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A multiple methods evaluation of a cognitive behavioural therapy group for people with learning disabilities and anxiety
- Authors:
- GIANNAKI Rengina, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 49(1), 2021, pp.87-99.
- Publisher:
- Wiley
Background: Existing studies show mixed results of the effectiveness of CBT for people with learning disabilities and anxiety. Method: A CBT group was run for people with learning disabilities and anxiety, who attended with a supporter. Qualitative interviews were conducted post‐group and analysed using thematic analysis. Standardised questionnaires measuring anxiety, psychological distress and overall functioning were administered at pre‐ and post‐group, and at follow‐up. Results: Participants’ anxiety decreased overall post‐group, which remained largely at follow‐up. The group and the supporters’ involvement was helpful. Both supporters and participants recalled coping strategies that were presented in the group. Three out of four participants found attending a group challenging initially. The supporters seem to have specific expectations about the impact of the group. Conclusions: The results of the study are consistent with the existing, growing body of evidence which supports the use of CBT for people with learning disabilities and anxiety. (Edited publisher abstract)
Having a son or daughter with an intellectual disability transition to adulthood: a parental perspective
- Authors:
- CODD Jon, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 49(1), 2021, pp.39-51.
- Publisher:
- Wiley
Background: Transition to adulthood is an important time for young people and may be a particularly challenging time for people with intellectual disabilities. However, there has been little research in the UK regarding the experiences of parents who have son or daughter with an intellectual disability transitioning to adulthood. Method: The study used interpretive phenomenological analysis to explore the lived experiences of ten parents who had a son or daughter (aged 18–25 years) with an intellectual disability. Half of the sample also had a diagnosis of autism. Results: Three superordinate themes were generated from the data: (a) Transition: The Good, the Bad and Unknown; (b) Striving for Independence; and (c) Supporting the Supporters. Parents experienced many difficulties and uncertainty related to their role, their son/daughter's independence, navigating services for their son/daughter and accessing support for themselves. Conclusions: Increased collaboration and consistency from statutory services is required in addition to providing emotional support to parents and facilitating parent support networks. (Edited publisher abstract)
‘Planning live’: using a person-centred intervention to reduce admissions to and length of stay in learning disability inpatient facilities
- Authors:
- BARTLE Janet, CROSSLAND Tom, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 44 (4), 2016, pp.277-283.
- Publisher:
- Wiley
Background: Recent government policy has focused on reducing the number of people with a learning disability receiving treatment for challenging behaviour or mental health difficulties in hospitals (including in assessment and treatment units; ATU). People with a learning disability should be supported to remain in their community when receiving support for challenging behaviour or mental health difficulties whenever possible. Methods: This study considered a novel intervention based on person-centred planning practice, which aimed to coordinate a person's support, identify outstanding needs and increase communication. This intervention intended to reduce rates of inpatient admission, and support the person to remain in their community, whilst ensuring their needs are met. This intervention was assessed by considering the number of people admitted to the inpatient services before and after the intervention, the length of inpatient admissions before and after the intervention, and by analysing qualitative feedback from participants in the intervention. Results: ‘Planning Live’ meetings were held for 102 people. Forty-five meetings were held retrospectively following an emergency admission. Following the ‘Planning Live’ meeting, five people had a planned admission and 52 people did not have an inpatient admission. The median length of inpatient stay fell from 143.5 days before the introduction of ‘Planning Live’ to 66 days (a statistically significant reduction). Qualitative feedback shows that the process was largely seen as helpful by professionals, families and individuals taking part in the meetings. Conclusions: The results suggest this person-centred intervention contributed towards a reduction in the amount of time individuals stayed in hospital. However, the total number of hospital admissions rose following the intervention. (Publisher abstract)
A qualitative investigation into the experiences of having a parent with a learning disability
- Authors:
- HEWITT Olivia, CLARKE Angela T.
- Journal article citation:
- British Journal of Learning Disabilities, 44 (4), 2016, pp.292-300.
- Publisher:
- Wiley
Background: More people with a learning disability are becoming parents. Little is known about the lived experiences of the children who have a parent with a learning disability. Methods: This study uses interpretative phenomenological analysis (IPA) to understand the lived experiences of people who have a parent with a learning disability. Five people who have a parent with a learning disability were asked about their experiences of being parented and their childhood more generally. Results: Four themes emerged from the interviews: 1) ‘Fitting in’ within the wider family system, 2) The parental relationship and the impact of disability, 3) A difficult childhood and 4) Resilience. Conclusions: These findings are compared with the existing literature, and similarities and emerging findings are noted. Implications for services when supporting families with a parent who has a learning disability are discussed. Additional ideas about areas that require additional research are identified. (Publisher abstract)
The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review
- Authors:
- JENNINGS Caroline, HEWITT Olivia
- Journal article citation:
- Tizard Learning Disability Review, 20(2), 2015, pp.54-64.
