Some observations on remote delivery of eye‐movement desensitisation and reprocessing to people with intellectual disabilities

Unwin, Gemma; Stenfert-Kroese, Biza; Rogers, Gemma; Swain, Sophie; Clifford, Clair; Farrell, Derek; Willner, Paul

doi:10.1111/jppi.12452

Cited by 5 publications

(14 citation statements)

References 39 publications

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“…Notably, in papers referring to EMDR with the Shapiro adult protocol (2001) ( 16 , 18 , 38 , 54 , 55 ), relatively more detailed difficulties and adaptations were described than in publications referring to EMDR with a version of the child’s EMDR protocol ( 35–37 , 56–59 ). The publication by Unwin et al introduces a significant modification to the EMDR protocol; the addition of a phase called psycho-education and emotional stabilization (PES) ( 25 ).…”

Section: Resultsmentioning

confidence: 99%

“…For the treatment of PTSD in the common population, trauma-focused Cognitive behavioral therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) therapy are recommended by the World Health Organization (WHO, 2013) and the National Institute for Clinical Excellence (NICE, 2018) guidelines ( 24 ). EMDR therapy might be a more suitable intervention for people with ID and PTSS because it is less reliant on verbal abilities than CBT ( 25 , 26 ). The focus of this review therefore will be on EMDR therapy.…”

Section: Introductionmentioning

confidence: 99%

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EMDR treatment for people with intellectual disabilities: a systematic review about difficulties and adaptations

Schipper-Eindhoven,

de Knegt,

Mevissen

et al. 2024

Front. Psychiatry

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IntroductionPeople with intellectual disabilities (ID) are at increased risk for developing Post Traumatic Stress Disorder (PTSD). Emerging evidence indicates that Eye Movement Desensitization and Reprocessing (EMDR) therapy is feasible and potentially effective for this group. However, communication, cognition, stress regulation, and attachment difficulties may interfere with the EMDR process. Adaptation of the EMDR protocol seems therefore required for this population.AimThis review aims to systematically identify and categorize the difficulties in applying EMDR to people with ID and the adaptations made by therapists to overcome these challenges.MethodsA literature search was performed in May 2023. Article selection was based on inclusion and exclusion criteria and quality appraisal.ResultsAfter screening, 13 articles remained for further review. The identified difficulties and adaptations were categorized into the three domains of adaptive functioning (i.e., conceptual, social, and practical functioning). Considerable difficulties in applying the EMDR protocol for this group were reported. The adaptations made by therapists to overcome these difficulties were highly variable. They could be divided into three main categories: adaptions in EMDR delivery (e.g., tuning to the developmental level of the client, simplifying language, decreasing pace), involvement of others (e.g., involving family or support staff during or in between sessions), and the therapeutic relationship (e.g., taking more time, supportive attitude).DiscussionThe variability of the number of mentioned difficulties and adaptations per study seems to be partly related to the specific EMDR protocol that was used. In particular, when the Shapiro adult protocol was administered, relatively more detailed difficulties and adaptations were described than in publications based on derived existing versions of an EMDR protocol for children and adolescents. A probable explanation is that already embedded modifications in these protocols facilitate the needed attunement to the client’s level of functioning.Practical implicationsThe authors of this review suggest that EMDR protocols for children and adolescents could be adapted for people with an intellectual disability. Further research should focus on the involvement of trusted others in EMDR therapy for people with ID and the therapeutic relationship from an attachment and relational-based perspective.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

EMDR treatment for people with intellectual disabilities: a systematic review about difficulties and adaptations

Schipper-Eindhoven,

de Knegt,

Mevissen

et al. 2024

Front. Psychiatry

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“…This service‐related project was conducted in an NHS service in the south of England for adults (18+ years) with intellectual disabilities. All interviewees had completed training in EMDR as part of the Trauma‐AID trial (further description of this study is available in Unwin et al, 2023). The project was led by two Clinical Psychologists and one Assistant Psychologist in the service, all of whom conducted interviews and were involved in the coding and the creation, review, and definition of themes.…”

