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Washington Post story on PTSD treatment ignores evidence in favor of detailed patient anecdote

Rating

3 Star

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She found relief for PTSD with a different kind of therapy. But does it work?

Our Review Summary

Image of a woman siiting curled up on the ground

Reducing symptoms of PTSD can be challenging. This story reflects on the journey of a young woman who finds relief in a strategy called eye movement and desensitization and reprocessing therapy (EMDR), which, according to the EMDR Institute, asks a client to reflect on “emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus”; in many cases, that external stimulus is some type of repetitive eye movement. Proponents of the therapy argue that it relieves emotional distress and reduces physiological reactions to traumatic memories.

The story does offer cautionary information from a psychologist who does not employ the strategy, and who questions the superiority of the technique over other established strategies. However, the overwhelming message of this vivid anecdotal account is that EMDR can help.

The story notes that the patient is indifferent to issues of evidence; “what mattered is whether it [EMDR] worked for her.” While that may be the case, urging readers to be similarly indifferent is a problem. The cautionary addition to the headline—“But does it work?—was a good signal but received too little attention in the text.

 

Why This Matters

Many people feel left to their own devices in the face of possible mental problems. PTSD can be difficult to treat and as with the patient described in the story, can go through years of struggling with symptoms.

That means they may act on what they read or see.  And that, in turn, means that mental health treatment stories must set a high evidentiary bar.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Cost of treatment surfaces only in the context of whether individuals’ health insurance plans will pay for the treatment. Some will and some won’t; regardless, we have no idea what that cost is.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Although the story provides vivid details of a patient’s reactions to the intervention, the text makes little effort to describe the nature of the benefits that EMDR therapy might confer, much less quantify them.

The only reference is to the movement of traumatic memories from short-term to long-term memory.  The individual who is the subject of the narrative never speaks to that; instead, she notes that the therapy made her trauma memories “less powerful” and that she is “not hurt by it anymore.”

It’s our opinion that much more should have been described about the benefits–what percentage of people respond, and to what degree?

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

Although studies of EMDR–including the occasional meta-analysis–are available, they are not discussed here. Instead, the story relies on cautious reactions of other psychologists.  It does reference the possibility of a placebo effect.

Does the story commit disease-mongering?

Satisfactory

PTSD is a legitimate health issue that is difficult to treat. No disease mongering.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

There is at least one independent source not connected with the patient’s story. We would have liked to have seen input from a psychiatrist, as well (not just psychologists).

Does the story compare the new approach with existing alternatives?

Satisfactory

Cognitive behavioral therapy, a popular alternative, is mentioned in the story, with conflicting reactions. The individual who is the subject of the story left that treatment modality to try EMDR, indicating that the therapy had not been sufficiently helpful.  A psychologist-source who appears to be independent, in contrast, indicates that he considers EMDR no more effective than cognitive behavioral therapy.

We do want to point out that medications were not discussed, although there are several approved for PTSD.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

It is clear that one can find clinical psychologists who will administer the therapy.

Does the story establish the true novelty of the approach?

Satisfactory

The story establishes when EMDR was developed (1987).

Does the story appear to rely solely or largely on a news release?

Satisfactory

The heavy focus on an individual and her efforts to handle her PTSD symptoms suggests that a news release was not a driver here.

Total Score: 6 of 10 Satisfactory

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