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-{{tag>IEMT Model Adaptation reframe Nursing}}  
-==== Integral Eye Movement Therapy (IEMT) - An Adaptive Model ==== 
-**Based on Sr. Callista Roy’s (1970) Adaptation Model** 
  
-Sister Callista Roy[(Callista_Roy>Callista Roy[[https://en.wikipedia.org/wiki/Callista_Roy|Wikipedia]])]  is an influential figure in the modern nursing profession. After graduating from Mount St. Mary’s College with a Bachelor of Science in Nursing and Sociology, she went on to pursue her Master's and Doctorate degrees at the University of California, Los Angeles. She contributed greatly to the field of nursing science with her research into Adaptation Model[( :harvard:Riehl1980>> +====== Integral Eye Movement Therapy (IEMT): An Adaptive Model ======
-authors   : C. Riehl +
-title     : Conceptual Models for Nursing Practice (Archive.org Online Library) +
-published : 1980 +
-publisher : Century Crofts +
-url       : https://archive.org/details/conceptualmodels0000rieh +
-)] [( :harvard:Roy1980>> +
-authors   : H. Andrews, C. Roy +
-title     : The Adaptation Model (Archive.org Online Library) +
-published : 1991 +
-publisher : Appleton & Lange +
-url       : https://archive.org/details/royadaptationmod0000andr +
-)] of Nursing, which includes assessing patient health issues through understanding their adaptation patterns for better, more informed care. +
  
-Her concept has been cited by various scholars and forms the basis for many current approaches to health evaluation and assistance. Moreover, her Adaptive Model has been expanded overseas, providing the opportunity for research collaboration between nurses around the world. Sister Callista Roy’s exceptional scientific contributions have set new precedents in holistic nursing assessment, making her an esteemed professional in both American and international healthcare communities.+**A conceptual bridge between Integral Eye Movement Therapy and Sister Callista Roy’s Adaptation Model**
  
-Nursing theories frame, explain or define the practice and delivery of nursing care. There are a number of [[nursing_models|prominent models in common use]], and different models may be used according to the organisational needs and the provisional requirements of the patient group served.  +Integral Eye Movement Therapy (IEMT) was not derived from the Roy Adaptation Model (RAM), and it is not a nursing theory. The two approaches nevertheless share a useful organising idea: people continually respond to internal and external change, and well-being depends partly on how flexibly those responses can be updated.
  
-Sister Callista Roy developed the Adaptation Model of Nursing[(Adaptation_model_of_nursing>Adaptation model of nursing[[https://en.wikipedia.org/wiki/Adaptation_model_of_nursing|Wikipedia]])] +This page develops an **Adaptive IEMT Model**: a practitioner-oriented framework for considering emotional imprints, identity imprints and the [[iemt#patterns_of_chronicity|Patterns of Chronicity]] alongside Roy’s concepts of environmental stimuli, coping processes, adaptive modes and feedback. It is a conceptual synthesis, not a claim that Roy endorsed IEMT or that the two models are clinically equivalent.
- which quickly became regarded as a major nursing theory worldwide, especially in rehabilitation environments.  Roy's model sees the individual as a set of interrelated biological, psychological and social systems. Whilst the individual strives to maintain a balance between these systems and the pressures of the outside world, an ideal level of balance is rarely found, thus the need for continual adaptation. +
  
-The [[orders_of_adaptation|Adaptation]] Model has been used in neurological rehabilitation units in a number of ways. Some examples[(application_Roys_adaptation_model>Application of Roy's Adaptation Model (RAM)[[https://currentnursing.com/nursing_theory/application_Roy%27s_adaptation_model.html|currentnursing.com]])] include:+The practical purpose of this framework is to guide decisions before, during and after an IEMT intervention. A proposed governing aim is to help the person develop responses that support their chosen life, health and relationships under actual conditions. This means considering environmental changes and other sources of help, agreeing outcomes beyond immediate relief, and revising the formulation in response to what happens. See [[governing_principles|Roy’s Adaptation Model as Governing Principles for IEMT Practice]] for the proposed principles and a formulation record.
  
-  * **Assessing the impact of neurological injuries** or conditions on an individual's physical, psychological, and social functioning.+<WRAP round important> 
 +**Evidence and scope**
  
-  * **Developing treatment plans** that address the unique needs and strengths of each individual, taking into account their personal goals and priorities.+IEMT is a developing approach. A 2026 peer-reviewed exploratory study involving 33 adults from the general population found lower self-reported distress after both IEMT-directed and EMDR-directed eye movements than after a control condition, immediately and at one-week follow-up. IEMT and EMDR did not differ significantly. The study was small, used a non-clinical sample and a single negative memory, and does not establish IEMT as a treatment for PTSD or any other diagnosis.[(iemtstudy>van Heugten-van der Kloet D, Boonstra A, Trouk N and ten Brinke A (2026), “An Exploratory Comparison of IEMT- Versus EMDR-Directed Eye Movements on Changes in Emotionality and Distress During Recall of Negative Memories”, //Journal of Evidence-Based Psychotherapies// 26(1), 1–18. [[https://doi.org/10.24193/jebp.2026.1.1|DOI]])]
  
-  * **Evaluating the effectiveness of rehabilitation interventions** by tracking changes in an individual's adaptation level over time.+This framework should therefore be read as a way of organising assessment, reflection and outcome monitoring. It is not a diagnosis, a medical explanation or a substitute for evidence-based mental-health or medical care. 
 +</WRAP>
  
-  * **Providing a framework for collaborative care**, where multiple healthcare professionals can work together to support the individual's adaptation and recovery.+===== At a glance =====
  
-  * **Educating individuals and their families about the impact of neurological injuries** or conditions on their lives, and helping them develop coping strategies to manage any challenges they may face.+^ Question ^ Roy Adaptation Model ^ Adaptive IEMT perspective ^ 
 +| **What is adapting?** | A human adaptive system in continuous interaction with a changing environment. | A person whose present responses may include learned emotional, physiological, behavioural and identity patterns. | 
 +| **What enters the system?** | Focal, contextual and residual stimuli. | Immediate demands, contributing conditions and uncertain influences; separately note whether a representation concerns remembered, current or anticipated content. | 
 +| **How is information processed?** | Through regulator and cognator coping subsystems. | Through bodily responses, attention, memory, meaning, language, identity and repeated interactional patterns. | 
 +| **Where is adaptation observed?** | Physiological-physical, self-concept, role function and interdependence modes. | In changes across felt state, self-description, behaviour, roles, relationships and day-to-day functioning. | 
 +| **What is the practitioner trying to do?** | Promote adaptation and integrity through nursing assessment and intervention. | Help the client update an unhelpful emotional or identity response while strengthening agency and real-world flexibility. | 
 +| **How is progress judged?** | By observable adaptive or ineffective responses in the four modes. | By repeated measurement of distress, meaning, behaviour, functioning, durability and any unwanted effects. |
  
