Page 103 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Experiences with intensive EMDR and rotating therapists
Introduction
Individuals with mild intellectual disability (MID; IQ 50-70) or borderline
intellectual functioning (BIF; IQ 70-85) may be at a higher risk of developing
post-traumatic stress disorder (PTSD) compared to the general population
(Mason-Roberts et al., 2018; Nieuwenhuis et al., 2019; Versluis et al.,
2025b). The prevalence of PTSD in this group ranges from 10% to 40%, with
higher rates reported among those living in supported housing (Mevissen
et al., 2020a; Versluis et al., 2025b). Frequent exposure to traumatic
events (McDonnel et al., 2019; Nieuwenhuis et al., 2019) and difficulties
in processing these events owing to deficits in adaptive and cognitive
functioning (Skelly, 2020) can be attributed to this elevated risk.
Although PTSD has an acute onset, its recovery can run a protracted course.
Treatments that only require a brief period to work are therefore particularly
helpful. Preliminary research indicates that Intensive EMDR therapy with a
team of rotating therapists is effective in treating PTSD in adults with MID-
BIF (Versluis et al., 2025a). To optimise treatment outcomes, it is important
to understand how clients experience this treatment format.
EMDR for individuals with MID-BIF
EMDR therapy is an eight-phase, structured therapy aimed at resolving
symptoms resulting from traumatic memories (Shapiro, 2018). EMDR is
currently the most extensively studied PTSD treatment among individuals
with MID-BIF, and findings suggest that it is a safe, feasible, and potentially
effective therapy for this group (e.g., Byrne et al., 2020; Penninx Quevedo
et al., 2021; Verhagen et al., 2023). For most of these studies, the EMDR
protocol for children and adolescents up to 18 years of age (De Roos et al.,
2021) was applied, which is adapted for individuals with lower language
skills and has proven to be suitable and potentially effective for individuals
with MID-BIF (Byrne et al., 2020; Penninx et al., 2021; Schipper-Eindhoven
et al., 2024; Verhagen et al., 2023). This protocol includes the same eight
phases as the standard protocol developed by Shapiro (2018).
Schipper-Eindhoven et al. (2024) conducted a systematic review of 13
studies to identify and categorise the difficulties therapists face when
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