Adaptaciones de la Terapia EMDR en Niños y Adolescentes con TEPT: Evidencia Clínica y Perspectivas de Investigación
DOI:
https://doi.org/10.5944/rdp.v36i132.46046Palabras clave:
EMDR, TEPT, niños, adolescentes, TEPT pediátrico, terapia centrada en el trauma, adaptado al desarrolloResumen
El EMDR se ha consolidado como una intervención eficaz para el tratamiento del TEPT en adultos. Su aplicación en población infanto-juvenil requiere adaptaciones específicas. Esta revisión narrativa sintetiza la evidencia sobre la implementación de la terapia EMDR en menores expuestos a experiencias traumáticas, tanto si tienen diagnósticos de TEPT como sintomatología postraumática subumbral. Se analizaron diez estudios independientes, que abarcan desde ensayos clínicos controlados hasta series de casos, con muestras que incluyen menores afectados por violencia, abuso sexual, desastres naturales, accidentes y experiencias de migración forzada. La mayoría de los estudios aplican adaptaciones basadas en manuales previamente publicados. Sin embargo, existe una considerable heterogeneidad en su implementación, y la descripción de las modificaciones es limitada. La implicación de los cuidadores varía significativamente, desde una presencia meramente formal hasta un rol activo de apoyo emocional durante las sesiones. En términos de eficacia, la escasa evidencia disponible indica que el EMDR supera generalmente a grupos en lista de espera y es comparable a intervenciones cognitivo-conductuales centradas en el trauma, con reducciones consistentes en la gravedad de los síntomas de TEPT. La revisión subraya la necesidad de documentar con detalle las adaptaciones y el rol de los cuidadores, aspectos clave para la replicación, estandarización y optimización de la práctica clínica en población infantojuvenil.
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Adler-Tapia, R., & Settle, C. (2008). EMDR and the art of psychotherapy with children: guidebook and treatment manual. Springer Publishing Company.
Ahmad, A., & Sundelin-Wahlsten, V. (2008). Applying EMDR on children with PTSD. European Child & Adolescent Psychiatry, 17(3), 127-132. https://doi.org/10.1007/s00787-007-0646-8
Ahmad, A., Sundelin-Wahlsten, V., Sofi, M. A., Qahar, J. A., & Von Knorring, A. L. (2000). Reliability and validity of a child-specific cross-cultural instrument for assessing posttraumatic stress disorder. European child & adolescent psychiatry, 9(4), 285-294. https://doi.org/10.1007/s007870070032
Ahmad, A., Larsson, B., & Sundelin-Wahlsten, V. (2007). EMDR treatment for children with PTSD: Results of a randomized controlled trial. Nordic journal of psychiatry, 61(5), 349-354. https://doi.org/10.1080/08039480701643464
Al-Attar, Z., & Worthington, R. (2024). Trauma or autism? Understanding how the effects of trauma and disrupted attachment can be mistaken for autism. Advances in Autism, 10(3), 120-134. https://doi.org/10.1108/AIA-07-2023-0041
Alisic, E., & Kleber, R. J. (2010). Measuring posttraumatic stress reactions in children: A preliminary validation of the children’s responses to trauma inventory. Journal of Child & Adolescent Trauma, 3(3), 192–204. https://doi.org/10.1080/19361521.2010.500979
Baethge, C., Goldbeck-Wood, S., & Mertens, S. (2019). SANRA—a scale for the quality assessment of narrative review articles. Research integrity and peer review, 4(1), 5. https://doi.org/10.1186/s41073-019-0064-8
Beer R, de Roos C (2008) EMDR bij kinderen en adolescenten, een nieuw perspectief. In: Ten Broeke E, de Jongh A, Oppenheim H-J (eds) Praktijkboek EMDR. Harcourt, Amsterdam.
