Table 2.
Characteristics and outcomes of the included studies.
| Author Year |
Sample Size Age Gender % |
Intervention | Measure | Pre | Post | Second Post/3 Months/6 Months | Different Mean Change |
|---|---|---|---|---|---|---|---|
| Three RCTs compare EMDR and CBT in Children and Adolescents | |||||||
| de Roos et al. (2011) [26] | 52 10.2 years 55.7% male |
EMDR using psychoeducation, then its protocol was applied on memory that has high levels of distress 1/eeek for 4–8 weeks/60 min per session. CBT using psychoeducation, focusing on exploration and correction on the behavior that is unwanted resulting from a traumatic memory through developing a trauma narrative. 1/week for 4–8 weeks |
CROPS (PTSD) Interrater reliability (Cohen’s kappa: 0.96) |
EMDR: 23.3 (9.9) CBT: 22.7 (9.6) |
EMDR: 12.0 (9.1) CBT: 12.3 (8.1) |
At 3 months: EMDR: 11.2 (8.0) CBT: 11.9 (8.3) |
Pre to post: Change: 11.3 Change: 10.4 Effect size between groups 1.02–1.16 Pre to 3 months: Change: 12.1 Change: 10.8 Effect size between groups 0.98–1.10 |
| MASC (Anxiety) Cronbach’s alpha (0.88) |
EMDR: 53.8 (17.7) CBT: 47.6 (16.8) |
EMDR: 33.3 (17.4) CBT: 33.8 (18.4) |
At 3 months: EMDR: 33.3 (17.4) CBT: 31.6 (18.4) |
Pre to post: Change: 20.7 Change: 13.8 Effect size between groups 0.62–1.12 Pre to 3 months: Change: 20.5 Change: 16 Effect size between groups 0.85–1.02 |
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| Diehle et al. (2015) [3] | 48 9 years 62.5% female |
TF-CBT therapy was focused on children’s trauma, by gradual exposure by creating the child’s trauma narrative, and working on it by using psychoeducation, relaxation, affective expression and regulation, and cognitive coping. 1/week for 8 weeks (60 min per session). EMDR used desensitization of the memory for children with traumatic events through a weekly session for eight weeks (60 min per session). |
CAPS-CA (PTSD) ICC for interrater reliability: 0.97–0.99 |
EMDR: 44.5 (19.4) TF-CBT: 42.3 (15.2) |
EMDR: 23.6 (30.0) TF-CBT: 22.1 (23.3) |
- | Change: 20.9 Change: 20.2 Effect size between groups 0.69 (95%CI 13.4, 14.8) |
| RCADS (Anxiety) Cronbach’s alphas ranged from 0.75 to 0.95 |
EMDR: 4.1 (3.5) TF-CBT: 4.3 (3.7) |
EMDR: 3.1 (3.7) TF-CBT: 3.1 (2.7) |
- |
Pre to post: Change: 1.2 Change: 1 Effect size between groups 0.24 (−3.0, 3.5) |
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| de Roos et al. (2017) [27] | 103 13.6 years 57% female |
Parenting and children were involved in EMDR treatment sessions in the form of group discussions. Every week, parents share their observations about their child’s functioning 5 min before and after each session. 1/week for six weeks (45 min per session). Psychoeducation, promoting healthy coping strategies, cognitive restructuring, and writing narrative about a traumatic memory were included during CBWT sessions. 1/week for six weeks (45 min per session). After randomization, participants received recurrent appointments for six weeks, were advised they would be randomly assigned to EMDR or CBWT (if necessary), and the treatment began one week after allocation. In case of a crisis or much worsening of symptoms, WL participants were provided with a contact telephone number. |
c-PTCI Child (PTSD) Cronbach’s alpha (0.78) |
EMDR: 45.25 (13.12) CBWT: 48.44 (14.86) WL: 48.43 (15.69) |
EMDR: 34.79 (12.34) CBWT: 36.56 (12.64) WL: 43.46 (14.09) |
At 3 months: EMDR: 35.58 (14.07) CBWT: 37.36 (15.34) WL: No measure at follow-up. |
Pre to post: Change: 10.46 Change: 11.88 Change: 4.97 Pre to 3 months: Change: 9.67 Change: 11.08 LMM: EMDR vs. WL (p = 0.03), CBWT vs. WL (p = 0.005), and EMDR vs. CBWT (p = 0.43). |
| RCADS (Anxiety) Cronbach’s alphas ranged from 0.75 to 0.95 |
EMDR: 33.93 (19.88) CBWT: 43.89 (20.49) WL: 36.49 (20.83) |
EMDR: 17.90 (19.18) CBWT: 24.63 (20.02) WL: 29.50 (18.09) |
At 3 months: EMDR: 16.53 (17.55) CBWT: 22.88 (21.52) WL: No measure at follow-up. |
Pre to post: Change: 16.03 Change: 19.26 Change: 6.99 Pre to 3 months: Change: 17.4 Change: 21.01 LMM: EMDR vs. WL (p = 0.01), CBWT vs. WL (p < 0.001), and EMDR vs. CBWT (p = 0.20). |
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| Five RCTs compare EMDR and CBT in Adults | |||||||
| Nijdam et al. (2012) [28] | 140 38.3 years 56.4% female |
BEP using psychoeducation, with an aim to relive the whole traumatic event in detailed imaginal exposure, writing assignments and cognitive restructuring were applied to participants. 1/week for 16 weeks (45–60 min per session). EMDR therapy: the distressing emotion was the target for examination and looking at that emotion in which part of the body, 1/week for 12 weeks (90 min per session). |
