Page 143 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

General discussion
into individual change in PTSD symptoms, it does not indicate which
subgroups, for example those differing in the type and number of traumatic
memories, within the MID-BIF population may benefit more or less from
intensive EMDR therapy. In addition, both Study 3 and Study 4 (Chapter
4 and 5) involved adults with MID-BIF living in supported housing within
one Dutch ID care organisation, and the participants in Study 4 formed a
small and selective group of young adult males treated within the same
institutional context. These factors limit the generalisability of the findings
to other settings or individuals.
This key finding supports offering EMDR therapy in an intensive format
for treating PTSD in adults with MID-BIF and severe behavioural problems.
An intensive approach may enhance treatment adherence and maintain
motivation. The positive experiences with multiple therapists further suggest
that working with a rotating team of therapists is feasible for individuals with
MID-BIF and behavioural problems. As this is, to our knowledge, the first
study to examine intensive EMDR therapy in adults with MID-BIF, further
research is required to replicate and extend these findings. Future research
should include more diverse groups, such as individuals from different types
of care settings, to examine the generalisability of brief intensive EMDR
therapy for individuals with MID-BIF. Furthermore, a randomised controlled
trial (RCT) comparing weekly EMDR therapy with intensive EMDR therapy
could provide valuable insight into the relative benefits of both treatment
formats and allow for the identification of potential moderators, such as the
number and type of traumatic events, living environment, or the presence of
severe behavioural problems, that may influence treatment responsiveness,
while also improving external validity. The absence of improvements in
adaptive functioning despite a reduction in PTSD symptoms highlights the
need for research examining the factors that determine whether treatment
effects translate into changes in everyday functioning. More research is
needed to identify which forms of caregiver involvement, environmental
adjustments, or additional interventions could support the generalisation
of treatment effects and facilitate improvements in adaptive behaviour
following trauma-focused treatment.
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