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Brief treatment for elementary school children with disaster‐related posttraumatic stress disorder: A field study
Abstract
Effective psychological intervention is needed to help children recover from disaster‐related posttraumatic stress disorder (PTSD). This controlled study evaluated the effectiveness of a brief intervention for disaster‐related PTSD. At one‐year follow‐up of a prior intervention for disaster‐related symptoms, some previously treated children were still suffering significant trauma symptoms. Using a randomized lagged‐groups design, we provided three sessions of Eye Movement Desensitization and Reprocessing (EMDR) treatment to 32 of these children who met clinical criteria for PTSD. The Children's Reaction Inventory (CRI) was the primary measure of the treatment's effect on PTSD symptoms. Associated symptoms were measured using the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). Treatment resulted in substantial reductions in both groups' CRI scores and in significant, though more modest, reduc‐ tions in RCMAS and CDI scores. Gains were maintained at six‐month follow‐up. Health visits to the school nurse were significantly reduced following treatment. Psychosocial intervention appears useful for children suffering disaster‐related PTSD. Conducting controlled studies of children's treatment in the postdisaster environment appears feasible. © 2002 John Wiley & Sons, Inc. J Clin Psychol 58: 99–112, 2002.
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“…CBT (Otto et al. 2003) Latino CBT for trauma in schools (Stein et al. 2003) Multiracial Hawaiian Eye movement desensitization and reprocessing (Chemtob et al. 2002) Mixed/comorbid problems African American Seeking safety (Boden et al. 2011) Asian American CBT (Hinton et al. 2009) Latino…”
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Self-citationCary, C. E., & McMillen, J. C. (2012) · Children and Youth Services Review · doi:10.1016/j.childyouth.2012.01.003 · Cited by 231
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“Thirteen studies [6,9,14,15,16,25,26,30,32,34,35,41,42] involved the use of blinded outcome assessors, whereas 13 studies [5,7,8,10,12,13,27,28,31,37, 38,39,40] did not report blinding.”
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“The results of the Brown, McQuaid, Farina, Ali, and WinnickGelles (2006) and Chemtob, Nakashima, and Carlson (2002) may be less reliable because despite small samples, parametric tests were used.”
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“[26] Chemtob CM, Nakashima J, Carlson CG.”
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“’’ These results do not agree with results from previous EMDR studies, which reported significant improvement on measures of anxiety and depression [17, 35].”
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“[94] 6 65 — No None — Exposure for water phobia [32] 13 0 100% Caucasian No All — In vivo exposure for spider phobia [109] — — — Yes All — Exposure for specific phobia [31] 10 — — No All — Exposure for specific phobia [110] 12 39 — No All — Exposure for specific phobia [30] 5 50 — No None — Graduated exposure for fear…”
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“Options include group psychotherapy for the most affected children (Chemtob et al., 2002; Goenjian et al., 1997; Saltzman et al., 2003), classroom teacher-delivered activation (Berger et al., 2007; Wolmer et al., 2003), and/or school revitalization engaging the whole community (Laor et al., 2003).”
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Lewis-Schroeder, N. F., Kieran, K., Murphy, B. L., Wolff, J. D., Robinson, M. A., & Kaufman, M. L. (2018) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000176 · Cited by 154
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“Since refugee children experienced many different kinds of traumatic events and developed psychological problems, it is necessary to develop effective intervention programmes for their healthy development (Chemtob et al., 2002; Pfefferbaum, 1997).”
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“The effectiveness of cognitive behavioral strategies in treating PTSD has been demonstrated by Chembtob, Nakashima, and Hamada ( 2002 ) as well as other researchers (see Feeny et al, 2004 , for review).”
