Pre-Post Study to Assess EMDR-Based Group Therapy for Traumatized Refugee Preschoolers

Abstract

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.

Eye Movement Desensitization and Reprocessing to Reduce Post-Traumatic Stress Disorder and Related Symptoms among Forcibly Displaced People: A Systematic Review and Meta-Analysis

“…Most studies involved refugees and asylum seekers displaced from war- and conflict-affected countries such as Afghanistan, Eritrea, Iraq, and Syria (Table 1). Most participants were female with a wide age distribution from as young as an average of 5 years (Lempertz et al, 2020) to just over 50 years (Grainger, Levin, Allen-Byrd, Doctor, & Lee, 1997). Sample sizes were generally small (less than 100).…”

How effective is group intervention in the treatment for unaccompanied and accompanied refugee minors with mental health difficulties: A systematic review

“…This aligns with the previously mentioned hypothesis that the SDQ is not an appropriate or sufficiently comprehensive outcome measure for this demographic, who suffer considerably from PTSD or PTSS. The only study with children as young as 4 to 6 years (Lempertz et al, 2020) found some decrease in PTSD symptoms and two out of six children transitioned from above to below threshold for PTSD diagnosis. However, it is worth noting the short time frame and smaller sample size of this study; five daily 50 to 60 minute sessions, and n = 10 respectively.…”

“…There was one study in this category (Hurn & Barron, 2018) (Supplemental Table S4). On a similar note to Lempertz et al (2020), this study focussed on a preadolescent demographic, with participants aged 6 to 11. The sample size was also small at n = 8.…”

“…One was a non-randomised controlled cluster trial (Thabet et al, 2005), and the other two were before-after trials with no control. This section contained the study that had the youngest participants, conducted with 10 4 to 6 years olds (Lempertz et al, 2020), which perhaps offers some evidence of the efficacy of group therapy in younger refugee children. The other two studies had 32 participants aged 10 to 15 and (Gormez et al, 2017) 111 young people aged 9 to 15 (Thabet et al, 2005).…”

“…When outcome was defined as absence of PTSD, crisis intervention was not significantly better compared with the control group (Odds Ratio = 0.92, 95% Of the 15 studies that had a quantitative component, 12 (80%) reported improvements in mental health symptoms. For self-reported symptoms, two studies that saw improvements did not carry out statistical analysis (Hurn & Barron, 2018;Lempertz et al, 2020). Meyer DeMott et al (2017 did not see significant difference in symptoms between the two groups.…”