Section: Methodsmentioning

confidence: 99%

“…Calls have been made for the 'rapid generation' of research into interventions for the intellectual disability population (Hastings, 2013). Further efforts are being made to assess EMDR quantitatively through the Trauma-AID trial, a multi-site RCT study (described further in Unwin et al, 2023). In addition to this, a recent study by Porter (2022) provided detailed descriptions of the adaptations made to the EMDR protocol.…”

Section: Treating the Effects Of Trauma With The Intellectual Disabil...mentioning

confidence: 99%

“…Trauma-AID trial (further description of this study is available in Unwin et al, 2023). The project was led by two Clinical Psychologists and one Assistant Psychologist in the service, all of whom conducted interviews and were involved in the coding and the creation, review, and definition of themes.…”

Section: All Interviewees Had Completed Training In Emdr As Part Of Thementioning

confidence: 99%

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Clinicians' experiences of learning to use eye movement desensitisation and reprocessing therapy with people with intellectual disabilities: A qualitative study

McKillop,

Spencer,

Marrington

2024

Research Intellect Disabil

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BackgroundEye Movement Desensitisation and Reprocessing therapy (EMDR) is a NICE recommended treatment for post‐traumatic stress disorder within the general population. Ongoing research is now investigating the use of EMDR for individuals with intellectual disability. Alongside quantitative research efforts, it is beneficial to explore the qualitative experience of clinicians adopting EMDR in their practice. The current study interviewed newly trained EMDR therapists working in intellectual disability services.MethodParticipants (six Clinical Psychologists from an NHS learning disability service) had recently undertaken EMDR training as part of a wider randomised control trial (Trauma‐AID). Interviews were qualitatively analysed using thematic analysis.ResultsThree themes emerged; learning EMDR, conducting EMDR and external factors, with respect to clinicians' experiences.ConclusionsFurther research is needed to provide guidance and reassurance for clinicians currently using or hoping to use this therapy with people with intellectual disabilities.

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“Without it, I am not sure I would still be here”: a mixed methods service evaluation for online EMDR trauma therapy in a primary care network in England

Kaptan,

Dernedde,

Dowden

et al. 2023

Front. Psychiatry

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IntroductionPsychological services are typically offered via specialized mental health services, which are often overwhelmed with long waitlists. To address this need and provide patients with a service characterized by shorter waiting times and increased accessibility, online Eye Movement Desensitization and Reprocessing (EMDR) was established in the North Norfolk 4 Primary Care Network.MethodsThis article presents this service’s collaborative funding, development and outcomes within local GP surgeries. It constitutes a mixed-method service evaluation encompassing the future of EMDR in primary care services. Additionally, it includes the assessment of anxiety, depression, and PTSD symptoms as well as work and social adjustment in a cohort of 83 patients alongside a Thematic Analysis involving eighteen patients and six GPs.ResultsThe evaluation showed high completion and attendance among service users. Quantitative scores combined with qualitative feedback from patients and practitioners highlight the potential impact of EMDR therapy on General Practice and its broader provision of trauma-focused therapies. The most significant improvements were observed in anxiety and depression scores. Thematic Analysis indicated that the patients found the service helpful, labeling it as a “life-saver.” They also discussed why they found the service effective; some also wished the service had been available earlier.DiscussionFindings underscore the potential of EMDR and online EMDR as an accessible and effective approach within primary care settings. The assessments showed an elevated level of access and attendance among service users. Therefore, it is recommended that timely EMDR services be extended through primary care networks.

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Some observations on remote delivery of eye‐movement desensitisation and reprocessing to people with intellectual disabilities

Cited by 5 publications

References 39 publications

EMDR treatment for people with intellectual disabilities: a systematic review about difficulties and adaptations

EMDR treatment for people with intellectual disabilities: a systematic review about difficulties and adaptations

Clinicians' experiences of learning to use eye movement desensitisation and reprocessing therapy with people with intellectual disabilities: A qualitative study

“Without it, I am not sure I would still be here”: a mixed methods service evaluation for online EMDR trauma therapy in a primary care network in England

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