EMDR by gambling addiction
A replicated single case study, wich investigates the value of EMDR in the treatment of gambling addiction.

Cognitive behavioral therapy has been used the most for the treatment of
pathological gambling addiction (IVO, 2014). Behavioral addictions form only a
small part of all the addictions for which the total client population seek
help. Therefore there are also only a few studies on the effectiveness of
treatments for behavioral addictions such as pathological gambling (IVO, 2014).
Although the literature indicates that a gambling addiction can be treated just
like any other (substance) addiction (Schippers et al 2014), clinical practice
shows that not al treatments are as effictive as treatments for substance
addictions. EMDR could be a treatment that works in addiction (Leeds 2009).
There is hardly any research into the effectiveness of EMDR in addictions and
specifically for EMDR applied to gambling addiction.
Eye movement desensitization and reprocessing (EMDR) is a therapy that has been
designed primarily for people who suffer from the effects of a traumatic
experience, such as an accident, sexual violence or a violent incident. It is a
therapeutic approach which involves the intrinsic information processing in the
storage of memories. Current stress symptoms are being controlled by unpleasant
events of the past (memory representations) that are not properly being
processed and are stored in a dysfunctional manner (Solomon & Shapiro 2008).
Research has shown that EMDR has an effect on the reduction of symptoms of
post-traumatic stress (i.a. Bisson et al., 2007).
The developments in the field of EMDR (Shapiro, 1989) and the use of EMDR with
other disorders then PTSD (Leeds, 2009), provide evidence that EMDR could also
work for treating addictions. There are case studies and reports (Barbiery
2008; Hase, 2009; Miller, 2010; Omaha, 1998), which indicate that EMDR can make
an effective contribution to the treatment of addiction.
There are only a few case studies about EMDR and gambling addiction. These
studies provide evidence that EMDR may influence the symptoms of gambling
addiction (Bae et al 2013. Miller 2010). Bae Han and Kim (2013) found evidence
that the impulsive behavior improved early in treatment with EMDR, because they
put the focus on trigger situations. Bae et al. found that the ego strength was
increased by the client, because they made use of empowering techniques,
allowing gamblers to get more control over the gambling. Evidence from this
study shows that EMDR affects the self-control and the urge to gamble. It is
important that more research is conducted about the role of EMDR in a
pathological gambling addiction treatment.

To gain more insight into the effects of EMDR in the treatment of a
pathological gambler. It is important to conduct research on the influence of
EMDR on pathologial gambling and on which factors are influenced by EMDR . This
study addresses the urge to gamble and the sense of self efficacy.

In this study, we make use of a replicated single case design, with a multiple
baseline A-B design. A distinction has been made between the baseline period
(no intervention ) and the intervention period in the treatment of gambling
addiction. The primary outcome is the time series analysis of the sens of
self-efficacy and urge to gamble with a visual analogue scale. This is a daily
measurement .Is the variable progressively affected or are there peaks or
valleys seen after a session of the intervention. Another reason to choose a
single case design is that there are only a few admissions of gambling addicts
in VNN . In addition, there is a pre- and post- measurement with standardised
measurements. However, tese measurement are not the primary measurements.

There EMDR is given according to the protocol of Hornsveld and Markus (2015) it
is offered to clients who are in the waiting period for the 'treatment as
usual'. Overall the 'treatment as usual is a group treatment containing both
psychoeducation and cognitive behavioral therapy elements.

The EMDR protocol for addiction:
Hornsveld and Marcus (2015) have developed a protocol for treating addiction by
using EMDR. The protocol has components about loss of control, reality testing
and about trigger situations. They describe this protocol as a toolbox with
modules that can be used for the treatment of addiction. The toolbox is based
on the standard protocol EMDR and the development of protocols for EMDR in the
field of addiction.

There are are six sessions of 90 minutes EMDR, which focuses on: to desensitize
memories of loss of control, desensitize positive memories, desensitize couple
reminders, desensitize trigger situations and desensitize a positive
flashforward. This will be done according to the protocol of Hornsveld and
Markus (2015). The treatments are given by, preferably, EMDR therapists who
have done the follow up EMDR training and preferably followed the masterclass
addiction and EMDR.

For the client , it is a new form of therapy, which provides a similar burden
and risc for the client as the " treatment as usual (CBT in group or individual
CBT) ." The client can benefit from a new treatment, but maintaining the
treatment as usual . The burden for the client is to fill out a daily list ,
which takes about 5 minutes and do so for at least 9 weeks (maximum is 11
weeks). At the start the client will fill out 3 questionnaires wich takes 30
minutes and at the end of the treatment it takes another 15-30 minutes to fill
out 2 questionnaires and write down there experiences about the treatment.