A randomised comparison of cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) in disaster-exposed children

Abstract

Background Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations.Objective The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR).Design Children (n=52, aged 4–18) were randomly allocated to either CBT (n=26) or EMDR (n=26) in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4–8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures) were conducted on the intention-to-treat sample and the completers.Results Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions.Conclusion Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children.

What does the data say about the importance of eye movement in EMDR?

“…Hence studies that directly compared these disparate treatments such as (Devilly & Spence, 1999;Taylor et al, 2003) were not included in our analysis. Numerous other studies also did this (de Roos et al, 2011;Ironson, Freud, M A N U S C R I P T…”

Eye movement desensitization and reprocessing (EMDR) in children and adolescents with subthreshold PTSD after medically related trauma: design of a randomized controlled trial

“…Any treatment effect observed could also be due to general contact aspects of a psychosocial intervention. However, it has repeatedly been shown that EMDR is as effective as TF-CBT or even more effective (De Roos et al, 2011, 2017; Diehle et al, 2014; Rodenburg et al, 2009). It is also possible that some of the participants in the care-as-usual group will nonetheless search psychological treatment during the assessment period.…”

“…Compared to TF-CBT, ‘EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework’ (World Health Organization, 2013, p. 1). Furthermore, EMDR seems to work faster (often < 8 sessions at 45–60 min; Beer and De Roos, 2017) than traditional TF-CBT (8–12 sessions at 90 min; van Balkom et al, 2013) and is thus cheaper and more efficient (De Roos et al, 2011, 2017). …”

Systematic search of Bayesian statistics in the field of psychotraumatology

“…A fourth advantage of Bayesian analysis is the treatment of missing data, as applied by de Roos et al (2011), who conducted a randomized controlled trial to compare cognitive behavioral therapy with EMDR in a group of disaster-exposed children. In the intention-to-treat analysis, the authors replaced outcome data that were missing owing to dropouts using multiple imputations by fully conditional specification using the MICE package (Van Buuren & Oudshoorn, 1999).…”