Is EMDR as Effective as CBT for Kids with Posttraumatic Stress?

Researchers from the Department of Child and Adolescent Psychiatry, Academic Medical Centre in Amsterdam, The Netherlands, explored the efficacy of EMDR (Eye Movement Desensitization and Reprocessing) for children with posttraumatic stress symptoms, comparing it to the more well-established treatment of trauma-focused cognitive behavioral therapy (TF-CBT).

A randomized controlled trial investigated the effectiveness and efficiency of both treatments. Forty-eight children (8-18 years) were randomly assigned to eight sessions of TF-CBT or EMDR.

The primary outcome was PTSS scores, as measured by the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Secondary outcomes included parental feedback regarding their child's PTSD diagnosis status, and questionnaires on comorbid problems.

In addition, the Children's Revised Impact of Event Scale was administered during the course of treatment.

Both interventions - TF-CBT and EMDR - showed large reductions from pre- to post-treatment on the CAPS-CA (-20.2; 95% CI -12.2 to -28.1 and -20.9; 95% CI -32.7 to -9.1). The difference in reduction was small and not statistically significant (mean difference of 0.69, 95% CI -13.4 to 14.8). Neither was treatment duration significantly shorter for EMDR (p = 0.09) over TF-CBT.

Mixed model analysis of monitored PTSS during treatment showed a significant effect for time (p < 0.001) but not for treatment (p = 0.44) or the interaction of time by treatment (p = 0.74).

The parents of children treated with TF-CBT reported a significant reduction of comorbid depressive and hyperactive symptoms.

The researchers conclude that both TF-CBT and EMDR are effective and efficient in reducing PTSS in children.

Citation: Diehle J1, Opmeer BC, Boer F, Mannarino AP, Lindauer RJ. Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial. European Child and Adolescent Psychiatry. 2015 Feb;24 (2):pages 227-36. doi: 10.1007/s00787-014-0572-5. Epub 2014 Jun 26. [email protected].