EMDR Research Foundation Clinical Newsletter
January 2023
EMDR and the Autism Spectrum Those with autism and other developmental or neurodivergent conditions often have difficulties fitting in with others and developing intellectually, socially, and personally. Their intellect, mannerisms, behavior, and even their appearance may deviate from the expectations and social norms of their peers and associates, magnifying normal stresses and challenges of the maturation and educational process. This renders them especially vulnerable to developing symptoms of anxiety, depression, poor self-esteem, and complex PTSD. While in many ways this makes them good candidates for EMDR therapy, their idiosyncrasies demand certain modifications. Below are several efforts addressing various aspects of treating clients on the spectrum using EMDR therapy. In addition, while not a formal study, Sherri Paulson, LCSW, has written an informative article for EMDR therapists working with Autism clients, in the summer, 2022 edition of Go With That, an EMDRIA magazine (S. Paulson, 10 Things About EMDR and Autism. Go With That, Vol.27, #3, pp.29-32.)
EMDR with Autism
Paulson, S. (2014, June). EMDR with autism. In EMDR clinical practice symposium (Marilyn Luber, Chair). Symposium presented at the 15th EMDR Europe Association Conference, Edinburgh, Scotland
Abstract EMDR and Autism can make an excellent combination. Using EMDR with individuals with autism can reduce both symptoms of PTSD and autism. These benefits are long-lasting and provide a foundation for continuing growth and development. Individuals with autism present with a variety of complex neurological differences that may make trauma processing more difficult and even harmful in some situations. In order to use the eight-step EMDR protocol successfully with these individuals some modifications are necessary, especially additional resource development in the preparation stage. This presentation will include a step-by-step journey through the 8-step protocol including modifications for use with autism. The preparation stage strategies have evolved into a self-contained program called “Finding Myself” which may be extracted for use in other situations. Interested therapists will learn the use of social stories, skill training, affect awareness and regulation, strategies to increase verbal expression, and more to help make the EMDR process successful and comfortable for autistic individuals. EMDR with these modifications has been used with individuals across the spectrum, including developmentally disabled children and adults with severe cognitive and verbal impairments. A wide range of benefits has been noted including a reduction in symptoms, increased verbal ability, improved social interaction, improved self-regulation, and general functioning. Cautions will also be included in this presentation.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events.
Lobregt-van Buuren, E. ; Sizoo, B.; Mevissen, L. and DeJongh, A. Eye Movement Desensitization and Reprocessing (EMDR) Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events. Journal of Autism and Developmental Disorders, Volume 49, pages 151–164 (2019)
Abstract The study investigated whether EMDR is a feasible therapy for adults with ASD and a history of adverse events and whether it is associated with reductions in symptoms of PTSD, psychological distress, and autism. Participants received 6 to 8 weeks of treatment as usual (TAU), followed by a maximum of 8 sessions of EMDR added to TAU and a follow-up of 6–8 weeks with TAU only. Results showed a significant reduction of symptoms of post-traumatic stress (IES-R: d = 1.16), psychological distress (BSI: d = 0.93), and autistic features (SRS-A: d = 0.39). Positive results were maintained at follow-up. The results suggest EMDR therapy to be a feasible and potentially effective treatment for individuals with ASD who suffer from the consequences of exposure to distressing events.
Using EMDR With Autistic Clients: How Do Therapists Adapt?
van Diest, Caroline; Leoni, Marguerite; Fisher, Naomi; and Spain, Debbie. Using EMDR With Autistic Clients: How Do Therapists Adapt? Journal of EMDR Practice and Research, Volume 16, Number 3, 2022, http://dx.doi.org/10.1891/EMDR-2022-0014
Abstract Autistic people commonly experience co-morbid mental health conditions, including post-traumatic stress disorder (PTSD), anxiety, and low mood. The general consensus is that autistic people can benefit from evidence-based psychological therapies, with the acceptability and effectiveness of eye movement desensitization and reprocessing (EMDR) therapy becoming a growing area of interest. One hundred and three EMDR therapists were asked if and how they adapt the standard EMDR protocol to make the process and content more tailored to the needs and preferences of autistic people. We analyzed the qualitative responses of participants to these questions, including barriers and adaptations to all eight phases of the EMDR standard protocol. Overall, therapists emphasized the need for flexibility and responsiveness to the individual client, and the importance of autism-specific knowledge and autism-informed clinical supervision. Implications and future directions are discussed
Using eye movement desensitization and reprocessing (EMDR) with autistic individuals: A Delphi survey with EMDR therapists
Fisher, N., Van Diest, C., Leoni, M., & Spain, D. (2022).
Using eye movement desensitization and reprocessing (EMDR) with autistic individuals: A Delphi survey with EMDR therapists. Autism. Online First, 6th April 2022. https://doi. org/10.1177/13623613221080254
Abstract Autistic individuals are at greater risk of experiencing adverse and traumatic life events. Eye Movement Desensitisation and Reprocessing (EMDR), a psychological therapy, is potentially effective for treating the constellation of difficulties arising from traumatic experiences, as well as mental health conditions. Yet minimal research has focused on how EMDR may require adaptation to improve its accessibility, acceptability, and effectiveness for autistic individuals. In a three-round Delphi survey, 103 EMDR therapists were asked about barriers to EMDR for autistic individuals and adaptations employed to enhance therapy, so as to generate consensus about important or essential components of adaptations to EMDR. Four types of barriers were highlighted: client-related characteristics, therapist-related characteristics, differences in the therapeutic relationship, and systemic issues. One hundred and twenty-four adaptations were identified, including 35 general adaptations (i.e. relevant across EMDR phases), 81 relating to specific EMDR phases, and 8 about EMDR clinical supervision. Of these, 27 adaptations were used often or always by at least 80% of participants; a further 61 were sometimes incorporated within therapy, depending on the client. Study findings highlight the need for EMDR therapists to have training about autism and the potential ways of tailoring EMDR, and that individual case conceptualisation is key.