Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
Mental Health, Addiction and Intellectual Disability Services, Te Whatu Ora Health New Zealand, Capital, Coast and Hutt Valley, Wellington, New Zealand.
Eur J Psychotraumatol. 2023;14(2):2282029. doi: 10.1080/20008066.2023.2282029. Epub 2023 Nov 27.
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. 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. 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. Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt 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 . Third, the therapy itself was initially emotionally taxing and but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (), describing significant symptom reduction and personal transformation. Lastly, EMDR bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future. 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. Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235. 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.
创伤后应激障碍（PTSD）在接触刑事司法系统的严重精神疾病患者中很常见。在法医心理健康领域，关于 EMDR 治疗的证据很少，也没有先前的定性研究探讨生活体验的观点。这项定性研究招募了患有 PTSD 和精神病的成年法医心理健康患者，主要是精神分裂症患者，他们作为临床试验的一部分接受了 EMDR 治疗，无论是在监狱还是在医院。我们试图了解他们在接受法医护理时接受 EMDR 治疗的体验。进行了 10 次深入的半结构化定性访谈，并使用主题分析进行分析。我们采用了归纳的、现实主义的方法，报告了参与者的经历、意义和现实。确定了五个总体主题。首先，严重创伤是普遍存在的，参与者感到自己的创伤经历受到了创伤，导致衰弱和持久的 PTSD 症状导致犯罪和精神病（“给声音一些东西吃”）。其次，EMDR 被视为一种。第三，治疗本身最初在情感上是很累人的，并且具有挑战性，但参与者通常感到安全并坚持下去。第四，他们通常对结果感到惊讶和高兴（），描述了显著的症状减轻和个人转变。最后，EMDR 在一个被认为没有权力的地方带来了赋权。人们报告说，他们的变化增加了他们对未来无暴力的希望。鉴于精神疾病罪犯中 PTSD 非常普遍，以及它可能阻碍康复并导致进一步犯罪的可能性，因此在法医心理健康方面进行的这项有限的研究是不幸的。这项首次定性研究发现，参与者经历了积极的变革性变化，不仅限于症状减轻。主题支持先前发表的定量结果，表明 EMDR 在这一队列中是安全有效的。EMDR 非常适合法医环境，被视为一种赋权疗法。澳大利亚和新西兰临床试验注册中心标识符：ACTRN12618000683235。该研究在澳大利亚和新西兰临床试验网络上注册，注册号为 ACTRN12618000683235（前瞻性注册，2018 年 4 月 24 日），https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374682。
