Time limited trauma-focused treatment for children and adolescents
Carlijn de Roos, klinisch psycholoog/psychotherapeut, deed promotieonderzoek naar de effectiviteit en efficiëntie van drie traumatherapieën voor kinderen en jongeren: EMDR en twee traumagerichte cognitieve gedragstherapieën (het opvangprotocol en schrijftherapie WRITEjunior). Alle drie de behandelingen bleken bij kinderen en jongeren (4-18 jaar) met PTSS na eenmalig trauma effectief in het verminderen van PTSS, angst- en depressieve klachten en gedragsproblemen in gemiddeld minder dan vier uur..
The main aims of this thesis were: (1) to determine the relative effectiveness and efficiency of three trauma-focused treatment methods (i.e., cognitive behavioral therapy, CBT; cognitive behavioral writing therapy, CBWT; EMDR therapy) in reducing the severity of PTSD symptoms and comorbid symptomatology in children and adolescents following exposure to a single traumatic event, (2) to determine the effectiveness and feasibility of a trauma-focused approach (i.e., EMDR therapy) for major depressive disorder, and (3) to identify potential predictors and moderators of PTSD outcomes based on the data obtained from a RCT comparing CBWT and EMDR.
The findings in this thesis demonstrate that all three treatments were effective in reducing pediatric PTSD in less than four hours, and showed generalization of the positive effects to a broad range of comorbid symptoms. EMDR therapy appeared more efficient than CBT and CWBT. For adolescents with major depressive disorder, six sessions of EMDR-therapy proved effective in reducing symptoms of depression and comorbidity. Of possible predictors of child PTSD outcome, parental psychopathology was found to be the most consistent factor, leading to poorer child PTSD outcomes. The time limited effect of moderator variables in our trial, the effectiveness, and brevity of the trauma treatments that were tested, support the importance of focusing on implementation hereof and of increasing the availability of these treatments so that children with (subclinical) PTSD can be treated in time and when needed.