Post-traumatic Stress Disorder and Bodily Distress (Medically Unexplained Symptoms); it would be worth investigating the place of Eye Movement Desensitisation Reprocessing (EMDR) versus Brief Eclectic Psychotherapy (BCP) or Trauma focused Cognitive Behavioural Therapy or Psychodynamic Interpersonal Therapy in such circumstances, (3) as faster recovery could have wider implications on health services. This may be by way of reduced use of acute/ emergency services, improved quality of life, increase sense of well being and reduction of risk.


1. Nijdam MJ., Gersons BPR., Reitsma JB., Jongh A., Olff M. Brief Eclectic Psychotherapy v. Eye Movement Desensitisation and Reprocessing Therapy for Post-traumatic Stress Disorder: Randomised Controlled Trial. BJPsych 2012; 200 (3):224-231.

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). American Psychiatric Association; 1994.

3. Creed F., Feltz-Cornelius C., Guthrie E., Henningsen P., Rief W., Schroder A., White P. Identification, Assessment and Treatment of Individual Patients. In: Creed F., Henningsen P., Fink P. (eds.) MedicallyUnexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services. Cambridge: Cambridge University Press; 2011. p175- 216.

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Conflict of interest: IIU is a member of EMDR Association UK & Ireland. The views expressed here are solely those of the author. IIU is trained in both CBT and EMDR.

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