Brief EMDR-Derived Interventions for Workers Facing Ongoing Exposure

A longitudinal study of 451 ambulance workers, published online August 13 in Psychological Trauma, found that more frequent exposure to critical incidents was associated with higher posttraumatic stress symptoms. Researchers assessed participants at baseline and at 3, 6, 9 and 12 months. Symptoms declined overall, but less among workers with high exposure. After researchers adjusted for new exposures, the association persisted only among workers who described high emotional intensity during their worst incident.

The ambulance study was observational. It identifies associations and symptom trajectories; it does not test a treatment or show that cumulative exposure caused the reported symptoms.

Separate studies have tested brief interventions for recent critical incidents and ongoing traumatic stress.

In 2019, a randomized controlled trial tested the EMDR Protocol for Recent Critical Incidents and Ongoing Traumatic Stress (EMDR-PRECI) with 60 active-duty first responders. Thirty participants received two 60-minute individual sessions, and 30 were assigned to a no-treatment control. The treatment group reported reductions in posttraumatic stress, anxiety and depression symptoms. The reduction in posttraumatic stress was maintained at the 90-day follow-up while participants remained on active duty. The authors called for replication.

A related intervention, the Acute Stress Syndrome Stabilization Remote Individual intervention (ASSYST-RI), was described in a 2021 field study. Forty-eight adults received one session averaging about 50 minutes and reported a large decline in subjective disturbance from before to after the session. Because the study had no comparison group, used a small sample and measured immediate subjective disturbance, it cannot establish comparative effectiveness or durability.

In 2023, a randomized crossover study tested a remote individual ASSYST intervention with 61 public-sector workers in Brazil during the COVID-19 pandemic. Participants received four weekly videoconference sessions. Symptoms of posttraumatic stress, anxiety and depression decreased more in the intervention group during the initial comparison period; every participant eventually received the intervention. The small sample, crossover design and pandemic-specific setting limit broader conclusions.

These studies should not be collapsed into a single claim. The ambulance study documents symptom patterns among ambulance personnel but tested no intervention. The EMDR-PRECI and ASSYST studies examined different populations, formats, measures and designs. None of the ASSYST studies cited here specifically tested ambulance workers, and this evidence does not support a recommendation that emergency-service organizations adopt a particular intervention.

Ongoing occupational exposure deserves explicit attention in research design, follow-up and workforce support. Early-intervention studies show promising symptom changes, but independent replication, larger samples, active comparators and longer follow-up are still needed.

Selected sources

• Lindekilde N, et al. “The lingering effect of prior critical incidents on today’s operational work among ambulance workers: A longitudinal study.” Psychological Trauma. Published online August 13, 2026. PubMed | DOI
• Jarero I, Schnaider S, Givaudan M. EMDR-PRECI randomized controlled trial. Journal of EMDR Practice and Research. 2019;13(2):100–110. DOI
• Smyth-Dent K, Becker Y, Burns E, Givaudan M. ASSYST-RI field study. Psychology and Behavioral Science International Journal. 2021;16(2). DOI
• Magalhães et al. Remote ASSYST randomized crossover study. Psychology and Behavioral Science International Journal. 2023;20(5). DOI
• “Eye movement desensitization and reprocessing for the treatment and early intervention of trauma among first responders: A systematic review.” Journal of Traumatic Stress. 2022. Full text

Editorial disclosure and boundaries

Ignacio Jarero is the first author of the 2019 EMDR-PRECI trial and a coauthor of the 2023 ASSYST-IR study; Martha Givaudan is a coauthor of the 2019 EMDR-PRECI trial and the 2021 ASSYST-RI field study. The evidence base remains preliminary. This article reports study results and limitations; it does not provide treatment instructions or clinical recommendations.