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Article
Publication date: 10 May 2023

Chloe Louise Williamson and Kelly Rayner-Smith

This paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have…

Abstract

Purpose

This paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have experienced trauma.

Design/methodology/approach

Relevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide support for the use of EMDR as a treatment for trauma in children with ID.

Findings

There is a growing body of evidence which demonstrates that EMDR therapy is successful for the treatment of trauma in adults and children. However, for children with ID, the research is limited despite those with ID being more likely than non-disabled peers to experience trauma such as abuse or neglect.

Practical implications

EMDR can only be facilitated by trained mental health nurses, psychiatrists, psychologists (clinical, forensic, counselling or educational) or occupational therapists or social workers with additional training. Finally, general practitioners who are experienced in psychotherapy or psychological trauma and have accreditation. Therefore, this highlights that there may be a lack of trained staff to facilitate this intervention and that those who are generally working with the client closely and long term such as learning disability nurses are not able to conduct this intervention.

Originality/value

This paper presents an account of NICE guidance and evidence of the efficacy of EMDR as a treatment for adults, children and those with ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 18 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 5 January 2022

Joanne L.B. Porter

Emerging evidence indicates that adapted eye movement desensitisation and reprocessing (EMDR) can be useful for people with intellectual disabilities in treating post-traumatic…

Abstract

Purpose

Emerging evidence indicates that adapted eye movement desensitisation and reprocessing (EMDR) can be useful for people with intellectual disabilities in treating post-traumatic stress disorder (PTSD). However, the required adaptations are not described in enough detail across the literature, making it difficult for therapists to easily adapt EMDR for people with intellectual disabilities. This paper aims to address this by describing 14 clinical cases, along with outcome data for six people, and the views of five people with intellectual disabilities about EMDR.

Design/methodology/approach

A total of 14 people with mild or moderate intellectual disabilities and varied experiences of trauma were offered EMDR by one clinical psychologist in a UK NHS setting; nine people completed EMDR therapy, six people provided outcome data with pre-post measures and five people were asked two questions about EMDR therapy.

Findings

Adaptations are described. The outcome data indicate reductions in symptoms of PTSD following EMDR intervention. EMDR was liked and perceived as useful.

Originality/value

This paper provides details about adaptations that can be made to the standard EMDR protocol, reports the views of service users about EMDR and adds evidence that EMDR reduces symptoms of PTSD in people who have intellectual disabilities.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 16 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

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 hospital with…

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

Keywords

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 with…

388

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

Keywords

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

343

Abstract

Details

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

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

Open Access
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 activities…

2094

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

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 disabilities…

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

Keywords

Article
Publication date: 21 August 2023

Angelo Zappalà, Ivan Mangiulli, Pekka Santtila, Elizabeth F. Loftus and Henry Otgaar

The purpose of this study was to investigate cognitive behavior therapists and trainees’s beliefs about various aspects of traumatic memory and to investigate cognitive behavior…

Abstract

Purpose

The purpose of this study was to investigate cognitive behavior therapists and trainees’s beliefs about various aspects of traumatic memory and to investigate cognitive behavior therapists’ practices in relation to alleged traumatic experiences and whether they are linked with their beliefs about various aspects of traumatic memory.

Design/methodology/approach

In the current study, the authors surveyed, by a questionnaire (in Italian), certified Italian cognitive behavioral (CB) therapists and trainees with respect to their beliefs in traumatic memories and whether they discussed about the possibility of repressed memory with their patients.

Findings

The majority of participants held strong beliefs about many controversial aspects related to traumatic memory, such as the mind being able to block out of consciousness memories of traumatic experiences. Also, more than half of CB therapists stated that they sometimes discussed about the importance of traumatic events in the genesis of their patient’s disorder and half of them sometimes talked with patients about memories for traumatic events of which they may be unaware. Such practices could lead to false memories of abuse

Originality/value

One particularly novel finding relates to the evidence that therapists reported that they had discussed with patients the importance of traumatic events in the genesis of their illness and frequently noted that they talked about the possibility of repressed memories with them. In turn, patients may be induced to recall traumatic experiences from their lives, thereby producing false memories which may tear families apart and could even lead to wrongful convictions.

Details

Journal of Criminal Psychology, vol. 14 no. 1
Type: Research Article
ISSN: 2009-3829

Keywords

1 – 10 of 78