Investigating the perceived effectiveness of Eye Movement Desensitisation Reprocessing (EMDR) treatment in adult survivors of childhood sexual abuse and the impact on neuropsychological, emotional and behavioural functioning and quality of life : a case series analysis

• Main Author: Bibi, H
• Format: Dissertation
• Language: English
• Published: University of Salford 2021

Childhood sexual abuse (CSA) is an ongoing issue (WHO, 2017) with 1 in 20 children annually reported as being abused in the UK (NSPCC, 2019; Radford et al, 2011). Many child survivors are of adolescent or young adult age before they request help from relevant services (HAVOCA, 2021; NSPCC, 2018; Noel, Dogaru, and Ellis, 2015; Flatley, 2017). The aim of this study was to investigate the perceived experiences of six young adult female survivors of CSA of their EMDR treatment as well as an assessment of the changes in the individual trauma stress response. This case series analysis explored (a) neuropsychological, emotional (namely low selfesteem, anxiety and depression), behavioural functioning and quality of life issues using descriptive statistics via outcome measures conducted before, during and after treatment and (b) client perspectives through qualitative interviewing at one-month follow-up to ensure adequate time was allowed to monitor changes using Thematic Analysis [TA]. The study setting was within the Improving Access to Psychological Therapies (IAPT) program framework, established to ensure service users accessing NHS treatment are presented with choice in their treatment. The triangulation of data in this study allowed for a deeper analysis of the experiences of adult CSA survivors undergoing EMDR treatment beyond an examination of differences in pre and post outcome measures. The descriptive statistics suggested overall positive changes in participant functioning in all measured domains (three positive, two moderate outcome cases and one sceptical no-improvement case; based on independent research rater feedback) however variable differences in neuropsychological processing from pre- to post-treatment. The descriptive statistics were limited in their generalisability because of certain limitations in data collection as inhibited by COVID-19 restrictions and because of the small sample size. Three key themes were identified in the qualitative analysis which contributed to the literature on treatment of adult CSA survivors by identifying which factors the clients identified as helpful and unhelpful to their treatment. These themes were identified as being an 'Unhelpful' process (service time restrictions, fear of the lack of confidentiality, fear of emotional reprocessing), 'Helpful' aspects of therapy (client choice in treatment, therapist interpersonal and professional skills, psychological resourcing, idiosyncratic approaches) and 'Mixed Responses' due to COVID-19 (face-to-face vs remote working). Overall, this study contributed to the literature about EMDR treatment for adult CSA survivors by shedding insight into the perceived experiences of clients and providing further evidence for the efficacy of this treatment. Importantly, further research could investigate a potentially larger sample, emphasis on neuropsychological functioning, and within differing settings, to understand deficits within the current study. A qualitative study of the perceptions and experiences of childhood sexual abuse survivors who opt for CBT over EMDR might lead to recommendations for changes in protocol that would make EMDR more acceptable. There is scope to further investigate EMDR as a reliable and valid treatment option within NHS IAPT settings, alongside essential service development in therapist training programmes to support the growing need for treatment of multiple-trauma and/or Complex-PTSD (ICD-11, International Classification of Diseases-11, 2018).