Multisite randomized controlled trial on the provision of the EMDR integrative group treatment protocol for ongoing traumatic stress remote to healthcare professionals working in hospitals during the Covid-19 pandemic

The aim of this longitudinal multisite randomized controlled trial (RCT), using a waitlist/delayed treatment control group design, was to evaluate the effectiveness of the Eye Movement Desensitization and Reprocessing-Integrative Group Treatment Protocol for Ongoing Traumatic Stress Remote (EMDR-IGTP-OTS-R) in reducing posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in healthcare professionals working in hospitals during the Covid-19 pandemic in Puebla, Mexico. The study was conducted in 2020 in the city of Puebla, Mexico with healthcare professionals (nurses and medical doctors) working in ten hospitals who received Covid-19 patients. A total of 80 healthcare professionals met the inclusion criteria. Participants’ ages ranged from 21 to 51 years old (M =33.24 years). In this study, the early EMDR online group therapy intervention was initiated seven weeks after the first Covid-19 patients died in the hospitals. Intensive EMDR group treatment was provided. Data analysis by repeated measures ANOVA, showed that the EMDR-IGTP-OT-R had a significant effect on the explored variables (PTSD, Anxiety, and Depression) in time, group, and interaction time by group. Comparisons within means of the different pairs of longitudinal measurements were also useful to observe the consistency of the data. Results showed a large effect size (Cohen´s d, from 1.93 to 1.25) between the pretest and the first posttreatment assessment, being able to attribute these effects to the EMDR-IGTP-OTS-R treatment. Results were confirmed with the between-group mean comparisons since the waitlist/delayed treatment act as a control group. In this case, the effect size (Cohen´s d) varied from 3.95 to 1.92 showing a large effect of the difference between groups, attributed to the start time of the treatment. Results also showed an overall subjective global improvement in the study participants. No adverse effects (e.g., symptoms of dissociation, fear, panic, freeze, shut down, collapse, fainting), or events (e.g., suicide ideation, suicide attempts, self-harm, homicidal ideation) were reported by the participants during treatment or at three months post-treatment follow-up while all participants were still working in their hospitals receiving COVID-19 patients. None of the participants showed clinically significant worsening/exacerbation of symptoms on the PCL-5 or HADS after treatment. To the best of our knowledge, this is the first RCT on early intervention with an evidence-based trauma-focus (TF) therapy (e.g., EMDR, TF-CBT) provided online in a group format and intensive treatment modality to healthcare professionals working in hospitals during the COVID-19 pandemic. This randomized controlled trial provides evidence for the effectiveness, efficacy, feasibility, and safety of the EMDR-IGTP-OTS-R in reducing posttraumatic stress, anxiety, and depression symptoms for healthcare professionals working in hospitals during the Covid-19 pandemic, expanding the EMDR therapy frontiers.

Journal

English

María Cristina Pérez 
María Elena Estévez 
Yael Becker
Amalia Osorio
Ignacio Jarero
Martha Givaudan

Pérez, M. C., Estévez, M. E., Becker, Y., Osorio, A., Jarero, I., & Givaudan, M. (2020, October). Multisite randomized controlled trial on the provision of the EMDR integrative group treatment protocol for ongoing traumatic stress remote to healthcare professionals working in hospitals during the Covid-19 pandemic. Psychology and Behavioral Science International Journal, 15(4). doi:10.19080/PBSIJ.2020.15.555920