*Note: We want to acknowledge there are varying opinions and discussions around language labels for Autism and neurodivergence. In addition, there are differences in how an individual diagnosed or undiagnosed may choose to identify. This post uses person first language although we want to acknowledge that some Autistic individuals prefer identity first language. We encourage awareness and sensitivity to this issue and promote asking and complying with the wishes of any person’s choice for self-identification.
It is National Autism Acceptance Month! People on the autism spectrum develop uniquely. Some may have challenges in communicating, social skills, sensory experiences, and behavior. As the Autism Speaks website points out, there are different ways autism can show up for people depending on a combination of genetic and environmental factors in an individual. Those with autism might think and problem-solve differently. Some people with autism may not need a lot of support in their daily lives, and some may need a lot of hands-on support. The Centers for Disease Control stated the prevalenceof children identified with autism is 1 in 54, is spread evenly throughout the population, and is more than 4 times more common in boys than in girls.
As Kildahl et al. (2019), Rumball (2019), and Sizoo and Lobregt (2016) point out in their literature reviews on identifying PTSD and treating trauma in individuals on the autism spectrum, therapists may not recognize trauma symptoms as quickly in people with autism because of symptoms that overlap between PTSD and autism spectrum disorder (ASD), such as avoidance, hyperarousal, and difficulties with thoughts. However, research on the use of EMDR therapy with those in this population in trauma treatment is encouraging.
We wanted to speak with an EMDRIA member known for her experience in working with people with autism: Sherri Paulson, LCSW. We reached out to her with some questions and here’s what she shared!
Interview with Sherri Paulson, LCSW
Tell us a little bit about you, your experience becoming an EMDR therapist and your experience with clients on the autism spectrum?
I am a psychotherapist specializing in trauma and autism and have worked with individuals with autism for 23 years. I am an EMDRIA Approved Consultant. I also have a teaching background. I am the proud aunt of a niece with autism.
What is your favorite part of being an EMDR therapist with clients on the autism spectrum?
I love working with individuals with autism because they are so grateful for the help and because they have taught me so much.
What value do your clients on the spectrum get from EMDR therapy?
It would take me many hours to describe the benefits of EMDR for individuals with autism. To name a few: EMDR works. It helps and it heals. It heals trauma and can improve the symptoms of autism, helping reduce anxiety, improve social understanding and interaction as well as verbal ability and self-esteem. In many places the accepted treatment for autism is behavior-based. Of course, EMDR takes this treatment to another level, treating the source of the behavior.
What myths would you like to bust about using EMDR therapy with these clients?
I was told when I first learned EMDR that it should not be used with people with autism, that it would be dangerous to try. The reality is that EMDR can help children and adults with autism in so many different ways. It is doable for them.
Any specific complexities or difficulties that you have experienced and overcome with clients on the spectrum?
Patience and respect and understanding are necessary to develop trust on both sides before treatment can begin.
What is your favorite free resource that you would suggest to other EMDR therapists when working with clients on the autism spectrum? (ie: article, podcast episode, video, handout)
There are few useful resources about autism. Many of the more obscure characteristics of autistics have been overlooked in the newer diagnostic manuals and publications. Also, most are behavior-based. My favorite free resource is the EMDR Protocol for Use with Autism that I developed some years ago and was approved by Dr. Francine Shapiro, the founder of EMDR therapy. This includes a step-by-step preparation as well as covering the 8 phases of EMDR. It also can be used with any age and individual across the spectrum. Besides related presentations, I have sent this protocol literally around the world to therapists requesting it. It is available at email@example.com. In addition, EMDRIA members can access it in the library of the EMDR and Autism online community.
What would you like people outside the EMDR community to know about EMDR therapy with clients on the autism spectrum?
Anything else you would like to add?
I hope to provide guidance and help others develop the confidence to use EMDR with people with autism and other developmental disabilities.
