Using EMDR with autistic individuals: A Delphi survey with EMDR therapists.
Naomi Fisher, Caroline van Diest, Marguerite Leoni and 1 others
PMID 35384753WHAT IT FOUND
Therapists agreed on three core principles for using EMDR with autistic clients: flexibility, clear communication, and responding to the individual.
They rejected a single scripted autism protocol, favouring a 'therapeutic toolbox' approach where adaptations depend on the client's specific needs and presentation.
Key findings
01Consensus adaptations were general therapeutic principles (flexibility, clear language, individual differences) rather than specific EMDR protocol changes.
02Therapists identified barriers including client and therapist factors, therapeutic relationship differences, and systemic issues.
03Clinical supervision requires knowledge of autism, trauma, and neurodevelopmental conditions to support effective practice.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study reports therapist opinions on what they do, not patient outcomes. It does not show if these adaptations make EMDR more effective. Participants were not asked to confirm they are autistic, and the views of autistic clients themselves were not included. The sample size decreased significantly from Round 1 (103) to Round 3 (26), which may affect the generalisability of the final consensus. Knowledge of autism and EMDR proficiency were self-reported and not objectively assessed. The survey focused only on adaptations made within the therapy room, ignoring broader systemic barriers to access.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for this research.
The easy way to misread this
Do not interpret these consensus adaptations as evidence that EMDR is effective for autistic individuals. This study reports what therapists say they do and agree is important; it does not measure treatment outcomes or compare adapted EMDR to standard care.