Page 78 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Chapter 4
measures were frequently taken, up to 43.6% (audio surveillance), 41.6%
(limited access to rooms/areas), and 33% (locking outer doors) for persons
residing in assisted living units for people with intellectual disabilities.
Trauma-focused therapeutic approaches such as eye movement
desensitisation and reprocessing (EMDR) therapy have shown promising
results for individuals in the general population (De Jongh et al., 2024).
However, the application of traditional treatments for PTSD in the general
population has been found to be associated with high dropout rates,
possibly due to symptom exacerbation, which can be challenging to
distinguish from the temporary distress inherent in trauma-focused therapy
(e.g. Bongaerts et al., 2022; Lewis et al., 2020; Van Woudenberg et al., 2018).
Between one-quarter and one-third of the participants undergoing trauma
treatment discontinued treatment, with some studies showing even higher
dropout rates (e.g. Niles et al., 2018). To address this issue, intensive trauma
treatments have been developed, involving multiple therapy sessions per
week or even multiple sessions per day, often with different therapists
rotating during sessions to maintain treatment intensity. Intensive trauma
treatments have been associated with improved therapeutic outcomes in
the general population (Hoppen et al., 2023), and these intensive treatments
have resulted in low dropout rates. For example, Van Woudenberg et al.
(2018) reported a dropout rate less than 3%, whereas Bongaerts et al.
(2022) achieved no dropout.
Although intensive trauma treatments have been shown to be effective
in children and adolescents with MID-BIF (Ooms-Evers et al., 2021), the
effectiveness of intensive EMDR therapy in adults with MID-BIF and severe
behavioural problems has not been investigated. Tests of suitable treatment
options, such as intensive EMDR therapy, for adults with MID-BIF and severe
behavioural problems are urgently needed for this vulnerable population.
The purpose of the present study was to determine the safety and
effectiveness of intensive EMDR therapy with a team of rotating therapists
in adults with MID-BIF and PTSD. We hypothesised that PTSD symptoms
and behavioural problems would significantly decline after treatment, and
that participants’ adaptive behaviour (i.e. behaviour in daily life, related to
PTSD symptoms, such as talking to strangers again; see Methods) would
improve, and these changes will persist at the 6-week, 9-week, and 4-month
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