title: A multi-site randomized study to compare the effects of Eye Movement Desensitization and Reprocessing (EMDR) added to TAU versus TAU to reduce craving and drinking behavior in alcohol dependent outpatients: study protocol.
abstract: BACKGROUND
  Addiction constitutes a major public health problem, and despite treatment, relapse rates remain very high. Preliminary findings suggest that Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based treatment for PTSD, may also reduce craving and relapse rates when applied in substance abuse. This study aims to determine the feasibility, efficacy and effectiveness of EMDR when added to treatment as usual (TAU) for addiction in alcohol dependent outpatients, compared to TAU only.
  
  
  METHODS
  A single blinded study in which 100 adult patients with a primary DSM-IV-TR diagnosis of alcohol dependence or abuse receiving treatment in one of six Dutch outpatient addiction care facility sites, will be enrolled. After baseline assessment participants will be allocated to one of two treatment conditions (allocation ratio of 1:1) using a stratified (per site, per care pathway), blocked randomization procedure. The intervention consists of EMDR (seven weekly 90 minute sessions) + TAU or TAU only. Assessments are scheduled pre-treatment (t0), post-treatment (t0 + eight weeks), and one and six months post treatment. The effects of both treatment arms are compared on indices of (a) drinking behavior, (b) mediators, moderators and predictors of treatment outcome, (c) quality of life and d) safety, acceptability and feasibility of treatment. Repeated measures ANOVA's will be conducted using an intention-to-treat and per-protocol approach. Multiple imputation will be used to deal with missing values when possible.
  
  
  CONCLUSIONS
  This study adapts and extends the standard EMDR treatment for traumatized patients for use with patients with alcohol use disorders without psychological trauma.
  
  
  BACKGROUND
  ClinicalTrial.gov: NCT01828866.
authors.affiliation: IrisZorg, Institute for Addiction Care, Sheltered Housing and Social Support Services, Kronenburgsingel 545, P.O. box 351, 6800 AJ, Arnhem, Netherlands. w.markus@iriszorg.nl.|Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud Universiteit Nijmegen/ACSW, P.O. box 9104, 6500 HE, Nijmegen, Netherlands. w.markus@iriszorg.nl.|Behavioral Science Institute (BSI), Radboud University Nijmegen, P.O. box 9104, 6500 HE, Nijmegen, The Netherlands. w.markus@iriszorg.nl.
authors.forename: Wiebren
authors.initials: W
authors.lastname: Markus
authors.affiliation: Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud Universiteit Nijmegen/ACSW, P.O. box 9104, 6500 HE, Nijmegen, Netherlands. gdweert@victas.nl.|Victas, Centre for Addiction Treatment, Tolsteegsingel 2A, 3582 AC, Utrecht, The Netherlands. gdweert@victas.nl.
authors.forename: Gerdien H
authors.initials: GH
authors.lastname: de Weert-van Oene
authors.affiliation: Behavioral Science Institute (BSI), Radboud University Nijmegen, P.O. box 9104, 6500 HE, Nijmegen, The Netherlands. e.becker@psych.ru.nl.
authors.forename: Eni S
authors.initials: ES
authors.lastname: Becker
authors.affiliation: Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud Universiteit Nijmegen/ACSW, P.O. box 9104, 6500 HE, Nijmegen, Netherlands. nispa.dejong@gmail.com.
authors.forename: Cor A J
authors.initials: CA
authors.lastname: DeJong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control; D000437:Alcoholism / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000379:methods; D000704:Analysis of Variance; D002908:Chronic Disease; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D066249:Craving; D057169:Eye Movement Desensitization Reprocessing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult