Eye movement desensitization and reprocessing for adults with intellectual disabilities: Process issues from an acceptability study.

BACKGROUND: Eye movement desensitization and reprocessing (EMDR) is recommended for post-traumatic stress disorder and emerging evidence indicates that it is effective for people with intellectual disabilities. However, acceptability from the perspectives of clients with intellectual disabilities, their therapists and other key people has not been formally evaluated. This study investigates process issues in the implementation of EMDR from perspectives of multiple stakeholders. METHOD: Semi-structured interviews were conducted with two adults with intellectual disabilities and three clinical psychologists who had participated in EMDR as well as a key supporter (N = 6) to provide information relating to three cases. The interviews were analysed thematically either directly from the audio recording or from transcripts. RESULTS: Five themes were identified: EMDR feels very different; EMDR is a technical process; the need to work with the present; talking is important; cautious optimism. CONCLUSIONS: Whilst a range of client- and therapist-related factors served as barriers to using EMDR in this small-scale study, such as preferences in working with the present and inexperienced therapists, there was cautious optimism that EMDR may be useful for "the right person at the right time.".

Male GPs' views on men seeking medical help: a qualitative study.

OBJECTIVE: Analysis of health service statistics reveals that men tend to under-use primary health care services. Previous research has suggested that men view illness as a form of weakness and have negative views about men who seek medical help. It has also indicated that some men believe that male General Practitioner (GP)s hold similar views, a factor which may influence their own tendency to self-refer. This study aims to explore male GPs' experiences of their male patients' patterns of self-referral and to identify factors that may negatively influence doctor-patient relationships. METHOD: Semi-structured interviews were carried out with 10 male GPs (ages=35-53). These were audiotaped and subjected to interpretative phenomenological analysis to identify relevant themes. RESULTS: For all participants, managing service demands were seen as a major challenge. Analysis of these GP's accounts suggested that they see men's self-referral as being primarily influenced by the need to conform to masculine gender roles and a number of ways that men accessed services in a way congruent with this were identified. This study also explored how participants' own adherence to gender roles may itself influence the doctor-patient relationship. CONCLUSION: This study suggests that, like other men, male GPs may have ambivalent attitudes towards male self-referral and that this may influence their interactions with male patients.

Patterns of self-referral in men with symptoms of prostate disease.

OBJECTIVE: Analysis of health statistics reveals that, although men have a shorter life expectancy and a higher mortality rate than women, they have less contact with their GP. This study investigates men's experiences of prostate disease, with a particular focus on how they made the decision to seek medical help. METHOD: Semi-structured interviews were carried out with 20 men aged 51-75 with prostate disease who had recently contacted their GP. These were audiotaped, transcribed and subjected to interpretative phenomenological analysis. RESULTS: Analysis revealed that their referral behaviours were profoundly influenced by a need to live up to traditional images of masculinity. Far from being uncaring, men were extremely anxious about their health and fears about the effects of illness and treatment emerged as major influences on their decision to seek help. Their delay in approaching their GP was due to their beliefs about symptoms as markers of serious disease, their ability to hide symptoms from others and their attitude towards male GPs who were often seen as having negative attitudes towards male patients. CONCLUSIONS: This study identifies some reasons why men with prostate disease may fail to seek medical care and has implications for increasing referral rates for men.

Can People With Intellectual Disability Resist Implications of Fault When Police Question Their Allegations of Sexual Assault and Rape?

When people alleging sexual assault are interviewed by police, their accounts are tested to see if they would stand up in court. Some tests are in the form of tendentious questions carrying implications (e.g., that the sex was consensual) damaging to the complainant's allegation. In a qualitative analysis of 19 English police interviews with people with intellectual disability (ID) defined in a variety of ways, we show how people with ID deal with the pragmatic complexity of such tendentious questions. We give examples in which the complainants detect and resist the questions' damaging implications; but we focus on occasions when the complainants do not do so. We discuss the use of tendentious questions in the light of national United Kingdom guidelines on the treatment of vulnerable witnesses.