Gladys Gonzales says she felt the urgent need within hours to find mental health services for her 10-year-old daughter, Caitlyne Gonzales, who survived the massacre at Robb Elementary School in Uvalde, Texas.
"I came home to the realization of what had transpired, and it hit me that they had undergone a terrible, terrible thing, and so I knew right then and there that she was going to need in-depth therapy," the mother told ABC News.
Nineteen children and two of their teachers were shot to death by an 18-year-old shooter, a former student, who attacked the school on May 24, 2022. Caitlyne's best friend, 9-year-old Jackie Cazares, was one of the children killed.
Caitlyne has been outspoken since the shooting and has advocated for gun reform. She traveled to Washington, D.C, in December and called for an assault weapons ban to be passed on Capitol Hill.
"I decided to be a voice for my friends who can't use their voice no more," Caitlyne said at the time.
Gonzales said her daughter went through several traditional cognitive behavior therapists for post-traumatic stress disorder, but Caitlyne had a difficult time making progress and instead began "regressing." Gonzales says she even brought her daughter to the Uvalde Together Resiliency Center, a site for long-term mental health services offered by Uvalde County officials and Texas Gov. Greg Abbott, however, Gonzales said the services weren't effective for Caitlyne.
Gonzales said that as Caitlyne began to regress, she lost interest in her favorite activities, became more isolated, and more paranoid about the thought of losing her mother.
It was last summer that Gonzales says she took Caitlyne to a grief camp in San Antonio and met a counselor who suggested Caitlyne try a form of therapy called eye movement desensitization and reprocessing, or EMDR.
The American Psychological Association describes EMDR as an eight-phase treatment in which patients "briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation." The bilateral stimulation is typically done with side-to-side eye movements or other rhythmic stimulations like taps or tones. This treatment causes a reduction in the "vividness and emotion associated with the trauma memories."
According to a spokesperson for the APA, EMDR is "conditionally recommended" in their 2017 Clinical Practice Guideline for the treatment of PTSD and "evidence that indicates that they can lead to good treatment outcomes."
In an email to ABC News, a spokesperson for the World Health Organization said that EMDR can be an effective treatment for children and is a recommended option for PTSD in the WHO guidelines.
Danielle Brown, an associate professor of social work at the University of Southern California and a licensed clinical social worker and psychotherapist who uses EMDR in her private practice, said that in simpler terms, EMDR "re-files" traumatic memories and allows the brain to make new connections around them.
"We're not wiping out memories, but we're reprocessing and reintegrating them with more positive—more kind of clear-eyed associations—so that it's something that you'll remember but it won't trigger the same emotional or physiological response that we see in PTSD," Brown said in an interview with ABC News.
Gonzales says Caitlyne's struggles with talk therapy caused some of those emotional and physiological triggers, but in addition to this, Gonzales recalled one specific example in which she says a cognitive behavioral therapist dismissed her concerns.
"That therapist—after one session—told me, 'There's nothing wrong with her,' those were her words and I was just shocked," Gonzales said.
But Gonzales knew better since Caitlyne opened up to her about how she was feeling, and she says she also began experiencing night terror, which left Caitlyne unable to sleep alone because of excruciating fear. Gonzales also attributed her current graduate studies in counseling at Sul Ross Rio Grande College, and her previous work as a mental health caseworker for children who had severe emotional disturbance.
Caitlyne was officially diagnosed with PTSD in December, Gonzales said.
Gonzales said she had never heard of EMDR prior to the grief camp's recommendation, and after an arduous approval process and waitlist, Caitlyne finally started EMDR therapy in San Antonio in January.
"I made a promise [the day of the shooting] that I would help my daughter the best to my ability, and if it's driving an hour and a half to two hours to get her the appropriate health services, then so be it," she said.
The 10-year-old survivor immediately expressed her satisfaction after the first session and her mom said she is finding success so far with EMDR.
Brown, who does not treat Caitlyne, said she is not surprised to hear about the trajectory of Caitlyne's therapy.
"A lot of CBT approaches have you retell or recount the story start to finish, which is problematic in a couple of ways," Brown said. "If you don't have the language for the experience—which often happens in trauma because our language centers can turn off during a trauma—you'll hear victims sometimes say, 'I don't have the words,' or 'I can't articulate it,' because literally the language isn't there, so there's not a cohesive narrative to describe."
"The other problem is that sometimes recounting the details, that in itself is re-traumatizing," she said. "So with EMDR, we approach it from a different way. You don't have to have all the words and you don't have to have all the memories for it and you don't have to retell the story and relive it as we're reprocessing the events or the memory."
Gonzales said she now aspires to become an EMDR therapist and hopes that spreading awareness about her daughter's experience will help inform other families dealing with PTSD.
"If a therapist doesn't work for your child, don't stay there, move on to the next one until you do find the correct therapist for your child," she said. "For kids going through PTSD and trauma, it's so important because they already have these risk factors in the future, and I would hate for them to fall into the cracks just because they didn't receive appropriate treatment."
Even though CBT did not work for Caitlyne, it still remains one of the recommended interventions for PTSD, according to the APA.
Uvalde:365 is a continuing ABC News series reported from Uvalde and focused on the Texas community and how it forges on in the shadow of tragedy.