Page 104 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Chapter 5
applying EMDR therapy to individuals with MID-BIF and the adaptations
used to overcome these difficulties. They divided the adaptations made into
three main categories: EMDR delivery (e.g., tuning to the developmental level
of the client, simplifying language, decreasing pace), involvement of others
(e.g., involving family or support staff during or in between sessions), and
the therapeutic relationship (e.g., taking more time, adopting a supportive
attitude).
Intensive trauma treatment
Intensive trauma treatment can be an effective alternative to weekly
treatment for PTSD (Gahnfelt et al., 2025; Hoppen et al., 2023; Hurley, 2018;
Sciarrino et al., 2020). Intensive trauma treatment is often performed by a
team of different therapists, rather than by a single therapist. This approach,
known as working with rotating therapists, means that patients have
therapy sessions with different professionals during their treatment. Such
treatment programs can consist of a single therapy such as EMDR therapy
(e.g., Hurley 2018), or a combination of various therapeutic components,
such as prolonged exposure, psychoeducation and physical and creative
activities (e.g., Voorendonk et al., 2023). Intensive trauma treatment
appears to be as effective as weekly trauma treatment (Hoppen et al.,
2023; Hurley, 2018) and may lead to faster symptom reduction (Gutner et
al., 2016). Consequently, intensive trauma treatment appears to result in
lower dropout rates than weekly trauma treatment (Gahnfelt et al., 2025).
For example, Van Woudenberg et al. (2018) reported a dropout rate of less
than three percent and Bongaerts et al. (2022) achieved no dropouts, which
is much lower than the dropout rates in weekly PTSD treatments, ranging
from 20% to over 30% (Imel et al., 2013; Niles et al., 2018).
For individuals with MID-BIF, intensive trauma treatment with rotating
therapists has also shown promising results, including for children and
adolescents (Ooms-Evers et al., 2021), families (Mevissen et al., 2020), and
adults with severe behavioural problems (Versluis et al., 2025a). Versluis
et al. (2025) investigated the efficacy of Intensive EMDR therapy delivered
twice a day, four days a week for two weeks by a team of six EMDR
therapists. PTSD symptoms were significantly reduced, with 9 out of 11
participants no longer meeting the diagnostic criteria post-treatment, and
one of twelve dropping out.
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