Some observations on remote delivery of eye-movement desensitisation and reprocessing to people with intellectual disabilities

Gemma Unwin; Biza Stenfert-Kroese; Gemma Rogers; Sophie Swain; Steve Hiles; Clair Clifford; Derek Farrell; Paul Willner

doi:10.1111/jppi.12452

Some observations on remote delivery of eye-movement desensitisation and reprocessing to people with intellectual disabilities

Gemma Unwin, Biza Stenfert-Kroese, Gemma Rogers, Sophie Swain, Steve Hiles, Clair Clifford, Derek Farrell, Paul Willner^*

^*Corresponding author for this work

Psychology

Research output: Contribution to journal › Article › peer-review

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Abstract

It is increasingly recognised that many people with intellectual disabilities suffer from post-traumatic stress disorder (PTSD). Eye-movement desensitisation and reprocessing (EMDR) has been proposed as a potentially helpful intervention that is less reliant on verbal skills than other effective treatments for PTSD and therefore could be more effective than verbal interventions for people with intellectual disabilities. The Trauma-AID project is a randomised clinical trial (RCT) evaluating the effectiveness of a bespoke EMDR protocol for adults with intellectual disability and PTSD, which incorporates a prolonged phase of Psycho-Education and Stabilisation (PES) prior to the trauma confrontation phase of EMDR. The COVID-19 pandemic struck during the feasibility phase of the Trauma-AID project, necessitating a second feasibility study to evaluate the acceptability and feasibility of remote or hybrid delivery of the PES + EMDR protocol. To this end, we conducted two online surveys of therapists followed by interviews with clients, carers and senior therapists. The surveys were analysed descriptively. Content analysis was used for client and carer interviews, and framework analysis for therapist interviews. All stakeholders reported positive experiences of EMDR; however, some challenges were identified. The majority of clients, carers and therapists interviewed reported that the intervention, whether PES alone or the full PES-EMDR package, had improved symptoms of PTSD and psychological well-being, and carers also reported decreases in challenging behaviour. A full account of the data is provided in four Supplementary Digital files. PES-EMDR therapy appears both feasible and acceptable for clients with intellectual disabilities and therapists, whether delivered face-to-face or in a remote or hybrid mode, though remote working appears easier for the PES phase than the EMDR phase of the intervention.

Original language	English
Pages (from-to)	205-215
Number of pages	11
Journal	Journal of Policy and Practice in Intellectual Disabilities
Volume	20
Issue number	2
Early online date	13 Jan 2023
DOIs	https://doi.org/10.1111/jppi.12452
Publication status	Published - Jun 2023

Bibliographical note

Funding Information:
This study is funded by the National Institute for Health Research (NIHR) [Health Technology Assessment project 17/125/04]. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Funding Information:
This paper reports initial data from the Trauma‐AID project (full title: Eye movement desensitisation and reprocessing for symptoms of PTSD in adults with intellectual disabilities), which is a randomised controlled trial (RCT) of a PES + EMDR intervention adapted for people with intellectual disabilities that is currently recruiting participants (funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme). The project began with a feasibility study designed primarily to test the acceptability of the PES‐EMDR intervention. A second feasibility study was subsequently initiated to examine the acceptability of remote or hybrid delivery, as a result of the COVID‐19 pandemic and a move to a remote working model across the participating sites. This article presents the results of those feasibility studies. (A separate publication will present a detailed account of the protocol for the RCT.) We aimed to confirm the acceptability of the adapted PES‐EMDR protocol implemented in the Trauma‐AID study, and to evaluate the acceptability and feasibility of remote delivery of the intervention. As a result of the pandemic, remote delivery of interventions has become routine within many clinical psychology services. To the best of our knowledge, this is the first account of the remote delivery of EMDR to people with intellectual disabilities.

Publisher Copyright:
© 2023 The Authors. Journal of Policy and Practice in Intellectual Disabilities published by International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals LLC.

Keywords

acceptability
eye-movement desensitisation and reprocessing
feasibility
hybrid delivery
intellectual disability
post-traumatic stress disorder
remote delivery

ASJC Scopus subject areas

Health(social science)
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/jppi.12452Licence: Creative Commons: Attribution (CC BY)

UnwinG2023ObservationsFinal published version, 581 KBLicence: Creative Commons: Attribution (CC BY)

Cite this

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abstract = "It is increasingly recognised that many people with intellectual disabilities suffer from post-traumatic stress disorder (PTSD). Eye-movement desensitisation and reprocessing (EMDR) has been proposed as a potentially helpful intervention that is less reliant on verbal skills than other effective treatments for PTSD and therefore could be more effective than verbal interventions for people with intellectual disabilities. The Trauma-AID project is a randomised clinical trial (RCT) evaluating the effectiveness of a bespoke EMDR protocol for adults with intellectual disability and PTSD, which incorporates a prolonged phase of Psycho-Education and Stabilisation (PES) prior to the trauma confrontation phase of EMDR. The COVID-19 pandemic struck during the feasibility phase of the Trauma-AID project, necessitating a second feasibility study to evaluate the acceptability and feasibility of remote or hybrid delivery of the PES + EMDR protocol. To this end, we conducted two online surveys of therapists followed by interviews with clients, carers and senior therapists. The surveys were analysed descriptively. Content analysis was used for client and carer interviews, and framework analysis for therapist interviews. All stakeholders reported positive experiences of EMDR; however, some challenges were identified. The majority of clients, carers and therapists interviewed reported that the intervention, whether PES alone or the full PES-EMDR package, had improved symptoms of PTSD and psychological well-being, and carers also reported decreases in challenging behaviour. A full account of the data is provided in four Supplementary Digital files. PES-EMDR therapy appears both feasible and acceptable for clients with intellectual disabilities and therapists, whether delivered face-to-face or in a remote or hybrid mode, though remote working appears easier for the PES phase than the EMDR phase of the intervention.",

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Some observations on remote delivery of eye-movement desensitisation and reprocessing to people with intellectual disabilities

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Fingerprint

Cite this