EMDR for Adolescent Trauma and Other Mental Health Conditions

Eye Movement Desensitization and Reprocessing (EMDR) is an integrative approach that is proven to be effective for healing from trauma, Post-Traumatic Stress Disorder (PTSD), and a wide range of other mental health conditions. Developed by psychologist and educator Francine Shapiro, EMDR therapy is designed to heal emotional distress.

Talking about the details of a traumatic experience is not required in EMDR sessions. That’s why EMDR for adolescent mental health conditions can be particularly effective, as many teens struggle with expressing themselves verbally in talk therapy.

How Does EMDR Work?

The goal of EMDR therapy is to process part experiences that are continuing to cause pain and suffering. However, this approach to healing from trauma does not involve talking about the past, as in traditional talk therapy. Instead, EMDR helps resolve and release traumatic experiences through specific techniques involving eye movement and memory, which are related to the biological mechanisms activated in Rapid Eye Movement (REM) sleep.

EMDR works directly with the brain and body’s natural capacity for healing, tapping into the mind-body connection. EMDR for adolescent mental health conditions supports a teen’s brain to process the negative experience. At the same time, EMDR for teens instills positive beliefs while balancing the right and left hemispheres of the brain through the bilateral stimulation via eye movements. 

Explaining EMDR to Parents and Teens

Because EMDR for teens can be hard to describe and understand, EMDR therapists often explain the technique by using the analogy of a physical wound. When we cut ourselves or get a splinter, the body works to heal the wound. However, if a foreign object or repeated injury keeps the wound from healing, we experience more pain. Once the splinter or other blockage is removed, healing can occur.

In EMDR theory, a traumatic event—whether a complex trauma or single-incident traumas—is like a mental and emotional wound. The brain’s information processing system tries to heal that wound. However, if the healing process is blocked or imbalanced by the ongoing negative impact of trauma, the wound cannot heal. Once the blocks are removed, the natural healing processes can go into effect.

Here’s another analogy for how EMDR works:

When we have bad or negative events in our lives like abuse, bullying, divorce, accidents, losses and death of a loved one, or violence in the home, among others, the brain creates “files” or “apps” that contain all the feelings, thoughts, and body sensations connected to this event. When the event is really bad or has happened several times, these files/apps get overloaded and the brain can’t do the work of sorting things out and putting all the pieces of the event together.

Different life events we call triggers can open up these files/apps or “click” on them. A “click” may be a classmate making fun of us, being ignored, not getting what we are asking for, parents asking us to clean up our room and so on. When these “clicks” open up the files/apps, we start to have the negative feelings, thoughts, and body reactions we had when the bad stuff happened.

EMDR helps the brain organize these files and put all the pieces together. When the files/apps are finally organized, the “clicks” of everyday life won’t have the power to make us feel angry, sad, or shameful, or to think that we are not worthy or that we are not enough, or to make us yell, become aggressive or do things we regret later.

Ana M. Gomez, author of EMDR Therapy and Adjunct Approaches with Children: Complex Trauma, Attachment, and Dissociation

Conditions and Populations That EMDR Therapy Helps

EMDR therapy for trauma is the most common usage and the one that most people are familiar with. However, EMDR success rates are also high for anxiety, depression, panic attacks, eating disorders, phobias, and stress caused by chronic disease.

The following populations have used EMDR to support healing from trauma:

• People who have been a victim of a disaster (such as a violent crime, accident, natural disasters, fire, etc.)
• Clients who experience discomfort with social situations, public speaking, or medical procedures
• People dealing with grief and loss, due to death, divorce, or loss of a home
• Police officers and other frontline providers
• Children and adolescents who have experienced sexual abuse or rape
• Accident or burn victims

Consequently, EMDR has a broad range of applications for young people as well as adults.

Read “PTSD and Teen Trauma: Symptoms, Signs, and Treatment.”

The Development of EMDR

In 1987, Francine Shapiro was walking in the park when she observed something. Moving her eyes from side to side seemed to reduce negative thoughts brought on by distressing memories. Subsequently, Shapiro began to investigate this through research. In her first study, she worked with 70 volunteers to determine whether they had the same experience. As a result, she discovered that eye movements alone did not offer therapeutic benefits. Therefore, she added additional treatment elements.

Shapiro conducted a controlled study and published the results in the Journal of Traumatic Stress. The study involved 22 people suffering from traumatic memories related to a range of traumatic experiences—military combat, childhood sexual molestation, sexual or physical assault, and emotional abuse. They suffered intense symptoms, such as intrusive thoughts, flashbacks, sleep disturbances, low self-esteem, and relationship problems. Half of the subjects received EMDR, and the other half received therapy that did not include eye movements. Following therapy for trauma, the EMDR group’s traumatic memories were successfully desensitized. Furthermore, the way they thought about their past experiences had shifted as well. Participants in the EMDR group reported larger changes than those in the imagery group.

After further research and elaboration of the methodology, Shapiro published books and a textbook detailing the eight phases of EMDR psychotherapy. Her book Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures includes a full description of the theory, sequence of treatment, and research on EMDR. Today, the EMDR International Association (EMDRIA) comprises more than 4,000 mental health professionals. In addition, more than 100,000 clinicians worldwide have completed formal training in order to receive EMDR certification.

