An integrative treatment model of EMDR and family therapy for children with severe symptomatology after child abuse and neglect: A SCED study

Background: Children who endured child abuse and neglect (CAN) may develop a spectrum of symptoms that goes beyond the development of posttraumatic stress symptoms (PTSS) alone. This can pose unique challenges within the treatment context that may hamper the application of direct trauma-focused treatments. A new treatment model, which focuses on more than PTSS alone, has been developed. Through preparatory work, it aims to engage children in trauma processing. Objective: This study aimed to examine if this integrative treatment model can diminish attachment problems, PTSS, behavior difficulties, and emotional control difficulties in children with a history of CAN who currently reside in permanent placement. Participants & Settings: We included 15 children between the ages of four and twelve who experienced CAN in the past and who were referred to specialized youth mental health care and their caregivers. Methods: We conducted a non-concurrent multiple baseline single-case experimental design study with weekly measurements on attachment problems, PTSS, behavior difficulties, and emotional control difficulties through questionnaires. Results: Eight cases were fit to analyze of which all but one participant showed improvement on one or more of the four outcome measures. On group level, we found evidence for functional relationships between the intervention and change in attachment problems, behavioral difficulties, and emotional control difficulties. Conclusions: This integrative treatment model appears to be a suitable treatment for children with a complex combination of psychiatric problems after CAN and therefore provides promising results for a complex population for whom limited treatment options are available.