Utilisation de la désensibilisation des mouvements oculaires et du reconditionnement (EMDR) avec des personnes autistes : une étude d'entretiens qualitatifs avec des thérapeutes EMDR

Aperçu: G.M.

Objectifs
La désensibilisation des mouvements oculaires et le reconditionnement (EMDR) est une thérapie psychologique fondée sur des données probantes qui cible la détresse associée aux traumatismes et aux troubles affectifs. Peu d'études ont examiné l'EMDR pour les personnes autistes qui ont des problèmes de santé mentale concomitants, mais il existe des preuves préliminaires de son efficacité. La présente étude a exploré les expériences de travail des thérapeutes EMDR avec des personnes autistes et les adaptations incorporées dans la pratique clinique pour la rendre plus accessible et efficace. 

Conception
Une conception d'entrevue qualitative a été utilisée. Les données ont été analysées par thème. 

Méthode
Vingt-trois thérapeutes EMDR basés au Royaume-Uni ont participé à des entretiens qualitatifs semi-structurés ponctuels. 

Résultats
Quatre thèmes principaux ont émergé : (1) l'expérience d'être autiste ; (2) les facteurs liés à l'accès à l'EMDR ; (3) adapter l'EMDR ; et (4) la supervision et le soutien des thérapeutes EMDR. Les participants ont décrit l'offre d'une approche nuancée et personnalisée ; celui qui a conservé les composants intégraux des huit phases de l'EMDR, tout en étant flexible et réactif à chaque client. 

Conclusions
Les résultats renforcent l'importance d'offrir une thérapie psychologique basée sur la formulation qui s'adapte de manière fondée sur des preuves, selon les préférences et les besoins des personnes autistes. Des recherches supplémentaires devraient établir les facteurs influençant l'accessibilité et l'efficacité de l'EMDR pour les personnes autistes, ainsi que l'impact de la formation pertinente sur l'autisme sur les connaissances, les compétences et la confiance des thérapeutes EMDR et des superviseurs cliniques travaillant avec ce groupe de clients.

. 2022 Dec;95(4):1071-1089.

doi: 10.1111/papt.12419. Epub 2022 Aug 11.

Using eye movement desensitisation and reprocessing (EMDR) with autistic individuals: A qualitative interview study with EMDR therapists

Naomi Fisher  ¹ , Henna Patel  ² , Caroline van Diest  ³ , Debbie Spain  ²

Affiliations

• PMID: 36334027
• DOI: 10.1111/papt.12419

Abstract

Objectives: Eye Movement Desensitisation and Reprocessing (EMDR) is an evidence-based psychological therapy that targets distress associated with trauma and affective disturbance. Few studies have examined EMDR for autistic individuals who have co-occurring mental health conditions, but there is preliminary evidence of effectiveness. The current study explored EMDR therapists' experiences of working with autistic individuals, and adaptations incorporated into clinical practice to make this more accessible and effective.

Design: A qualitative interview design was used. Data were thematically analysed.

Method: Twenty-three UK-based EMDR therapists attended one-off semi-structured qualitative interviews.

Results: Four main themes emerged: (1) the experience of being autistic; (2) factors around accessing EMDR; (3) adapting EMDR; and (4) supervision and support for EMDR therapists. Participants described offering a nuanced and tailored approach; one that retained the integral components of the eight phases of EMDR, while also being flexible and responsive to each client.

Conclusions: Findings reinforce the importance of offering formulation-based psychological therapy that flexes in an evidence-informed way, according to the preferences and needs of autistic individuals. Further research should establish factors influencing accessibility and effectiveness of EMDR for autistic individuals, and the impact of autism-relevant training on the knowledge, skills and confidence of EMDR therapists and clinical supervisors working with this client group.

Keywords: autism; clinical supervision; eye movement desensitisation and reprocessing (EMDR); mental health; psychological therapy; trauma.

© 2022 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.

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Construire la validité et la fiabilité test-retest de l'inventaire d'adaptation (CI) pour les enfants ayant une déficience intellectuelle

Aperçu: G.M.

OBJECTIF:
Une méthode fiable, valide et facilement utilisable de mesure de la capacité d'adaptation est essentielle pour les praticiens en ergothérapie et les chercheurs travaillant avec des enfants ayant une déficience intellectuelle. Le but de cette étude était d'examiner les preuves de la validité et de la fiabilité interne et de test-retest de l'inventaire Coping Inventory (CI), une enquête à 48 items conçue pour être utilisée avec des enfants.
Méthode:
Le personnel de l'école (N = 39) a rempli des IC auprès de 79 élèves ayant une déficience intellectuelle à l'âge de 5 à 13 ans (moyenne = 8,0, écart type = 2,0) et qui étaient principalement des garçons (n ​​= 52; 68%) avec un diagnostic de "troubles du spectre de l'autisme . 47 diagnostics fournis). Nous avons utilisé l'analyse Rasch pour examiner la validité des concepts, la fiabilité interne et la redondance possible des éléments et des corrélations intraclasses, les corrélations de Pearson, les diagrammes de Bland-Altman et des tests t pour examiner la fiabilité test-retest.
RÉSULTATS:
L'analyse de Rasch a fourni des preuves de la validité du test: tous les éléments étaient corrélés positivement avec la mesure globale; les données de 94% des articles étaient conformes aux attentes de Rasch, et les articles forment une hiérarchie logique. Les corrélations intraclasse ont révélé un coefficient moyen de 0,96, ce qui prouve la fiabilité test-retest.
CONCLUSION:
L'IC a démontré de bonnes preuves de la validité conceptuelle et de la fiabilité interne et test-retest. La redondance des éléments suggère que certains éléments pourraient être éliminés après de nouvelles recherches.