-<blockquote center> +===== Origins and intellectual context =====
-Health is not freedom from the inevitability of death, disease, unhappiness or stress, but rather is the ability to cope with them in a competent way.+
  
-<cite>Ivan Illich</cite> +==== Sister Callista Roy and the development of RAM ====
-</blockquote>+
  
 +Sister Callista Roy began developing her adaptation model while studying nursing in the 1960s and published its conceptual framework in 1970. The model became internationally influential in nursing education, research and practice. Boston College describes its central proposition as the promotion of patient adaptation through attention to the whole person—biological, psychological, social and spiritual—in interaction with a changing environment.[(roybc>Boston College (2016), “50th Anniversary of the Roy Adaptation Model”. [[https://www.bc.edu/bc-web/bcnews/science-tech-and-health/nursing/roy-adaptation-model.html|Boston College]])]
  
-<blockquote center> +Roy and colleagues continued to refine the model across several decades.[(royresearch>Roy C, Whetsell MV and Frederickson K (2009), “The Roy Adaptation Model and Research”, //Nursing Science Quarterly// 22(3), 209–211. [[https://pubmed.ncbi.nlm.nih.gov/19694080/|PubMed]])] The model is best understood as a nursing conceptual system: it provides a disciplined way to assess the person and environment, identify effective and ineffective responses, select interventions and review outcomes.
-We now act as if we really believe that disease, aging, and death are unnatural acts and all things are remediable. All we have to do, we think, is know enough (or spend enough), and disease and death can be prevented or fixed.+
  
-<cite>Faith T. Fitzgerald</cite> +==== IEMT and the adaptation lens ====
-</blockquote>+
  
-==== Overview of the theory ====+IEMT was developed by Andrew T. Austin from 2006, drawing on earlier eye-movement approaches and later incorporating work on language, identity and interactional patterns. A concise account appears in the //SAGE Encyclopedia of Theory in Counseling and Psychotherapy//.[(austin2015>Austin AT (2015), “Integral Eye Movement Therapy”, in //The SAGE Encyclopedia of Theory in Counseling and Psychotherapy//, pp. 540–541. [[https://doi.org/10.4135/9781483346502.n187|DOI]])]
  
-The Adaptation model has four domain concepts of: (i) person, (ii) health, (iii) environment, and (iv) nursing; +IEMT asks how a person learned a particular feeling or way of being, how that pattern is reproduced in the present, and what happens when the associated representation is updated. The Adaptive IEMT Model adds a wider systems question:
  
-The model views the person as "//a biopsychosocial being in constant interaction with a changing environment//".+> **If this response changes, what becomes possible across the person’s body, self-concept, roles, relationships and environment?**
  
-As in systems theory, a person is an open and adaptive system that uses internal coping skills to deal with environmental stressors. The environment is defined as "all conditions, circumstances and influences that surround and affect the development and behaviour of the person".+The value of the bridge is therefore not that the theories are identical. It is that RAM prevents a narrow focus on symptom intensity alone, while IEMT offers a structured way of exploring selected emotional and identity patterns within the larger adaptive system.
  
-Stressors are defined as stimuli and the model uses the term //residual stimuli// to describe those stressors whose influence on the person is not immediately clear. Many life experiences and events that are long over may continue to exert residual stress upon the individual.+===== The Roy Adaptation Model in detail =====
  
-Health is defined as the process of "being and becoming an integrated and whole person" and Callista Roy's goal for the delivery of nursing care is "//the promotion of adaptation in each of the four modes*, thereby contributing to the person's health, quality of life and dying with dignity//".+==== Four domain concepts ====
  
-*//The four modes referred to are: (i) physiological, (ii) self-concept, (iii) role function and (iv) interdependence.//+RAM organises nursing knowledge around four broad concepts:
  
 +  * **Person** — an adaptive system, whether an individual or a collective, whose parts operate together rather than in isolation.
 +  * **Environment** — the conditions, circumstances and influences surrounding and affecting the person.
 +  * **Health** — a process of becoming integrated and whole, not merely the absence of illness.
 +  * **Nursing** — the professional activity of assessing behaviour and stimuli, intervening to promote adaptation, and evaluating the response.
  
-==== Adaptive Model and IEMT ====+The person is an **open system**. Inputs from the environment are processed through coping mechanisms; responses become visible in behaviour and functioning; consequences then feed back into the person–environment relationship.
  
-Embedded within the operating mechanism of [[iemt_wiki|IEMT]] is a fundamental assumption that holds a person as a dynamic being who is in constant interaction with the ever-changing environment. Human beings are an intricate design of biological, social and psychological factors, both internal and external. +<WRAP round box> 
 +**A simplified adaptive loop**
  
-Every environment offers the individual resources, challenges, struggles and stressors of different forms and variable degrees thereby resulting in all consequential effects being subjective and occurring on a spectrum. +Environmental and internal stimuli → coping processes → responses in four adaptive modes → consequences and feedback → revised adaptation 
 +</WRAP>
  
-An important aspect of IEMT is an increase in resilience in order to get the client more effective to face, handle and adapt to the current environment. IEMT attempts to increase adaptability and maturity on part of the individual in order to manage life and its' ongoing complexities. +This loop is not a claim that human experience is mechanically linear. Several stimuli and responses may operate at once, feedback may be delayed, and meaning is shaped by culture, relationships, history and material circumstances.
  
-Being an “[[orders_of_adaptation|adaptive system]]”, a person has input from the environment, which is subject to internal processing, eventually leading to an output. Our model presumes that the individual uses both innate and acquired (learned) mechanisms to adapt. Some of these adaptations may bring about unintended negative consequences and may be termed maladaptive.+==== Three classes of environmental stimulus ====
  
-The environmental stimuli that present as a resource, challenge, stressor or any combination of these may have its’ origin in the historical biography of an individual. This, in turn, can exert an effect in the present through its psychological, physiological, emotional, social and/or environmental nature.+Roy distinguishes three stimulus classes:
  
-The Adaptive IEMT Model states that well-being is an integral and central feature of a person’s life, and can be represented on a well-being/distress spectrum. Along with health, well-being can be described as a state and process of being and becoming integrated and whole as a person, freed from the negative historical stresses and maladaptive responses.+  - **Focal stimulus** — the internal or external stimulus most immediately confronting the person. 
 +  - **Contextual stimuli** — other factors present in the situation that contribute to the effect of the focal stimulus. 
 +  - **Residual stimuli** — background factors whose influence may be relevant but is unclear or difficult to verify, including prior experience, attitudes and traits.
  
