Whether EMDR therapy targeting 'flashforwards' (catastrophic future mental imagery) reduces daily social anxiety and avoidance compared to a randomized baseline phase, in 8 adults with social anxiety disorder who had failed prior CBT or had treatment complexity.
Preregistered randomization tests found no statistically significant between-phase differences in daily social anxiety, daily avoidance, or weekly social anxiety severity. Exploratory permutation tests suggested possible reductions in daily social anxiety (6/8 participants), daily avoidance (3/8), and weekly severity (5/8), with aggregated effect sizes that were medium for social anxiety and small for avoidance.
The preregistered primary analyses were non-significant, making all positive findings hypothesis-generating only; no active treatment control condition was included; long-term follow-up was absent; and one participant lacked a clearly identifiable flashforward.
EMDR targeting flashforwards in social anxiety disorder cannot yet be recommended based on this evidence alone — the confirmatory tests were negative. Clinicians should await adequately powered controlled trials before adopting this approach, though the exploratory signal for anxiety reduction may warrant further investigation.
