Comparing the Effectiveness of EMDR and TF-CBT for Children and Adolescents: a Meta-Analysis

Abstract

Efficacy of EMDR and TF-CBT for posttraumatic stress symptoms (PTSS) was explored through meta-analysis. A comprehensive search yielded 494 studies of children and adolescents with PTSS who received treatment with these evidence-based therapeutic modalities. Thirty total studies were included in the meta-analysis. The overall Cohen’s d was small (−0.359) and statistically significant (p < 0.05), indicating EMDR and TF-CBT are effective in treating PTSS. Major findings posit TF-CBT is marginally more effective than EMDR; those with sub-clinical PTSS responded more favorably in treatment than those with PTSD; and greater reductions in PTSS were observed with presence of comorbidity in diagnosis. Assessment of publication bias with Classic fail-safe N revealed it would take 457 nonsignificant studies to nullify these findings.

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Fig. 1

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Acknowledgements

The authors would first like to posthumously thank our professor, advisor, mentor, and co-author, Dr. Siobhan K. O’Toole, for her guidance and tutelage, as well as sharing with us her passion for meta-analysis. The authors would like to thank Jennie L. Bedsworth, LCSW, who serves as a Licensed Clinical Social Worker in the state of Missouri, for her knowledge and expertise in trauma-focused therapies for vulnerable populations that have significantly informed our discussion for this research endeavor. And finally, the authors would like to thank Colt J. Blunt, Psy.D., L.P., for his thoughtful editing of this manuscript.

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Correspondence to Jennifer H. Lewey.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000.

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Siobhan K. O’Toole is recognized for her authorship posthumously.

The first author delineates that this article and included views and research findings are the author’s own and are in no way affiliated with Minnesota Department of Human Services, Direct Care and Treatment – Forensic Services.

Appendices

Appendix

Table 5 Comprehensive List of All Databases Used in the Meta-Analysis

Appendix

Table 6 Comprehensive List of Measures from Included Studies

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Lewey, J.H., Smith, C.L., Burcham, B. et al. Comparing the Effectiveness of EMDR and TF-CBT for Children and Adolescents: a Meta-Analysis. Journ Child Adol Trauma 11, 457–472 (2018). https://doi.org/10.1007/s40653-018-0212-1

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Keywords

  • Eye movement and desensitization and reprocessing (EMDR)
  • Trauma-focused cognitive behavioral therapy (TF-CBT)
  • Effectiveness
  • Posttraumatic stress symptoms (PTSS)
  • Posttraumatic stress disorder (PTSD)
  • Meta-analysis
  • Children
  • Adolescents