-{{:adaptive_1_.png?600|}}+This distinction is especially useful because the presenting problem is not automatically the whole problem. A focal event may be intensified by sleep loss, pain, relationship conflict, financial pressure, isolation or earlier learning. Conversely, changing the context may reduce the impact of the focal event without any memory-focused intervention.
  
-==== Environmental stressors have four components: ====+IEMT also attends to anticipated situations. In this proposed formulation, **prospective** describes the content of a representation rather than adding a fourth category to Roy’s classification. An imagined future event can be focal if it is what immediately confronts the person, or contextual if it shapes another focal response. Record both its present role and its anticipated content.
  
-  - **Focal** - current and specific stresses (extraneous pressures, intrinsic health issues) applied to the individual present in many or all contexts. The focal stimuli are those which attract the most attention from individuals (injury, divorce, debt, etc) or communities (such as a bombing, kidnap, environmental disaster, etc);  +^ Stimulus class or content descriptor ^ Practical question ^ Example ^ 
-  - **Contextual** - all context-dependent stimuli, that is, those present in the background, and frame the situations that exacerbate the consequences of the focal stresses; +| **Focal** | What requires attention now? | Thinking about a forthcoming presentation currently evokes intense dread. | 
-  - **Residual** - historical stresses whose after-effects continue into the current situation and affect the individual’s well-being. This may include attitudes, beliefs, and strong influences in the form of either people or experiences.  +| **Contextual** | What else is amplifying, reducing or shaping the response? | Poor sleep, a critical manager, caffeine use, workload and limited preparation time. | 
-  - **Prospective Stresses** - can reasonably be known, anticipated, and expected prior to their occurrence. +| **Residual** | Which possible influences remain unclear in this situation? | A past experience or current belief whose contribution has not yet been established. | 
 +| **Prospective content (additional descriptor)** | What future scene is being mentally rehearsed as if it were occurring now? | Imagining going blank and being rejected by colleagues. |
  
-With the IEMT model, well-being is affected when an individual’s adaptation fails to de-potentiate residual negative states resulting from historical environmental interactions and pressures. This in turn leads to specific maladaptive patterns, The Patterns of Chronicity, which inadvertently serve to maintain the residual negative state. +A stimulus is not residual simply because it concerns the past. Its classification depends on its role in the present formulation and what is known about that role. Remembering an earlier event may itself be focal; an identified contribution from earlier learning may be contextual; an uncertain influence remains residual. [[https://www.msmu.edu/learning-and-research-communities/roy-adaptation-association/roy-adaptation-model/|Roy Adaptation Association: stimulus definitions]].
-  - **Focal** - the presenting problem +
-  - **Contextual** - via reactive patterns of chronicity +
-  - **Residual** - past events and traumas that leave a residual kinaesthetic that affects well-being and behaviour in the present moment  +
-  - **Prospective** - habitual responses to “routine” triggers+
  
-==== Adaptation ====+==== Coping subsystems: regulator and cognator ====
  
-The Adaptation model proposes 3 levels of adaptation+RAM describes two major coping subsystems for the individual:
  
-1. Adaptive (systemic reorganisation) +  * The **regulator subsystem** refers to automatic neural, chemical and endocrine responses. 
-2. Compensatory (part-system reorganisiton) +  * The **cognator subsystem** refers to perception and information processing, learning, judgement and emotion.
-3. Maladaptive (failure to reorganise)+
  
-{{ :coping_processes.png|}}+These are theoretical organising concepts, not clinical tests or claims that a practitioner can directly observe a particular neural or endocrine process. What can be observed or reported are the resulting changes in bodily state, attention, meaning, decisions and behaviour.
  
-----+For an Adaptive IEMT formulation, the distinction encourages the practitioner to track both:
  
-{{:image-2.jpg?800|}}+  * **bottom-up information** — breathing, posture, tension, pain, temperature, nausea, startle and other bodily signals; and 
 +  * **top-down information** — memory, imagery, language, interpretation, expectation, identity and choice.
  
-----+Neither channel should automatically be treated as the single cause. The question is how they interact in this person, in this context, at this time.
  
 +==== The four adaptive modes ====
  
-==== The IEMT Adaptive Model makes fifteen operating assumptions. ====+RAM assesses responses in four interdependent modes. A change in one mode may improve or destabilise another, so the modes are best treated as a map rather than four separate compartments.
  
-  - The person is a dynamic system that operates within the web of biological, psychological and social influences.  +=== 1. Physiological-physical mode ===
-  - The person is a product of his/her interaction with an ever-changing environment.  +
-  - Well-being, eustress and distressing stressors are an in-built part of human life.  +
-  - The environment is embedded with stressors and changes. Adaptation is not a choice, but a necessity for life.  +
-  - The adaptation of an individual is a function of the relationship between the flexibility and skills of adaptation and the familiarity and degree of the stimuli.  +
-  - All behaviours are learned within a socio-cultural context.  +
-  - No symptom of distress exists in isolation from this context. +
-  - Maladaptive emotional responses can give rise to patterns of chronicity that inadvertently serve to maintain a distressed state and prevent natural healing across time. +
-  - There is a dynamic objective for existence with the ultimate goal of achieving dignity and integrity. +
-  - Movement of the eyes while thinking of an unhelpful memory changes the contents of the memory and the feelings/reactions attached to the memory. +
-  - A person can be reduced to parts for therapeutic change work and then needs to be looked at as part of the whole.  +
-  - IEMT is based on the principle of causality. Feelings, emotions, roles, identities and events have a cause. Each experience sets up an effect in motion.  +
-  - A patient’s behavioural, emotional and cognitive patterns can be challenged effectively by the IEMT model. +
-  - A positive and effective state of adaptation leads toward greater integration in an individual and also frees a person’s energy to respond to other stimuli.  +
-  - A limitation of IEMT is to only be able to make changes to the body's conditioned reflex responses, IEMT cannot, for example, change the genetics of a body, although it is hypothesised that further research could well find epigenetic adaptations occurring as a result from working with PTSD clients. +
-==== Goal and Intention of IEMT ====+
  
-The goal of IEMT is to free the client from the effect of negative memories, feelings of distress and constricted identities that restrict the fundamental idea of life which is to experience it fully. It is to know and imbibe that stressors are integral to living and our adaptability to them defines well-being. Therefore, IEMT gives an empowering choice to stay on the spectrum towards robust health, in all domains, physical, mental, social and spiritual. +This mode concerns bodily integrity and function, including oxygenation, nutrition, elimination, activity and rest, protection, senses, fluid and electrolyte balance, neurological function and endocrine function.
  
-The intention of IEMT is the integration of experience and maturing of identity thereby leading to increased well-being within the dynamic system called the human being. +In an IEMT-informed assessment, the practitioner may note the bodily expression of a target state—for example, constricted breathing, jaw tension, nausea or a startle response—without presuming that the symptom is purely psychological. New, severe, unexplained or persistent physical symptoms require appropriate medical assessment.
  
-An integrated individual with greater well-being is more contributive to self and their social environment invariably leading to a better quality of life. +**Useful outcome questions include:**
  
-==== Steps of IEMT ====+  * Is the bodily response less intense, shorter or easier to recover from? 
 +  * Has sleep, activity or concentration changed? 
 +  * Does the response vary by context? 
 +  * Is a medical, medication-related, substance-related or neurological factor plausible?
  
-  - Addressing a troublesome memory and mitigating the impact of unpleasant feelings +=== 2. Self-concept mode ===
-  - De-linking the cognate emotion-physiologic-memory web (separating stimuli and response) by identifying patterns of distress and specific stimuli +
-  - Increasing awareness of the maladaptive behaviours ("Patterns of Chronicity") that hinder healing and evolution +
-  - Identifying triggers within the body-mind loop +
-  - Introducing choice towards any frame/ state of mind +
-  - Evaluation of the intervention in the real world  +
  
-{{:image-3.jpg?800|}}+For individuals, self-concept concerns psychological and spiritual integrity: the physical self, personal self, values, continuity and the person’s sense of who they are. 
 + 
 +This mode closely overlaps IEMT’s distinction between an **emotional imprint** (“how I learned to feel”) and an **identity imprint** (“how I learned to be”). A person may experience temporary anxiety without defining themselves by it, or may organise the experience into a broader conclusion such as “I am weak”, “I am unsafe” or “I am an outsider”. 
 + 
 +The adaptive question is not simply whether a negative label can be replaced by a positive one. It is whether the person gains a more flexible, accurate and context-sensitive relationship with the experience. 
 + 
 +=== 3. Role function mode === 
 + 
 +Role function concerns the positions a person occupies and the behaviours expected in relation to those positions. Roles may include parent, partner, colleague, leader, carer, student, patient or community member. 
 + 
 +A role transition can be difficult even when it is welcome. After a change in health, employment, relationship or status, the person may need to revise expectations, skills and boundaries. IEMT work may be relevant when a specific emotional or identity imprint constrains that process, but practical adaptation may also require training, accommodation, rest, negotiation or social support. 
 + 
 +=== 4. Interdependence mode === 
 + 
 +Interdependence concerns relational integrity: giving and receiving care, respect, value and support while maintaining appropriate autonomy. 
 + 
 +Here the practitioner considers whether the target pattern affects trust, closeness, communication, help-seeking, conflict, dependency or isolation. Improvement is not measured by compliance with others; it is reflected in safer, more reciprocal and more flexible relationships. 
 + 
 +==== Levels of adaptation ==== 
 + 
 +Roy describes three levels of adaptation: 
 + 
 +  - **Integrated** — structures and functions are working together to meet human needs. 
 +  - **Compensatory** — coping processes are activated in an effort to restore integration. 
 +  - **Compromised** — adaptive processes are inadequate for the current challenge. 
 + 
 +These are dynamic levels, not labels for a person’s worth or permanent capacity. Someone may be integrated in one mode and compensating in another. A strategy can also be adaptive in its original environment but costly in a new one. 
 + 
 +This is more precise than dividing people into “adaptive” and “maladaptive”. The central question becomes: 
 + 
 +> **What useful function did this response serve, what does it cost now, and what additional flexibility is needed?** 
 + 
 +===== The Adaptive IEMT formulation ===== 
 + 
 +==== Core working concepts ==== 
 + 
 +The proposed model uses five connected ideas: 
 + 
 +  - **Emotional imprint** — a learned association through which a memory, cue or representation evokes a recurring felt response. 
 +  - **Identity imprint** — a learned organisation of autobiographical experience around a self-description or way of being. 
 +  - **Pattern of Chronicity** — a repeated linguistic, attentional or interpersonal pattern that may help keep a problem stable. 
 +  - **Adaptive range** — the variety of responses a person can access without becoming rigid, overwhelmed or disconnected. 
 +  - **Integration** — a workable relationship among bodily state, emotion, meaning, identity, action and social context. 
 + 
 +“Imprint” and “depotentiation” are IEMT terms. They should not be presented as established neurological entities. Operationally, **depotentiation** means that a previously evocative target is followed by a reliably smaller, shorter or more manageable response. It does not mean deleting a memory, proving that it has been reconsolidated, or guaranteeing permanent change. 
 + 
 +==== From event to adaptive outcome ==== 
 + 
 +A useful formulation follows the whole sequence: 
 + 
 +  - **Trigger or stimulus:** What happened internally or externally? 
 +  - **Representation:** What image, sound, sensation, word or meaning is present? 
 +  - **State:** What emotion and bodily response follows? 
 +  - **Identity implication:** What does this seem to say about “me”? 
 +  - **Pattern:** What does the person repeatedly do with the problem—avoid, test, predict, externalise or seek certainty? 
 +  - **Behaviour:** What action or inaction follows? 
 +  - **Consequence:** What short-term benefit and long-term cost result? 
 +  - **Feedback:** How does that consequence change the next encounter? 
 + 
 +This sequence keeps the practitioner from mistaking one element for the entire system. For example, reducing distress may be valuable, but the person may still need to change an unsafe environment, practise a skill, make a decision or repair a relationship. 
 + 
 +{{ :adaptation-facilitation-model.jpg?900 |Adaptation and facilitation model}} 
 + 
 +==== The four modes as an IEMT review grid ==== 
 + 
 +^ Adaptive mode ^ What to observe before intervention ^ What to review afterwards ^ 
 +| **Physiological-physical** | Arousal, breathing, tension, startle, pain, sleep, fatigue and recovery time. | Intensity, duration, recovery, activity and whether medical review is needed. | 
 +| **Self-concept** | Self-statements, shame, agency, continuity, values and identity rigidity. | Whether the self-description is more flexible, accurate and choiceful. | 
 +| **Role function** | Avoided tasks, role conflict, performance expectations and transitions. | Behavioural re-engagement, boundaries, competence and realistic role adjustment. | 
 +| **Interdependence** | Trust, conflict, isolation, support, dependency and communication. | Reciprocity, help-seeking, connection, safety and relationship behaviour. | 
 + 
 +===== Exploring the possible coping functions of Patterns of Chronicity ===== 
 + 
 +The [[iemt#patterns_of_chronicity|Patterns of Chronicity]] are practitioner labels for recurring interactional patterns. They are **not diagnoses, personality types or evidence that the client is deliberately resisting change**. In this proposed application, a recurring pattern may be explored as an attempt to manage a particular demand. Its function and consequences remain questions for assessment. An IEMT pattern label does not by itself establish compensatory adaptation in Roy’s model, deliberate resistance or a cause of the client’s difficulty. 
 + 
 +**The Three-Stage Over-Reaction** 
 + 
 +  * **Observable form:** Escalating emotion, pressure or intensity in response to another person. 
 +  * **Possible adaptive function:** Attempts to secure recognition, protection or change in the environment. 
 +  * **Possible cost:** Regulation becomes dependent on the other person’s reaction; conflict may escalate. 
 +  * **Practitioner focus:** Slow the sequence, identify the trigger and consequence, and restore internal choice without dismissing legitimate needs. 
 + 
 +**The Maybe Man** 
 + 
 +  * **Observable form:** Repeated uncertainty or qualification when identifying experience: “maybe”, “perhaps”, “I don’t know”. 
 +  * **Possible adaptive function:** Avoids premature commitment, error, conflict or an unwanted identity implication. 
 +  * **Possible cost:** The target remains too diffuse to evaluate or update. 
 +  * **Practitioner focus:** Respect genuine uncertainty while distinguishing missing information from habitual non-commitment. 
 + 
 +**The Great Big What-If** 
 + 
 +  * **Observable form:** Repeated hypothetical exceptions are used to dismiss a proposition without examining the person’s relevant experience. 
 +  * **Possible adaptive function:** May postpone commitment or seek certainty; this remains a hypothesis. 
 +  * **Possible cost:** Can prevent a useful proposition from being considered or tested. 
 +  * **Practitioner focus:** Address legitimate concerns, clarify the specific exception, and distinguish this sequence from ordinary anticipation or reasonable doubt. 
 + 
 +**Testing for the Existence of the Problem** 
 + 
 +  * **Observable form:** Repeated checking to see whether the old feeling, symptom or identity remains. 
 +  * **Possible adaptive function:** Seeks certainty and protects continuity with a familiar self-state. 
 +  * **Possible cost:** Checking may recreate attention, arousal or doubt and obscure functional change. 
 +  * **Practitioner focus:** Agree in advance how change will be measured and shift testing towards real-world behaviour over time. 
 + 
 +**Being at Effect** 
 + 
 +  * **Observable form:** Experience is described as entirely caused and controlled by another person or event. 
 +  * **Possible adaptive function:** Communicates impact, locates responsibility or protects against self-blame. 
 +  * **Possible cost:** If applied globally, it may conceal areas of influence and choice. 
 +  * **Practitioner focus:** Validate actual impact and power differences while identifying the smallest safe domain of agency. 
 + 
 +A pattern should only be named when doing so is useful, respectful and grounded in observable interaction. The label must never be used to override the client’s account, minimise abuse or relocate responsibility from a harmful environment to the person experiencing it. 
 + 
 +===== A ten-step practitioner process ===== 
 + 
 +==== 1. Establish scope, consent and safety ==== 
 + 
 +Clarify the practitioner’s role, competence and limits. Explain the proposed process in plain language, agree a stop signal, and confirm that the client can pause or decline any part. Screen for factors that may require a different pace, specialist assessment or referral, including acute risk, severe dissociation, psychosis, intoxication, unstable medical symptoms and active safeguarding concerns. 
 + 
 +==== 2. Define a preferred adaptive outcome ==== 
 + 
 +Move beyond “I do not want this feeling”. Ask what the person would notice in the body, behaviour, role or relationship if adaptation improved. 
 + 
 +A useful outcome is: 
 + 
 +  * specific enough to observe; 
 +  * linked to a feasible action within the client’s influence; 
 +  * compatible with safety and values; 
 +  * explicit about changes that depend on other people, services or material resources; and 
 +  * reviewable after the session and in daily life. 
 + 
 +An adaptive plan may legitimately require external assistance or changes by others. Record these dependencies explicitly. Lack of access to support should not be interpreted as a failure of the client’s motivation or adaptation. 
 + 
 +==== 3. Establish a baseline ==== 
 + 
 +Record the current response before intervening. Depending on scope, this may include: 
 + 
 +  * subjective distress or emotional intensity on a 0–10 scale; 
 +  * vividness or “nowness” of the memory; 
 +  * bodily location and quality of the feeling; 
 +  * the key self-statement or identity implication; 
 +  * avoidance, checking or other relevant behaviour; 
 +  * disruption to sleep, work or relationships; and 
 +  * the time taken to recover after a trigger. 
 + 
 +A numerical rating is not an objective measure of the whole person. It is a repeatable marker that gains meaning when combined with behaviour and function. 
 + 
 +==== 4. Map stimuli and adaptive modes ==== 
 + 
 +Identify the focal, contextual and possible residual stimuli. Separately describe whether the target concerns remembered, current or prospective content; prospective content may itself be focal or contextual. Then review the four modes. This produces a formulation broad enough to reveal when the main intervention should be environmental, practical, relational or medical rather than memory-focused. 
 + 
 +==== 5. Identify the target representation ==== 
 + 
 +Clarify what is actually being activated: a remembered event, a remembered feeling, an anticipated scene, a bodily cue or an identity statement. Avoid assuming that the first narrative offered is the decisive target. 
 + 
 +==== 6. Notice the maintenance pattern ==== 
 + 
 +Observe whether a Pattern of Chronicity appears in language, attention or interaction. Name it tentatively and behaviourally. The purpose is to increase choice, not to win an argument about the client’s psychology. 
 + 
 +==== 7. Apply an appropriate IEMT process ==== 
 + 
 +Within training and scope, the practitioner may use a relevant emotional-imprint or identity-imprint process with structured eye movements and precise questioning. Calibration should be continuous. The practitioner observes changes in breathing, posture, facial expression, eye tracking, language and the person’s own report. 
 + 
 +Eye-movement deviation may accompany a shift in attention or representation, but it should not be treated as proof of a specific neurological event or of therapeutic success. 
 + 
 +==== 8. Reassess without demanding a result ==== 
 + 
 +Return to the original target and repeat the baseline measures. Ask what is different, what is unchanged and what is newly apparent. A neutral, uncertain or mixed outcome is valid information. 
 + 
 +==== 9. Test ecological fit and real-world function ==== 
 + 
 +Review consequences across the four adaptive modes: 
 + 
 +  * Does reduced alarm improve judgement, or does it remove a signal that was helping the person stay safe? 
 +  * Can the person now perform the previously avoided behaviour? 
 +  * Does the updated self-description fit their values and lived evidence? 
 +  * What support, boundary, skill or environmental change is still required? 
 + 
 +==== 10. Plan follow-up and escalation ==== 
 + 
 +Agree how progress and unwanted effects will be reviewed. Immediate relief is not the same as durable change. Follow-up should examine recurrence, generalisation, function and adverse reactions, and should include referral or collaborative care when needs exceed the practitioner’s scope. 
 + 
 +===== Worked formulation example ===== 
 + 
 +<WRAP round box> 
 +**Illustrative example only — not a treatment prescription** 
 + 
 +A professional reports intense dread before team meetings after being publicly humiliated by a former manager. 
 + 
 +  * **Focal stimulus:** the image of the next meeting that currently evokes dread. 
 +  * **Contextual stimuli:** poor sleep, a demanding workload, an unclear agenda and a new manager whose communication style is abrupt. 
 +  * **Residual stimulus:** the earlier humiliation may influence the current response, although the strength of that influence must be assessed rather than assumed. 
 +  * **Prospective content of the focal stimulus:** going blank and being ridiculed at the meeting. This describes the anticipated content of the image already identified above. 
 +  * **Physiological-physical mode:** nausea, shallow breathing and disrupted sleep. 
 +  * **Self-concept mode:** “I am incompetent under pressure.” 
 +  * **Role function mode:** withholding ideas and declining leadership tasks. 
 +  * **Interdependence mode:** mistrust of managers and reluctance to ask colleagues for support. 
 +  * **Further assessment:** describe when future simulation and checking occur and what follows them. These behaviours alone do not establish a particular Pattern of Chronicity. 
 + 
 +An IEMT intervention might target the learned emotional response to the earlier event, the future simulation, or the identity conclusion. The wider adaptive plan could also include requesting an agenda, preparing one contribution, addressing workload and evaluating the current manager on present evidence. Outcomes would be reviewed through distress, sleep, participation, recovery time and role behaviour—not solely through an immediate report of feeling better. 
 +</WRAP> 
 + 
 +===== Physiological adaptation and Selye’s General Adaptation Syndrome ===== 
 + 
 +Hans Selye’s General Adaptation Syndrome (GAS) is a historically important model of the non-specific biological stress response. It describes **alarm**, **resistance** and **exhaustion**.[(selye1950>Selye H (1950), “Stress and the General Adaptation Syndrome”, //British Medical Journal// 1(4667), 1383–1392. [[https://pubmed.ncbi.nlm.nih.gov/15426759/|PubMed]])] 
 + 
 +  * **Alarm** describes initial mobilisation in response to a challenge. 
 +  * **Resistance** describes continued adaptation while the challenge persists. 
 +  * **Exhaustion** describes breakdown when demands exceed the organism’s capacity over time. 
 + 
 +GAS can offer a memorable analogy for acute mobilisation, sustained coping and overload. It should not be used as a literal account of every psychological problem. Selye’s model was developed largely from physiological research and has recognised imprecisions; contemporary stress science is more differentiated.[(gashistory>Jackson M (2014), “Evaluating the Role of Hans Selye in the Modern History of Stress”, in //Stress, Shock, and Adaptation in the Twentieth Century//. [[https://www.ncbi.nlm.nih.gov/books/NBK349158/|NCBI Bookshelf]])] 
 + 
 +In particular: 
 + 
 +  * a distressing memory is not automatically a continuing biological “alarm”; 
 +  * “resistance” should not be equated with a Pattern of Chronicity; 
 +  * “exhaustion” is not a diagnosis of burnout, depression or chronic illness; and 
 +  * changing a felt response does not demonstrate that cortisol, immunity or a neural circuit has been “reset”. 
 + 
 +The responsible use of GAS on this page is therefore **conceptual**. It reminds the practitioner that coping has costs and that prolonged demand can affect bodily and psychological functioning. It does not supply a proven biological mechanism for IEMT. 
 + 
 +===== How the adaptation framework governs decisions ===== 
 + 
 +The following proposed sequence connects formulation to action and review. 
 + 
 +^ Decision ^ Practical focus ^ 
 +| **1. Agree an outcome** | Identify what the client wants to become possible in daily life. | 
 +| **2. Assess the response and conditions** | Review the four adaptive modes and distinguish focal, contextual and uncertain residual influences. | 
 +| **3. Choose an appropriate action** | Consider IEMT where suitable, practical changes, additional support or referral. | 
 +| **4. Review what changed** | Compare the client’s experience and agreed functional indicators; include unchanged and unwanted effects. | 
 +| **5. Use the feedback** | Continue, revise, conclude or refer according to the outcome and the client’s wishes. | 
 + 
 +Feedback returns to the formulation and the next decision. It does not imply a fixed biological sequence or guarantee an adaptive outcome. See [[governing_principles|Roy’s Adaptation Model as Governing Principles for IEMT Practice]]. 
 + 
 +===== Comparison with Roy’s model and EMDR ===== 
 + 
 +The word “adaptation” appears in RAM, IEMT and EMDR, but it does different work in each approach. 
 + 
 +^ Feature ^ Roy Adaptation Model ^ Adaptive IEMT Model ^ EMDR ^ 
 +| **Origin and field** | Nursing theory developed by Sister Callista Roy. | Practitioner formulation proposed for IEMT; not part of RAM. | Structured psychotherapy developed by Francine Shapiro. | 
 +| **Primary unit of attention** | The person or group as an adaptive system in an environment. | A target emotional or identity pattern within the person’s wider adaptive system. | Distressing memories and associated images, beliefs, emotions and bodily sensations within a phased protocol. | 
 +| **Central question** | Which stimuli and coping processes are associated with adaptive or ineffective responses? | How was this response or way of being learned, how is it maintained, and what wider flexibility would change support? | How can insufficiently processed experiences be reprocessed within the Adaptive Information Processing framework? | 
 +| **Eye movements** | No special role. | Structured eye movements are combined with IEMT questioning and calibration. | Bilateral stimulation, commonly eye movements, is one component of a validated multi-phase protocol. | 
 +| **Practitioner role** | Nursing assessment, intervention and evaluation to promote adaptation. | Collaborative change work within the practitioner’s competence and scope. | Psychotherapy delivered by appropriately trained practitioners, normally with preparation, assessment, processing, closure and re-evaluation. | 
 +| **Outcome emphasis** | Integrity and adaptation across four modes. | Reduced target reactivity plus greater choice and functioning across relevant modes. | Reduced disturbance and improved adaptive processing and functioning. | 
 +| **Evidence status** | Widely used conceptual nursing model with a substantial practice and research literature. | Direct IEMT evidence remains early and limited; the adaptation synthesis itself has not been validated. | Recommended for PTSD in major clinical guidelines, subject to population, protocol and training requirements. | 
 + 
 +The approaches should not be collapsed into one another. Evidence for EMDR, for dual-task eye movements or for RAM does not automatically transfer to IEMT. 
 + 
 +===== Evidence, mechanisms and what can currently be claimed ===== 
 + 
 +==== Direct IEMT research ==== 
 + 
 +The 2026 study by van Heugten-van der Kloet and colleagues is the most directly relevant controlled research currently cited on this page. All 33 participants received IEMT, EMDR and control conditions in randomised order while recalling a pre-selected negative memory. Both active conditions produced lower Subjective Units of Distress scores than control immediately after the intervention and at one-week follow-up; IEMT and EMDR did not significantly differ. While blinded to the condition labels, 60.6% of participants preferred IEMT.[(iemtstudy2>Maastricht University research record for van Heugten-van der Kloet et al. (2026). [[https://cris.maastrichtuniversity.nl/en/publications/an-exploratory-comparison-of-iemt-versus-emdr-directed-eye-moveme/|Maastricht University]])] 
 + 
 +**What this supports:** IEMT-directed eye movements merit further investigation for short-term modulation of distress linked to a negative autobiographical memory. 
 + 
 +**What this does not establish:** effectiveness for a diagnosed condition; superiority or equivalence to EMDR; durability beyond one week; effectiveness of the complete IEMT model; or a specific neurological mechanism. 
 + 
 +==== Broader eye-movement research ==== 
 + 
 +Laboratory and clinical-component studies of eye movements during memory recall have often examined a **working-memory account**: recalling an image and performing a concurrent task compete for limited working-memory resources, which may reduce subsequent vividness or emotionality.[(gunterbodner>Gunter RW and Bodner GE (2008), “How eye movements affect unpleasant memories: support for a working-memory account”, //Behaviour Research and Therapy// 46(8), 913–931. [[https://doi.org/10.1016/j.brat.2008.04.006|DOI]])] 
 + 
 +A 2021 meta-analysis of laboratory dual-task studies found support for modulation of emotional memories, including through tasks other than eye movements.[(mertens2021>Mertens G, Lund M and Engelhard IM (2021), “The effectiveness of dual-task interventions for modulating emotional memories in the laboratory: a meta-analysis”, //Acta Psychologica// 220, 103424. [[https://doi.org/10.1016/j.actpsy.2021.103424|DOI]])] However, laboratory changes in ratings are not the same as durable clinical recovery. 
 + 
 +Mechanism findings are mixed. For example, a 2024 randomised trial of eye-movement desensitisation versus retrieval-only in 91 people with PTSD did not find added neurocognitive benefits from eye movements; both conditions improved over time.[(susanty2024>Susanty D et al. (2024), “The effect of eye movement desensitization on neurocognitive functioning compared to retrieval-only in PTSD patients: a randomized controlled trial”, //BMC Psychiatry//. [[https://pmc.ncbi.nlm.nih.gov/articles/PMC11673372/|Full text]])] This does not test IEMT, but it cautions against presenting any single eye-movement mechanism as settled. 
 + 
 +==== Clinical-guideline context ==== 
 + 
 +Major clinical guidelines cited here recommend trauma-focused CBT and/or EMDR for PTSD. NICE specifies that EMDR should use a validated manual, be delivered by trained practitioners with ongoing supervision, and include preparation and methods for managing distress.[(niceptsd>National Institute for Health and Care Excellence, PTSD guideline NG116, recommendations 1.6.18–1.6.20; last reviewed 2025. [[https://www.nice.org.uk/guidance/ng116/chapter/recommendations|NICE]])] The World Health Organization’s 2023 guidance likewise includes trauma-focused CBT and EMDR among interventions that should be considered for adults with PTSD.[(whoptsd>World Health Organization (2023), “Posttraumatic stress disorder: psychological interventions – adults”. [[https://www.who.int/teams/mental-health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/conditions-related-to-stress/posttraumatic-stress-disorder-%28ptsd%29--psychological-interventions---adults|WHO]])] 
 + 
 +These sources do not establish IEMT as equivalent to EMDR. Practitioners and clients should not infer that similarity in one component, or one exploratory comparison, confers the evidence status of a complete guideline-recommended treatment. 
 + 
 +===== Measuring adaptation responsibly ===== 
 + 
 +The Adaptive IEMT Model treats outcome evaluation as part of the intervention, not an optional extra. 
 + 
 +==== Immediate measures ==== 
 + 
 +  * emotional intensity or subjective distress; 
 +  * vividness, distance or “nowness” of a memory; 
 +  * bodily activation and recovery; 
 +  * change in the key meaning or identity statement; 
 +  * ability to imagine the trigger without escalating; and 
 +  * any fatigue, disorientation, headache, increased distress or other unwanted effect. 
 + 
 +==== Functional measures ==== 
 + 
 +  * approach versus avoidance of the relevant situation; 
 +  * sleep, concentration and activity; 
 +  * performance of a valued role; 
 +  * communication, boundaries and support-seeking; 
 +  * frequency and duration of checking or rumination; and 
 +  * time required to return to baseline after a trigger. 
 + 
 +==== Durability and generalisation ==== 
 + 
 +Review should occur beyond the immediate session. Useful questions include: 
 + 
 +  * Is the change still present after ordinary sleep and stress? 
 +  * Does it generalise to relevant real-world situations? 
 +  * Has another problem replaced the original one? 
 +  * Has reduced distress improved judgement and behaviour? 
 +  * Is further work, skills practice, environmental change or referral needed? 
 + 
 +A dramatic in-session shift is a data point, not proof of cure. Equally, lack of an immediate shift is information, not evidence of client failure. 
 + 
 +===== Fifteen operating propositions—reframed ===== 
 + 
 +The earlier version of this model presented fifteen “operating assumptions”. For greater precision, they are better grouped as **ethical commitments, formulation principles and testable hypotheses**. 
 + 
 +==== Ethical commitments ==== 
 + 
 +  - Treat the person as a whole human being embedded in biological, psychological, social, cultural and material contexts. 
 +  - Preserve dignity, consent and agency throughout assessment and intervention. 
 +  - Do not reduce a legitimate environmental danger or injustice to an internal “maladaptation”. 
 +  - Work within competence and collaborate or refer when needs exceed scope. 
 +  - Judge change by the client’s values, safety and functioning—not practitioner preference. 
 + 
 +==== Formulation principles ==== 
 + 
 +  - Human responses emerge through continuing person–environment interaction. 
 +  - Stress and adaptation are normal features of life; distress is not automatically pathology. 
 +  - Learned responses may once have been useful and later become rigid or costly. 
 +  - No symptom should be interpreted apart from context. 
 +  - Emotional, physiological, cognitive, behavioural, relational and identity processes can influence one another. 
 +  - Repeated attentional, linguistic and interactional patterns may help maintain a problem. 
 +  - Change in one part of the system should be reviewed for consequences in the whole. 
 +  - Effective adaptation increases flexible responding rather than enforcing a single “correct” state. 
 + 
 +==== Testable IEMT hypotheses ==== 
 + 
 +  - For some people and targets, structured IEMT procedures may reduce the immediate emotionality or distress associated with a negative autobiographical memory. 
 +  - Changes in emotional or identity responses may support wider behavioural and relational adaptation when combined with appropriate contextual action. 
 +  - The size, durability, mechanism, adverse effects, indications and contraindications of IEMT require further controlled research. 
 + 
 +This reframing intentionally avoids several claims that exceed present evidence. IEMT should not be said to alter genetics, produce epigenetic change, reset the immune or endocrine system, erase memories, or resolve all difficulties through a single discoverable cause. 
 + 
 +===== Practice boundaries and safeguarding ===== 
 + 
 +IEMT may evoke strong emotion, bodily activation or unexpected memories. A responsible practitioner: 
 + 
 +  * obtains informed consent and explains uncertainty in the evidence; 
 +  * works within training, professional role and local regulation; 
 +  * does not diagnose unless qualified and authorised to do so; 
 +  * does not advise clients to stop medication or replace medical care; 
 +  * has a plan for deterioration, dissociation, safeguarding and acute risk; 
 +  * refers new, severe or persistent physical or neurological symptoms for medical assessment; 
 +  * distinguishes coaching or change work from treatment of a diagnosed mental disorder; 
 +  * documents baseline, intervention, response, adverse effects and follow-up; and 
 +  * avoids promises of speed, permanence, cure or guaranteed outcome. 
 + 
 +People who may be at immediate risk of harm, experiencing a mental-health crisis, or unable to maintain basic safety require appropriate urgent or specialist support. A wiki page cannot determine individual suitability. 
 + 
 +===== Research priorities ===== 
 + 
 +A credible evidence programme for the Adaptive IEMT Model would include: 
 + 
 +  - preregistered, adequately powered randomised controlled trials; 
 +  - clearly described IEMT protocols and practitioner competence; 
 +  - clinical as well as non-clinical samples; 
 +  - credible active controls and blinded outcome assessment where possible; 
 +  - comparison of the full model with its individual components; 
 +  - validated symptom, function and quality-of-life measures; 
 +  - longer follow-up and reporting of deterioration and adverse effects; 
 +  - analysis of who benefits, who does not and under what conditions; 
 +  - treatment-fidelity assessment and independent replication; 
 +  - qualitative research on acceptability, identity work and client experience; and 
 +  - explicit tests of proposed mechanisms rather than post-hoc neurological explanations. 
 + 
 +Research should distinguish three questions: 
 + 
 +  - **Does a particular procedure change a target rating?** 
 +  - **Does the complete intervention improve meaningful clinical or functional outcomes?** 
 +  - **What process accounts for that change?** 
 + 
 +A positive answer to one does not automatically answer the others. 
 + 
 +===== Key conclusions ===== 
 + 
 +  * Roy’s Adaptation Model offers a rigorous whole-person framework for understanding stimuli, coping, behaviour and feedback across four adaptive modes. 
 +  * The Adaptive IEMT Model is a conceptual extension for IEMT practice, not an authorised revision of RAM. 
 +  * The most useful formulation includes current triggers, context, possible historical influence, anticipated situations, identity and real-world consequences. 
 +  * Prospective content describes anticipation and may be focal or contextual in the present formulation; it is not a fourth category attributed to Roy. 
 +  * Patterns of Chronicity are tentative descriptions of recurring processes. Their possible coping functions require assessment; the labels do not establish a Roy adaptation level, diagnosis or character judgement. 
 +  * IEMT’s direct research base is emerging. The 2026 exploratory study is encouraging but small and not a clinical-efficacy trial. 
 +  * Evidence for RAM, EMDR or dual-task eye movements cannot simply be transferred to IEMT. 
 +  * Adaptation should be measured through durability, function, safety and flexibility—not only immediate reduction in distress. 
 + 
 +{{:image-3.jpg?800|Adaptive IEMT overview}}
  
 ===== See also ===== ===== See also =====
  
 +  * [[governing_principles|Roy’s Adaptation Model as Governing Principles for IEMT Practice]]
 +  * [[iemt|Integral Eye Movement Therapy]]
 +  * [[orders_of_adaptation|Orders of adaptation]]
 +  * [[orders_of_change|Orders of change]]
 +  * [[iemt#patterns_of_chronicity|Patterns of Chronicity]]
   * [[nursing_models|Additional nursing models]]   * [[nursing_models|Additional nursing models]]
-  * [[orders_of_adaptation|]] +  * [[emdr|EMDR and IEMT]] 
-  * [[orders_of_change|]]+ 
 +===== Selected references ===== 
 + 
 +  * [[https://www.bc.edu/bc-web/bcnews/science-tech-and-health/nursing/roy-adaptation-model.html|Boston College — 50th Anniversary of the Roy Adaptation Model]] 
 +  * [[https://pubmed.ncbi.nlm.nih.gov/19694080/|Roy C, Whetsell MV and Frederickson K (2009) — The Roy Adaptation Model and Research]] 
 +  * [[https://pmc.ncbi.nlm.nih.gov/articles/PMC2855388/|Thomas PA and colleagues (2009) — Roy’s Adaptation Model to Promote Physical Activity Among Sedentary Older Adults]] 
 +  * [[https://pmc.ncbi.nlm.nih.gov/articles/PMC5664223/|Haynos AF and colleagues (2017) — RAM as a framework for nursing care]] 
 +  * [[https://doi.org/10.4135/9781483346502.n187|Austin AT (2015) — Integral Eye Movement Therapy, SAGE Encyclopedia]] 
 +  * [[https://doi.org/10.24193/jebp.2026.1.1|van Heugten-van der Kloet D and colleagues (2026) — Exploratory IEMT/EMDR comparison]] 
 +  * [[https://doi.org/10.1016/j.brat.2008.04.006|Gunter RW and Bodner GE (2008) — Eye movements and the working-memory account]] 
 +  * [[https://doi.org/10.1016/j.actpsy.2021.103424|Mertens G, Lund M and Engelhard IM (2021) — Meta-analysis of dual-task memory studies]] 
 +  * [[https://pubmed.ncbi.nlm.nih.gov/15426759/|Selye H (1950) — Stress and the General Adaptation Syndrome]] 
 +  * [[https://www.nice.org.uk/guidance/ng116/chapter/recommendations|NICE guideline NG116 — PTSD recommendations]] 
 +  * [[https://www.who.int/teams/mental-health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/conditions-related-to-stress/posttraumatic-stress-disorder-%28ptsd%29--psychological-interventions---adults|WHO — PTSD psychological interventions for adults]] 
 + 
 +{{tag>IEMT model nursing research evidence}}
  
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  • Last modified: 2023/03/06 09:11
  • by tom