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Smith, P. A., Dalgleish, T., & Meiser‐Stedman, R. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12983 · Cited by 118
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“EMDR has been reported as effective in the treatment of children following a hurricane in Hawaii ( Chemtob, Nakashima, Hamada, & Carlson, 2002 ), with victims of the 9/11 terrorist attacks in New York City (Silver, Rogers, Knipe, & Colelli, 2005), and with victims of earthquakes in Turkey (E. Konuk, personal communica…”
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Psychological Assessment of Children in Disasters and Emergencies
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“Furthermore, there is a growing recognition that schools can play a central role in identifying traumatised children and in providing secondary prevention and mental health treatment following traumatic events ( Chemtob, Nakashima, & Carlson, 2002; Chemtob, Nakashima, & Hamada, 2002; Klingman, 1993; Layne, Pynoos, Sal…”
BackgroundMethodInfluentialComparing the Effectiveness of EMDR and TF-CBT for Children and Adolescents: a Meta-Analysis
Lewey, J. H., Smith, C. L., Burcham, B., Saunders, N. L., Elfallal, D., & O’Toole, S. K. (2018) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-018-0212-1 · Cited by 114
“Current literature demonstrates the effectiveness of these treatments for children and adolescents (Chemtob et al. 2002; Cohen et al. 2004a; Puffer et al. 1998).”
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Eye Movement Desensitization and Reprocessing Therapy (EMDR)
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“The former was comparable with the effect size of 1.55 obtained by Chemtob et al. (2002) and although non-trauma measures (self-reported anxiety and depression, and parent ratings of behaviour and depressive symptoms) did not show significant improvement, the significant improvement in PTSD…”
BackgroundResultInfluentialKramer, D. N., & Landolt, M. A. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.7858 · Cited by 89
Treating acute posttraumatic reactions in children and adolescents
Cohen, J. A. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01868-1 · Cited by 86
Zaghrout-Hodali, M., Al-Issa, F. A. R., & Dodgson, P. G. (2008) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.2.2.106 · Cited by 86
“In a randomized controlled trial of children with a diagnosis of PTSD at a 1-year followup of a previous counseling intervention, Chemtob et al. (2002) found that, after EMDR, children showed a substantial decrease on the Child Reaction Index (Pynoos, Frederick, & Nader, 1987), a semistructured…”
EMDR therapy: An overview of its development and mechanisms of action
Oren, E., & Solomon, R. M. (2012) · European Review of Applied Psychology · doi:10.1016/j.erap.2012.08.005 · Cited by 83
The EMDR Integrative Group Treatment Protocol: Application With Child Victims of a Mass Disaster
Jarero, I., Artigas, L., Lena, M. M.-L., & Lena, L. (2008) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.2.2.97 · Cited by 80
de Jongh, A., Amann, B. L., Hofmann, A., Farrell, D. P., & Lee, C. W. (2019) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.13.4.261 · Cited by 79
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Pfefferbaum, B. J., Newman, E., & Nelson, S. D. (2014) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2013.0061 · Cited by 79
“Several studies have examined this approach as the primary treatment (e.g., Chemtob et al. 2002; Tufnell 2005; Fernandez 2007; Kemp et al. 2009) or as a component of another treatment (e.g., Ehntholt et al. 2005; Shooshtary et al. 2008).”
Silver, S. M., Rogers, S., Knipe, J., & Colelli, G. (2005) · International Journal of Stress Management · doi:10.1037/1072-5245.12.1.29 · Cited by 77
“A randomized study of the use of EMDR provided 1 to 3 years after Hurricane Iniki showed again clinically significant and lasting symptom reductions after three EMDR sessions among children who had not benefited from a previous school-based intervention ( Chemtob, Nakashima, & Carlson, 2002 ).”
MethodStrategies for Delivering Mental Health Services in Response to Global Climate Change
Palinkas, L., O’Donnell, M., Lau, W., & Wong, M. (2020) · doi:10.20944/preprints202010.0150.v1 · Cited by 77
“For example, Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) [64,65], Cognitive Processing Therapy (CPT) [66,67], Narrative Exposure Therapy [68,69], Cognitive Behavioral Therapy—Post Disaster (CBT-PD) [70], and Eye Movement Desensitization and Reprocessing (EMDR [71] have been found to be effective in the treatm…”
BackgroundAcceptance and Commitment Therapy for the Treatment of Posttraumatic Stress Among Adolescents
Woidneck, M. R., Morrison, K. L., & Twohig, M. P. (2014) · Behavior Modification · doi:10.1177/0145445513510527 · Cited by 73
Three- and 6-Month Follow-Up of EMDR Treatment of PTSD in an HMO Setting.
