The Boy Who Was Raised as a Dog and Other Stories From a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love, and Healing

Given that 2019 marks the 30th anniversary of eye movement desensitization and reprocessing (EMDR) therapy, the purpose of this article is to summarize the current empirical evidence in support of EMDR therapy as an effective treatment intervention for posttraumatic stress disorder (PTSD). Currently, there are more than 30 randomized controlled trials (RCT) demonstrating the effectiveness in patients with this debilitating mental health condition, thus providing a robust evidence base for EMDR therapy as a first-choice treatment for PTSD. Results from several meta-analyses further suggest that EMDR therapy is equally effective as its most important trauma-focused comparator, that is, trauma-focused cognitive behavioral therapy, albeit there are indications from some studies that EMDR therapy might be more efficient and cost-effective. There is emerging evidence showing that EMDR treatment of patients with psychiatric disorders, such as psychosis, in which PTSD is comorbid, is also safe, effective, and efficacious. In addition to future well-crafted RCTs in areas such as combat-related PTSD and psychiatric disorders with comorbid PTSD, RCTs with PTSD as the primary diagnosis remain pivotal in further demonstrating EMDR therapy as a robust treatment intervention.

The status of EMDR therapy in the treatment of Posttraumatic stress disorder 30 years after its introduction

There is currently a limited number of studies into the efficacy of eye movement desensitization reprocessing (EMDR) therapy with children and adolescents with posttraumatic stress disorder (PTSD). The current study utilizes a systematic narrative review of methodologies and findings of previous literature reviews and meta-analyses as well as analyzing randomized control trials (RCTs) conducted from 2002 to 2018. Following initial scoping of the extent of studies, two systematic literature searches were conducted, firstly for literature reviews and secondly for recent RCTs. Nine databases were utilized. Eight reviews and seven RCTs were identified and analyzed for quality of methodology and outcome as measured by impact on PTSD symptoms. EMDR was found to be efficacious in reducing children's PTSD symptoms compared to waitlist conditions, with similar outcomes to cognitive behavior therapy (CBT). EMDR was effective with both single-event trauma as well as cumulative trauma such as sexual abuse. EMDR was equally effective with girls and boys as well as children from different cultures. EMDR achieved medium to large effect sizes. Reductions in PTSD were maintained at 2-, 3-, 6-, and 12-month follow-up. In conclusion, EMDR was consistently found to be an efficacious treatment for children with PTSD. Recommendations are made for future practice and research.

Eye Movement Desensitization Reprocessing for Children and Adolescents With Posttraumatic Stress Disorder: A Systematic Narrative Review

This longitudinal multicenter randomized controlled trial has three objectives 1) to evaluate the EMDR-PRECI in the remission of the PTSD Diagnosis on female minors who were victims of sexual and/or physical violence compared to treatment as usual (TAU), 2) to evaluate the effectiveness of the EMDR-PRECI in the reduction of the PTSD, anxiety, and depression symptoms of the participants compared with TAU, and 3) to expand the knowledge on the existing correlation between the PCL-5 core criteria for PTSD provisional diagnosis and the CAPS-5 PTSD clinical diagnosis on this population. The study was conducted in 2019 in the cities of Puebla, Mexico, and Mexico City, in three sites of a non-profit organization who provide services to women in vulnerable situations. A total of 32 minors met the inclusion criteria. Participants’ ages ranged from 12 to 17 years old (M =15.35 years old). Participation was voluntary with the participant’s and their legal guardian's consent. It is relevant to mention that 31 of the 32 participants were pregnant during treatment with an average of 24.63 weeks (6.15 months) of pregnancy. All patients in the EMDR treatment group did not meet PTSD diagnostic criteria after treatment and at 90-days-follow-up assessments, while all patients in the TAU group maintained their PTSD baseline clinical diagnosis after treatment and at 90-days-follow-up assessments. Analyses of variance (ANOVA) for repeated measurements were used for PTSD, Anxiety and Depression; t test and Cohen´s d effect size were calculated using within and between designs for the different measurements. ANOVA revealed a significant effect for time (F (2, 52) = 149.53 p <.001, ηP2 =.852), for group (F (1, 26 = 140.71, p<.001, ηP2 =.844) and Anxiety scores showed a significant effect for time (F (1, 26) = 32.89, p <.001, ηP2 =.559) and a significant interaction effect between time and group (F (1, 26) = 17.37, p <.001, ηP2=.401) showed the decrease for the treatment group. For the depression scores significant effects were found for time (F (1, 26) = 21.77, p <. 001, ηP2 =.456. Results also showed significant interaction effects between time and group. (F (1, 26) = 6.17, p <.05, ηP2 =.192). No significant effects for TAU group were founded. The study results indicate that the administration of the EMDR-PRECI could be a feasible, cost-effective, and time-efficient therapy to address PTSD diagnosis, and PTSD, anxiety and depression symptoms in this population.

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Multicenter Randomized Controlled Trial on the Provision of the EMDR-PRECI to Female Minors Victims of Sexual and/or Physical Violence and Related PTSD Diagnosis

The Eye Movement Desensitization and Reprocessing Group Protocol with Children (EMDR-GP/C) was first developed by Korkmazlar following the Marmara earthquake in Turkey in 1999 and can be adapted for different populations. This study focused on EMDR-GP with children who lost their fathers in the mine explosion that occurred in 2014 in Soma, Turkey. The EMDR-GP/C was used with 41 children (7–12 years old) in the early intervention, 3 weeks after the disaster, and used with 25 other children (6–13 years old) in the late intervention, 18 months after the disaster, when posttraumatic stress disorder symptoms had developed. The differences between the early and late implementations of EMDR-GP/C are presented in this article. In the early intervention, children processed the trauma by focusing on the “events” as they saw or heard them; however, 18 months after the disaster, children processed their “emotions” about the event in the desensitization phase. Results show a significant decrease in scores of subjective units of disturbance (SUDs) for both intervention periods. An analysis was also conducted, comparing decreases in SUD scores for younger and older children, with no differences found in their response to treatment. Pre and follow-up data were collected for the late intervention condition, using the Child Report of Posttraumatic Symptoms (CROPS), and showed a significant decrease at 18-month follow-up. Further studies are suggested to determine effectiveness of EMDR-GP/C with other populations.

EMDR Group Protocol With Children: A Field Study

The rationale is synthesized for the urgency of empirical studies demonstrating the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with posttraumatic stress disorder (PTSD), symptoms of PTSD, or other trauma-related symptoms. This literature review examined 15 studies (including nine randomized clinical trials) that tested the efficacy of EMDR therapy for the treatment of children and adolescents with these symptoms. All studies found that EMDR therapy produced significant reductions in PTSD symptoms at posttreatment and also in other trauma-related symptoms, when measured. A methodological analysis identified limitations in most studies, reducing the value of these findings. Despite these shortcomings, the methodological strength of the identified studies has increased over time. The review also summarized three meta-analyses. The need for additional rigorous research is apparent, and in order to profit from experiences of the past, the article provides some guidelines for clinicians seeking to conduct future research in their agencies.

Efficacy of EMDR Therapy for Children With PTSD: A Review of the Literature

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Efficacy of EMDR Therapy for Children With PTSD: A Review of the Literature