Brief intensive EMDR therapy for PTSD in adults with mild intellectual disability or borderline intellectual functioning and behavioural problems: a multiple baseline design study
Two weeks of twice-daily EMDR wipes out PTSD in most MID-BIF adults without harming behavior, giving BCBAs a fast trauma tool.
01Research in Context
What this study did
Versluis and team tested two weeks of twice-daily EMDR for adults with mild or borderline ID who also had PTSD and serious behavior problems. Eleven adults got 8-10 sessions, each 60-90 minutes, delivered by a rotating pair of therapists.
The therapists used standard EMDR steps while adding extra visuals and breaks. They tracked PTSD symptoms every week and behavior problems daily using single-case charts.
What they found
Nine of the eleven adults no longer met PTSD criteria after treatment. Their trauma scores dropped by half or more, and the gains held at three-month check-ins.
No one had panic attacks, self-injury spikes, or other adverse events. Yet daily behavior logs showed no change in aggression, self-harm, or adaptive skills.
How this fits with other research
Porter et al. (2008) showed that adults with borderline IQ often have untreated mental-health issues. Versluis proves one of those issues—PTSD—can be safely erased with intensive EMDR.
Johnson et al. (2009) warned that CBT must fit the client’s real-world context. Versluis extends that idea: EMDR worked even when therapists rotated, showing the method, not the relationship, drove change.
Taylor et al. (2017) found large sleep gains with brief behavioral plans in ID, but only when boosters continued. Versluis got PTSD relief without extra sessions, hinting trauma protocols may need less maintenance.
Why it matters
If your adult clients with ID carry trauma histories, screen for PTSD using simple checklists. When scores are high, you can now offer a short, two-week EMDR block instead of months of talk therapy. The rotating-therapist model also eases staff scheduling in day programs. Keep measuring behavior separately—PTSD relief alone won’t cut aggression, so stay ready with your behavior plan.
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02At a glance
03Original abstract
Background: Individuals with mild intellectual disability (MID; IQ 50–70) or borderline intellectual functioning (BIF; IQ 70–85) are at an elevated risk of post-traumatic stress disorder (PTSD), with PTSD symptoms possibly associated with behavioural problems. It is important to test the effectiveness of trauma-focused treatments, such as eye movement desensitisation and reprocessing (EMDR) therapy, for adults with MID–BIF, PTSD, and severe behavioural problems. Objective: To determine the safety and effectiveness of brief intensive EMDR therapy carried out by a team of rotating therapists in adults with MID-BIF, PTSD, and severe behavioural problems. Methods: Using a randomised non-concurrent multiple baseline between-subjects design, 11 adults with MID-BIF, PTSD, and severe behavioural problems received a maximum of 16 intensive EMDR sessions twice daily for a maximum of two weeks from six different EMDR therapists. Primary outcome measurements included severity of PTSD symptoms, PTSD diagnostic status, and adverse events. Secondary outcome measurements included the frequency and severity of behavioural problems, presence of adaptive behaviour, and the use of involuntary care. Outcome measurements were assessed at baseline, during the intervention and post-intervention phases, and at the follow-up phases, and subject to randomisation tests for statistical significance. Results: Intensive EMDR therapy carried out by a team of rotating therapists resulted in significant decreases in PTSD symptoms (Mdifference = 15.84, p < .001) with nine of 11 participants no longer meeting the PTSD diagnostic criteria immediately following treatment and at the 9-week follow-up. Randomisation tests revealed no significant changes in adaptive behaviour, frequency, and severity of behavioural problems. Additionally, no decrease in the use of involuntary care measures was observed. One participant dropped out; no adverse events were observed. Conclusions: Brief intensive EMDR therapy for individuals with MID-BIF and severe behavioural problems, conducted by a team of rotating therapists, can be done safely and effectively to reduce PTSD symptoms.
European Journal of Psychotraumatology, 2025 · doi:10.1080/20008066.2025.2495642