> ## Documentation Index > Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt > Use this file to discover all available pages before exploring further. # The research behind EMDR > Where EMDR sits in the evidence base — Shapiro's original protocol, the EMDR 2.0 variant, and the international guidance that recommends it. EMDR (Eye Movement Desensitization and Reprocessing) is one of the most heavily studied trauma psychotherapies in the literature. What follows is a brief tour of the citations behind the protocol Rivet's Workspace supports — not a clinical training, but the evidentiary backdrop a working clinician can point to when a client asks "what is this?" ## The original protocol EMDR was developed by **Francine Shapiro** beginning in the late 1980s. Her canonical reference text — now in its third edition — defines the 8-phase protocol, the bilateral stimulation modality, and the use of the SUDS (Subjective Units of Distress) and VOC (Validity of Cognition) scales inside the protocol: > Shapiro, F. (1995/2001/2018). *Eye Movement Desensitization and Reprocessing > (EMDR) Therapy: Basic Principles, Protocols, and Procedures.* Guilford > Press. The 8-phase structure (history-taking, preparation, assessment, desensitization, installation, body scan, closure, reevaluation) has become the standard international reference for how an EMDR course of therapy is sequenced. See [The 8-phase protocol](/emdr/the-8-phase-protocol) for how Rivet's Workspace and clinical templates pair with each phase. ## International guidance EMDR is recommended as a first-line trauma treatment by several major international bodies: * **World Health Organization** — included in WHO mhGAP guidelines as a recommended treatment for PTSD in adults and children. * **NICE (UK National Institute for Health and Care Excellence)** — included in NICE clinical practice manuals as a recommended treatment for PTSD, alongside trauma-focused CBT. * **American Psychological Association** — listed in APA clinical practice guidance for adult PTSD. * **Veterans Affairs / Department of Defense (US)** — included in joint VA/DoD clinical practice guidelines for PTSD. The convergent recommendation across these bodies is what makes EMDR distinctive — it's not a niche modality but a widely endorsed first-line treatment for trauma-related presentations. ## The EMDR 2.0 variant **EMDR 2.0** is a protocol variant developed by **Suzy Matthijssen**, **Ad de Jongh**, and colleagues in the Netherlands between 2017 and 2021. It differs from Shapiro standard in three measurable ways: * **Faster BLS speed** — typically 1.2 to 2.0 Hz, versus the Shapiro 1.0 Hz baseline * **Multimodal stimulation** — visual + audio (and sometimes haptic) running simultaneously, rather than visual alone * **Dual-task working memory loading** — verbal prompts the practitioner reads aloud during BLS sets to load working memory in parallel with the bilateral stimulation itself Key citations: > Matthijssen, S. J. M. A., et al. (2021). "The current status of EMDR > therapy, specific target areas, and goals for the future." *Journal of > EMDR Practice and Research,* 15(3): 105–130. > de Jongh, A., et al. (2019, 2021). Working memory taxation and EMDR > research programme. Multiple papers establish the dual-task > working-memory rationale. Matthijssen 2021 reported **equivalent outcomes with fewer sets** for EMDR 2.0 versus Shapiro standard. "Equivalent" is the right word — EMDR 2.0 is not "better than" EMDR; it's a protocol option that reaches the same endpoint with different stimulus design and fewer sets. Rivet offers both. EMDR 2.0 is the default for the Workspace, with the dual-task prompt panel enabled and 1.5 Hz set as the rate (the midpoint of the de Jongh / Matthijssen 1.2–2.0 Hz published range). Classic Shapiro is a one-tap selection in the Configure modal — 1.0 Hz, visual only, dual-task off. ## The butterfly hug The butterfly stimulus shape in Rivet's Workspace nods to the **butterfly hug**, a self-administered bilateral stimulation method documented by Artigas and Jarero: > Artigas, L., & Jarero, I. (2014). "The butterfly hug: A self-administered > bilateral stimulation method." Published in EMDR clinical resource > literature; widely used in trauma and disaster work. It's a clinically familiar silhouette for therapists trained in EMDR — the butterfly icon in the stimulus picker is meant to be recognized at a glance. ## The SUDS scale The 0–10 Subjective Units of Distress Scale that Rivet captures between sets comes from **Joseph Wolpe**: > Wolpe, J. (1969). *The Practice of Behavior Therapy.* Pergamon Press. > (Earlier appearance in Wolpe, 1958, *Psychotherapy by Reciprocal > Inhibition.*) EMDR convention uses the 0–10 scale (older exposure traditions used 0–100). Rivet uses 0–10 to match EMDR practice. See [The SUDS scale](/emdr/the-suds-scale) for how the scale renders in the Workspace and what each band tends to mean. ## What "designed around EMDR 2.0" means Rivet is **a delivery surface for clinicians trained in EMDR therapy**, not a substitute for EMDR training, credentialing, or supervision. The Workspace gives you the tools — rate, stimulus, modalities, dual-task prompts, SUDS capture — at the parameters the published protocols specify. The clinical judgment, the consent process, the case formulation, the homework, the training history that lets you safely run reprocessing — that all stays with you. See [Who should not use EMDR](/emdr/who-should-not-use-emdr) for the training-and-credentialing context. "EMDR" is a registered trademark of the EMDR Institute. Rivet describes the Workspace as "bilateral stimulation designed for clinicians trained in EMDR therapy" rather than branding the product itself as EMDR. ## Related articles How the BLS Workspace and Rivet's clinical templates pair with the Shapiro 8-phase structure. Wolpe's 0–10 scale, how Rivet captures it, and what to do with the arc. Contraindications, training requirements, and what the Workspace is and isn't.