Eye Movement Desensitization and Reprocessing with Adults with Intellectual Disability

People with intellectual disability have historically been excluded from the benefits of psychotherapy, despite the higher incidence of mental illness, in general, and PTSD, in particular, in this population. It had been thought that intellectual disability precluded the cognitive and emotional ability required to participate in therapy. A growing body of literature is reporting successful application of a number of these therapies, established as empirically effective for the general population, with people with intellectual disability. Typically, minor modifications are required. Criticism continues, now based on the problem of using therapies with a population for which they have not been empirically established as effective. The current study contributes to the empirical process of establishing effectiveness of a specific trauma therapy for people with intellectual disability. It applies the EMDR therapy to six participants in a multiple-baseline, ABA, time-series experiment design. EMDR has previously been used with people with intellectual disability, reporting improved symptoms and functioning for the more than 35 cases published. For the current study, the participants were all diagnosed with PTSD and other diagnoses reflecting the emotional distress associated with histories of multi- and poly-traumatization, beginning at an early age. They received weekly assessments on multiple measures: self-report, physiological, observer ratings, and continuous actigraph recordings. Each participated for a minimum of 60 weeks, which included: an A phase, the Baseline; a B phase, the Intervention; and, a second A phase, Maintenance. After a Hiatus of six weeks, participants returned for Follow-up testing. The EMDR therapy was delivered during the Intervention phase, only. All participants lost the diagnosis of PTSD and showed emotional and functional improvement on a number of measures. The self-report measures produced the most descriptive time-series data, providing indication of change in a number of dimensions, visually interpretable from graphs of the data, included in this document. Linear regression analyses support visual analysis. Additional research in using the EMDR therapy with people with intellectual disability is recommended, with the purpose of establishing it as appropriate for use with this population. Limitations of the study are addressed