Francine Shapiro Library: EMDR Bibliography

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1. Lievegoed, R. (2005, June). EMDR for mentally retarded people. Poster presented at the annual meeting of the EMDR Europe Association, Brussels, Belgium.

Language: English

Format: Conference

Abstract:
After a short introduction concerning the special problems people with an intellectual handicap often have in their iives and the many forms of psychotrauma which arise for them in situations which are by others sometimes not experienced as traumatic, we'll show by means of case studies how the protocol can be adapted to the limited skills of people in this target group. We also refer to the adaptations of the protocol for young children. Participants will learn to see that EMDR can very well be applied for this target group and how they should proceed with the treatment. Our most important aim is that therapists can become motivated to also use EMDR for these people!

Keywords: Mental Retardation  Poster  


2. Lievegoed, R., & Seubert, A. (2004, June). Trauma and beyond: EMDR in the treatment of traumatized clients with mental retardation (MH/MR diagnosis). In children and EMDR (J. Morris-Smith, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .

Language: English

Format: Conference

Abstract:
For the past three decades, clinical experience as well as research has supported the validity of counseling and psychotherapy in the treatment of dually diagnosed (MH/MR) clients. At first behavioral therapies and later various forms of process-oriented therapy (Gestalt, creative arts, body-centered, play) have been effectively employed with this population, Particularly through the use of process therapies it has become clear that traditional insight and cognitive therapy must be adapted in favor of experience, action, body-centeredness and “right-brain” functioning to be impactful with this population.
EMDR< given its primarily non-verbal mode of functioning, holds great promise as an effective and efficient therapy for trauma treatment with dually diagnosed clients, a population inherently vulnerable to traumatic impact. Anecdotal case presentations with mental retarded clients, corroborated by both client report and by clinical observation. In all cases, therapeutic gains remained intact after treatment.
This presentation will introduce a “phase model” of trauma treatment for this population and will demonstrate were EMDR would be most effective within this model. Attention will also be given to ways in which the basic EMDR protocol would need to be adapted to meet the needs of these clients.

Keywords: Children  Developmentally Disabled  Dually Diagnosed (MH/MR)  Mental Retardation  Symposium  Posttraumatic Stress Disorder  PTSD  Trauma Treatment  


3. Mevissen, L., & de Jongh, A. (2010). PTSD and its treatment in people with intellectual disabilities: A review of the literature. Clinical Psychological Review, 30(3), 308-316. doi:10.1016/j.cpr.2009.12.005.

Language: English

Format: Journal

Abstract:
Although there is evidence to suggest that people with intellectual disabilities (ID) are likely to suffer from Post-Traumatic Stress Disorder (PTSD), reviews of the evidence base, and the potential consequences of this contention are absent. The purpose of this article is to present a comprehensive account of the literature on prevalence, assessment, and treatment of PTSD in people with ID. Some support was found for the notion that people with ID have a predisposition to the development of PTSD. Differences in comparison with the general population may consist of the expression of symptoms, and the interpretation of distressing experiences, as the manifestation of possible PTSD seems to vary with the level of ID. Since reliable and valid instruments for assessing PTSD in this population are completely lacking, there are no prevalence data on PTSD among people with ID. Nine articles involve treatment of PTSD in people with ID. Interventions reported involve those aimed to establish environmental change, the use of medication and psychological treatments (i.e., cognitive behavioral therapy, EMDR and psychodynamic based treatments). Case reports suggest positive treatment effects for various treatment methods. Development of diagnostic instruments for assessment of PTSD symptomatology in this population is required, as it could facilitate further research on its prevalence and treatment. Copyright © 2010 Elsevier Ltd. All rights reserved.

Keywords: Assessment  Intellectual disability (ID)  Learning Disabilities  Mental retardation (MR)  Post-Traumatic Stress Disorder (PTSD)  Prevalence  Psychological trauma  Trauma treatment  


4. Miller, R., & Tay, K. H. (2009, August). Adapting the standard EMDR protocol for clients with mild mental retardation: Some guidelines and implications. Poster presented at the annual meeting of the EMDR International Association, Atlanta, GA .

