Page 93 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Brief intensive EMDR therapy for PTSD
Discussion
The results demonstrated a significant reduction in PTSD symptoms, with
nine out of 11 participants no longer meeting the PTSD diagnostic criteria
post-intervention. These improvements were maintained at both the 9-week
and 4-month follow-ups, indicating the sustained efficacy of intensive EMDR
therapy in this population. These findings align with previous research on
intensive trauma therapy in children and adolescents with MID-BIF and
PTSD (Ooms-Evers et al., 2021). Importantly, the intervention showed no
adverse events, underscoring its safety.
Only one participant discontinued therapy. This is consistent with the low
dropout rates consistently reported in intensive trauma-focused treatment
programs (for example, Bongaerts et al., 2022; Voorendonk et al., 2023)
in the general population. The intensive format, with frequent scheduled
sessions has been found to be capable of reducing avoidance behaviour
and fostering greater engagement (Hendriks et al., 2018; Szafranski et
al., 2017).
The outcomes for adaptive behaviour indicated improvements in some
participants, whereas others exhibited less noticeable changes. Meaningful
changes in adaptive behaviour may require direct, targeted intervention
aimed at learning new skills and adapting the environment. For example,
adaptive behaviour, such as ‘the participant independently walking home
from work’, may be facilitated by a reduction in PTSD symptoms, but the
ongoing involvement of professional caregivers may result in the caregivers
continuing walking alongside the individual, preventing actual improvement
in adaptive behaviour in the participant.
Some participants showed minimal change in behavioural problems,
whereas others showed weak improvement. In addition, no change
(meaning no increase and no decrease) in involuntary care measures
were observed, which could be attributed to the continued presence of
behavioural problems. Although brief tracks of trauma-focused treatment
have generally been found to reduce the severity of PTSD symptoms
(Hoppen et al., 2023; Voorendonk et al., 2023), this may not necessarily
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