Page 105 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Experiences with intensive EMDR and rotating therapists
Experiences with intensive trauma treatment
In a questionnaire study with participants in the general population, Van
Minnen et al. (2018) found that participants generally preferred treatment
from a rotating team of therapists rather than from an individual therapist.
A qualitative study by Thoresen et al. (2022) reported that participants
experienced daily sessions as very demanding but worth the effort in
terms of reducing symptoms. Therapists’ rotation was also highlighted as
important for treatment efficacy. Butler and Ramsey-Wade et al. (2024)
conducted in-depth interviews to explore the experiences of participants
undergoing Intensive EMDR therapy. EMDR therapy was perceived by their
participants as safe when carried out intensively, promoting the autonomy,
and involvement of the participants.
 Individuals with MID-BIF and rotating therapists
In psychotherapy and trauma treatment literature, on people in the
general population, therapeutic alliance is recognised as a key predictor of
treatment outcomes (Baier et al., 2020; Flückiger et al., 2018; Horvath et
al., 2011; Howard et al., 2022). These authors define therapeutic alliance
as a collaborative relationship between therapist and client, built on
agreement about treatment goals, consensus on therapeutic tasks, and the
development of a positive emotional bond, an understanding grounded in
Bordin’s pantheoretical model (Bordin, 1979, 1994).
Therapeutic alliance may be particularly important for individuals with
MID-BIF and severe behavioural problems. Cognitive deficits, limited social
and communicative skills, and attachment difficulties (Adams & Emerson,
2015; Hamadi et al., 2021; Van Herwaarden et al., 2022) may make it more
challenging to build trust, agree on goals, understand the tasks in the same
way, and experience a bond. Additionally, individuals with MID-BIF relatively
frequently experience interpersonal traumatic events, such as physical,
sexual, and emotional violence (Rittmansberger et al., 2020; Wigham &
Emerson, 2015), which may increase their need for safe and continuous
interpersonal relationships. Against this background, the use of rotating
therapists to deliver intensive trauma treatments may appear at odds with
what clients with MID-BIF may need. However, even if the trauma therapy
does not offer an opportunity for fulfilling interpersonal needs, for example
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