A randomised pilot feasibility study of eye movement desensitisation and reprocessing recent traumatic episode protocol, to improve psychological recovery following intensive care admission for COVID-19
Open accessAbstract
Background: Approximately 50% of intensive care survivors experience persistent psychological symptoms. Eye-movement desensitisation and reprocessing (EMDR) is a widely recommended trauma-focussed psychological therapy, which has not been investigated systematically in a cohort of intensive care survivors: We therefore conducted a randomised pilot feasibility study of EMDR, using the Recent Traumatic Episode Protocol (R-TEP), to prevent psychological distress in intensive care survivors. Findings will determine whether it would be possible to conduct a fully-powered clinical effectiveness trial and inform trial design. Method: We aimed to recruit 26 patients who had been admitted to intensive care for over 24 h with COVID-19 infection. Consenting participants were randomised (1:1) to receive either usual care plus remotely delivered EMDR R-TEP or usual care alone (controls). The primary outcome was feasibility. We also report factors related to safety and symptom changes in post-traumatic stress disorder, (PTSD) anxiety and depression. Results: We approached 51 eligible patients, with 26 (51%) providing consent. Intervention adherence (sessions offered/sessions completed) was 83%, and 23/26 participants completed all study procedures. There were no attributable adverse events. Between baseline and 6-month follow-up, mean change in PTSD score was −8 (SD = 10.5) in the intervention group versus +0.75 (SD = 15.2) in controls ( p = 0.126). There were no significant changes to anxiety or depression. Conclusion: Remotely delivered EMDR R-TEP met pre-determined feasibility and safety objectives. Whilst we achieved group separation in PTSD symptom change, we have identified a number of protocol refinements that would improve the design of a fully powered, multi-centre randomised controlled trial, consistent with currently recommended rehabilitation clinical pathways. Trial registration: ClinicalTrials.gov: NCT04455360.
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The process of EMDR with ICU survivors has been described in publications and there is an emerging evidence base.
“the process of EMDR with ICU survivors has been described in publications and there is an emerging evidence base.29–32”
From “It saved me”: A thematic analysis of experiences of psychological therapy following critical illness and intensive care (2024) · cites this paper as [29]
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Surviving Sepsis campaign: international guidelines for Management of Sepsis and Septic Shock 2026
Prescott, H. C., Antonelli, M., Alhazzani, W., Møller, M. H., Alshamsi, F., Azevedo, L. C. P., Belley-Cote, E., De Waele, J., Derde, L., Dionne, J. C., et al. (2026) · Critical Care Medicine · doi:10.1097/ccm.0000000000007075 · Cited by 117 · see citing works
Clarke, R., Weare, V., Chow, H., Bowering-Sheehan, L., & Hitchcock, C. (2024) · Journal of the Intensive Care Society · doi:10.1177/17511437241241243 · Cited by 7 · see citing works
- Authors
- Bates, A., Golding, H., Rushbrook, S., Shapiro, E., Pattison, N., Baldwin, D. S., Grocott, M. P. W., & Cusack, R.
- Affiliations
- National Health Service (GB)
- Dorset HealthCare University NHS Foundation Trust (GB)
- Independent EMDR Europe Consultant Practitioner, Haifa, Israel
- University of Hertfordshire (GB)
- Southern Health NHS Foundation Trust (GB)
- Corresponding author
- Bates, Andrew
- ORCID
- Venue
- Journal of the Intensive Care Society
- Publisher
- SAGE Publications
- Published
- 2022-11-19
- Volume
- 24
- Issue
- 3
- Pages
- 309-319
- ISSN
- 1751-1437 (ISSN-L)
- PMC
- PMC9679313
- OpenAlex
- W4309561523
- Cited by
- 19
- References
- 65
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 8 · 2023: 2
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the Intensive Care Society (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- University of Hertfordshire Research Archive (University of Hertfordshire) (acceptedVersion)
- University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion)
- Funders
- Research Trainees Coordinating Centre (19792)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- EMDR, intensive care unit survivors, COVID-19 pandemic, post-traumatic stress disorder, psychological recovery, remote psychological intervention, trauma-focused psychotherapy, anxiety, depression, feasibility
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