Given the significant growth in the migration flow of refugees who are fleeing from persecution, terrorism, and war-torn countries to Europe, there is an urgent need for effective interventions for the treatment of this highly traumatized population. EMDR Integrative Group Treatment Protocol (EMDR-IGTP) was provided to 14 child refugees (7 females) in 2016 at a Turkey orphanage near the Syrian border which was housing adult and child Syrian refugees. Treatment was provided in three groups, one each for children aged 3–7 years, pre-adolescents aged 9–12, and adolescents aged 13–18 with three sessions provided to each group. Pre-treatment assessment with multiple measures was compromised by difficulties with translator availability and refugee mobility, resulting in high attrition. When the post-treatment assessment was conducted 45 days later, many refugees had already left the orphanage. The sparse character of the data matrix produced analyzable data for 8 children (mean age 11 ± 3; 4 females) on the Children's Revised Impact of Event Scale (CRIES). Statistical analysis showed a significant decrease in CRIES scores, reflecting a decrease in severity of posttraumatic symptoms.
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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.
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.
- Go to article: The EMDR Integrative Group Treatment Protocol in a Psychosocial Program for Refugee Children: A Qualitative Pilot Study
The EMDR Integrative Group Treatment Protocol in a Psychosocial Program for Refugee Children: A Qualitative Pilot Study
The current study evaluated the eye movement desensitization and reprocessing integrative group treatment protocol (EMDR-IGTP) delivered within a novel psychosocial program for child refugees. One Libyan and seven Syrian children, aged 6 to 11 years 10 months (five boys), received four 3-hour sessions, with IGTP in the second session. The study investigated whether IGTP would be valuable for child refugees whose trauma symptoms failed to reach Child and Adolescent Mental Health Service thresholds. In addition, the project aimed to identify cultural hurdles that may hinder access to Western psychological approaches. Qualitative data were collected from eight children, two therapists (an eye movement desensitization and reprocessing [EMDR] practitioner and a family care worker), and a focus group of four Arab interpreters. The qualitative design involved children completing rating scales at the beginning and end of each session and the Subjective Units of Disturbance (SUD) scale for traumatic memories before and after EMDR-IGTP. Therapists reflected on outcomes in a postintervention report, and the interpreters discussed cultural challenges in a focus group. IGTP appeared to lead to reduced internal distress and perceived increases in emotional awareness for children. Therapists’ reports affirmed reduced disturbance and highlighted the cultural sensitivity of IGTP. The interpreters’ focus group emphasized the challenges of language, the stigma of mental illness, and the differing levels of communicative control across cultures. Future studies of IGTP, embedded within psychosocial programs for refugee children, need to utilize experimental research designs including culturally sensitive outcome measures.
- Go to article: The Online Nurtured Heart Approach to Parenting: A Randomized Study to Improve ADHD Behaviors in Children Ages 6–8
The Online Nurtured Heart Approach to Parenting: A Randomized Study to Improve ADHD Behaviors in Children Ages 6–8
To evaluate the efficacy of the Nurtured Heart Approach (NHA) to improve attention deficit hyperactivity disorder (ADHD) behaviors in children.
In 2017, we conducted a trial among parents (n = 104) with children ages 6–8 years diagnosed with ADHD/at risk for a diagnosis. Participants were randomly selected, but not blinded, to the immediate (NHA) or delayed (control) group. The NHA training was held online over 6 weeks.
The NHA group (−7.0 ± 8.1), but not the control group (0.2 ± 6.6), reported a decrease in inattention (p < .001). The NHA group (−7.9 ± 9.3), but not the control group (−0.5 ± 7.3), reported a decrease in hyperactivity/impulsivity (p < .001).
The study provides preliminary data of the NHA's potential to improve ADHD related behaviors.
- Go to article: The Effectiveness of Eye Movement Desensitizationand Reprocessing in the Treatment of TraumatizedChildren and Youth
The Effectiveness of Eye Movement Desensitizationand Reprocessing in the Treatment of TraumatizedChildren and Youth
This article provides a summary of all the studies that have investigated eye movement desensitization and reprocessing (EMDR) treatment of traumatized children and adolescents. The effectiveness of the treatment is revealed in more than 15 studies. This article considers the differences between Type I and Type II traumas and specifically examines the effects of EMDR on traumatic stress experienced by children and youth following Type I and Type II traumas. There is a considerable body of research evaluating EMDR treatment of Type I traumas, showing strong evidence for its efficacy, but there are few studies that have specifically investigated EMDR treatment of Type II traumas. The effect of EMDR on various symptoms and problem areas is also examined. Recommendations are made for the clinical application of EMDR and for further research.
- Go to article: Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study
Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study
Self-help treatments are an important intervention tool, with high accessibility and ease of application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then, children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial (intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed a significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.
“Specialty Topics on Using EMDR With Children” is written for therapists who have learned the basic eye movement desensitization and reprocessing (EMDR) protocol and are interested in expanding their skills in using EMDR in individual treatment with children. This article explores the advanced application of EMDR with other clinical, emotional, developmental, and behavioral issues, including children who have been diagnosed with attention deficit/hyperactivity disorder (ADHD) or have experienced trauma, attachment, and dissociation. The text is organized into headings of specific childhood diagnoses, issues, or presenting problems, with recommendations for procedural considerations and adjustments to the EMDR protocol. Unless indicated otherwise, the EMDR protocol follows the 8 phases, as discussed in the book, EMDR and the Art of Psychotherapy With Children (Adler-Tapia & Settle, 2008) with additions or modifications, as indicated.
- Go to article: Eye Movement Desensitization Reprocessing for Children and Adolescents With Posttraumatic Stress Disorder: A Systematic Narrative Review
Eye Movement Desensitization Reprocessing for Children and Adolescents With Posttraumatic Stress Disorder: A Systematic Narrative Review
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.
“Never again” is the cry relating to the Holocaust that thunders around the world. Yet, we see in the events of September 11, 2001 tragedies of equal barbarity continuing. One way to prevent this is to keep the stories alive for future generations. Remembering the Holocaust and 9/11, and their stories alive for our families is one way. Aphenomenological approach was used. Seven second-generation survivors were interviewed. The findings include themes of surviving, frightening experiences, safety, loss, daily thoughts, denial, minimizing, connections, passing on heritage, and identity. With this major societal issue, we must look at the structure and behaviors in our society and at ways to change the cruelty of people to people.