---
title: "EMDR to Reduce Pain Interference in Children with Sickle Cell Disease: RELAX RCT Protocol"
id: "pubmed-42649491"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42649491"
content_type: "clinical_feed_article"
specialty: "Pediatrics"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42649491/"
doi: "10.1186/s12887-026-07153-2"
published_at: "2026-08-27T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# EMDR to Reduce Pain Interference in Children with Sickle Cell Disease: RELAX RCT Protocol
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42649491
- **Specialty:** [Pediatrics](https://medichelpline.com/clinical-feed/pediatrics.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42649491/)
- **DOI:** [10.1186/s12887-026-07153-2](https://doi.org/10.1186%2Fs12887-026-07153-2)
- **Published At:** 2026-08-27T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Children with **sickle cell disease (SCD)** frequently experience vaso-occlusive crises that cause severe pain and hospitalizations; these events can be traumatic and contribute to psychological distress, including (subclinical) **PTSD**. - Elevated **pain interference** — the extent to which pain negatively affects daily life — in pediatric SCD appears to be linked more strongly to psychological than strictly biological factors. - Eye Movement Desensitization and Reprocessing (**EMDR**), a therapy developed for PTSD, has been explored for pain reduction in other contexts but has not been tested specifically for children with SCD targeting pain interference. - The RELAX study is a single-center randomized controlled trial enrolling children and adolescents aged 6–18 years with SCD who have clinically relevant pain interference scores. - Participants are randomized 1:1 to immediate **EMDR** (n = 20) or a waiting-list control (n = 20); waiting-list participants are offered EMDR after 9 weeks; follow-up occurs 3 months post-treatment. - The primary outcome is **pain interference**. Secondary outcomes include PTSD symptoms, anxiety and depression, physical mobility, number of painful days, pain intensity, analgesic use, and school absence; additional assessments address pain- and trauma-related memories and EMDR feasibility. - The trial is registered at ClinicalTrials.gov (NCT07001631), retrospectively registered May 23, 2025; ethical approval was granted by the Amsterdam UMC medical ethical committee (NL86274.018.24). - The protocol emphasizes EMDR as a non-pharmacological, non-invasive intervention that—if effective—could reduce chronic pain burden in children with SCD and may be applicable to pediatric chronic pain of other etiologies. - Conflicts of interest: one author (CdeR) receives income from an EMDR book and training; other authors declare no competing interests. - Study details such as exact EMDR session content, duration, therapist qualifications, recruitment procedures, statistical analysis plan, and baseline characteristics were not reported in the abstract and require consulting the full protocol for complete information.
## Clinical Analysis & Structured Key Points
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Effect of EMDR for reduction of pain interference in children with sickle cell disease, the RELAX study: a randomized controlled trial protocol [Mariana Nery](https://pubmed.ncbi.nlm.nih.gov/?term=Nery+M&cauthor_id=42649491)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-1 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-2 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Meibergdreef 9, Amsterdam, The Netherlands.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-3 "Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-4 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands."), [Linde Scholten](https://pubmed.ncbi.nlm.nih.gov/?term=Scholten+L&cauthor_id=42649491)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-1 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands."), [Carmen Voorrips](https://pubmed.ncbi.nlm.nih.gov/?term=Voorrips+C&cauthor_id=42649491)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-1 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-3 "Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-4 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands."), [Carlijn de Roos](https://pubmed.ncbi.nlm.nih.gov/?term=de+Roos+C&cauthor_id=42649491)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-5 "Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-6 "Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, The Netherlands."), [Karin Fijnvandraat](https://pubmed.ncbi.nlm.nih.gov/?term=Fijnvandraat+K&cauthor_id=42649491)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-2 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Meibergdreef 9, Amsterdam, The Netherlands.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-4 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands."), [Lotte Haverman](https://pubmed.ncbi.nlm.nih.gov/?term=Haverman+L&cauthor_id=42649491)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-7 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. L.haverman@amsterdamumc.nl.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-8 "Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#full-view-affiliation-9 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl.") Affiliations Expand ### Affiliations * 1 Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. * 2 Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Meibergdreef 9, Amsterdam, The Netherlands. * 3 Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands. * 4 Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands. * 5 Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands. * 6 Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, The Netherlands. * 7 Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. L.haverman@amsterdamumc.nl. * 8 Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl. * 9 Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl. * PMID: **42649491** * DOI: [ 10.1186/s12887-026-07153-2 ](https://doi.org/10.1186/s12887-026-07153-2) Item in Clipboard Randomized Controlled Trial # Effect of EMDR for reduction of pain interference in children with sickle cell disease, the RELAX study: a randomized controlled trial protocol Mariana Nery et al. BMC Pediatr. 