Bellis, M. A., Hughes, K., Ford, K., Rodriguez, G. R., Sethi, D., & Passmore, J. (2019). Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. The Lancet Public Health, 4(10), e517-e528. http://dx.doi.org/10.1016/S2468-2667(19)30145-8
Callaghan, B. L., Gee, D. G., Gabard-Durnam, L., Telzer, E. H., Humphreys, K. L., Goff, B., ... & Tottenham, N. (2019). Decreased amygdala reactivity to parent cues protects against anxiety following early adversity: An examination across 3 years. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 4(7), 664-671. https://doi.org/10.1016/j.bpsc.2019.02.001
Chemtob, C. M., Nakashima, J., & Carlson, J. G. (2002). Brief treatment for elementary school children with disaster‐related posttraumatic stress disorder: A field study. Journal of clinical psychology, 58(1), 99-112. https://doi.org/10.1002/jclp.1131
Christoffersen, M. N., & Thorup, A. A. (2024). Post-traumatic stress disorder in school-age children: a nationwide prospective birth cohort study. Journal of child & adolescent trauma, 17(2), 139-157. https://doi.org/10.1007/s40653-024-00611-y
Cortés Viniegra, C. (2023). Esculpiendo palabras en la arena. Desclée de Brouwer.
de Roos C, Beer R, De Jongh A & Ten Broeke. Protocol EMDR. 2019. Available from: www.emdr.nl.
de Roos, C., Beer, R., de Jongh, A., & Ten Broeke, E. (2013). EMDR protocol voor kinderen en jongeren tot18 jaar. Vereniging EMDR Nederland.
de Roos, C., van der Oord, S., Zijlstra, B., Lucassen, S., Perrin, S., Emmelkamp, P., & De Jongh, A. D. (2017). Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait‐list in pediatric posttraumatic stress disorder following single‐incident trauma: A multicenter randomized clinical trial. Journal of Child Psychology and Psychiatry, 58(11), 1219-1228. https://doi.org/10.1111/jcpp.12768
de Roos, C., Zijlstra, B., Perrin, S., van der Oord, S., Lucassen, S., Emmelkamp, P., & de Jongh, A. (2021). Predictors and moderators of treatment outcome for single incident paediatric PTSD: a multi-centre randomized clinical trial. European Journal of Psychotraumatology, 12(1), 1968138. https://doi.org/10.1080/20008198.2021.1968138
Diehle, J., Opmeer, B. C., Boer, F., Mannarino, A. P., & Lindauer, R. J. (2015). Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: What works in children with posttraumatic stress symptoms? A randomized controlled trial. European child & adolescent psychiatry, 24(2), 227-236. https://doi.org/10.1007/s00787-014-0572-5
Greenwald R. EMDR within a phase model of trauma-informed treatment. New York: Routledge; 2007.
Greenwald, R., & Rubin, A. (1999). Assessment of posttraumatic symptoms in children: Development and preliminary validation of parent and child scales. Research on Social Work Practice, 9(1), 61-75. https://doi.org/10.1177/104973159900900105
Gomez, A. M. (2012). Healing the caregiving system: Working with parents within a comprehensive EMDR treatment. Journal of EMDR Practice and Research, 6(3), 136-144. https://doi.org/10.1891/1933-3196.6.3.136
Hase, M., Balmaceda, U. M., Ostacoli, L., Liebermann, P., & Hofmann, A. (2017). The AIP model of EMDR therapy and pathogenic memories. Frontiers in psychology, 8, 1578. https://doi.org/ 10.3389/fpsyg.2017.01578
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Biopsychosocial Science and Medicine, 41(3), 209-218.
Jaberghaderi, N., Rezaei, M., Kolivand, M., & Shokoohi, A. (2019). Effectiveness of cognitive behavioral therapy and eye movement desensitization and reprocessing in child victims of domestic violence. Iranian journal of psychiatry, 14(1), 67.
