An EMDR group therapy for traumatized former child slaves in India: a pilot randomized controlled trial

Child slavery is a major problem in India: 12% of the children between the age of 5 to 14 years old are forced to work excessively and in unbearable circumstances. These circumstances often involve traumatic events, that may lead to posttraumatic stress disorder (PTSD) and other mental health problems. Adequate treatment of these problems is typically unavailable and the effectiveness of treatments used in Western countries is unclear in Indian youth. The purpose of the current pilot randomized controlled trial is to determine if a protocolized brief Eye Movement Desensitization and Reprocessing (EMDR) group therapy, called the EMDR Group-Traumatic Episode Protocol (G-TEP), can reduce symptoms of PTSD, dysfunctional trauma-related cognitions and depression symptoms in former child slaves with PTSD or partial PTSD. The study was executed in a rehabilitation centre for children liberated from slavery near Jaipur. Based on the Mini-International Neuropsychiatric Interview (MINI), 26 boys between 8 and 18 years who were diagnosed with PTSD or partial PTSD were randomly allocated to an experimental EMDR-condition or a waiting-list control condition. Reductions of PTSD symptoms, dysfunctional trauma-related cognitions and depression symptoms in the EMDR-condition and control condition were not significantly different when controlling for baseline symptom levels. Explanations for the lack of treatment effects include suboptimal circumstances for training and delivery of the treatment, insufficient treatment engagement due to cultural unfamiliarity with psychological treatment or unease with disclosing psychological problems in the participants, and the possibility that participants suffered from complex forms of PTSD for which individual and more comprehensive therapy is indicated. Further studies that remedy these limitations are warranted, given the large and continuous need for effective but brief PTSD interventions in India.