Studier viser, at børn let kan få Post-Traumatisk Stress Disorder (PTSD), hvis de har været udsat for traumer som terror, ulykke, seksuelt eller fysisk overgreb. Heldigvis er der også studier, som viser, at der kan sættes aktivt ind med EMDR samt CBWT. To forkortelser for effektive metoder til at hjælpe traumatiserede børn.
Af Hanne Hæsum, Aut. cand psych., EMDR terapeut
Artiklen blev bragt i magasinet sund-forskning – december 2017/januar 2018
På Amsterdams Universitet har man i samarbejde med Traumecenter for Børn og Unge set, hvordan man hurtigt kan hjælpe børn, der har været udsat for et traume, hvis man kombinerer to kendte behandlingsstrategier.
PTSD (posttraumatisk stress) er en psykisk lidelse, som personen kan udvikle efter at have været udsat for en voldsom begivenhed som fx terror, ulykke, seksuelle eller fysiske overgreb.
Tidligere undersøgelser har vist, at PTSD hos voksne kan behandles effektivt med EMDR eller traumefokuseret kognitiv adfærdsterapi. (WHO 2013).
Nu har et forskerhold sammenlignet effekten af behandling med henholdsvis EMDR og med Cognitive Behavioral Writing Therapy (WRITEjunior) også kaldet Skriveterapi hos i alt 103 børn og unge i alderen 8 år til 18 år. Alle børn og unge i undersøgelsen havde oplevet en enkeltstående traumatisk begivenhed som trafikulykke, voldtægt, fysisk overfald eller tab.
I begge former for behandling arbejdede man direkte med erindringen om den voldsomme hændelse uden nogen forberedende sessioner.
I EMDR-terapien aktiveres den traumatiske erindring samtidig med at barnets arbejdshukommelse er beskæftiget med en ekstern opgave – det betyder i praksis, at barnet skal huske på den traumatiske hændelse, samtidig med at barnet følger terapeutens finger, der bevæger sig frem og tilbage med øjnene.
Ved Skriveterapi skriver barnet sammen med terapeuten en historie om begivenheden og om konsekvenserne af den, herunder alle de forfærdelige aspekter af erindringen. I den sidste session deler barnet historien om, hvad der skete med en eller flere vigtige personer, fx forældrene.
I gennemsnit var fire sessioner tilstrækkeligt for en vellykket behandling.
EMDR og Skriveterapi var lige effektive med hensyn til at mindske posttraumatiske stressreaktioner som angst, depression og adfærdspro-blemer.
Forskningsleder psykolog De Roos påpeger, at begge metoder også viste sig at tage kort tid og dermed at være omkostningseffektive. Forskerne brugte bogstaveligt talt et stopur til at måle, hvor lang tid de to traumebehandlinger tog.
Målingen viste, at EMDR hurtigst opnåede positive resultater (2 timer og 20 minutter i gennemsnit) sammenlignet med Skriveterapien (3 timer og 47 minutter i gennemsnit).
Allervigtigst var det dog, at effekten havde holdt sig i en opfølgning et år senere.
Ca. 16 % af børnene, der udsættes for traumer, udvikler PTSD. Ifølge De Roos lider børn, der ikke får den rette behandling, unødigt og risikerer at udvikle yderligere lidelser og at blive retraumatiseret.
”Udfordringen for sundhedspersonale er at identificere symptomer på PTSD så hurtigt som muligt og straks henvise til traumebehandling”, fortæller De Roos og fortsætter: ”Metoderne bør være standard i forbindelse med behandling af børn. Ved PTSD kan en kort traumefokuseret behandling mindske symptomerne og dermed mindske lidelse og føre til besparelser på sundhedsområdet”.
Undersøgelsen gik på enkeltstående traumer for børn mellem 8 og 18 år. Forskeren formoder, at behandlingsmetoderne også kan anvendes til yngre børn og for børn med flere traumer. Det må forskning i fremtiden vise.
Allervigtigst var det dog, at effekten havde holdt sig, målt i en opfølgning et år senere.
Læs mere om EMDR-behandling på http://www.emdr.dk hvor du også kan finde en behandler.
Artiklens forfatter arbejder med EMDR for børn og voksne og er ligeledes supervisor i EMDR for børn og for voksne.
Find en kognitiv terapeut på www.SAKT.dk
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