A comparison of attachment-based EMDR therapy and standard EMDR therapy for adolescents with bullying-related trauma symptoms: A randomized controlled trial

Adolescent bullying is a significant public health concern, often leading to anxiety, depression, and trauma-related symptoms. While Eye Movement Desensitization and Reprocessing (EMDR) has proven effective in addressing trauma in youth, its application specifically for bullying-related trauma remains limited, particularly in non-Western contexts. Attachment-based therapies, which enhance relational security, have shown potential in reducing trauma symptoms, but their integration with EMDR has not been widely explored. Considering the relational nature of bullying-related trauma, combining attachment-focused approaches with EMDR may improve therapeutic outcomes. This study evaluated the efficacy of Attachment-Based EMDR (AB-EMDR) in reducing trauma and anxiety symptoms in adolescent bullying victims compared to standard EMDR therapy. A randomized controlled trial was conducted with 50 adolescent bullying victims aged 12 to 18 years, who were randomly assigned to either the experimental group (AB-EMDR; n = 25) or the control group (standard EMDR; n = 25). We used the Bangla Children's Revised Impact of Event Scale (CRIES-13) and Beck Anxiety Inventory (BAI Y) for assessing trauma and anxiety symptoms at baseline, mid-intervention, post-intervention, and two-month follow-up. AB-EMDR incorporated attachment-focused adjuncts, including self-compassion exercises, emotion regulation strategies, empathy training, and relational role-play, alongside the standard EMDR eight-phase protocol. MANOVA showed significant group differences, with AB-EMDR yielding greater reductions in trauma and anxiety (ηp 2 = 0.721). Significant time effects (ηp 2 = 0.530) indicated improvement from baseline to post-intervention, maintained at follow-up. The group × time interaction (ηp 2 = 0.243) suggested faster and larger symptom reduction in AB-EMDR. Post-hoc analysis revealed substantial enhancements from T0 to T2. EMDR effectively reduced trauma symptoms and anxiety in a sample of adolescent bullying victims, and incorporating attachment-based interventions enhances outcomes. Integrating attachment-focused elements within EMDR appears promising; however, further studies with larger, more diverse populations are warranted.