2026. Show details Display options Display options Format Abstract PubMed PMID BMC Pediatr Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22BMC+Pediatr%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22BMC+Pediatr%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42649491/) . 2026 Aug 27;26(1):797. doi: 10.1186/s12887-026-07153-2. ### Authors [Mariana Nery](https://pubmed.ncbi.nlm.nih.gov/?term=Nery+M&cauthor_id=42649491)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-1 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-2 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Meibergdreef 9, Amsterdam, The Netherlands.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-3 "Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-4 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands."), [Linde Scholten](https://pubmed.ncbi.nlm.nih.gov/?term=Scholten+L&cauthor_id=42649491)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-1 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands."), [Carmen Voorrips](https://pubmed.ncbi.nlm.nih.gov/?term=Voorrips+C&cauthor_id=42649491)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-1 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-3 "Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-4 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands."), [Carlijn de Roos](https://pubmed.ncbi.nlm.nih.gov/?term=de+Roos+C&cauthor_id=42649491)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-5 "Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-6 "Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, The Netherlands."), [Karin Fijnvandraat](https://pubmed.ncbi.nlm.nih.gov/?term=Fijnvandraat+K&cauthor_id=42649491)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-2 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Meibergdreef 9, Amsterdam, The Netherlands.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-4 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands."), [Lotte Haverman](https://pubmed.ncbi.nlm.nih.gov/?term=Haverman+L&cauthor_id=42649491)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-7 "Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. L.haverman@amsterdamumc.nl.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-8 "Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42649491/#short-view-affiliation-9 "Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl.") ### Affiliations * 1 Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. * 2 Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Meibergdreef 9, Amsterdam, The Netherlands. * 3 Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands. * 4 Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands. * 5 Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands. * 6 Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, The Netherlands. * 7 Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. L.haverman@amsterdamumc.nl. * 8 Amsterdam Public Health, Mental health and Digital Health, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl. * 9 Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands. L.haverman@amsterdamumc.nl. * PMID: **42649491** * DOI: [ 10.1186/s12887-026-07153-2 ](https://doi.org/10.1186/s12887-026-07153-2) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Children with sickle cell disease (SCD) suffer from vaso-occlusive crises, extremely painful episodes that may require hospitalization. Traumatic experiences during hospitalization and frequent pain experiences may lead to psychological distress and the development of (subclinical) posttraumatic stress disorder (PTSD). Children with SCD also experience elevated pain interference (the negative impact of pain on daily life), which research suggests may be more strongly associated with psychological than biological factors. Due to the association between psychological distress and pain, Eye Movement Desensitization and Reprocessing (EMDR), originally developed for treating PTSD, has recently been investigated for its potential to reduce pain. However, its effectiveness has not been studied for children and for SCD populations with the aim of reduction in pain interference. **Methods:** In this single-center randomized controlled trial children and adolescents (aged 6-18 years) with SCD and clinical relevant scores on pain interference will be randomized to either EMDR therapy (n = 20) or waiting list control group (n = 20). Waiting list participants were reallocated to EMDR after 9 weeks. Follow-up was conducted 3-months post-treatment. Primary outcome is pain interference. Secondary outcomes include PTSD symptoms, anxiety and depressive symptoms, physical mobility, number of painful days, pain intensity, pain medication use and school absence, with additional outcomes assessing themes of pain and trauma-related memories and EMDR feasibility. **Discussion:** This paper outlines the study protocol of a randomized controlled trial aiming to investigate the efficacy of EMDR therapy in reducing pain interference in the lives of children with SCD. If proven effective, this will be a promising intervention to reduce pain interference and chronic pain experienced by this group, with the advantage of being a non-pharmacological and non-invasive intervention. This method may also hold potential for children living with chronic pain of other causes. **Trial registration:** clinicaltrials.gov, [NCT07001631](http://clinicaltrials.gov/show/NCT07001631 "See in ClinicalTrials.gov"), retrospectively registered on May 23rd 2025, clinicaltrials.gov/study/NCT07001631. **Keywords:** Pain interference; Pain, EMDR; Sickle cell disease. © 2026. The Author(s). [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Ethics approval and consent to participate: Approval and consent to perform this study was given by Amsterdam UMC medical ethical committee (NL86274.018.24). Consent for publication: Not applicable. Competing interests: CdeR receives income from a published book about EMDR therapy and for training postdoctoral professionals in EMDR. The other authors declare that they have no competing interests. ## References 1. 1. Rees DC, Williams TN, Gladwin MT. Sickle-cell disease. Lancet. 2010;376(9757):2018–31. - [DOI](https://doi.org/10.1016/s0140-6736\(10\)61029-x) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/21131035/) 2. 1
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