- Publisher:
- Emerald
Purpose: This paper is to identify, outline and evaluate current research on the effectiveness of cognitive behavioural therapy (CBT) for depression for people with a learning disability. The clinical, service and research implications are considered. Design/methodology/approach: A systematic search was conducted on the databases AMED, MEDLINE, PsychINFO and CINAL. Five relevant articles were identified for critical review. Findings: There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities. Research limitations/implications: The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms. Practical implications: Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression. (Edited publisher abstract)
Evaluating an anxiety group for people with learning disabilities using a mixed methodology
- Authors:
- MARWOOD Hayley, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 41(2), 2013, pp.150-158.
- Publisher:
- Wiley
A 6-week cognitive behavioural therapy (CBT) anxiety management group was delivered to eight adults with a mild learning disability by a trainee psychologist and an assistant psychologist. Participants' ages ranged from 17 to 73 years. All participants lived in the local community. Not all participants had a specific anxiety diagnosis, but all required anxiety management input. A mixed methodology using quantitative and qualitative analysis of group outcomes was used. The outcomes from this group suggest that the intervention was successful in treating anxiety for people with learning disabilities. Measures included the Quality of Life Scale, the Glasgow Anxiety Scale and the Health of the Nation Outcome Scale–Learning Disability Version. Interpretative Phenomenological Analysis (IPA) was also used. Data from interviews were coded and analysed thematically. The main themes that emerged included group versus individual input, helpful aspects of the group, talking in front of other people, group composition (including age differences), support partners, and written materials. The outcomes for this group suggest that the intervention was successful in treating anxiety for people with learning disabilities. Practical applications of group therapies for these clients are considered, and recommendations for future groups made. Quantitative and qualitative evaluation methods are compared. (Edited publisher abstract)
Do group interventions help people with autism spectrum disorder to develop better relationships with others? A critical review of the literature
- Authors:
- ATKINSON-JONES Katherine, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 47(2), 2019, pp.77-90.
- Publisher:
- Wiley
Background: Social and communication impairments are a core diagnostic feature of autism spectrum disorder (ASD) and can act as a barrier to developing relationships. The National Institute for Health and Care Excellence (2016) guidelines recommend group social skills interventions as the first‐line treatment to help adults with ASD improve their social skills and relationships. To date, reviews have only explored the impact of group social skills interventions for adults with ASD without intellectual disability (ID). This review aimed to critically appraise studies investigating group social skills interventions for adults with ASD both without intellectual disability and with a mild or moderate intellectual disability. Method: A systematic search of four databases (PsycINFO, MEDLINE, EMBASE and CINAHL), as well as hand‐searching of references, was conducted. Ten studies were identified, employing different designs and methodologies, and covering six different group social skills interventions. Results: Overall, the review provided fairly consistent evidence that group social skills in different formats can reduce social impairments and increase social interaction, social knowledge and empathy for adults with ASD. Conclusion: There was variation in the quality of studies, and the most robust evidence was provided for the efficacy of the PEERS‐YA intervention. There was less evidence supporting the effectiveness of group social skills interventions for adults with ASD and intellectual disability, and more research is needed in this area. (Publisher abstract)
Outcomes and experiences of an adapted Dialectic Behaviour Therapy skills training group for people with intellectual disabilities
- Authors:
- CROSSLAND Tom, HEWITT Olivia, WALDEN Sarah
- Journal article citation:
- British Journal of Learning Disabilities, 45(3), 2017, pp.208-216.
- Publisher:
- Wiley
Background: A growing body of evidence supports the use of Dialectic Behaviour Therapy with people with an intellectual disability. Various adaptation have been used in studies exploring the efficacy of this intervention. Method: A Dialectic Behaviour Therapy DBT skills training group was attended by people with an intellectual disability and their support staff. Standardised measures of psychological well-being, overall functioning and psychological distress were taken before and after the group and at 4 months follow-up. Qualitative interviews were conducted and analysed using thematic analysis. Results: Results suggested an improvement in all areas for three of the four participants, which were largely maintained at follow-up. Conclusions: This study adds to the growing literature supporting the use of DBT with people with an intellectual disability. The role of support workers in supporting generalisation of skills is considered. Ideas for improving the quality of future studies are considered. (Publisher abstract)
Training a family in physical interventions as part of a positive behaviour support intervention for challenging behaviour
- Authors:
- HEWITT Olivia, KEELING Natalie
- Journal article citation:
- British Journal of Learning Disabilities, 44(2), 2016, p.159–166.
- Publisher:
- Wiley
Between 10% and 15% of people with a learning disability have behaviour that challenges others, and half of these people live within the family home (Emerson et al., Research in Developmental Disabilities, 2001; 22, 77). Current best practice in managing challenging behaviour combines person-centred planning, functional analysis, and proactive and reactive strategies, and teaching alternative skills to manage behaviour in a way that keeps both service user and carers safe (positive behaviour support). This study considers the case study of a young man who lives with his parents in their family home. Reactive strategies including physical interventions have been taught to the family which has allowed them to manage their son's behaviour effectively and allowed him to remain living with his family. Frequency and intensity of challenging behaviour reduced, and family confidence in managing challenging behaviour was increased. (Publisher abstract)
A valid point of view
- Author:
- HEWITT Olivia
- Journal article citation:
- Young Minds Magazine, 96, September 2008, pp.32-33.
- Publisher:
- YoungMinds
Briefly reports on research which used two focus groups to explore the views of young people with learning disabilities about emotional issues.