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Article
Publication date: 28 February 2019

Phyllis Annesley, Adedayo Alabi and Laura Longdon

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure…

Abstract

Purpose

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT).

Design/methodology/approach

Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation.

Findings

The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks.

Practical implications

This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure.

Originality/value

The case report offers an important contribution to an area that requires much further research.

Details

Journal of Criminological Research, Policy and Practice, vol. 5 no. 1
Type: Research Article
ISSN: 2056-3841

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Article
Publication date: 6 April 2012

Rachel Worthington

The purpose of this paper is to explore the impact of trauma with specific consideration to the neurological impact this has on information processing and potential links…

Abstract

Purpose

The purpose of this paper is to explore the impact of trauma with specific consideration to the neurological impact this has on information processing and potential links with aggression.

Design/methodology/approach

This paper provides a summary of the literature in relation to theories of aggression and trauma. The paper considers how the two may interact and overlap and considers a theoretical rationale for why addressing trauma through a treatment such as Eye Movement Desensitization Reprocessing (EMDR) may assist to reduce aggression.

Findings

The paper argues that the experience of trauma may contribute to inputs which may take a person closer towards engaging in aggression. This is consistent with information processing models and unified models of aggression such as the General Aggression Model. Factors that were specifically identified included physiological hyper‐arousal, hostile attributions of stimulus, and neurological impairments. In addition, the paper also argued that there is evidence that as a result of trauma, a person's ability to provide cognitive accounts for the function of their behaviour may also be impaired because of the reduced interactivity between the two prefrontal hemispheres.

Research limitations/implications

The paper argues that as a result, interventions designed to reduce aggression may benefit from including additional elements which directly assist clients to process emotional information and that a reprocessing treatment such as EMDR could assist to reduce levels of emotional arousal and improve treatment effectiveness. Differences in the way in which EMDR is carried out and the variances in treatment protocols used should be attended to increase the reliability of future research.

Originality/value

Current modes of aggression therapy have focused on exposure based and cognitive behavioural therapy (CBT). However, there is evidence that EMDR has benefits over exposure and CBT approaches because of the way in which cognitive verbal accounts of the trauma are not required and because EMDR does not require the individual to have insight into their trauma experience and the link with aggression.

Details

Journal of Aggression, Conflict and Peace Research, vol. 4 no. 2
Type: Research Article
ISSN: 1759-6599

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Article
Publication date: 2 March 2015

Alastair L. Barrowcliff and Gemma A. L Evans

The purpose of this paper is to provide a detailed description of an adapted Eye-Movement Desensitisation and Reprocessing (EMDR) intervention in the treatment of chronic…

Abstract

Purpose

The purpose of this paper is to provide a detailed description of an adapted Eye-Movement Desensitisation and Reprocessing (EMDR) intervention in the treatment of chronic Post-Traumatic Stress Disorder (PTSD) in an individual with moderate-severe Intellectual Disability (ID), blindness, and Mucopolysaccharidosis Hunters Syndrome.

Design/methodology/approach

A case study reporting on the implementation of an eight phase EMDR approach adapted for intellectual and sensory requirements. The intervention involved a series of preparatory meetings and four sessions of EMDR.

Findings

The intervention was successful in ameliorating most symptoms attributed to a PTSD presentation.

Research limitations/implications

The availability of the full breadth of treatment options for PTSD as indicated in National Institute for Health and Care Excellence (2005) is questionable in clinical practice with individuals with ID. Appropriate investment in research determining the most efficacious interventions for this clinical population is required.

Originality/value

This case study addresses issues of complexity in respect of the assessment and treatment of trauma in an ID population. It raises a number of important social/research questions in addition to providing a high level of detail in regard to the adaptations required to deliver EMDR for a complex individual whilst retaining fidelity to the standard treatment model.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

Content available
Article
Publication date: 18 October 2011

Abstract

Details

Health Education, vol. 111 no. 6
Type: Research Article
ISSN: 0965-4283

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Article
Publication date: 9 March 2015

Rachel Worthington

– The purpose of this paper is to explore the ways in which trauma may manifest both in terms of internalising and externalising symptoms.

Abstract

Purpose

The purpose of this paper is to explore the ways in which trauma may manifest both in terms of internalising and externalising symptoms.

Design/methodology/approach

The paper will argue that the effects of trauma can contribute to victims engaging in problematic behaviours (such as aggression) both towards themselves and others which may require them to attend treatment programmes to target these problem behaviours. However, standard interventions designed to target these problem behaviours do not sufficiently take into account the effects of trauma in terms of attending to the therapy interfering behaviours which are brought to treatment. The paper will argue that these trauma related therapy interfering behaviours should be attended to prior to the client engaging in specific groups to target other problem behaviours (e.g. aggression).

Findings

Clients who are referred for standard group based interventions to target problem behaviours such as aggression towards themselves or others should be offered a trauma intervention first in order to improve concentration, reduce drop-out rates and enhance feelings of safety to engage effectively in the group. Group based Eye Movement Desensitisation and Reprocessing (EMDR) should be used as a method of targeting therapy interfering behaviours associated with the effects of trauma and this should also incorporate meditation and neurobiologically informed approaches. Standard target problem behaviour groups should be adapted and modified to account for the role of trauma in information processing.