Marcus, S. V., Marquis, P., & Sakai, C. (2004) · International Journal of Stress Management · doi:10.1037/1072-5245.11.3.195 · Cited by 68
“Substantial research by numerous independent investigators has supported the position that EMDR effects are sustained over time in tightly controlled research studies (e.g., Chemtob, Nakashima, Hamada, & Carlson, 2002; Lee et al., 2002; Power et al., 2002; Rothbaum, 1997; Scheck, Schaeffer, & Gillette, 1998; Wilson, B…”
ResultChildren and Natural Disasters
Evans, L. G., & Oehler-Stinnett, J. J. (2006) · School Psychology International · doi:10.1177/0143034306062814 · Cited by 66
“While there are calls for more controlled studies examining the particular components of the therapy that are effective, Chemtob et al. (2002) report a significant decrease in PTSD symptoms in children exposed to a hurricane using this technique.”
BackgroundTreating Traumatized Children: Current Status and Future Directions
Cohen, J. (2005) · Journal of Trauma & Dissociation · doi:10.1300/j229v06n02_10 · Cited by 46
Cue‐Centered Treatment for Youth Exposed to Interpersonal Violence: A Randomized Controlled Trial
Carrión, V. G., Kletter, H., Weems, C. F., Berry, R. R., & Rettger, J. P. (2013) · Journal of Traumatic Stress · doi:10.1002/jts.21870 · Cited by 64
Efficacy of Treatment for Child and Adolescent Traumatic Stress
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Self-citationKonuk, E., Knipe, J., Eke, İ., Yuksek, H., Yurtsever, A., & Ostep, S. (2006) · International Journal of Stress Management · doi:10.1037/1072-5245.13.3.291 · Cited by 63
“Four studies have examined the effectiveness of EMDR following disaster events (Fernandez et al., 2004; Grainger, Levin, Allen-Byrd, Doctor, & Lee, 1997; Chemtob et al., 2002; and Silver, Rogers, Knipe, & Colleli, 2005) and found significant reductions in posttraumatic symptoms.”
BackgroundHoagwood, K., Jensen, P. S., Acri, M. C., Olin, S.-C. S., Lewandowski, R. E., & Herman, R. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.09.004 · Cited by 65
Dawson, K. S., Joscelyne, A., Meijer, C., Steel, Z., Silove, D. M., & Bryant, R. A. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867417714333 · Cited by 61
“…of Psychiatry, 52(3) A number of evidence-based child-focused interventions for post-traumatic stress have been validated in the developed world (Chemtob et al., 2002; Cohen and Mannarino, 2008; Stein et al., 2003), with trauma-focused cognitive behavioral therapy (CBT) the treatment of choice…”
BackgroundCovell, N. H., Allen, G., Essock, S. M., Pease, E. A., Felton, C. J., Lanzara, C. B., & Donahue, S. A. (2006) · Psychiatric Services · doi:10.1176/ps.2006.57.9.1277 · Cited by 54
Nevo, G. A., & Manassis, K. (2005) · Depression and Anxiety · doi:10.1002/da.20123 · Cited by 53
“EMDR was developed in 1987 by a psychology graduate student named Francine Shapiro.”
