EMDR with traumatized refugees

While EMDR is treatment of choice for traumatized adults with PTSS, its efficacy has not been validated with traumatized refugees. As long as no evidence is available for EMDR with this population, EMDR with refugees should be informed by theoretical approaches to treatment of PTSS in adults. Four approaches are discussed: the phased approach that advocates stabilization before EMDR; the multimodal approach that advocates combining EMDR with other interventions; the trauma-focused approach that advocates offering EMDR to all adults with PTSS, including refugees and, the transcultural approach that advocates a culturally sensitive administration of EMDR. Several pilot studies on EMDR with traumatized refugees, randomized controlled trials of EMDR with multiply traumatized populations, and a trial of EMDR in a non-western setting may further inform EMDR-therapists working with traumatized refugees. Suggestions are made for combining the four approaches and scientific evidence in treatment planning and execution of EMDR with this population. The EMDR protocol itself prescribes several interventions for treating multiply traumatized patients, such as resource development and installation, clustering of traumatic experiences, and cognitive interweaves. Additionally, culturally sensitive interventions may enable the refugee to actively partake in the treatment process by increasing motivation for trauma processing, by diminishing language barriers, and by facilitating the formulation of culturally congruent meanings to trauma. The question remains whether EMDR, which offers an individualistic approach to trauma, is sufficiently suited to address the collective traumatization of victims of war and organized violence.