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.
Cross-culturally effective, low-threshold therapies for refugees that can be carried out quickly are urgently required. Worldwide, therapies are lacking, particularly for preschool refugee children, which support coping and prevent chronification of posttraumatic stress. This pilot study examined eye movement desensitization and reprocessing (EMDR)-based group treatment for preschool refugee children in German daycare centers. Ten refugee preschool children aged 4–6 years (n = 5 female) with posttraumatic stress disorder (PTSD) symptoms took part in an EMDR-based group treatment (with 2–4 children per group). PTSD symptoms were rated by parents and preschool teachers using items from the Child Behavior Checklist (CBCL 1½–5), pre- and posttreatment, and at 3-month follow-up. After treatment children tended to display less fear of animals or situations than before treatment. According to preschool teachers' perspective, the total number of PTSD symptoms dropped significantly at posttreatment (d = .93) and at follow-up (d = .81). Before the intervention, preschool teachers rated the children as being more defiant than their parents did (p = .020). After the intervention, the PTSD symptoms of boys were significantly higher than those of girls (p = .036) according to preschool teachers. The results indicate that timely psychotherapeutic interventions can be conducted with refugee children displaying PTSD symptoms in daycare centers. The efficacy of this intervention needs to be studied in a larger sample under controlled randomized conditions.
Zusammenfassung. Kinder im Vorschulalter zwischen drei und sechs Jahren weisen ein hohes Risiko für Gewalterfahrungen und Unfälle auf oder können durch lebensbedrohliche Erkrankungen bzw. schwere medizinische Eingriffe bei sich oder engen Bezugspersonen bereits schwere psychische Belastungen erleben. Dennoch lassen sich Studien zur Häufigkeit von traumatischen Erfahrungen sowie zu Traumafolgestörungen, wie der Posttraumatischen Belastungsstörung (PTBS), bei Vorschulkindern weltweit bisher nur vereinzelt finden. Der Beitrag a) gibt daher einen Überblick über Kriterien und Instrumente zur Diagnostik der PTBS bei Vorschulkindern, b) fasst die Ergebnisse eines systematischen Literaturreviews zur Häufigkeit der PTBS bei traumatisierten Vorschulkindern zusammen und c) beschreibt die wenigen verfügbaren Befunde zur psychiatrisch-psychotherapeutischen Versorgung junger Kinder mit Traumafolgestörungen unter Berücksichtigung möglicher Barrieren für die Inanspruchnahme von professionellen Hilfen in Deutschland. Die sieben in das Literaturreview eingeschlossenen Studien, in denen insgesamt 1029 Drei- bis Sechsjährige mit Kriegserlebnissen und anderen Traumata in Israel bzw. Palästinensischen Gebieten, USA und Deutschland untersucht wurden, zeigten PTBS-Häufigkeiten zwischen 0 % und 50 %. Die wenigen Untersuchungen zur Inanspruchnahme von Psychotherapien durch Vorschulkinder in Deutschland deuten auf eine Unterversorgung dieser Gruppe hin. Es fehlt allerdings an repräsentativen Studien zur Häufigkeit der PTBS im Vorschulalter sowie zur Versorgung von posttraumatisch belasteten Vorschulkindern. Bei traumatisierten Vorschulkindern muss unter anderem aufgrund der für diese Altersgruppe wenig sensitiven PTBS-Kriterien in der ICD-10, der starken Abhängigkeit von Bezugspersonen und vom sozialen Umfeld sowie aufgrund genereller Barrieren in der psychiatrisch-psychotherapeutischen Versorgung von einer Unterschätzung der Anzahl an betroffenen Kindern sowie von einer Unterversorgung ausgegangen werden.
Background Traumatic experiences can lead to posttraumatic stress disorder (PTSD). For young children, even minor, inconspicuous looking events can lead to posttraumatic stress symptoms. Trauma-focused treatment with Eye Movement Desensitization and Reprocessing (EMDR) offers children an age-adapted intervention to help them successfully process traumatic experiences. So far, there has been a lack of well evaluated trauma-focused treatments for young children. Methods These case series examine the effectiveness of a short-term treatment with EMDR therapy for children showing PTSD symptoms after experiencing a single incident induced trauma. Five children between 5 and 10 years of age who developed PTSD after a single incident trauma received a manualized EMDR treatment for 6 weeks (mean number of sessions: seven including a mean number of EMDR sessions: 3.4). Posttraumatic stress symptoms were assessed prior to treatment, following treatment and at a 3-month follow-up with standardized instruments for caregivers and children. Results PTSD symptoms decreased for all children after completing the treatment from clinical to non-clinical level. Reductions in vegetative hyperarousal, fears and clinging behaviour were achieved. Furthermore, reductions in the parental stress levels, as well as a recovery of everyday routine and everyday stability were observed. Conclusion Short-term EMDR treatment appears to be a promising treatment for single incident trauma in young children providing a potentially successful quick and safe psychological treatment for children. Results contribute to the knowledge of feasibility and acceptability of short-term, trauma-focused treatments of children with EMDR. Replication of the results of these case series in larger samples using a randomized controlled design is warranted.
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