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Literature on trauma and post‐traumatic stress disorder (PTSD) has neglected the needs of people with intellectual disability, particularly those in forensic settings. The National Centre for High Secure Learning Disability Services at Rampton Hospital conducted a service evaluation on aspects of trauma experience and post‐trauma symptoms in the current population. File information and self‐reports indicated that most individuals had experienced a great deal of lifetime trauma, typically multiple types of abuse. A high rate of potentially trauma‐related symptoms was noted in files. However, file records of potentially traumatic events, including abuse, were often lacking in detail. There was limited information about the events themselves, and there was no information to suggest that any trauma‐specific assessments had been used to measure trauma exposure or symptoms. PTSD as a diagnosis was rarely considered, and there was little consideration of trauma‐specific interventions. While some individuals said that their experiences had resulted in a lot of distress, others could not talk about the past at all. This paper discusses the problem of assessing past trauma and response in a forensic intellectual disability population, and future directions for practice in forensic services. The service under study plans to address the needs of patients who have experienced trauma and abuse by conducting routine structured assessments, offering adapted evidence‐based psychological interventions where appropriate, and providing trauma‐specific education for staff to promote a compassionate approach.

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.

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.

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.

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