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Abstract：
Background: 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.Objective: 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.Method: 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.Results: Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt Seriously Messed Up 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 Early Scepticism. Third, the therapy itself was initially emotionally taxing and Not Easy but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (And it Worked!), describing significant symptom reduction and personal transformation. Lastly, EMDR Fits the Forensic Setting, bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future.Conclusions: 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.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235.Study registration: 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.
摘要：
背景：创伤后应激障碍（PTSD）在与刑事司法系统接触的严重精神疾病患者中很常见。关于EMDR治疗在法医心理健康方面的证据很少，之前没有定性研究探索生活经验的观点。目的:这项定性研究招募成年法医心理健康患者,主要是精神分裂症，作为临床试验的一部分接受了EMDR，无论是在监狱还是在医院。我们试图了解他们在接受法医治疗时的EMDR治疗经验。方法：十个深入，进行了半结构化的定性访谈，并使用主题分析进行了分析。我们用了一个归纳法,现实主义的方法，报告经验，含义,和参与者的现实。结果：确定了五个总体主题。首先,严重的创伤无处不在，参与者感到他们的创伤经历严重搞砸了，使人衰弱和持久的创伤后应激障碍症状导致冒犯和精神病（“给声音一些东西来养活”）。第二,EMDR被认为是早期的怀疑论。第三，治疗本身最初是情绪负担和不容易,但参与者通常感到安全和坚持.第四，他们经常对结果感到惊讶和高兴（而且很有效！），描述显著的症状减轻和个人转变。最后,EMDR适合法医环境，在一个被认为是剥夺权力的地方带来权力。人们报告的变化增加了他们对无暴力未来的希望。结论：鉴于PTSD在精神不健康的罪犯中很常见，并且有可能阻碍康复并导致进一步犯罪，因此对EMDR在法医心理健康方面的研究有限。这项首次定性研究发现参与者经历了积极的变革性变化，超越症状减轻。主题支持先前发表的定量结果，表明EMDR在该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。试验注册：澳大利亚新西兰临床试验注册标识符：ACTRN12618000683235。研究注册：该研究在澳大利亚和新西兰临床试验网络上注册，注册号ACTRN12618000683235(前瞻性注册，2018年4月24日),https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374682。
这项研究调查了接受EMDR治疗PTSD的法医患者的生活经历，这些人的观点很少被捕获。他们描述受到创伤的深刻影响，发展衰弱和持久的PTSD症状，这些症状会导致冒犯和精神病。参与者第一次听说EMDR时没有良好的第一印象，认为这是“庸医”。然而,他们对结果感到惊讶和高兴，大多数人描述了明显的症状减少和个人转变。针对适应不良行为的一些潜在驱动因素，人们报告希望有更美好的未来。EMDR非常适合法医环境，被视为一种赋权疗法。
这项研究调查了接受EMDR治疗PTSD的法医患者的生活经历，这些人的观点很少被捕获。他们描述受到创伤的深刻影响，发展衰弱和持久的PTSD症状，这些症状会导致冒犯和精神病。参与者第一次听说EMDR时没有良好的第一印象，认为这是“庸医”。然而,他们对结果感到惊讶和高兴，大多数人描述了明显的症状减少和个人转变。针对适应不良行为的一些潜在驱动因素，人们报告希望有更美好的未来。EMDR非常适合法医环境，被视为一种赋权疗法。
