There are several psychological interventions consistently recommended by clinical practice guidelines for the treatment of post-traumatic stress disorder (PTSD) in adults due to their strong evidence, such as Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure (Berliner et al., 2019; Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group, 2023; National Institute for Health and Clinical Excellence (NICE), 2018; Phoenix Australia, 2020). In contrast, the evidence is less strong for preventive interventions for PTSD. Some guidelines only recommend trauma-focused cognitive behavioral psychotherapy for the prevention of PTSD in patients diagnosed with acute stress disorder or with PTSD symptoms in the first three months after the trauma (Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group, 2023; National Institute for Health and Clinical Excellence (NICE), 2018).

Guidelines are less consistent in recommending EMDR for the early treatment or prevention of PTSD. Some guidelines do not recommend for or against EMDR for the prevention of PTSD in the indicated population (Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group, 2023), other guidelines conditionally recommend it for the early treatment (in the first three months) of PTSD symptoms (Berliner et al., 2019; Phoenix Australia, 2020). The NICE guideline (National Institute for Health and Clinical Excellence (NICE), 2018) recommends EMDR for PTSD or PTSD symptoms starting three months after the traumatic event, and consider it if the patient has a preference for this option between 1 and 3 months after the trauma. NICE (National Institute for Health and Clinical Excellence (NICE), 2018) bases this recommendation on the fact that there is evidence limited to a single study of the effectiveness of EMDR between months 1 and 3 after trauma (Jarero et al., 2013), and there is insufficient evidence of the effectiveness of EMDR within the first month post-trauma (Gil-Jardiné et al., 2018).

According to Francine Shapiro (2001), the memory of a recent trauma is more fragmented, less organized and integrated into a narrative than the memory of a distant trauma, so a single image does not represent it adequately. Considering that the memory of recent trauma is not consolidated, several adaptations of the standard EMDR protocol have been made. These adaptations have been designed to be applied in the few days after the trauma until 3 months after the traumatic event. Examples of these interventions are, among others, the EMD protocol (Shapiro, 2004), the EMDR protocol for recent critical incidents (EMDR-PRECI) (Jarero et al., 2011) or the EMDR recent traumatic episode protocol (R-TEP) (Shapiro and Laub, 2014).

Several trajectories have been identified based on the psychopathology and level of functioning of people exposed to a traumatic event (Bonanno et al., 2011). The majority of the exposed population (35%–65%) would have a resilient trajectory, while 5%–30% would have a trajectory with chronic symptoms and functional impairment (Bonanno et al., 2011). If resilience is the norm, the implementation of early PTSD prevention interventions should be characterized by a clear benefit over no intervention, so as not to interfere with the natural recovery process. In this sense, the clinical guidelines do not recommend universal psychological preventive interventions for the exposed population, but they do observe greater benefit than no treatment for some psychological interventions for indicated prevention (PTSD symptoms in the first three months after the trauma) (Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group, 2023; Phoenix Australia, 2020).

To our knowledge there are no meta-analyses with the objective of evaluating the effectiveness of EMDR as an early intervention for PTSD symptoms. The objective of this quantitative review is to evaluate the effectiveness of EMDR therapy for early intervention after a traumatic event. As a main objective, we propose to evaluate the effect of EMDR as an early intervention on post-traumatic symptoms in the short and long term. As secondary objectives, we propose to evaluate its effect as an early intervention on depressive and anxious symptoms in the short and long term, as well as its safety and tolerability.