When traumatizing nightmares plague a child’s sleep routine, parents often search for answers. University of Tulsa faculty and student researchers in the Department of Psychology have investigated this psychological condition since the early 2000s. Today, Associate Professor of Psychology and clinical psychologist Lisa Cromer leads a team of graduate and undergraduate students in nightmare treatment for children and adolescents.

The University of Tulsa’s specialization in sleep among children began with graduate student research that was mentored by Professor of Psychology Joanne Davis. She focuses on nightmare and sleep problems in trauma-exposed individuals and when Cromer joined the psychology faculty, Davis invited her to expand upon the original project. With her expertise in children and adolescents, Cromer developed manuals and workbooks to adapt the research more broadly. Since then, graduate and undergraduate students have helped her establish a children’s sleep lab. Cromer and her students currently are conducting their second clinical trial that provides a five-session therapy series for youth, ages 5 to 17, who experience nightmares.

Combining sports and child psychology

Second-year grad student Jack Stimson earned a bachelor’s degree in psychology and worked with traumatized, abused and neglected children in Seattle, Washington, before beginning the psychology Ph.D. program at TU. A former rugby athlete, he is interested in both sports and child psychology. “That’s the reason I chose TU and Dr. Cromer in particular,” he said. “She is an expert in a lot of areas, and I have an immense passion for working with kids.”

Stimson contributes to the clinical trial by asking questions and assessing participants once they have received therapy for nightmares. So far, 14 kids and teenagers have entered the treatment with encouraging results. Stimson said the youth and teens are “almost glowing” when he meets with them following the successful therapy sessions. They sleep sounder, feel better and experience fewer nightmares. “In supervision, we’ll sometimes watch tapes from earlier assessments before they went through treatment, and it’s amazing to see the shift in body language,” he said. “Instead of having nightmares every single night, they now maybe have one once or twice a month.”

As an undergraduate, psychology senior Andrew Helt also serves an important purpose in Cromer’s lab. He discovered his career interests in trauma psychology while working with children with communicative disorders at Happy Hands Education Center his freshman year. Helt’s research is the focus of a Tulsa Undergraduate Research Challenge (TURC) project and his final class project. After learning about the enriching environment of Cromer’s lab, basic literature reviews and data entry led him to explore a sub-study within her clinical trial. “We started to notice that while there’s a lot of kids with nightmares, some of them were reluctant to get into research,” Cromer said. “We wanted to understand the hesitation for either seeking treatment or seeking treatment for a research study when the therapy is free.”

During the summer, Helt learned how to use software systems and review literature to understand the psychological constructs associated with children who suffer from frequent nightmares. Overcoming barriers to treatment can help make it more accessible for children who desperately need relief. “I’m looking at what factors play into whether a parent decides to express interest in joining the trial (before) and what impact the nightmare treatment has in reducing symptoms (after) related to cognitive, behavioral functions,” Helt said.

Additional benefits of nightmare treatment

Published findings show parents who pursue therapy typically are of a higher socioeconomic status, and Cromer’s lab wants to learn how to make therapy and research more accessible to diverse groups. Helt’s sub-study also looks at how treatment can improve executive functions such as impulse control, working memory, task switching and goal-directed behavior. “For most of the medical studies I’ve read about, it’s not about convenience but rather factors like a person’s evaluation of the risks vs. benefits of participating,” Helt explained. “Underprivileged populations, for various reasons, have lower executive function, which plays into poor academic and social outcomes. It’s important to find any way possible to improve those executive functions in kids. We want nightmares to go away, but we also want to see if nightmare treatment can help in other areas too.”

The main objective of the second clinical trial is to determine if nightmares decrease in severity and frequency after the five-session therapy series. To accomplish this, Cromer is teaming up with Dr. Tara Buck, assistant professor of psychiatry and Oxley Chair in Child and Adolescent Psychiatric Research at the University of Oklahoma School of Community Medicine. The university collaboration allows OU to recruit participants for the study while TU graduate students conduct the therapy and post-therapy assessments.

Resilience amid adversity

Cromer and TU have built a credible reputation nationwide for sleep research, but her lab also encompasses other important areas of study, including psychological resilience amid adversity. “Dissertations that have come out of my lab have focused on special populations such as athletes and military families,” she said. “Through the ongoing SHAPE (Student Health, Academic Performance and Education) program, we work directly with TU teams and coaches on goal setting, mental toughness and preventing anxiety.”

Cromer’s research in child and sports psychology is extensive, and her special interest in how sleep affects other aspects of physical and emotional health inspires students like Stimson and Helt to continue working in the field. “The cool part of being in Dr. Cromer’s lab is that we view sleep as this underlying thing that we’re finding pops up in so many disorders and problems,” Stimson said. “We’re on the leading edge of this kind of research.”