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

Bibi, H

Abstract

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).

Citation

Bibi, H. 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. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Dec 14, 2021
• Publicly Available Date: Dec 14, 2021
• Award Date: Jul 8, 2021