Investigating eye movement desensitisation and reprocessing to improve the mental health recovery of intensive care survivors

Post-traumatic stress disorder (PTSD) affects a substantial proportion of intensive care survivors, with adverse consequences for mental health, daily functioning, and quality of life. Despite this burden, trauma-focused psychological therapies remain largely absent from critical care rehabilitation pathways. A scoping review identified a substantial evidence gap: only two studies have evaluated evidence-based trauma-focused therapies, such as Eye Movement Desensitisation and Reprocessing (EMDR), and both were conducted during the COVID-19 pandemic, under exceptional conditions.This thesis aimed to evaluate the feasibility, acceptability, and preliminary clinical outcomes of using EMDR to treat traumatised survivors of intensive care. A mixed-methods feasibility trial was conducted using a trauma-informed, two-part consent process. Participants were stratified according to PTSD symptom burden at three months post-discharge. Those with post-traumatic stress symptoms were invited into a randomised controlled trial (RCT) of EMDR versus ‘treatment as usual’ (TAU). Those with below-threshold traumatic stress symptoms and those who declined randomisation were enrolled into a parallel observational cohort.Primary findings support the feasibility and acceptability of the trial protocol. Recruitment targets were achieved, retention was high, and fidelity to the EMDR protocol was maintained. The mean reduction in Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) scores from pre- to post-intervention was –15.6 points (95% CI: –21.4 to –9.8) in the EMDR group compared to –1.6 points (95% CI: –6.9 to +3.7) in the TAU group (p