Kemp, M., Drummond, P., & McDermott, B. (2010). A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents. Clinical child psychology and psychiatry, 15(1), 5-25. https://doi.org/10.1177/1359104509339086
Knipschild, R., Klip, H., van Leeuwaarden, D., van Onna, M. J., Lindauer, R. J., Staal, W. G., ... & de Jongh, A. (2023). Treatment of multiple traumatized adolescents by enhancing regulation skills and reducing trauma related symptoms: rationale, study design, and methods of randomized controlled trial (the Mars-study). BMC psychiatry, 23(1), 644. https://doi.org/10.1186/s12888-023-05073-4
Lovett, J. (1999). Small wonders: Healing childhood trauma with EMDR. The Free Press.
Lovett, J. (2015). Trauma-attachment tangle: Modifying EMDR to help children resolve trauma and develop loving relationships. Routledge.
Madigan, S., Deneault, A. A., Racine, N., Park, J., Thiemann, R., Zhu, J., ... & Neville, R. D. (2023). Adverse childhood experiences: a meta‐analysis of prevalence and moderators among half a million adults in 206 studies. World psychiatry, 22(3), 463-471. https://doi.org/10.1177/0706743718792194
McDonald, A.C., Ejesi, K. (2020). When Trauma Mimics ADHD. In: Schonwald, A. (eds) ADHD in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-62393-7_13
Meentken, M. G., van Beynum, I. M., Aendekerk, E. W., Legerstee, J. S., El Marroun, H., van der Ende, J., ... & Utens, E. M. (2018). Eye movement desensitization and reprocessing (EMDR) in children and adolescents with subthreshold PTSD after medically related trauma: design of a randomized controlled trial. European Journal of Psychotraumatology, 9(1), 1536287. https://doi.org/10.1080/20008198.2018.1536287
Meentken, M. G., Van Der Mheen, M., Van Beynum, I. M., Aendekerk, E. W., Legerstee, J. S., Van Der Ende, J., ... & Utens, E. M. (2021). Long-term effectiveness of eye movement desensitization and reprocessing in children and adolescents with medically related subthreshold post-traumatic stress disorder: a randomized controlled trial. European Journal of Cardiovascular Nursing, 20(4), 348-357. https://doi.org/10.1093/eurjcn/zvaa006
Meentken, M. G., van der Mheen, M., van Beynum, I. M., Aendekerk, E. W., Legerstee, J. S., van der Ende, J., ... & Utens, E. M. (2020). EMDR for children with medically related subthreshold PTSD: short-term effects on PTSD, blood-injection-injury phobia, depression and sleep. European Journal of Psychotraumatology, 11(1), 1705598.
https://doi.org/10.1080/20008198.2019.1705598
Moreno-Alcázar, A., Treen, D., Valiente-Gómez, A., Sio-Eroles, A., Pérez, V., Amann, B. L., & Radua, J. (2017). Efficacy of eye movement desensitization and reprocessing in children and adolescent with post-traumatic stress disorder: A meta-analysis of randomized controlled trials. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.01750
Morris-Smith, J., & Silvestre, M. (2013). EMDR for the Next Generation: Healing Children and Families. Academic Publishing International Limited.
Morris-Smith, J., & Silvestre, M. (2015). L'EMDR avec l'enfant et sa famille: contextualisation et travail intégratif. Dunod.
Nader, K., Kriegler, K. A., Blake, D. D., Pynoos, R. S., Newman, E., & Weathers, F. W. (1996). Clinician-administered PTSD scale for children and adolescents.
