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Cited by 11Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsElectroconvulsive Therapy Studies

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

Open access
Unwin, Gemma, Stenfert‐Kroese, Biza, Rogers, Gemma, Swain, Sophie, Hiles, Steve, Clifford, Clair, Farrell, Derek, Willner, Paul·2023·Journal of Policy and Practice in Intellectual Disabilities
DOI 10.1111/jppi.12452
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Abstract

Abstract It is increasingly recognised that many people with intellectual disabilities suffer from post‐traumatic stress disorder (PTSD). Eye‐movement desensitisation and reprocessing (EMDR) has been proposed as a potentially helpful intervention that is less reliant on verbal skills than other effective treatments for PTSD and therefore could be more effective than verbal interventions for people with intellectual disabilities. The Trauma‐AID project is a randomised clinical trial (RCT) evaluating the effectiveness of a bespoke EMDR protocol for adults with intellectual disability and PTSD, which incorporates a prolonged phase of Psycho‐Education and Stabilisation (PES) prior to the trauma confrontation phase of EMDR. The COVID‐19 pandemic struck during the feasibility phase of the Trauma‐AID project, necessitating a second feasibility study to evaluate the acceptability and feasibility of remote or hybrid delivery of the PES + EMDR protocol. To this end, we conducted two online surveys of therapists followed by interviews with clients, carers and senior therapists. The surveys were analysed descriptively. Content analysis was used for client and carer interviews, and framework analysis for therapist interviews. All stakeholders reported positive experiences of EMDR; however, some challenges were identified. The majority of clients, carers and therapists interviewed reported that the intervention, whether PES alone or the full PES‐EMDR package, had improved symptoms of PTSD and psychological well‐being, and carers also reported decreases in challenging behaviour. A full account of the data is provided in four Supplementary Digital files. PES‐EMDR therapy appears both feasible and acceptable for clients with intellectual disabilities and therapists, whether delivered face‐to‐face or in a remote or hybrid mode, though remote working appears easier for the PES phase than the EMDR phase of the intervention.

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  • EMDR therapy is effective in mitigating PTSD symptoms among individuals with intellectual disabilities, possibly surpassing verbal interventions.

    “Furthermore, the efficacy of EMDR therapy in mitigating symptoms of PTSD among individuals with intellectual disabilities has been emphasized, implying that it might surpass the effectiveness of verbal interventions tailored to this population [77,78].”

    From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [77]

    The Abstract proposes that EMDR could be more effective than verbal interventions for people with intellectual disabilities, and the Carers section reports perceived improvements in PTSD symptoms. But those improvements were reported for either PES alone or the full PES–EMDR package; the Introduction says firm conclusions about EMDR's effectiveness cannot yet be drawn. The paper therefore supports the possibility, not established efficacy or superiority. (LLM, conf=0.86)

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Research works printed but not linked: 3

  1. Hall, J. C., Jobson, L., & Langdon, P. E. (2014). Measuring symp- toms of posttraumatic stress disorder in people with intellectual disabilities: The development and psychometric properties of the impact of event scale-intellectual disabilities (IESIDs). Brit- ish Journal of Clinical Psychology, 53, 315-322.
  2. Mevissen, L., Didden, R., Korzilius, H., & De Jongh, A. (2017). EMDR therapy for PTSD in children and adolescents with mild to borderline intellectual disability: A multiple baseline across subjects study. Journal of Applied Research in Intellectual Dis- abilities, 30, 34-41.
  3. van Teijlingen, E., & Ireland, J. (2003). Research interviews in mid- wifery. RCM Midwives Journal, 6(6), 260-263.

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Authors
Unwin, G., Stenfert‐Kroese, B., Rogers, G., Swain, S., Hiles, S., Clifford, C., Farrell, D., & Willner, P.
Affiliations
  • University of Birmingham (GB)
  • School of Psychology University of Birmingham Birmingham UK
  • Kent and Medway NHS and Social Care Partnership Trust (GB)
  • Midlands Partnership NHS Foundation Trust (GB)
  • Swansea University (GB)
  • Independent Researcher Solihull UK
  • University of Worcester (GB)
Corresponding author
Willner, Paul
ORCID
Venue
Journal of Policy and Practice in Intellectual Disabilities
Publisher
Wiley
Published
2023-01-13
Volume
20
Issue
2
Pages
205-215
ISSN
  • 1741-1122 (ISSN-L)
  • 1741-1130
DOI
10.1111/jppi.12452
OpenAlex
W4319862082
Cited by
11
References
41
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 1
FWCI
3.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Policy and Practice in Intellectual Disabilities (publishedVersion, cc-by)
  • Cronfa (Swansea University) (submittedVersion, cc-by)
  • Worcester Research and Publications (University of Worcester) (submittedVersion)
Funders
  • National Institute for Health and Care Research (17/125/04)
  • Department of Health and Social Care
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
EMDR, intellectual disability, post-traumatic stress disorder, remote therapy delivery, hybrid therapy, feasibility and acceptability, behavioral problems, caregiver experiences, therapist experience, COVID-19 pandemic

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