EMDR Success Rates

More than 30 controlled studies have assessed EMDR success rates. As a result of the research, it is well recognized for its ability to support people in healing from trauma. Furthermore, many mental health organizations recognize it as an effective form of treatment for trauma and other conditions. Specifically, organizations that recognize it as an effective modality include the American Psychiatric Association, the World Health Organization, the Department of Veterans Affairs, and the Department of Defense.

Here is a sampling of the research done on EMDR for trauma in particular.

• Research conducted at a Veterans Affairs facility reported a 78 percent remission in PTSD after 12 treatment sessions.
• Another study, funded by Kaiser Permanente, found that 100 percent of single-trauma victims and 77 percent of multiple-trauma victims participating were no longer diagnosable with PTSD, after only six 50-minute sessions.
• Participants received treatment two weeks following a 7.2 earthquake in Mexico. Researchers found improvement in symptoms of post-traumatic stress. Moreover, these results maintained at a 12-week follow-up, despite the fact that frightening aftershocks continued to occur.
• Transportation employees who had experienced “person-under-train” accidents or had been assaulted at work participated in an EMDR study. Following six sessions, 67 percent experienced remission of PTSD, compared to 11 percent in the control group.
• The second-ever randomized EMDR study of civilians reported a 90 percent PTSD remission in sexual assault victims after just three 90-minute sessions.

Research on EMDR for Adolescent Mental Health Conditions

Studies on EMDR for teens show that this modality is effective for adolescents who are struggling with a wide range of mental health conditions. Here is a sampling of the research on how EMDR can help teens struggling with various disorders.

EMDR for Adolescent Trauma and PTSD

A recent review of research looked at of multiple studies on EMDR for adolescent trauma and PTSD, published between 2002 and 2018. The findings showed that EMDR was effective in addressing PTSD arising from both single-event trauma and cumulative trauma, such as sexual abuse. Moreover, the researchers stated, MDR was equally effective with girls and boys as well as with children from different cultures. 

EMDR for Adolescent Depression

In a 2019 study of EMDR for teens with major depressive disorder (MDD), 61 percent of participants no longer met the criteria for MDD after six weekly 60-minute EMDR sessions. At follow-up several months later, that number had increased to 70 percent. An earlier small-scale study found that teens who participated in EMDR therapy experienced a complete remission from depressive symptoms. In both cases, researchers theorized that because the depression was associated with underlying trauma, healing from trauma using EMDR resulted in recovery from depression as well.

EMDR for Child Anxiety

Research has examined the impact of EMDR on anxiety in children and adolescents. In a study focused on addressing both PTSD and anxiety, children and teens showed significant improvements in anxiety levels as well as post-traumatic symptoms. As with depression, addressing the root cause of anxiety—underlying trauma—is what ultimately results in positive change.

EMDR for ADHD in Children and Adolescents

Is EMDR good for ADHD? Research points to a link between ADHD and childhood trauma. Hence, healing from trauma through EMDR techniques can also improve ADHD symptoms. Moreover, improvements in depression and anxiety as a result of EMDR treatment can also reduce ADHD symptoms.

“The World Health Organization recognizes EMDR as a first-choice treatment for PTSD. However, one of the biggest misconceptions about EMDR is that it’s only for trauma. EMDR can help anyone who has had negative beliefs about themself—and I don’t know anyone who hasn’t.”

Olivia Lynch, MS, LPC, Newport EMDR Program Training and Development Manager

Brainspotting vs. EMDR

The main difference between brainspotting and EMDR protocol is that they use slightly different types of eye movement to process underlying emotional issues. In EMDR therapy for trauma and other conditions, the eyes are directed to move from side to side. In brainspotting, the eyes remain fixed on particular points. Moreover, brainspotting often uses sound played through headphones, while EMDR sometimes uses tapping.

However, brainspotting and EMDR also have many similarities. Both modalities work by identifying, processing, and releasing neurobiological sources of trauma, dissociation, and other symptoms. In addition, both modalities focus on the client’s thoughts, memories, physical sensations, and emotions.

What Happens in an EMDR Session

Below, we look at the eight phases of the EMDR treatment approach. First, however, let’s examine how this approach integrates eye movement. To begin, clients identify a visual image related to the traumatic memory. They then focus on a negative belief about themselves, while noticing any difficult emotions and bodily sensations they are experiencing.

Next, the client identifies a positive belief. The practitioner then instructs the client to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing. The client focuses on the troubling image or negative thought while simultaneously moving their eyes back and forth. To prompt this eye moment, EMDR practitioners might move their fingers from side to side, tap their hand from side to side, or wave a wand. As a result, the client moves their eyes back and forth to follow the prompt.

During this processing, the client notices whatever thoughts, feelings, images, memories, or body sensations might arise. Subsequently, the client repeats these steps numerous times throughout the session. Additionally, if the client becomes distressed or has difficulty, the therapist follows procedures to help the client return to the processing work. Throughout these sets of eye movements, the brain makes associations and neural connections that help integrate the disturbing memory. Eventually, the distress associated with the memory dissolves. At this point, the practitioner directs the client to focus on the positive belief they identified at the beginning of the session.

