Eye Movement Desensitization and Reprocessing (EMDR) in children with a medically related trauma

Around 1 in every 10 children admitted to the hospital for undergoing an invasive and painful medical procedure develops a posttraumatic stress disorder (PTSD) and circa 3 in every 10 children develop a partial/subclinical PTSD. Although PTSD is associated with unfavourable medical and mental health outcomes, children are often not structurally screened on PTSD. If PTSD symptoms are left untreated, this may harm the child’s quality of life and psychosocial functioning. Currently, cognitive behavioural therapy (CBT) is the most evidence-based intervention for PTSD. A new innovative treatment is Eye Movement Desensitization and Reprocessing (EMDR), which is less intensive, is less burdensome for patients, works faster and is thus cheaper compared to CBT. This is the first RCT to investigate the direct effectiveness of standardized EMDR in children with medically related trauma. Therefore we will include all consecutive patients who underwent one or more admissions to the ErasmusMC Sophia Children's Hospital and who are 6-16 years old between July 2016 – July 2017, encompassing:

1) previously healthy children (with no underlying illness/handicap) admitted to the hospital for the first time after an unexpected emergency with no comorbidity (trauma type I) and

2) patients with congenital heart disease admitted for a recurrent procedure (trauma type II; e.g. surgery).

Patients with PTSD symptoms are allocated to: a) EMDR or b) care-as-usual CAU. All patients will receive adequate medical care (CAU).

1) EMDR will lead to significant improvement of psychosocial functioning, quality of life and somatic complaints in children with elevated PTSD symptoms (subclinical/partial PTSD).

2) Children with unfavourable predictors (low socioeconomic status, less adequate coping) will benefit more from EMDR as compared to children with favourable predictors.

Pre-post assessments (T1,T2) and a 6 months
follow-up assessment (T3)

Eye Movement Desensitization and Reprocessing (EMDR). EMDR is a standardized treatment method for trauma, consisting of a structured nine-phase approach to address the past, present, and future aspects of a traumatic or distressing memory. The EMDR treatment will consist of six weekly sessions of 1 hour.



In this study the active control group will receive care as usual, which means they get the regular medical care.