Establishing Fidelity, Acceptability, Feasibility, and Efficacy of Urdu Translated Single-Session EMDR Integrative Group Treatment Protocol for Ongoing Traumatic Stress among Adolescents: A Randomized Controlled Trial

The main aim of the present investigation was (a) to establish a translation/adaptation of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol for Ongoing Traumatic Stress (EMDR-IGTP-OTS) for adolescents who have experienced childhood adverse experiences in the Pakistani context and (b) to demonstrate the fidelity, acceptability, feasibility, and efficacy of Urdu translated single-session EMDR-IGTP-OTS in reducing psychological distress among Pakistani adolescents. This study was premeditated to address the high vulnerability of adolescents to psychological distress after experiencing childhood trauma and the existing treatment gap. The study encompassed 2 phases; in phase I, EMDR-IGTP-OTS was translated/adapted into Urdu according to the Pakistani culture, whereas phase II consisted of a feasibility trial of the adapted protocol. A sample of 94 adolescents aged 11 to 16 years were selected from 2 government schools and randomized into the treatment group and control group with pre-treatment, post-treatment (immediately after the intervention), and follow-up assessments (after 3 months) through the Urdu version of the Depression, Anxiety, and Stress Scale (DASS-21). The single session of EMDR-IGTP-OTS was delivered in a group setting where bilateral stimulation was self-administered through the butterfly hug method and reprocessing was represented through an art therapy format, following the original EMDR-IGTP-OTS protocol. Findings provided evidence of the program’s fidelity with good inter-rater reliability ( r = 0.90**) along with high acceptability and feasibility through quantitative and qualitative measures. Additionally, results of mixed between-within-subjects’ analysis of variance (ANOVA) depicted that psychological distress was significantly reduced at post-treatment and follow-up assessments through single-session EMDR-IGTP-OTS for the treatment group as compared to the control group ( F = 56.54, P = 0.000, η p 2 = 0.161) with a notable decrease in subjective units of disturbance. The adapted version of EMDR-IGTP-OTS demonstrates fidelity, feasibility, acceptability, and efficacy in reducing psychological distress among adolescents and provides directions for an extensive randomized controlled trial on the efficacy of EMDR-IGTP-OTS within the context of Pakistan.