Originality/value

The paper will introduce Trauma Informed Additional – Programme (TIA-P) which is a newly designed group designed to assist clients to tolerate and modify therapy interfering behaviours which are present as a result of trauma in order that they can then go on to attend standardised interventions. The TIA-P attends to the latest research in relation to the treatment of trauma utilising EMDR within the group to enhance safety and reduce therapy interfering behaviours.

Details

Journal of Criminological Research, Policy and Practice, vol. 1 no. 1
Type: Research Article
ISSN: 2056-3841

Keywords

Content available
Article
Publication date: 30 January 2012

Ad de Jongh

A disproportionate fear of vomiting, or emetophobia, is a chronic and disabling condition which is characterized by a tendency to avoid a wide array of situations or…

Abstract

A disproportionate fear of vomiting, or emetophobia, is a chronic and disabling condition which is characterized by a tendency to avoid a wide array of situations or activities that might increase the risk of vomiting. Unlike many other subtypes of specific phobia, emetophobia is fairly difficult to treat. In fact, there are only a few published cases in the literature. This paper presents a case of a 46-year old woman with emetophobia in which a trauma-focused treatment approach was applied; that is, an approach particularly aimed at processing disturbing memories of a series of events which were considered to be causal in the etiology of her condition. Four therapy sessions of Eye Movement Desensitization and Reprocessing (EMDR) produced a lasting decrease in symptomatology. A 3-year follow up showed no indication of relapse.

Details

Mental Illness, vol. 4 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

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Article
Publication date: 1 January 2014

Richard Dilly

The purpose of this paper is to explore the effectiveness of Eye Movement Desensitisation and Reprocessing (EMDR) therapy in an individual with mild intellectual…

Abstract

Purpose

The purpose of this paper is to explore the effectiveness of Eye Movement Desensitisation and Reprocessing (EMDR) therapy in an individual with mild intellectual disabilities currently compulsorily detained in secure care.

Design/methodology/approach

The intervention utilised the EMDR eight-phase protocolised psychotherapeutic approach. Sessions utilised symbol cards to explore the impact of the client's experiences in relation to his thoughts, emotional feelings, physical feelings and behaviour. Drawings were also utilised to assist the client to develop a picture of the traumatic incident. A “safe place visualisation technique” was also utilised at the end of every session to manage any distress. The Posttraumatic Stress Diagnostic Scale (PDS) with some minor adaptations for use with people with intellectual disabilities was utilised as a pre- and post-measure.

Findings

The study identified reductions in symptoms in all three core clinical subgroups of the PDS: re-experiencing, avoidance and arousal, with outcomes being maintained at one-month and six -month follow-up. Reduction in the strength of ratings was most evident in the avoidance domain.

Originality/value

There are limited studies exploring the effectiveness of EMDR with individuals with intellectual disabilities.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 1
Type: Research Article
ISSN: 2044-1282

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Book part
Publication date: 25 August 2020

Johnrev Guilaran and Hong An Nguyen

Disaster responders play a crucial role in providing aid to individuals and communities following catastrophic events. Being tasked to protect and preserve life and…

Abstract

Disaster responders play a crucial role in providing aid to individuals and communities following catastrophic events. Being tasked to protect and preserve life and property, these groups of professionals are constantly exposed to various hazards, which puts them at risk of negative mental health consequences. This chapter describes and discusses these mental health effects and interventions for disaster responders in Southeast Asia. The chapter defines who the disaster responders are in Southeast Asian countries. Drawing from the literature, this chapter enumerates the various positive and negative psychological consequences of disaster response, and the risk and protective factors associated with disaster response work. This chapter also describes the different interventions, such as psychological first aid and psychotherapy, following the Inter-agency Standing Committee (IASC) (2007) guidelines on conducting mental health and psychosocial support services (MHPSS), and focusing on the Southeast Asian context. This chapter ends with a discussion of the different challenges of providing MHPSS in Southeast Asia and with some recommendations on how to improve the delivery of these services and the mental health of disaster responders in general.

Details

Resistance, Resilience, and Recovery from Disasters: Perspectives from Southeast Asia
Type: Book
ISBN: 978-1-83909-791-1

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Article
Publication date: 1 April 1987

Athena Petraki Kottis

Despite certain improvements in the relative position of working women in Greece in recent years, there are still significant female‐male earnings differentials in all…

Abstract

Despite certain improvements in the relative position of working women in Greece in recent years, there are still significant female‐male earnings differentials in all sectors and industries of the economy. As can be seen from Table I, the earnings of women in most manufacturing industries in 1984 were way below the earnings of men, particularly in the case of salaried employees. Comparing the female‐male earnings ratios for 1976 and 1984 we see an improvement in women's relative position but the gender gap still remained quite large in 1984.

Details

International Journal of Manpower, vol. 8 no. 4
Type: Research Article
ISSN: 0143-7720

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Article
Publication date: 25 September 2019

John Barry Sims

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as…

Abstract

Purpose

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK.

Design/methodology/approach

This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author.

Findings

The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity.

Research limitations/implications

The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions.

Practical implications

A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes.

Originality/value

This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.

Details

Journal of Public Mental Health, vol. 18 no. 4
Type: Research Article
ISSN: 1746-5729

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