Language: English

Format: Conference

Abstract:
EMDR as a psychotherapeutic approach has been shown to be effective. However, there is a paucity of studies examining the efficacy of EMDR for clients diagnosed with mild mental retardation. The DSM-IV defines mild mental retardation as below average intelligence (IQ between 70 and 55) along with some deficiencies in adaptive functioning skills demonstrated before age 18. The purpose of our clinical project was to explore the applicability of EMDR for our adult clients (n = 12; mean age 22.5) diagnosed with mild mental retardation by adapting the standard protocol. Studies showed that individuals with mental retardation learn and retain information more effectively when materials are presented to them in a visual, concrete, and interactive manner while utilizing the principles of positive reinforcements.
The prevalence of mental health problems and the wide range of clinical symptoms among these individuals have been reported in several studies. Additionally, these adults are misunderstood as being overly limited in their ability to reap any therapeutic benefit from counseling interventions. Prout and Strohmer (1998), for instance, argued that adults with mental retardation do benefit from counseling interventions. However, they stressed the need for more sophisticated or modified use of psychotherapeutic interventions. Psychotherapeutic techniques and models should be modified, if feasible, in regards to language and cognitive levels commensurate with the clients’ background.
Based on our clinical observations, the following are some examples of proposed guidelines to assist the EMDR clinicians in thinking more creatively when adapting the standard protocol.
1) Considerable amount of preparation at the onset of EMDR is necessary, as it plays a pivotal role in ensuring a successful outcome.
2) Visual depiction of the SUDs and VOCs on a scale of 0 through 5, or 0 through 10, depending on the client’s cognitive abilities is beneficial. Use of “faces” to depict concretely various levels of distress should be made.
3) The concepts of PC and NC may be too abstract for some in this population. We assist clients by operationally defining those concepts with the list of commonly used PCs and NCs in simpler language.
4) Coping resources are sometimes limited for these adults. Clients will benefit from having multiple reinforcements of self-soothing skills thorough the installation of the “safe place” and “resources”.
5) Positive reinforcements (e.g., frequent verbal reminders) should be used regularly in sessions throughout treatment. However, be mindful of clients’ desire to please the clinician.
6) Role-playing should be used when feasible throughout treatment, e.g., during the installation of future templates, as it heightens more sensory, affective, and behavioral modes of learning rather than verbal modality alone.
Based on the treatment outcomes reported by our clients, EMDR is an effective treatment option, as evidenced by sustained reduction in their level of distress to traumatic memories. Findings from this clinical project have practice and research implications. First, the standard protocol should be adapted for use with adults with mild mental retardation to achieve optimal gain. Second, empirical research is needed to provide further evidence for the efficacy of EMDR for adults with mild mental retardation.

Keywords: Mental Retardation  


5. Seubert, A. (2006, September). The heart with a door: An EMDR with clients with mental disabilities. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
For the past three decades clinical experience, as well as research, has supported the validity of counseling and psychotherapy in the treatment of dually diagnosed (MH/MR) clients. At first behavioral therapies and later various forms of process-oriented therapy (Gestalt, creative arts, body-centered, play) have been effectively employed with this population. Particularly through the use of process therapies it has become clear that traditional insight,and cognitive therapy must be adapted in favor of experience, action, body-centeredness and "right-brain" functioning to be impactful with this population. EMDR, given its primarily non-verbal mode of functioning, holds great promise as an effective and efficient therapy for trauma treatment with dually diagnosed clients, a population inherently vulnerable to traumatic impact. This presentation will emphasize the "phase model" aspects of trauma treatment and will demonstrate where EMDR is effective within this model. Attention will also be given to ways in which the basic EMDR protocol would need to be adapted to meet the needs of these clients. A report on the progress of a series of single case studies with clients with mental disabilities in Pennsylvania, as well as anecdotal reports, will be utilized to demonstrate EMDR effectiveness with this population. Video clips of sessions involving clients with varying levels of functioning will give the audience a concrete experience of the adaptive use of EMDR. The workshop will leave time for participants to apply the learning to cases of their own.

Keywords: Mental Retardation  


6. Seubert, A. & McDonagh, J. M. (2002, June). EMDR with mentally handicapped clients (MH/MR diagnosis. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Abstract: Only within the past few decades has the use of counseling and psychotherapy for this much neglected population been validated and explored. Given the non-verbal and "right-brain" characteristics of EMDR, it seems there would be a natural fit between the needs of this population and the way in which EMDR works. Case studies will demonstrate successful use of EMDR with dually diagnosed (MH/MR)clients as well as ways in which the standard protocol may need to be adapted for this work. Theoretical speculation regarding EMDR's effectiveness with mentally impaired clients will be explored.

Keywords: Mental Retardation