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Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial

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Abstract

To prevent adverse long-term effects, children who suffer from posttraumatic stress symptoms (PTSS) need treatment. Trauma-focused cognitive behavioral therapy (TF-CBT) is an established treatment for children with PTSS. However, alternatives are important for non-responders or if TF-CBT trained therapists are unavailable. Eye movement desensitization and reprocessing (EMDR) is a promising treatment for which sound comparative evidence is lacking. The current randomized controlled trial investigates 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 as measured with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Secondary outcomes included parental report of child PTSD diagnosis status and questionnaires on comorbid problems. The Children’s Revised Impact of Event Scale was administered during the course of treatment. 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). Treatment duration was not significantly shorter for EMDR (p = 0.09). 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). Parents of children treated with TF-CBT reported a significant reduction of comorbid depressive and hyperactive symptoms. TF-CBT and EMDR are effective and efficient in reducing PTSS in children.

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Acknowledgments

The authors would like to thank all children and parents who took part in the current study. Furthermore, we would like to thank the Frijling Prins Fonds for financial support. We also want to acknowledge the work of all the therapists and research assistants who were involved in this project. Especially we want to thank Renée Beer for her contributions to the research project.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands

    Julia Diehle, Frits Boer & Ramón J. L. Lindauer

  2. Clinical Research Unit, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Brent C. Opmeer

  3. Academic Center for Child and Adolescent Psychiatry de Bascule, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands

    Frits Boer & Ramón J. L. Lindauer

  4. Department of Psychiatry, Four Algheny Center, Drexel University College of Medicine, Pittsburgh, PA, 15212, USA

    Anthony P. Mannarino

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  1. Julia Diehle
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Correspondence to Julia Diehle.

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Diehle, J., Opmeer, B.C., Boer, F. et al. Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial. Eur Child Adolesc Psychiatry 24, 227–236 (2015). https://doi.org/10.1007/s00787-014-0572-5

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  • DOI: https://doi.org/10.1007/s00787-014-0572-5

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