Am J Occup Ther. 2019 Jul/Aug;73(4):7304205100p1-7304205100p10. doi: 10.5014/ajot.2019.029561.

Construct Validity and Test-Retest Reliability of the Coping Inventory (CI) for Children With Developmental Disabilities

Beetham KS¹, Bundy AC², Wyver S³, Ragen J⁴, Villeneuve M⁵, Tranter P⁶, Naughton G⁷.

Author information

1

Kassia S. Beetham, PhD, is Lecturer, School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia. At the time of the study, she was Research Associate, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.

2

Anita C. Bundy, ScD, is Professor and Department Head, Occupational Therapy, Colorado State University, Fort Collins, and Honorary Professor, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia; anita.bundy@colostate.edu.

3

Shirley Wyver, PhD, is Senior Lecturer, Department of Educational Studies, Macquarie University, Sydney, New South Wales, Australia.

4

Jo Ragen, MM, is PhD Candidate, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.

5

Michelle Villeneuve, PhD, is Senior Lecturer, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.

6

Paul Tranter, PhD, is Honorary Associate Professor, School of Science, University of New South Wales, Canberra, Australian Capital Territory, Australia.

7

Geraldine Naughton, PhD, is Honorary Professor, Department of Educational Studies, Macquarie University, Sydney, New South Wales, Australia.

Abstract

OBJECTIVE:

A reliable, valid, and readily usable method of measuring coping is essential for occupational therapy practitioners and researchers working with children with developmental disabilities. The aim of this study was to examine evidence for the construct validity and internal and test-retest reliability of the Coping Inventory (CI), a 48-item survey designed for use with children.

METHOD:

School staff (N = 39) completed CIs for 79 students with developmental disabilities age 5-13 yr (mean = 8.0, standard deviation = 2.0) who were primarily boys (n = 52; 68%) with autism spectrum disorder (n = 40 of 47 diagnoses provided). We used Rasch analysis to examine construct validity, internal reliability, and possible redundancy of items and intraclass correlations, Pearson correlations, Bland-Altman plots, and t tests were used to examine test-retest reliability.

RESULTS:

Rasch analysis provided evidence of construct validity: All items correlated positively with the overall measure; data from 94% of items conformed with Rasch expectations, and the items form a logical hierarchy. Intraclass correlations revealed an average coefficient of .96, providing evidence of test-retest reliability.

CONCLUSION:

The CI demonstrated good evidence for construct validity and internal and test-retest reliability. Redundancy of items suggests that some items could be eliminated after further research.

Copyright © 2019 by the American Occupational Therapy Association, Inc.

PMID: 31318674

DOI:10.5014/ajot.2019.029561

Acceptation ou désespoir? Ajustement maternel pour avoir un enfant autiste

Aperçu: G.M.

L'adaptation psychologique à un diagnostic de "trouble du spectre de l'autisme" chez un enfant a des répercussions importantes sur la santé mentale d'un parent. Dans une étude longitudinale, les chercheurs ont examiné l'association entre l'adaptation de la mère au diagnostic et les mesures de détresse et de bien-être chez 90 mères d'enfants autistes (début et 18 mois). Ils ont utilisé une nouvelle échelle de 30 items «Ajustement au diagnostic de l'autisme».  

L'analyse factorielle a identifié trois dimensions de l'ajustement: l'acceptation, l'autoaccusation et le désespoir.  

L'acceptation semblait être une réponse protectrice, car elle était associée à des symptômes dépressifs plus faibles, transversalement et au fil du temps.  

À l'inverse, les soignants ayant des niveaux croissants d'autoaccusation et de désespoir au sujet du diagnostic après 18 mois ont connu une détérioration de la santé mentale et de la satisfaction de vivre pendant cette période.

J Autism Dev Disord. 2018 Jan 6. doi: 10.1007/s10803-017-3450-4.

Acceptance or Despair? Maternal Adjustment to Having a Child Diagnosed with Autism

Da Paz NS¹, Siegel B², Coccia MA³, Epel ES³.

Author information

1

Center for Health and Community, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA. nikko.dapaz@ucsf.edu.

2

Autism Center of Northern California, San Francisco, CA, USA.

3

Center for Health and Community, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA.

Abstract

Psychological adjustment to having one's child diagnosed with an autism spectrum disorder has important implications for a parent's mental health. In a longitudinal study, we examined the association between maternal adjustment to the diagnosis and measures of distress and well-being in 90 mothers of children with autism (baseline and 18 months). We used a novel 30-item scale "Adjustment to the Diagnosis of Autism." Factor analysis identified three dimensions of adjustment: acceptance, self-blame, and despair. Acceptance appeared to be a protective response, as it was associated with lower depressive symptoms, cross-sectionally and over time. Conversely, caregivers with increasing levels of self-blame and despair about the diagnosis over 18 months had worsening of mental health and satisfaction with life during this period.

PMID:29307036

DOI:10.1007/s10803-017-3450-4