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When the Levee Breaks: Treating Adolescents and Families in the Aftermath of Hurricane Katrina
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Interventions for post-traumatic stress disorder in children and adolescents
Carr, A. (2004) · Developmental Neurorehabilitation · doi:10.1080/13638490410001727464 · Cited by 50
“Participants in the other studies were earthquake survivors in Armenia and Italy [56, 57]; survivors of the sinking of the ship Jupiter in Greece [25]; hurricane survivors in the US [58] and survivors of single incident stressors in the US such as road traffic accidents, gunshot injury, fires, severe storms, severe il…”
BackgroundPackman, W. L., Fine, J., Chesterman, B., VanZutphen, K. H., Golan, R., & Amylon, M. D. (2004) · Children s Health Care · doi:10.1207/s15326888chc3303_3 · Cited by 50
EMDR as treatment of post-traumatic reactions: A field study on child victims of an earthquake
Fernández, I. (2007) · Educational and Child Psychology · doi:10.53841/bpsecp.2007.24.1.65 · Cited by 50
Diseth, T. H., & Christie, H. J. (2005) · Nordic Journal of Psychiatry · doi:10.1080/08039480500213683 · Cited by 60
Measurement of Posttraumatic Growth in Young People: A Review
Clay, R. A., Knibbs, J., & Joseph, S. (2009) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104509104049 · Cited by 49
The Current Status of EMDR Therapy, Specific Target Areas, and Goals for the Future
Matthijssen, S. J. M. A., Lee, C. W., de Roos, C., Barron, I. G., Jarero, I., Shapiro, E., Hurley, E. C., Schubert, S. J., Baptist, J., Amann, B. L., et al. (2020) · Journal of EMDR Practice and Research · doi:10.1891/emdr-d-20-00039 · Cited by 48
Grolnick, W. S., Schonfeld, D. J., Schreiber, M. D., Cohen, J. A., Cole, V. L., Jaycox, L. H., Lochman, J. E., Pfefferbaum, B. J., Ruggiero, K. J., Wells, K. B., et al. (2018) · American Psychologist · doi:10.1037/amp0000181 · Cited by 50
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Vickers, B. (2005) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104505051212 · Cited by 41
“Research on young people who had PTSD as a result of exposure to a disaster includes that by Chemtob, Nakashima, and Carlson (2002) examining adolescents with PTSD 2–3 years following exposure to a disaster, and that by Goenjian et al. (1997) in which CBT for PTSD began 1.5 years after exposure to…”
BackgroundInfluentialChina earthquake relief: Participatory action work with children
Zeng, E. J., & Silverstein, L. B. (2011) · School Psychology International · doi:10.1177/0143034311402921 · Cited by 41
Pfefferbaum, B. J., Nitiéma, P., & Newman, E. (2019) · Child & Youth Care Forum · doi:10.1007/s10566-019-09494-9 · Cited by 43
“2012) and in four trials regarding the blinding of outcome assessors (Chemtob et al. 2002; Day and Sadek 1982; Shen 2002; Tol et al. 2012) (see Fig.”
BackgroundKirlić, N., Cohen, Z. P., & Singh, M. K. (2020) · Adversity and Resilience Science · doi:10.1007/s42844-020-00001-x · Cited by 44
»Eye-Movement Desensitization and Reprocessing« (EMDR)
Schubbe, O. (2009) · Springer eBooks · doi:10.1007/978-3-540-88489-7_17 · Cited by 41
Adler‐Tapia, R., & Settle, C. (2009) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.3.4.232 · Cited by 40
“…et al., 2009; Oras et al., 2004), and traumatic stress from natural and manmade disasters including car accidents (Tufnell, 2005), Hurricane Iniki ( Chemtob et al., 2002), Hurricane Andrew (Greenwald, 1994), fi reworks explosion (de Roos et al., 2009), earthquake (Fernandez, 2007), and war (Oras…”
BackgroundMethodInfluentialCarrión, V. G., & Kletter, H. (2012) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2012.05.004 · Cited by 38
“A randomized, controlled trial of EMDR in youth exposed to a natural disaster resulted in a decrease in trauma related memories and their associated symptoms.(87) Other modalities that have been employed in single-trauma intervention include play therapy and mind–body skills.”
BackgroundChildren express: war and peace themes in the drawings of Iraqi refugee children in Jordan
Jabbar, S. K. A., & Betawi, I. A. (2018) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2018.1455058 · Cited by 37
Yohannan, J., & Carlson, J. S. (2018) · Psychology in the Schools · doi:10.1002/pits.22202 · Cited by 54
Self-citationFinzi‐Dottan, R., Dekel, R., Lavi, T., & Su'ali, T. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2005.05.001 · Cited by 37
“Exposure to traumatic events damages self-control and emotional regulation, marked by less organized thinking and a mix-up of cognition, affect, and sensation and a loss of perspective and feeling for the future [14].”
