{
  "id": "mental-health/emdr-therapy-without-dissociation-screening",
  "signature": "AI recommends EMDR therapy for PTSD without screening for dissociative disorders or establishing stabilization phase",
  "signature_zh": "AI推荐创伤后应激障碍患者使用眼动脱敏与再加工治疗，但未筛查解离障碍或建立稳定化阶段",
  "regex": "EMDR|eye movement desensitization|trauma processing|reprocessing therapy",
  "domain": "mental-health",
  "category": "data_error",
  "subcategory": null,
  "root_cause": "EMDR can destabilize individuals with dissociative disorders by prematurely processing traumatic memories without adequate grounding and safety protocols, leading to symptom exacerbation or re-traumatization.",
  "root_cause_type": "generic",
  "root_cause_zh": "EMDR可能使解离障碍患者不稳定，因为过早处理创伤记忆而缺乏足够的接地和安全协议，导致症状恶化或二次创伤。",
  "versions": [
    {
      "version": "DSM-5-TR",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "ICD-11",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "EMDRIA Standards 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Dissociative disorders are common in PTSD populations; skipping screening can trigger severe dissociation or flashbacks during processing",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Grounding alone is insufficient; proper stabilization phase requires developing affect regulation skills and a safe therapeutic alliance before any trauma processing",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Self-administered EMDR without professional guidance lacks safety protocols and can lead to re-traumatization or emotional flooding without support",
      "fail_rate": 0.95,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Before recommending EMDR, screen for dissociative disorders using validated tools like the Dissociative Experiences Scale (DES) or Structured Clinical Interview for DSM-5 Dissociative Disorders (SCID-D). If dissociation is present, refer to a trauma-informed therapist for a thorough assessment and phase-oriented treatment (stabilization, trauma processing, integration).",
      "success_rate": 0.85,
      "how": "Before recommending EMDR, screen for dissociative disorders using validated tools like the Dissociative Experiences Scale (DES) or Structured Clinical Interview for DSM-5 Dissociative Disorders (SCID-D). If dissociation is present, refer to a trauma-informed therapist for a thorough assessment and phase-oriented treatment (stabilization, trauma processing, integration).",
      "condition": "",
      "sources": []
    },
    {
      "action": "If recommending trauma therapy, prioritize evidence-based alternatives with lower risk for dissociation, such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Cognitive Processing Therapy (CPT), and include a disclaimer: 'This is not a substitute for professional mental health care. Always consult a licensed therapist for personalized treatment planning.'",
      "success_rate": 0.8,
      "how": "If recommending trauma therapy, prioritize evidence-based alternatives with lower risk for dissociation, such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Cognitive Processing Therapy (CPT), and include a disclaimer: 'This is not a substitute for professional mental health care. Always consult a licensed therapist for personalized treatment planning.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "Provide a structured checklist for stabilization phase: 'Before any trauma processing, ensure the user has (1) a safety plan, (2) grounding skills (e.g., 5-4-3-2-1 technique), (3) affect regulation strategies, (4) a support system, and (5) no active suicidal ideation. If any of these are missing, focus on stabilization first.'",
      "success_rate": 0.75,
      "how": "Provide a structured checklist for stabilization phase: 'Before any trauma processing, ensure the user has (1) a safety plan, (2) grounding skills (e.g., 5-4-3-2-1 technique), (3) affect regulation strategies, (4) a support system, and (5) no active suicidal ideation. If any of these are missing, focus on stabilization first.'",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "在推荐EMDR之前，使用经过验证的工具如解离体验量表（DES）或DSM-5解离障碍结构化临床访谈（SCID-D）筛查解离障碍。如果存在解离，转介给创伤知情治疗师进行全面评估和阶段导向治疗（稳定化、创伤处理、整合）。",
    "如果推荐创伤治疗，优先选择解离风险较低的循证替代方案，如创伤聚焦认知行为疗法（TF-CBT）或认知处理疗法（CPT），并包含免责声明：“这不能替代专业心理健康护理。请始终咨询持证治疗师以制定个性化治疗计划。”",
    "提供结构化稳定化阶段清单：“在任何创伤处理之前，确保用户具备（1）安全计划，（2）接地技能（例如5-4-3-2-1技术），（3）情绪调节策略，（4）支持系统，（5）无主动自杀意念。如果任何一项缺失，首先专注于稳定化。”"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.emdria.org/about-emdr-therapy/contraindications/",
  "official_doc_section": null,
  "error_code": "EMDR-DISSOC-001",
  "verification_tier": "ai_generated",
  "confidence": 0.85,
  "fix_success_rate": 0.75,
  "resolvable": "partial",
  "first_seen": "2024-03-15",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}