Developing guided EMDR to treat PTSD in primary care

Approximately four per cent of the UK population has post-traumatic stress disorder (PTSD). PTSD is a mental health condition that can be triggered when someone experiences or witnesses something traumatic. Symptoms may include:

• Flashbacks
• Nightmares
• Avoiding people or places which are a reminder of the trauma
• Difficulties relaxing

Eye-movement desensitization and reprocessing therapy (EMDR) is very effective at treating PTSD. The National Institute of Health and Care Excellence (NICE) recommends it as a standard treatment for the condition.

EMDR is usually delivered in-person at specialist clinics (secondary care), and usually involves 12 90-minute sessions.

However, the waiting lists for accessing treatment in specialist clinics can exceed one year. In addition, some people find it difficult to access treatment at a specialist clinic because of difficulties travelling or caring responsibilities. They may also prefer to be treated in the community (primary care), as a less stigmatising environment.

All of these factors mean that people affected by PTSD would benefit from having access to effective treatments delivered in primary care. NICE guidelines also recommend that such treatments should be developed.

Project aims

Our aim is to develop a prototype of a guided self-help EMDR intervention that could successfully be delivered in primary care. This intervention will have two elements to it:

• The self-help element would allow patients to access treatment in their own time through a computer, tablet or smartphone
• The guided element means patients would also occasionally meet with a therapist

To develop the intervention we will:

• Review currently available computerised, self-help EMDR interventions for PTSD
• Explore clinicians’ and patients’ views of the utility and acceptability of a guided self-help EMDR intervention, its’ main components and delivery

What we hope to achieve

We will develop a paper prototype of the guided self-help EMDR intervention for people with mild to moderate PTSD in primary care. We will then apply for additional funding to build on our work from this project. Future work would include:

Further piloting and refinement of the prototype and delivery approach to ensure the intervention is engaging to patients

Establishing the feasibility of conducting a large multi-centre trial to evaluate the clinical and cost-effectiveness of this intervention for people with mild to moderate PTSD in primary care

The research team is made up of Dr Daniela Strelchuk (lead), Professor Nicola Wiles and Professor Katrina Turner.