By Samantha Gamboa, LPC Associate
Eye Movement Desensitization Reprocessing is an eight-step process that utilizes bilateral stimulation (BLS). BLS is the process of alternatively stimulating the left and right sides of the brain, to reduce the physical and emotional response to a traumatic event and allow the brain to process the memory so that healing can take place. EMDR with both adults and children is effective in the treatment of depression, anxiety, PTS, and behavioral issues associated with trauma. EMDR for those who have experienced trauma is often effective in less time than other treatment modalities. EMDR is effective for single-incident as well as multiple-incident or complex traumas. (Karadag et al., 2020). For more information about the basics of EMDR, see our blog on EMDR.
EMDR with children reduces the physiological effects of trauma and allows the child to develop positive self-awareness, compassion, and confidence. We work with the child to identify and develop internal strengths, healthy coping skills, and relational resources that they can use during the EMDR process. With practice, the child can access these skills and resources between sessions at home or utilize them in the future with other life issues such as difficulties in school, negative peer interactions, or other sources of distress (Adler-Tapia & Settle, Carolyn, MSW, LCSW, 2016).
When working with children, the techniques used in EMDR can look different from those used with adolescents and adults. In fact, it is strongly encouraged that EMDR clinicians seek additional, advanced training to facilitate EMDR with children. For example, BLS with adults is commonly facilitated through eye movement in which the counselor will guide eyesight with their hand or a light bar. For children, tactile or audible bilateral stimulation may be a better fit. While adolescents and adults can focus on a counselor’s hands or alternating flashing lights for visual bilateral stimulation, younger children may benefit from BLS with tools like hand buzzers, puppets, or tapping on shoulders (butterfly hug). We will also adapt our assessments, language, and distress ratings in order to meet the child at their developmental level.
EMDR with children is often used in conjunction with other treatment modalities, such as play therapy and sand tray therapy (Shapiro, 2018). When integrated with other treatment modalities, we will use creative strategies to create safety and utilize creative tools for communication—such as allowing the child to create an image through art or sandplay rather than describe an internal visualization. Children may not have the cognitive tools or language to describe their feelings and experiences. We may incorporate movement and storytelling through play rather than using a verbal check-in. EMDR does not require the child to discuss the event repeatedly. This can reduce the likelihood of re-traumatization and allow the child to maintain a sense of control and boundaries. A child can process the effects of a traumatic event without having to recount the details or rely on language.
What we want caregivers to know
We stage treatment intentionally to give your child a chance to develop resources that will help them tolerate difficult feelings both in session and outside session. Resources that have been identified, such as safe people and healthy coping activities, are taught and practiced during the initial phase of EMDR. These may include breathing exercises, container, grounding exercises, and a safe place. Resources help the child regulate emotions when they begin to feel overwhelmed by the memories or the therapeutic process.
Once resources are established, we will work with the child and the family to move into trauma processing in a way that honors your child’s boundaries and maintains safety and support. We will be open with you throughout the process so that it is not too overwhelming. Therapy can be challenging, and you deserve support.
We want your support and involvement. We believe caregivers are vital resources to the child during the EMDR process. Caregivers can provide the opportunity for healthy attachment repair by participating in co-regulation and emotional support as well as the creation of new experiences of support that a child can draw from (Shapiro, 2018). We also work with caregivers to develop strategies to implement at home, such as listening to music, eating a snack, getting a drink of water, talking to a friend or trusted adult, drawing, going for a walk, blowing bubbles, and dancing (Mark-Griffin, 2023). We will take time to teach the caregivers the resources the child is developing during therapy so they can practice outside of session. For caregivers, it is essential to know what resources their child can use in between sessions if they become triggered.
It is also important for everyone involved to be patient with the process. Ultimately it is the parents and caregivers that are the change makers. Consistency, practice, patience, and most of all your support for your child are key. Never underestimate the value of your presence. Your willingness to show up and your child’s willingness to implement what they are learning can make a huge difference. We are glad you are here.
We have several talented clinicians here at APCC who have specialized skills to facilitate EMDR with children. Please let us know if you have any additional questions or if you would like to request an appointment.
Contact one of our clinicians skilled in facilitating EMDR with children: Tiffany Carpenter, Allison Coon, Elizabeth Clark.
References
Adler-Tapia, R., & Settle, Carolyn, MSW, LCSW. (2016). Emdr and the art of psychotherapy with children: Infants to adolescents treatment manual (2nd ed.). Springer Publishing Company.
Karadag, M., Gokcen, C., & Sarp, A. S. (2020). EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six week follow-up study. International Journal of Psychiatry in Clinical Practice, 24(1), 77–82.
Mark-Griffin, C. (2023). Emdr workbook for kids: A collection of emdr handouts & worksheets to help kids process trauma, stress, anger, sadness & more (1st ed.). PESI Publishing, Inc.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (emdr) therapy (3rd ed.). The Guilford Press.
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