Addiction-focused eye movement desensitization and reprocessing therapy as an adjunct to regular outpatient treatment for alcohol use disorder: Results from a randomized clinical trial

Abstract

Background: This study examined the feasibility, safety and efficacy of Addiction Focused Eye Movement Desensitization and Reprocessing (AF-EMDR) treatment, as an add-on intervention to treatment as usual (TAU). Methods: Adult outpatients with Alcohol Use Disorder (AUD) (N = 109) who already received or had just started with TAU (Community Reinforcement Approach) were recruited at six outpatient addiction care facilities. They were randomly assigned to either TAU + 7 weekly 90-minute sessions of AF-EMDR (N = 55) or TAU-only (N = 54). Assessments were made at baseline, post AF-EMDR therapy (+ 8 weeks in the TAU-only group) and 1- and 6-month follow-up. The primary outcomes were changes in drinking behavior as reported by the participant and biomarker indices. Results: Data were analyzed as intent-to-treat with linear mixed models. Additionally, sensitivity analyses were performed. No group or interaction effects were found for any of the outcome variables. Only limited change over time was seen with regard to indices of personal and societal recovery and in some secondary indices of clinical recovery (craving, desire thinking and rumination). Reliable Change Index calculations showed that more TAU-only participants showed clinical improvement with regard to alcohol consumption while a somewhat higher proportion of participants in the TAU + AF-EMDR group experienced less craving. The acceptability, safety and feasibility of the treatments received in both groups were comparable. Conclusions: There was no add-on effect of AF-EMDR on TAU with regard to drinking behavior in outpatients with an AUD. Possible explanations are discussed. Future studies should first establish proof-of-principle regarding the potential of AF-EMDR therapy to disrupt operant learning and habits relevant in addiction.