BackgroundPsychosocial and pharmacological interventions for child crime victims
Cohen, J. A., Berliner, L., & Mannarino, A. P. (2003) · Journal of Traumatic Stress · doi:10.1023/a:1022851324044 · Cited by 37
“Eye movement desensitization and reprocessing(EMDR) has been used in a study of children traumatized by a natural disaster ( Chemtob, Nakashima, & Carlson, 2002 ), although it has not to date been used in any studies of child crime victims.”
BackgroundMethodInfluentialTrentini, C., Lauriola, M., Giuliani, A., Maslovaric, G., Tambelli, R., Fernández, I., & Pagani, M. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00862 · Cited by 38
“Furthermore, in the field of mass disaster contexts, several studies have examined the role of EMDR in alleviating trauma-related symptoms following natural disasters (Grainger et al., 1997; Chemtob et al., 2002; de Roos et al., 2011; Tang et al., 2015).”
BackgroundResultInfluentialEffectiveness of MASTR EMDR Therapy for Traumatized Adolescents
Farkas, L., Cyr, M., Lebeau, T. M., & Lemay, J. (2010) · Journal of Child & Adolescent Trauma · doi:10.1080/19361521003761325 · Cited by 36
Carrión, V. G., Wong, S. S., & Kletter, H. (2012) · Journal of Family Violence · doi:10.1007/s10896-012-9489-2 · Cited by 43
“The most widely known and researched psychotherapy for youth with PTSD symptoms is trauma focused cognitive-behavioral therapy (TF-CBT), which exposes children to their trauma narrative and helps identify trauma-related triggers in order to: (a) overcome avoidance of traumatic memories, (b) teach affect modulation and…”
BackgroundMotivation-Adaptive Skills-Trauma Resolution (MASTR) Therapy for Adolescents with Conduct Problems
Greenwald, R. (2002) · Journal of Aggression Maltreatment & Trauma · doi:10.1300/j146v06n01_12 · Cited by 36
Vostanis, P. (2009) · Cited by 34
Field, A., & Cottrell, D. J. (2011) · Journal of Family Therapy · doi:10.1111/j.1467-6427.2011.00548.x · Cited by 33
Child Disaster Mental Health Interventions: Therapy Components
Pfefferbaum, B. J., Sweeton, J. L., Nitiéma, P., Noffsinger, M. A., Varma, V., Nelson, S. D., & Newman, E. (2014) · Prehospital and Disaster Medicine · doi:10.1017/s1049023x14000910 · Cited by 33
EMDR With Children and Adolescents After Single-Incident Trauma An Intervention Study
Hensel, T. (2009) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.3.1.2 · Cited by 33
Tufnell, G. (2005) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104505056320 · Cited by 33
Disaster Response: EMDR and Family Systems Therapy under Communitywide Stress
Gelbach, R. A., & Davis, K. E. B. (2007) · doi:10.1002/9781118269985.ch19 · Cited by 32
Metadata
- Authors
- Chemtob, C. M., Nakashima, J., & Carlson, J. G.
- Affiliations
- United States Department of Veterans Affairs (US)
- University of Hawaiʻi at Mānoa (US)
- Corresponding author
- Chemtob, Claude M.
- ORCID
- Carlson, John G.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2001-12-12
- Volume
- 58
- Issue
- 1
- Pages
- 99-112
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2107989494
- Cited by
- 301
- References
- 27
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 13 · 2018: 15 · 2017: 9 · 2016: 11 · 2015: 27 · 2014: 17 · 2013: 18 · 2012: 18
- FWCI
- 13.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- children, EMDR, brief psychological intervention, school-based treatment, anxiety, depression, disaster mental health, maintenance therapy
- MeSH terms
- Affect, Anxiety, Child, Depression, Desensitization, Psychologic, Eye Movements, Follow-Up Studies, Humans, Interpersonal Relations, Surveys and Questionnaires, Self Concept, Stress Disorders, Post-Traumatic, Students, Cognitive Behavioral Therapy
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