EMDR treatment for PTSD and Intellectual Disability: a case study
| Pages | 90-98 |
| Date | 02 March 2015 |
| DOI | https://doi.org/10.1108/AMHID-09-2014-0034 |
| Published date | 02 March 2015 |
| Author | Alastair L. Barrowcliff,Gemma A. L Evans |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Accounting education |
EMDR treatment for PTSD and Intellectual
Disability: a case study
Alastair L. Barrowcliff and Gemma A.L. Evans
Dr Alastair L. Barrowcliff is a
Consultant Clinical
Psychologist, based at Five
Boroughs Partnership NHS
Foundation Trust, Community
Adult Learning Disability
Service, Prescott, UK.
Dr Gemma A.L. Evans is a
Clinical Psychologist, based at
Department of Clinical
Psychology, University of
Manchester, Manchester, UK.
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/researchquestions 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.
Keywords Trauma, PTSD, Intellectual Disability, Learning disability, EMDR,
Mucopolysaccharidosis Hunters Syndrome
Paper type Case study
Introduction
A dilemma that often presents within the clinical setting, is the complex client who does not fit
comfortably within the parameters specified for delivery of the established therapeutic
interventions, that would otherwise be automatically considered if the service user did not have
an Intellectual Disability (ID). In this paper we reflect on a clinical case presenting with Post-
TraumaticStress Disorder (PTSD) treatedusing an adaptedEye-Movement Desensitisation and
Reprocessing (EMDR) intervention. Whilst there is a small but developing literature highlighting
the application of EMDR for ID populations, the presenting complexity and the necessary
treatment protocol adaptations makes this case study of particular interest.
ID and PTSD
ID is characterised by limitations in intellectual, social, and adaptive functioning, with an onset
before adulthood (British Psychological Society,2000). PTSD is characterised as the experience
or witnessing of a traumatic event with subsequent symptoms involving intrusions, avoidance,
hyper-arousal and negative alterations in cognitions and mood (American Psychiatric
Association, 2013). Proposed adaptations for the recognition of PTSD in clients with ID
include: increased breadth of events considered traumatic; increased likelihood of disorganised
PAGE 90
j
ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 9 NO. 2 2015, pp. 90-98, CEmerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-09-2014-0034
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