Peer-Reviewed Research (Note that not all articles are open access, but those that are should be indicated that way)
Barol, B. I., & Seubert, A. (2010). Stepping stones: EMDR treatment of individuals with intellectual and developmental disabilities and challenging behavior. Journal of EMDR Practice and Research, 4(4), 156-169. Open access: https://doi.org/10.1891/1933-3188.8.131.52
Fisher, N., van Diest, C., Leoni, M., & Spain, D. (2022). Using EMDR with autistic individuals: A Delphi survey with EMDR therapists. Autism, online. Open access: https://doi.org/10.1177%2F13623613221080254
Fisher, N., Patel, H., van Diest, C., & Spain, D. (2022). Using eye movement desensitization and reprocessing (EMDR) with autistic individuals: A qualitative interview study with EMDR therapists. Psychology and Psychotherapy Theory, Research, and Practice. Open access: https://doi.org/10.1111/papt.12419
Ipci, M., Inci, S. B., Akyol Adric, U., & Ercan, E. S. (2017). A case of Asperger syndrome with comorbidity of posttraumatic stress disorder and selective mutism: Significant remission with the combination of aripiprazole and eye movement desensitization and reprocessing. Journal of Clinical Psychopharmacology, 37(1), 109-110. http://doi.org/10.1097/JCP.0000000000000627
Kosatka, D., & Ona, C. (2014). Eye movement desensitization and reprocessing in a patient with Asperger’s disorder: Case report. Journal of EMDR Practice and Research, 8(1), 13-18. Open access: https://doi.org/10.1891/1933-3184.108.40.206
Lobregt-van Buuren, E., Sizoo, B., Mevissen, L., & de Jongh, A. (2019). Eye movement desensitization and reprocessing (EMDR) therapy as a feasible and potential effective treatment for adults with autism spectrum disorder (ASD) and a history of adverse events. Journal of Autism and Developmental Disorder, 49(1), 151-164. https://doi.org/10.1007/s10803-018-3687-6
Mevissen, L., Didden, R., Korzilius, H., & de Jongh, A. (2016). Assessment of PTSD in children with mild to borderline intellectual disabilities. European Journal of Psychotraumatology, 7, 29786. Open access: https://doi.org/10.3402/ejpt.v7.29786
Mevissen, L., Didden, R., Korzilius, H., & de Jongh, A. (2017). Eye movement desensitization and reprocessing therapy for posttraumatic stress disorder in a child and an adolescent with mild to borderline intellectual disability: A multiple baseline across subjects study. Journal of Applied Research in Intellectual Disabilities, 30(S1), 34-41. https://doi.org/10.1111/jar.12335
Mevissen, L., Lievegoed, R., & de Jongh, A. (2011). EMDR treatment in people with mild ID and PTSD: 4 cases. Psychiatric Quarterly, 82, 43-57. Open access: https://doi.org/10.1007/s11126-010-9147-x
Sizzo, B., & Lobregt, E. (2016). Treating trauma with EMDR in adults with autism spectrum disorders (ASD) – A literature review. European Psychiatry, 33(S1), S561. https://doi.org/10.1016/j.eurpsy.2016.01.2081
van Diest, C., Leoni, M., Fisher, N., & Spain, D. (2022). Using EMDR with autistic clients: How do therapists adapt? Journal of EMDR Practice and Research, 16(3), 123-134. http://dx.doi.org/10.1891/EMDR-2022-0014
Lobregt-van Buuren, E., Mevissen, L., & de Jongh, A. (2020). Eye movement desensitization and reprocessing (EMDR) therapy in children and adults with autism. In F. R. Volkmar (Ed.), Encyclopedia of Autism Spectrum Disorders (2nd ed.). New York, NY: Springer Publishing. https://doi.org/10.1007/978-1-4614-6435-8_102388-1
General Resources for Mental Health Therapists
If you are a therapist interested in the EMDR training, visit our EMDR Training & Education tab:
If you are EMDR trained:
- Learn more about EMDRIA membership
- Search for Continuing Education opportunities
- Check out the EMDRIA blog, Focal Point
If you are an EMDRIA Member: