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-{{tag>IEMT adaptation model nursing biopsychosocial formulation resilience research evidence}} 
  
 ====== Integral Eye Movement Therapy (IEMT): An Adaptive Model ====== ====== Integral Eye Movement Therapy (IEMT): An Adaptive Model ======
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 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. 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.
  
-This page develops an **Adaptive IEMT Model**: a practitioner-oriented framework for considering emotional imprints, identity imprints and the [[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.+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.
  
-<WRAP center round important 90%>+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. 
 + 
 +<WRAP round important>
 **Evidence and scope** **Evidence and scope**
  
-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]])]+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]])]
  
 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. 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.
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 ^ Question ^ Roy Adaptation Model ^ Adaptive IEMT perspective ^ ^ 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 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. | Current triggers, surrounding conditions, earlier learning and anticipated situations. |+| **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. | | **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. | | **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. |
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 ==== Sister Callista Roy and the development of RAM ==== ==== Sister Callista Roy and the development of RAM ====
  
-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]])]+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]])]
  
-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.+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.
  
 ==== IEMT and the adaptation lens ==== ==== IEMT and the adaptation lens ====
  
-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]])]+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]])]
  
 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: 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:
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 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. 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.
  
-<WRAP center round box 90%>+<WRAP round box>
 **A simplified adaptive loop** **A simplified adaptive loop**
  
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 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. 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.
  
-The Adaptive IEMT framework adds a fourth, explicitly non-Roy category:+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.
  
-  - **Prospective stimulus** — an anticipated situation that is represented in advance and already evokes a present response.+^ Stimulus class or content descriptor ^ Practical question ^ Example ^ 
 +| **Focal** | What requires attention now? | Thinking about a forthcoming presentation currently evokes intense dread. | 
 +| **Contextual** | What else is amplifying, reducing or shaping the response? | Poor sleep, a critical manager, caffeine use, workload and limited preparation time. | 
 +| **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. |
  
-“Prospective” is an IEMT formulation aid, not one of Roy’s original three stimulus categories. It helps separate a current event from the person’s prediction, rehearsal or simulation of what may happen next. +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]].
- +
-^ Stimulus class ^ Practical question ^ Example ^ +
-| **Focal** | What requires attention now? | A forthcoming presentation that evokes intense dread. | +
-| **Contextual** | What else is amplifying, reducing or shaping the response? | Poor sleep, a critical manager, caffeine use, workload and limited preparation time. | +
-| **Residual** | What earlier learning may still influence this situation, and how certain are we? | A memory of public humiliation at school and a learned expectation of ridicule. | +
-| **Prospective (IEMT extension)** | What future scene is being mentally rehearsed as if it were occurring now? | Imagining going blank and being rejected by colleagues. |+
  
 ==== Coping subsystems: regulator and cognator ==== ==== Coping subsystems: regulator and cognator ====
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 | **Interdependence** | Trust, conflict, isolation, support, dependency and communication. | Reciprocity, help-seeking, connection, safety and relationship behaviour. | | **Interdependence** | Trust, conflict, isolation, support, dependency and communication. | Reciprocity, help-seeking, connection, safety and relationship behaviour. |
  
-===== The Patterns of Chronicity as possible compensatory responses =====+===== Exploring the possible coping functions of Patterns of Chronicity =====
  
-The [[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 an adaptation framework, each can be treated as a compensatory response: an attempt to preserve certainty, safety, connection or identity that may now limit flexibility.+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.
  
-^ Pattern ^ Observable form ^ Possible adaptive function ^ Possible cost ^ Practitioner focus ^ +**The Three-Stage Over-Reaction** 
-| **The Three-Stage Over-Reaction** | Escalating emotion, pressure or intensity in response to another person. | Attempts to secure recognition, protection or change in the environment. | Regulation becomes dependent on the other person’s reaction; conflict may escalate. | Slow the sequence, identify the trigger and consequence, and restore internal choice without dismissing legitimate needs. | + 
-| **The Maybe Man** | Repeated uncertainty or qualification when identifying experience: “maybe”, “perhaps”, “I don’t know”. | Avoids premature commitment, error, conflict or an unwanted identity implication. | The target remains too diffuse to evaluate or update. | Respect genuine uncertainty while distinguishing missing information from habitual non-commitment. | +  * **Observable form:** Escalating emotion, pressure or intensity in response to another person. 
-| **The Great Big ‘What If?’** | A future possibility is repeatedly simulated as an immediate threat. | Rehearses danger in an effort to prevent surprise or failure. | Prospective imagery continuously evokes present distress and narrows behaviour. | Separate present evidence from future simulation; work with the felt response and create practical contingency plans where appropriate. | +  * **Possible adaptive function:** Attempts to secure recognition, protection or change in the environment. 
-| **Testing for the Existence of the Problem** | Repeated checking to see whether the old feeling, symptom or identity remains. | Seeks certainty and protects continuity with a familiar self-state. | Checking may recreate attention, arousal or doubt and obscure functional change. | Agree in advance how change will be measured and shift testing towards real-world behaviour over time. | +  * **Possible cost:** Regulation becomes dependent on the other person’s reaction; conflict may escalate. 
-| **Being at Effect** | Experience is described as entirely caused and controlled by another person or event. | Communicates impact, locates responsibility or protects against self-blame. | If applied globally, it may conceal areas of influence and choice. | Validate actual impact and power differences while identifying the smallest safe domain of agency. |+  * **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 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.
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   * specific enough to observe;   * specific enough to observe;
-  * within the client’s influence;+  * linked to a feasible action within the client’s influence;
   * compatible with safety and values;   * compatible with safety and values;
-  * stated without requiring another person to change; and+  * explicit about changes that depend on other people, services or material resources; and
   * reviewable after the session and in daily life.   * 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 ==== ==== 3. Establish a baseline ====
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 ==== 4. Map stimuli and adaptive modes ==== ==== 4. Map stimuli and adaptive modes ====
  
-Identify the focal, contextual and possible residual stimuli, plus any prospective representation. 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.+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 ==== ==== 5. Identify the target representation ====
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 ===== Worked formulation example ===== ===== Worked formulation example =====
  
-<WRAP center round box 95%>+<WRAP round box>
 **Illustrative example only — not a treatment prescription** **Illustrative example only — not a treatment prescription**
  
 A professional reports intense dread before team meetings after being publicly humiliated by a former manager. A professional reports intense dread before team meetings after being publicly humiliated by a former manager.
  
-  * **Focal stimulus:** the next scheduled meeting.+  * **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.   * **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.   * **Residual stimulus:** the earlier humiliation may influence the current response, although the strength of that influence must be assessed rather than assumed.
-  * **Prospective stimulus:** a vivid image of going blank and being ridiculed again.+  * **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.   * **Physiological-physical mode:** nausea, shallow breathing and disrupted sleep.
   * **Self-concept mode:** “I am incompetent under pressure.”   * **Self-concept mode:** “I am incompetent under pressure.”
   * **Role function mode:** withholding ideas and declining leadership tasks.   * **Role function mode:** withholding ideas and declining leadership tasks.
   * **Interdependence mode:** mistrust of managers and reluctance to ask colleagues for support.   * **Interdependence mode:** mistrust of managers and reluctance to ask colleagues for support.
-  * **Possible chronicity pattern:** repeated “what if?” simulation and checking for anxiety before every meeting.+  * **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. 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.
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 ===== Physiological adaptation and Selye’s General Adaptation Syndrome ===== ===== 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]])]+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.   * **Alarm** describes initial mobilisation in response to a challenge.
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   * **Exhaustion** describes breakdown when demands exceed the organism’s capacity over time.   * **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]])]+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: In particular:
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 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. 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.
  
-{{ ::adaptation-model-iemtcallista-roy.jpg?900 |Roy’s adaptation concepts and the Adaptive IEMT model}}+===== 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 ===== ===== Comparison with Roy’s model and EMDR =====
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 ==== Direct IEMT research ==== ==== 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]])]+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 supports:** IEMT-directed eye movements merit further investigation for short-term modulation of distress linked to a negative autobiographical memory.
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 ==== Broader eye-movement research ==== ==== 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]])]+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.+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.+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 ==== ==== 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]])]+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. 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.
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   * The Adaptive IEMT Model is a conceptual extension for IEMT practice, not an authorised revision of RAM.   * 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.   * The most useful formulation includes current triggers, context, possible historical influence, anticipated situations, identity and real-world consequences.
-  * “Prospective stimulus” is an IEMT addition and should not be attributed to Roy. +  * 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 best treated as tentative descriptions of compensatory interactional patterns, never as diagnoses or character judgements.+  * 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.   * 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.   * Evidence for RAM, EMDR or dual-task eye movements cannot simply be transferred to IEMT.
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 ===== See also ===== ===== See also =====
  
 +  * [[governing_principles|Roy’s Adaptation Model as Governing Principles for IEMT Practice]]
   * [[iemt|Integral Eye Movement Therapy]]   * [[iemt|Integral Eye Movement Therapy]]
   * [[orders_of_adaptation|Orders of adaptation]]   * [[orders_of_adaptation|Orders of adaptation]]
   * [[orders_of_change|Orders of change]]   * [[orders_of_change|Orders of change]]
-  * [[patterns_of_chronicity|Patterns of Chronicity]]+  * [[iemt#patterns_of_chronicity|Patterns of Chronicity]]
   * [[nursing_models|Additional nursing models]]   * [[nursing_models|Additional nursing models]]
   * [[emdr|EMDR and IEMT]]   * [[emdr|EMDR and IEMT]]
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   * [[https://www.nice.org.uk/guidance/ng116/chapter/recommendations|NICE guideline NG116 — PTSD recommendations]]   * [[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]]   * [[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}}
  
  • Last modified: 2026/08/16 07:36
  • by andrewtaustin