Through the clinicians eyes. The experiences and barriers behinddelivering EMDR to Children with PTSD in CAMHS

1. Through Clinicians’ Eyes: EMDR, Bizarre, Discombobulating, Magical? — EMDR Delivery Experiences to Children and Young People with Post-Traumatic Stress Disorder in London CAMHS 2. This study embarked on a critical inquisition on clinicians’ experience of delivering eye movement desensitisation, and reprocessing (EMDR) therapy, specifically in London. Utilising a mixed methods methodology, clinicians’ perspectives were analysed quantitatively to identify factors contributing to confidence, whilst a semi-structured interview explored their experiences more broadly, and in detail. A stepwise regression model was utilised to identify predictors for clinicians’ confidence in their EMDR knowledge and skills, whilst a deductive thematic analysis was undertaken to identify themes. Both quantitative and qualitative findings concur on four themes relating to (a) clinicians’ confidence, (b) socio-environmental factors that affect EMDR opportunities and engagement, (c) the EMDR experience, and (d) young person factors that affect EMDR opportunities and engagement. Consequently, some findings were aligned with previous studies. Results emphasised the importance of EMDR training for confidence levels in delivery, with a future shift towards a more specialised, active learning model for the EMDR syllabus. A gap was identified, where a majority of the EMDR clinicians in London Child and Adolescent Mental Health Services (CAMHS) had not completed their child and adolescent EMDR training. This was crucial, as the training would better equip clinicians’ skills to modify standard protocol to meet the differential developmental needs of individuals under 18, utilising trauma narratives, a systemic standpoint, and using constant installation of present orientation and safety (CIPOS) with children whose traumatic memories are outside their window of tolerance. The sub theme of Lack of Confidence Associated with Increased Uncertainty underscores the importance of having confident clinicians in CAMHS, and discussions suggest a shift to a hybrid EMDR training (including child and adolescent modules), or one that includes a compulsory specialisation into child and adolescent track, or the adult track. Additionally, the constellation of complexity in cases clinicians’ experience were vast, with specialised challenges depending on their client groups in the service, urging future EMDR training to target a myriad of complexities, to enable confident clinicians. More comprehensive indicators of EMDR success were identified for CYP, proposing the importance of evaluating effectiveness more holistically. Within EMDR therapy sessions, aside from the primary role of remedying psychological distress associated with trauma, the preventative and development work to inhibit non-adaptive responses and to enable CYP towards optimal functioning can be indicators of EMDR effectiveness. Finally, unique elements of EMDR reveal advantages for certain symptom presentations, nudging a further exploration into matching PTSD presentations in CYP to therapeutic suitability.

Conference

English

Valerie Hartland
Megan Chia

Hartland, V., & Chia, M. (2024, March). Through the clinicians eyes. The experiences and barriers behind delivering EMDR to Children with PTSD in CAMHS. Presentation at the 22nd EMDR UK Association Conference, York, UK