Next, the client may adjust the positive belief if necessary. Then they focus on this positive belief while processing the next set of targeted memories. Research suggests that the repeated redirection of attention caused by the eye movements used in EMDR creates a neurobiological state that resembles REM sleep.

“EMDR induces a fundamental change in brain circuitry, similar to what happens in REM sleep, that allows the person undergoing treatment to more effectively process and incorporate traumatic memories. This helps the individual integrate and understand the memories within the larger context of [their] life experience.”

—Robert Stickgold, PhD, Harvard Medical School

What to Expect in an EMDR Session: The Eight Phases of EMDR Treatment

An EMDR session involves an eight-phase treatment process. However, the number of sessions needed varies according to the client’s needs and history. The age of PTSD onset and the number of times the person experienced traumatic events or incidents determine how long they will be in treatment. According to some experts, clients with a single incident of trauma, such as a one-time assault or accident, may need only five hours to integrate the event. By contrast, people who have experienced childhood trauma or multiple incidents of trauma may require a longer treatment time.

The EMDR approach includes the following eight phases.

Phase 1: History Taking and Treatment Planning

In the first phase, the EMDR therapist assesses the client’s readiness and establishes trust. In addition, they work with them to develop a treatment plan. Together, the client and therapist identify distressing memories and current situations that could benefit from EMDR processing. Moreover, the treatment plan focuses on helping the client develop skills. This helps them establish healthy behaviors for coping with future situations.

Phase 2: Preparation

During the Preparation phase, the clinician explains the theory of EMDR, how it is done, and what to expect during and after treatment. Moreover, the therapist helps the client learn ways of handling emotional distress. Consequently, the therapist may teach the client a variety of imagery and stress-reduction techniques to use during and between sessions. Therefore, the client has a greater chance of emotional stability throughout.

Phase 3: Assessment

Subsequently, the practitioner and the client use EMDR therapy techniques to process particular “targets.” That is traumatic incidents or memories. Moreover, they identify positive replacements for these negative memories. The client rates their belief in these positive replacements using the Validity of Cognition (VOC) scale, in which 1 equals “completely false,” and 7 equals “completely true.”

Phase 4: Desensitization

This phase focuses on desensitization. This includes the eye movement technique described above. This process continues until the client reports that the memory is no longer distressing.

Phase 5: Installation

In this phase, the client focuses on positive emotions and beliefs to replace those created by the trauma. In addition, they again use the VOC scale to determine whether they accept the positive statements as truth. Ideally, the client accepts the full truth of their positive self-statement at a level of 7 (completely true).

Phase 6: Body Scan

The client performs a body scan to assess sensations and tension. Therefore, they can determine whether the trauma has been processed. This phase references research indicating that trauma is stored in the body, not just the mind.

Phase 7: Closure

In this phase of closure, the therapist assists the client in using a variety of self-calming techniques. Hence, the goal is to regain a sense of equilibrium. Moreover, the therapist may ask the client to keep a log during the week. In addition, the log documents any related symptoms, thoughts, etc. that the client may experience. Furthermore, it is a reminder for the client of the coping skills and self-calming activities.

Phase 8: Reevaluation

Finally, in phase eight, the client and practitioner examine the progress. Typically, they do this at the beginning of each session. Therefore, they can evaluate progress and determine which targets to address next.

EMDR Adolescent Treatment at Newport Academy

EMDR for trauma and other mental health conditions is part of Newport Academy’s comprehensive trauma-informed care for teens. At Newport Academy, EMDR is one of a variety of evidence-based modalities incorporated into our integrated model of care.

Each client has a tailored treatment plan integrating EMDR sessions with trained and experienced therapists. Teen treatment plans also include CBT, DBT, family therapy, and experiential activities like Adventure Therapy and creative arts therapies.

Our clinical model views trauma as the root cause of mental health disorders and behavioral issues. Hence, we ensure that every teen who comes to us has safe and effective ways to process emotions and past experiences, so they can move forward with confidence and healthy coping skills. Contact us today to learn more about treatment approach.

Key Takeaways

• EMDR helps resolve and release traumatic experiences through specific techniques involving eye movement and memory, which are related to the biological mechanisms activated in Rapid Eye Movement (REM) sleep.
• Studies on EMDR for teens show that this modality is effective for adolescents who are struggling with a wide range of mental health conditions, including trauma and PTSD, depression, anxiety, and possibly ADHD as well.
• In an EMDR session, the EMDR therapist works with teens by asking them to focus on specific images, thoughts, and body sensations while simultaneously moving their eyes back and forth as directed.
• An EMDR session involves an eight-phase treatment process. The number of sessions needed varies according to the client’s needs and history. Research shows improvement and even full remission can take place in as few as six sessions.
• At Newport Academy, EMDR for adolescents, facilitated by trained and experienced EMDR therapists, is an essential aspect of each client’s tailored treatment plan.

Frequently Asked Questions About EMDR for Adolescents

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Perm J. 2014 Winter; 18(1):71–77.