HADS (Depression) Internal consistency reliability was assessed at 0.92 |
EMDR:10.93 (4.14) BEP:12.07 (4.05) |
EMDR: 4.65 (4.39) BEP: 8.68 (5.57) |
Second post: EMDR: 5.67 (4.54) BEP: 7.38 (6.42) |
Pre to First post: change: 6.28 change: 3.39 Between groups p < 0.001 Pre to Second post: change: 5.26 change: 4.69 Between groups p = 0.13 Effect sizes from baseline to second post-assessment (Cohen’s d = 0.87 for brief eclectic psychotherapy and Cohen’s d = 1.21 for EMDR) |
| van den Berg et al. (2015) [31] | 155 42.6 years 54% female |
The PE therapy used imaginal exposure and vivo exposure based on a list of avoided trauma-related stimuli for participants. 8 weekly 90-min sessions within a 10-week timeframe. The EMDR therapy used the dual-attention stimulus for treating traumatic memories with participants. 1/week for 8 weeks (90 min) within a 10-week timeframe. The participants in the WL condition were seen once by a study therapist and informed about the PTSD diagnosis and further study course. After the 6-month follow-up period, appointments were made to begin their treatment of choice. |
CAPS total score (PTSD) Consistency was measured at 0.81 |
EMDR: 72.1 (17.6) PE: 69.6 (14.9) WL: 68.1 (15.9) |
EMDR: 40.3 (33.6–47.1) PE: 37.8 (31.2–44.3) WL: 56.5 (49.5–63.6) |
At 6 months: EMDR: 38.8 PE: 36.7 WL: 51.9 |
Pre to post: change: 31.8 change: 31.8 change: 11.6 Effect size between groups 0.65–0.78 Pre to 6 months: change: 33.3 change: 32.9 change: 16.2 Effect size between groups 0.53–0.63 |
| De Bont et al. (2016) [25] | 155 42.6 years 54% female |
The PE therapy used imaginal exposure and in vivo exposure based on a list of avoided trauma-related stimuli for participants. 1/week for 8 weeks (90 min). The EMDR therapy used the dual-attention stimulus for treating traumatic memories with participants. 1/week for 8 weeks (90 min). During the study, the therapist explained to participants once about the symptoms of PTSD and the further study course in the condition of WL. They then made appointments for their chosen treatment after the 6-month follow-up period |
BDI-II (Depression) Reliability coefficient was 0.92 |
EMDR: 28.2 (55) PE: 30.9 (53) WL: 29.7 (47) |
EMDR: 22.2 (44) PE: 18.3 (47) WL: 26.7 (39) |
At 6 months: EMDR: 22.9 (43) PE: 17.8 (45) WL: 24.5 (39) |
Pre to post: change: 6 change: 12.6 change: 3 Effect size between groups 0.42–0.78. Pre to 6 months: change: 5.3 change: 13.1 change: 5.2 Effect size between groups 0.15–0.64 |
| Nijdam et al. (2018) [29] | 116 39.5 years 52% female |
BEP therapy: Imaginal exposure, cognitive restructuring and meaning making, and psychoeducation. 1/week for 16 weeks (45–60 min). EMDR therapy sessions for the remaining painful images, and the therapy is completed when the trauma memory has returned to normal status. 1/week for 16 weeks (90 min) |
PTGI total (PTSD) Internal consistency reliability at 0.87 |
EMDR: 42.12 (17.93) BEP: 36.86 (19.62) |
- | Second post: EMDR: 54.93 (23.77) BEP: 53.73 (22.14) |
Pre to second post: change: −12.81 change: −16.87 Effect size between groups 0.05–0.65 |
| Stanbury & Drummond (2020) [30] | 20 45.5 years 70% female |
The therapist led the participant’s eyes to follow the therapist’s fingers as they directed their attention to the memory, their negative belief, and the current body sensations during desensitization. 2/week for 6 weeks (15–90 min). Several sessions of PE therapy focused on the participant’s reactions to revisiting the trauma, integrating their thoughts, feelings, and meaning in life. 2/week for 6 weeks (90 min). |
CAPS overall (PTSD) Coefficients between 0.90 and 0.97 |
EMDR: 86.71 (22.85) PE: 77.88 (13.07) |
EMDR: 22.57 (21.68) PE: 17.13 (16.23) |
At 3 months: EMDR: 21.43 (21.17) PE: 18.38 (13.26) |
Pre to post: change: 64.14 change: 60.75 Between groups p = 0.09 Pre to 3 months: Change: 65.28 Change: 59.5 |
Abbreviations: EMDR: eye movement desensitization and reprocessing; CBT: cognitive behavior therapy; CROPS: Child Report of Post-Traumatic Symptoms; MASC: Multidimensional Anxiety Scale for Children; TF-CBT: trauma focused-cognitive behavior therapy; CAPS-CA: Clinician-Administered PTSD Scale for Children and Adolescents; RCADS: Revised Child Anxiety and Depression Scale; CBWT: cognitive behavior writing therapy; WL: wait list; c-PTCI: Children’s Post-Traumatic Cognitions Inventory; PE: prolonged exposure; CAPS: Clinician-Administered PTSD Scale; BEP: brief eclectic psychotherapy; PTGI: Post-Traumatic Growth Inventory; HADS: Hospital Anxiety and Depression Scale; BDI-II: Beck Depression Inventory; LMM: linear mixed model.