Eye movement desensitisation and reprocessing (EMDR) therapy in prison and forensic services: a qualitative study of lived experience
Creators: name: Every-Palmer, Susanna
name: Ross, Brigit
name: Flewett, Tom
name: Rutledge, Eoghan
name: Hansby, Oliver
name: Bell, Elliot
Publisher: name: Taylor & Francis
Year: 2023
Subjects: Biological Sciences not elsewhere classified
Science Policy
Mental Health

description: <b>Background:</b> Posttraumatic stress disorder (PTSD) is common in people with serious mental illness who come into contact with the criminal justice system. Little evidence exists on EMDR treatment in forensic mental health, with no prior qualitative research exploring lived experience perspectives. <b>Objective:</b> This qualitative study recruited adult forensic mental health patients with PTSD and psychotic disorders, predominantly schizophrenia, who had received EMDR as part of a clinical trial, either in prison or in hospital. We sought to understand their experiences of EMDR therapy while receiving forensic care. <b>Method:</b> Ten in-depth, semi-structured qualitative interviews were undertaken and analysed using thematic analysis. We used an inductive, realist approach, reporting the experiences, meanings, and reality of the participants. <b>Results:</b> Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt <i>Seriously Messed Up</i> by their traumatic experiences, with debilitating and enduring PTSD symptoms contributing to offending and psychosis (‘giving the voices something to feed on’). Second, EMDR was regarded with <i>Early Scepticism</i>. Third, the therapy itself was initially emotionally taxing and <i>Not Easy</i> but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (<i>And it Worked!</i>), describing significant symptom reduction and personal transformation. Lastly, EMDR <i>Fits the Forensic Setting,</i> bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future. <b>Conclusions:</b> The limited research on EMDR in forensic mental health is unfortunate given how common PTSD is in mentally unwell offenders and its potential to impede recovery and contribute to further offending. This first qualitative study found participants experienced positive transformative change, extending beyond symptom reduction. Themes support previously published quantitative outcomes showing EMDR to be safe and effective in this cohort. EMDR was well suited to a forensic setting and was seen as an empowering therapy. <b>Trial registration:</b>Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235. <b>Study registration:</b> The study was registered on the Australia and New Zealand Clinical Trials Network, registration number ACTRN12618000683235 (registered prospectively, 24 April 2018), https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 374682 This study canvases the lived experiences of forensic patients receiving EMDR for PTSD – people whose views are seldom captured. They described being profoundly impacted by trauma, developing debilitating and enduring PTSD symptoms which variably contribute to offending and psychosis.Participants did not have favourable first impressions when they first heard about EMDR, thinking it ‘quackery’. However, they were surprised and delighted by results, with the majority describing marked symptom reduction and personal transformation. Having targeted some of the underlying drivers of maladaptive behaviour, people reported hope for a better future.EMDR was well suited to a forensic setting and was seen as an empowering therapy. This study canvases the lived experiences of forensic patients receiving EMDR for PTSD – people whose views are seldom captured. They described being profoundly impacted by trauma, developing debilitating and enduring PTSD symptoms which variably contribute to offending and psychosis. Participants did not have favourable first impressions when they first heard about EMDR, thinking it ‘quackery’. However, they were surprised and delighted by results, with the majority describing marked symptom reduction and personal transformation. Having targeted some of the underlying drivers of maladaptive behaviour, people reported hope for a better future. EMDR was well suited to a forensic setting and was seen as an empowering therapy.