Comparing the effectiveness of EMDR and TF-CBT for children with posttraumatic stress: A meta-analysis

Eye Movement Desensitization and Reprocessing (EMDR) and Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) are established evidence-based methods for treating traumatized adults. Studies examining treatment of traumatized children have found positive results for both of these treatments. However, there is a critical need for meta-analytic reviews of this research, and the present study is the first to directly compare these two treatments for this vulnerable population. Type of treatment and presence of a PTSD diagnosis were explored as moderators. Inclusion criteria specified children under age 18 who experienced a traumatic event, self-reported posttraumatic stress symptoms (PTSS), and received either TF-CBT or EMDR treatment. Studies written in English using an outcome measure of PTSS were included for analysis. All articles were coded by trained researchers. To ensure interrater reliability, all articles were blind coded and discrepancies were discussed until resolved. Results were computed using Comprehensive Meta-Analysis software from Biostat. A random effects model demonstrated a significant overall effect size, indicating EMDR and TF-CBT are effective treatments; though, multiple indices indicated heterogeneity in the effect size. Type of treatment as a moderator variable demonstrated a significant difference between the treatments delivered. Specifically, TF-CBT was related to a greater reduction in PTSS in children than EMDR. It is hypothesized that greater efficacy of TF-CBT may be related to the psychoeducation utilized to teach clients and family about trauma symptoms. Moderator analysis of diagnosis demonstrated children with PTSS showed a greater reduction in symptomatology than children with a diagnosis of PTSD. Given that PTSS develop as soon as three months following a traumatic event, and that full criteria for PTSD may not be met for months or even years, these results suggest that children do benefit from early intervention. The implications and limitations of these findings will be further discussed.

Conference

English

Brandi Burcham
Christopher L. Smith
Nia L. Saunders
Dina Elfallal
Jennifer H. Lewey
Siobhan K. O’Toole

Burcham, B., Smith, C. L., Saunders, N. L., Elfallal, D., Lewey, J. H., & O'Toole, S. K. (2016, April). Comparing the effectiveness of EMDR and TF-CBT for children with posttraumatic stress: A meta-analysis. Presented at theCentral California Research Symposium, Fresno, California