The study presented in this article, conducted by Michael Kemp, Peter Drummond and Brett McDermott (2010), examines the effectiveness of four Eye Movement Desensitization and Reprocessing (EMDR) sessions in treating 27 children, including 15 boys and 12 girls (aged 6 to 12) with symptoms of post-traumatic stress disorder (PTSD) after a car accident. The aim is therefore to study the effectiveness of EMDR on children who have suffered trauma due to a car accident. This study presents two conditions: an experimental condition, the group “EMDR” (children who benefit from the treatment) and a control condition, the group “waiting list” (children who do not receive treatment). Participants were excluded from the study when they: were taking psychotropic medications, had concurrent psychological conditions (e.g., major depressive disorder) and / or a history of physical or sexual abuse. In addition, the article presents two detailed case studies (Jack and Steve), reflecting the progression of EMDR sessions, the alternatives that may have been developed to adapt to the child and the results that have resulted.
First, EMDR is a therapy using eye movements to remove the pain and negative emotions related to traumatic shock, to install it, instead, a positive belief. These movements would thus make it possible to deactivate the negative emotions that accompany the memory, the traumatic information. EMDR would therefore have the function of reforming the encoding of memory and the emotions that accompany it. Nowadays, it is widely accepted that this therapy is particularly effective in the treatment of PTSD.
In designing their study, the authors used several scales of assessments in order to obtain different preliminary and important measures for further research. Furthermore, parental assessments were central to obtaining comprehensive results regarding the impact of EMDR on children’s traumatic symptoms after follow-up, by comparing them with those found before treatment. In addition, all participants had to meet two or more DSM-IV PTSD diagnostic criteria or have a score of at least 12 on the Child Post-Traumatic Stress Scale (CPTS-RI): this scale reflects the frequency of PTSD symptoms, guilt and impulse control in children.
According to the authors, after EMDR treatment, the rate of PTSD symptoms decreases to 25%, while this rate remains at 100% in the so-called “waiting list” group. In addition, these treatment gains were maintained over 3 to 12 months of follow-up, which suggests the use of EMDR to treat PTSD symptoms in children. To present their results, the authors explained two clinical cases : Jack and Steve’s case. Jack, 6, was on his skateboard (lying on his back) when he lost control and a car ran over his leg causing a fracture of his tibia and fibula. Steve, 12, was hit by a car crossing the street and suffered the same psycho-traumatic consequences as Jack. These traumas caused each of them to experience symptoms of PTSD such as reliving, avoiding, awakening, exposure to a traumatic event and an intense sense of psychological distress.
It was from the fourth session, after a heavy work of desensitization, the establishment of a sense of security and a sense of control, Steve and Jack managed to introduce a positive cognition to the memory of their trauma. Thus, Jack and Steve no longer met the PTSD criteria in the DSM-IV for reviviscence and sleep difficulties, even after 3 and 12 months of follow-up. Thus, these results reflect the effectiveness of EMDR treatment in reducing the intensity of symptoms and their suppression in children who have experienced a traumatic event due to a car accident. The significant improvement in symptoms in only four treatment sessions indicates that EMDR is effective for this type of traumatic event (in this case, a road accident).
It is important to note that the authors have adapted to children, integrating alternatives and options into the EMDR process to facilitate the desensitization of traumatic memory (e. g. eye movements with the cuddly toy). Thus, a certain degree of flexibility has been allowed in the application of the protocol to meet the needs of children. To conclude, certain inherent limitations (sample size, a single judge/clinician, date of accident, etc.) in this study should be considered, obviously preventing the generalization of the results. Larger samples could increase the statistical power of this study. In addition, it would be interesting to compare the effects of EMDR and those of cognitive and behavioural therapies on trauma to determine whether EMDR treatment is more effective in treating PTSD symptoms.
Finally, the authors included, at the end of their article, in an appendix, the protocol for children, describing the eight phases of this child-friendly treatment. It allows us to better understand the path of EMDR and the important points to be made in this therapy.
Bibliography :
Kemp, M., Drummond, P., & McDermott, B. (2010). A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents. Clinical child psychology and psychiatry, 15(1), 5-25.