Nader, K., & Pynoos, R.S (1993). The children of Kuwait after the Gulf crisis. In L.A. Leavitt, & N.A. Fox (Eds.) The psychological effects of war and violence on children. Hillsdale, NJ: Lawrence Erlbaum Associates
National Institute for Health and Care Excellence. (2018). Post-traumatic stress disorder (NICE Guideline No. 116). https://www.nice.org.uk/guidance/ng116
Odachowska-Rogalska, E. (2023). Differentiation of the clinical diagnoses of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). https://doi.org/10.15557/PiPK.2023.0037
Potharst, E. S., Holtkamp, P., Walliser, L., Dommerholt, A. H., van den Heuvel, M. E., Spierts, I., & Maric, M. (2025). Improving Infant Mental Health: A Pilot Study on the Effectiveness, Acceptability and Feasibility of Eye Movement Desensitization and Reprocessing (EMDR) Storytelling in Infants With Post-traumatic Distress After Medical Procedures. Evaluation & the Health Professions, 48(1), 55-70. https://doi.org/10.1177/01632787241268176
Pynoos, R.S., Goenjian, A.K., & Steinberg, A.M. (1998). A public mental health approach to the postdisaster treatment of children and adolescents. Child & Adolescent Psychiatric Clinics of North America, 7, 195–210. https://doi.org/10.1016/S1056-4993(18)30268-2
Rolling, J., Fath, M., Zanfonato, T., Durpoix, A., Mengin, A. C., & Schröder, C. M. (2024, October). EMDR–Teens–cPTSD: Efficacy of eye movement desensitization and reprocessing in adolescents with complex PTSD secondary to childhood abuse: A case series. In Healthcare (Vol. 12, No. 19, p. 1993). MDPI. https://doi.org/10.3390/healthcare12191993
Schäfer, I., Gast, U., Hofmann, A., Knaevelsrud, C., Lampe, A., Liebermann, P., ... & Wöller, W. (2019). S3-leitlinie posttraumatische belastungsstörung. Berlin: Springer.
Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. Guilford Press.
Shapiro F. (2001) Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. (2nd ed). Guilford Press.
Shapiro, F., Kaslow, F. W., & Maxfield, L. (Eds.). (2007). Handbook of EMDR and family therapy processes. John Wiley & Sons.
Simpson, E., Carroll, C., Sutton, A., Forsyth, J., Rayner, A., Ren, S., ... & Wood, E. (2025). Clinical and cost‐effectiveness of eye movement desensitization and reprocessing for treatment and prevention of post‐traumatic stress disorder in adults: A systematic review and meta‐analysis. British Journal of Psychology. https://doi.org/10.1111/bjop.70005
Steinberg, A. M., Brymer, M. J., Kim, S., Briggs, E. C., Ippen, C. G., Ostrowski, S. A., ... & Pynoos, R. S. (2013). Psychometric properties of the UCLA PTSD reaction index: Part I. Journal of traumatic stress, 26(1), 1-9. https://doi.org/10.1002/jts.21780
Struik, A. (2024). EMDR With Children. an Overview of Research and Clinical Practice. Journal of the New Zealand College of Clinical Psychologists, 34(1), 49–58.
https://doi.org/10.5281/zenodo.10939142
Szota, K., Schulte, K. L., & Christiansen, H. (2023). Interventions involving caregivers for children and adolescents following traumatic events: a systematic review and meta-analysis. Clinical Child and Family Psychology Review, 26(1), 17-32. https://doi.org/10.1007/s10567-022-00415-2
Tinker, R. H., & Wilson, S. A. (1999). Through the Eyes of a Child: EMDR with Children. WW Norton & Co.
Velu, M. E., Martens, I., Shahab, M., de Roos, C., Jongedijk, R. A., Schok, M., & Mooren, T. (2022). Trauma-focused treatments for refugee children: study protocol for a randomized controlled trial of the effectiveness of KIDNET versus EMDR therapy versus a waitlist control group (KIEM). Trials, 23(1), 347. https://doi.org/10.1186/s13063-022-06178-z
Viniegra, C. C., & Aumeunier-Gizard, M. F. (2021). Facilitating integrated mental, emotional, and physical states in children who have suffered early abandonment trauma. European Journal of Trauma & Dissociation, 5(4), 100214. https://doi.org/10.1016/j.ejtd.2021.100214
Wolpe, J. (1982). The practice of behavior therapy. Pergamon Press.
World Health Organization. (2013). Guidelines for the management of conditions specifically related to stress. Geneva: World Health Organization.
https://www.who.int/publications/i/item/9789241505406
Yule, W. (1994). Posttraumatic stress disorder. In T.H. Ollendick, N.J. King, & W. Yule (Eds.), International Handbook of Phobic and Anxiety Disorders in Children and Adolescents. New York: Plenum Press.
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