Tiptoes Child Therapy Services

EMDR Children

EMDR Considerations

As with all the child therapies offered, it is a requirement that the child is protected and safe. Whilst we recognise there are times that this cannot be guaranteed, there must be reasonable certainty that this is the case. If the child is living in a fragile situation, but the family support can be scaffolded then EMDR can be provided.

There are legal considerations that need to be considered for EMDR. If a child is required to undertake an ABE interview, or is to be a witness, EMDR can be contra-indicatory as the traumatic memories will reduce and fade, thus potentially impeding the child's ability to recall information. It is suggested EMDR is left until after the legal proceedings.

There are also some medical conditions that need to be considered such as some heart conditions and epilepsy. However, epilepsy can also be misdiagnosed and stem instead from dissociation as a result of trauma.

The EMDR sessions can be undertaken either with or without the parent/carer present. The determinants for the decision are dependant on the type of trauma the child experienced, their temperament, developmental and chronological age.

EMDR Phases

The process, like the adult therapy has eight phases of treatment. These include;

1) Child chronology/ History: This is a historical timeline that includes the child's developmental history, child's trauma history, familial trauma history as well as transition/ change, care history and losses.

2) Preparation: Screening for contra-indicators, preparing the parent/ carer, gaining consent, preparing the child, developing rapport and building a therapeutic alliance.

3) Assessment: This refers to assessing the impact of the trauma on the child, from the child's perspective.

4) Desensitisation: The process of reducing the impact of the trauma

5) Installation: This refers to the replacement of a negative self-belief about the troublesome memory with a positive self-belief.

6) Body scan: This phase refers to the therapists observations of the child's body tone in assessing whether the memory has dissipated or is still being held.

7) Closure: This phase refers to the closure of each individual session. This enables the child to leave the therapy session feeling safe and contained.

8) Re-evaluation: Ongoing evaluation of changes experienced by the child, their parent/ carer or school.

How Many Sessions Are Needed?

All children are different as are their circumstances, but as a rough guide the following may be helpful;

A single trauma may need 1-3 sessions
Repeated traumas may require 4-8 sessions
Multiple or complex traumas may require 16+
Attachment Issues may require months
Complex, multiple traumas with attachment and dissociative issues could be months to years.