development of online emdr therapy system and its comparative testing with face-to-face emdr therapy for treatment of anxiety and depressive disorders in pakistan

Conditions: Generalized Anxiety Disorder; Major Depressive Disorder; Social Anxiety Disorder; Somatic Symptom; Panic Attacks; Obsessive-Compulsive Disorder and Symptoms

Summary: this study aims at developing an online system for the remote delivery of emdr therapy in pakistan. moreover, this study will compare the efficacy of online emdr therapy with face-to-face emdr therapy.

depressive and anxiety disorders have higher global prevalence. moreover, they are leading causes of global burden of mental diseases (i.e., 24th leading cause of global disability-adjusted life years). such increase in the global prevalence of depression and anxiety disorders is due to the complexities of modern life. nowadays various evidence-based psychotherapies, like e.g., emdr therapy are available. therapists have been using face-to-face modes for a long time, but with the expansion of computer technologies, online psychotherapies have been developed. the need for online psychotherapies was further increased due to corona virus-19 pandemic. scientists have developed online modes of cognitive behavioral therapy, prolonged exposure therapy and mindfulness therapy, etc., but there are limited research studies on the online emdr therapy, especially in the asian countries. therefore, questions arises a) is it possible to treat anxiety \& depressive disorders through online emdr therapy? b) what adaptations would be required to be made in the face-to-face protocols of emdr therapy? c) whether the online emdr therapy will be: i) fit and safe for use; ii) usable; iii) operable \& practicable; and iv) efficient in delivering a timely treatment? the existing online programs of emdr therapy, e.g., virtualemdr have been built in the western-developed countries, hence may not be accessible to the local patients in pakistan. moreover, these programs might not be compatible with the requirements of patients in pakistan. keeping in view such facts, this study aims at developing an online system for the remote delivery of emdr therapy in pakistan. moreover, this study will compare the efficacy of online emdr therapy with face-to-face emdr therapy. for this purpose, patients will be recruited through a consecutive sampling technique, with a sample size of n=30. data on symptomology and other technical data will be collected through standard scales. qualitative data were analyzed by qualitative techniques, while the quantitative data were analyzed by descriptive and multivariate statistics. this study will be unique in its nature since a) an online emdr therapy will be developed for pakistani patients, b) this online system will be scientifically validated, c) and its efficacy will be compared with face-to-face emdr therapy. this study will provide a base for the future researchers to design and implement online psychotherapies in pakistan. in this way, the mental healthcare system of pakistan could be ultimately revolutionized through the online treatment facilities.

Eligibility criteria:
inclusion criteria: 1. both male and female patients. 2. patients between the age of 18 to 50 years (since this study is neither on children nor on old patients). 3. patients who have basic knowledge \& skills of computer, mobile and internet (although the recruited patients will be given training for using the online emdr). 4. patients do not suffer from severe neuropsychological and cognitive impairments. 5. patients have not received any pharmacological therapy in the last three months. 6. patients have not received any other psychotherapy like cognitive behavioral therapy.

Keywords: emdr online emdr depression anxiety pakistan pilot study