Substance Use Disorders Clinical Trial
Official title:
The Efficiency of Eye Movement Desensitization and Reprocessing (EMDR) for the Treatment of Substance Use Disorders: A Randomized Controlled Trial
The purpose of this clinical study is to examine the established, therapeutic EMDR intervention for patients with substance use disorders (SUD). The EMDR method is an integrative and structured therapeutic method which assumes that memories which have been dysfunctionally stored can lead to harmful behavior. The EMDR protocol used for this clinical trials has been specifically developed for patients with SUD - the results should be compared with traditional therapy. For the assessment of the EMDR treatment some questionnaires are given at several times.
Substance use disorders (SUD) have been prominently described on a neuronal level as a
chronic and relapsing brain disorder, which is associated with changes in emotion, motivation
and cognition. Furthermore on a behavioral level, SUD have been found to be linked to an
increased amount of attachment and personality pathology. More in general, SUD treatment has
been demonstrated to be a complex phenomenon, with high relapse rates of 30-50% after
(successful) treatment.
As emotion regulation is associated with a vast amount of parameters of mental health and
psychological well-being such as more satisfied employment, healthier relationships, better
academic performance, and physical health, the long-term abuse of drugs on the other hand
plays a detrimental role in patients' emotions and mind-sets. Research suggests that
individuals who cannot regulate their emotions in an adequate way in everyday life,
experience more mental turbulences or confusions. In turn this deficit might lead to
substance abuse as one kind of dysfunctional method to regulate inner tensions.
Specifically, an increased amount of impulsivity has been named as being predictive for
addictive diseases. Accordingly, impulsivity was observed as being linked to a poorer SUD
treatment outcome, especially by promoting relapse, as the emotion regulation is hindered and
damaged in SUD patients. Thus the increase of capacities to moderate emotional strain becomes
an important factor for the treatment of SUD. Accordingly, many SUD treatment approaches have
developed specific techniques in order to address the deficient emotion regulation system.
Furthermore a history of traumatic experiences may be essential for the therapeutic work,
because individuals with SUD often present a history of trauma with comorbid rates of up to
75%. Consequentely, various findings suggest that traumatic experiences represent a high risk
factor for the development of SUD.
The method of Eye Movement Desensitization and Reprocessing (EMDR) is an integrative and well
structured psychotherapeutic treatment which has received approval as an efficacious
evidence-based approach for posttraumatic stress disorder (PTSD). EMDR, as a
psychotherapeutic technique, accelerates the accessing and reprocessing of traumatic
materials and supports the brain to release the nervous system from these traumatic
experiences by means of normal handling of emotional information. Due to the fact that up to
40% of individuals with PTSD turn to substance abuse in their lifetime, EMDR is effective in
the treatment of SUD especially in case of unsolved traumata, which are keeping up the
vicious circle of SUD. Furthermore several studies suggest that EMDR is effective in
addiction treatment by significantly reducing substance craving and thus also the rate of
relapse, extending consecutive sobriety, as well as more than twice as many graduates in EMDR
integrated programs. However, the evidence of the efficacy and effectiveness of EMDR on
addiction treatment is still limited, because many findings are preliminary as being
narratively or just case-study based or paying less attention to the role of emotions.
Therefore, the purpose of this study is to further explore and determine the effectiveness of
EMDR for the regulation of emotional processes in long-term addiction treatment.
This study is conceptualized as a randomized controlled trial with two groups: EMDR + TAU vs.
TAU + sham intervention (TAU: Treatment As Usual; the sham intervention is a cognitive
training). The groups are compared pre-treatment, post-treatment, and there are two follow-up
points of assessment: one month after post-treatment and three months after post-treatment.
There will be a total sample of 60 clinical SUD male participants, which will be investigated
during their in-patient stay at a therapeutic community center (after an initial phase of
acclimatization of six weeks). One half of the sample: 30 participants will receive EMDR +
TAU (experimental group; EG), the other half receives TAU + sham intervention (control group;
CG).
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