Page 123 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Experiences with intensive EMDR and rotating therapists
al. (2024). These elements may have supported agreement on treatment
goals and tasks, aligning with key components of a therapeutic alliance
(Bordin, 1979, 1994), even though a positive emotional bond was likely not
established. In contrast, it remains unclear whether working with rotating
therapists influenced the third participant’s decision to stop therapy.
Involvement of the Support System
A component of Intensive EMDR treatment was the involvement of
participants’ professional caregivers and, if possible, a relative of the
participant. They received psychoeducation and were expected to ensure
that participants attended therapy sessions on time, provide emotional
support after difficult sessions, and help them resume their daily routines.
Nevertheless, participants’ support systems were only minimally involved
in the therapy process. Only one clear example was identified in which a
professional caregiver provided support by accompanying the participant
and being available to listen to him, and this seemed incidental rather than
structurally integrated into the treatment. Despite this limited involvement,
most participants still made progress. The extent to which a more active
and consistent involvement of the support system before, during, and after
therapy could have improved outcomes remains unclear.
Limitation and future research
IPA is not designed for generalisation (Pietkiewicz & Smith, 2014; Smith &
Osborn, 2008), and as common in these types of studies, there is a notable
homogeneity within the set of participants: all were males aged between 20
and 30, living in supported housing at a care park of a single ID care service
in the Netherlands, and all were treated by the same therapists at the
same time. It is important to acknowledge that the particular institutional
care environment, staff expertise, and cultural context of this setting likely
shaped participants’ experiences, which means these findings may not
fully translate to other care settings or populations. Future studies could
examine whether similar experiences and outcomes are observed in more
diverse populations, including different age groups, gender, living situations,
and care contexts.
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