J Appl Res Intellect Disabil. 2019;1–13. wileyonlinelibrary.com/journal/jar
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Published for the British Institute of Learning Disabilities
© 2019 John Wiley & Sons Ltd
1 | INTRODUCTION
Reported prevalence rates for post‐traumatic stress disorder
(PTSD) among people with intellectual disabilities vary widely
from 2.5% to 60% (Mevissen & De Jongh, 2010), but are likely to
be higher among people with intellectual disabilities as they are
more likely to experience adverse life events than the general pop‐
ulation (Hatton & Emerson, 2004; Sequeira & Hollins, 2003), in
part because they are more likely to experience loss and are more
vulnerable to abuse. Such experiences lead to trauma‐related
mental health problems and psychopathology (Hulbert‐Williams,
Hastings, Crowe, & Pemberton, 2011; Wigham, Taylor, & Hatton,
2014). People with intellectual disabilities may be more vulnera‐
ble to the effects of stressful and traumatic experiences due to
impairments in stress appraisal, difficulties in appraising and pro‐
cessing information, difficulties in reasoning and adaptability, a
need for a structured and predictable environment, and a limited
behaviour repertoire leading to reduced successful avoidance of
Received: 21 March 2018
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Revised: 8 October 2018
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Accepted: 22 November 2018
DOI: 10.1111/jar.12557
ORIGINAL ARTICLE
Eye movement desensitization and reprocessing for adults with
intellectual disabilities: Process issues from an acceptability
study
Gemma Unwin
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| Sara Willott
2
| Stacey Hendrickson
1
| Biza Stenfert Kroese
1
1
School of Psychology, University of
Birmingham, Birmingham, UK
2
Birmingham Community Healthcare NHS
Foundation Trust, Birmingham, UK
Correspondence
Gemma Unwin, School of Psychology,
University of Birmingham, Edgbaston,
Birmingham, UK.
Email: G.L.Unwin@bham.ac.uk
Funding information
Birmingham Community Healthcare NHS
Foundation Trust funded this project.
Abstract
Background: Eye movement desensitization and reprocessing (EMDR) is recom‐
mended for post‐traumatic stress disorder and emerging evidence indicates that
it is effective for people with intellectual disabilities. However, acceptability from
the perspectives of clients with intellectual disabilities, their therapists and other
key people has not been formally evaluated. This study investigates process is‐
sues in the implementation of EMDR from perspectives of multiple
stakeholders.
Method: Semi‐structured interviews were conducted with two adults with intellec‐
tual disabilities and three clinical psychologists who had participated in EMDR as well
as a key supporter (N = 6) to provide information relating to three cases. The inter‐
views were analysed thematically either directly from the audio recording or from
transcripts.
Results: Five themes were identified: EMDR feels very different; EMDR is a technical
process; the need to work with the present; talking is important; cautious optimism.
Conclusions: Whilst a range of client‐ and therapist‐related factors served as barriers
to using EMDR in this small‐scale study, such as preferences in working with the
present and inexperienced therapists, there was cautious optimism that EMDR may
be useful for “the right person at the right time.”.
KEYWORDS
eye movement desensitization and reprocessing, mental health problems, post‐traumatic
stress disorder, therapy, trauma