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Doing more, feeling better: a behavioural approach to helping a woman overcome low mood and anxiety
- Authors:
- STUART Simon, GRAHAM Christopher D., BUTLER Sarah
- Journal article citation:
- British Journal of Learning Disabilities, 42(4), 2014, pp.328-335.
- Publisher:
- Wiley
A substantial body of literature exists concerning the adaptation of cognitive behavioural therapy for people with learning disabilities. However, it is possible that cognitive approaches have been prioritised at the expense of behavioural techniques that are simpler and more effective. This case conceptualisation considers a behaviourally focused approach to helping a woman with a mild learning disability who was experiencing low mood and anxiety, delivered by a trainee clinical psychologist working within a multidisciplinary team. (Edited publisher abstract)
A cognitive behavioural intervention for dental anxiety for people with learning disabilities: a case study
- Authors:
- PRANGNELL Simon J., GREEN Karen
- Journal article citation:
- British Journal of Learning Disabilities, 36(4), December 2008, pp.242-248.
- Publisher:
- Wiley
Very little work has been done to investigate effective non-medical approaches for supporting people with a learning disability and dental anxiety to access dental care. Using a case study, this paper demonstrates that a simple cognitive behavioural intervention can be effective in reducing dental anxiety, and offer a more meaningful choice of treatment options. This paper is limited in that no formal assessment measures were used, and was evaluated through client feedback. It is possible that this intervention could be applied by other practitioners to increase the accessibility of dental health services.
Acceptance and commitment therapy (ACT) with a learning disabled young person experiencing anxious and obsessive thoughts
- Authors:
- BROWN Freddy Jackson, HOOPER Sian
- Journal article citation:
- Journal of Intellectual Disabilities, 13(3), September 2009, pp.195-201.
- Publisher:
- Sage
- Place of publication:
- London
This case study, of a young person (Sarah) with moderate to severe learning disabilities who was experiencing obsessive and anxious thoughts, illustrates how the Acceptance and Commitment Therapy (ACT) model, a type of Cognitive Behavioural Therapy (CBT), can be individually adapted to help people with learning disabilities. Using ACT-based experimental activities, including mindfulness and defusion exercises, Sarah learned to notice her thoughts, distance herself from their literal content, remain calmer, become more socially confident and return to a part-time college course. The activity-based nature of ACT is concluded to be more suited for people with learning disabilities than the verbal reasoning skills utilised traditionally in CBT. The authors call for further work as both techniques require adaptation and individualisation for each client and are dependent on both the extent of a person’s learning disabilities and how well their language and cognitive skills allow engagement with the therapeutic process.
Dog gone good: managing dog phobia in a teenage boy with a learning disability
- Authors:
- NEWMAN Craig, ADAMS Katie
- Journal article citation:
- British Journal of Learning Disabilities, 32(1), March 2004, pp.35-38.
- Publisher:
- Wiley
This is a case study of a 17-year-old boy with a moderate learning disability who had a severe phobia of dogs. A systematic desensitization approach with relaxation and modelling was used to manage his phobic response to dogs. A hierarchy of fear was identified, and progress was made by increasing the level of exposure to dogs whilst controlling for anxiety levels. Results showed that after 28 sessions the client was able to manage his both behaviour and anxiety level when in contact with unfamiliar loose dogs. The study highlighted the importance of selecting an appropriate model and brought into light some ethical concerns in working with young people who have fears of possibly dangerous animals such as dogs.
Learning disabilities: positive practice guide
- Authors:
- DAGNAN Dave, et al
- Publisher:
- Foundation for People with Learning Disabilities
- Publication year:
- 2015
- Pagination:
- 34
- Place of publication:
- London
This practice guide provides information on how to best support people with learning disabilities to access their local Access to Psychological Therapies (IAPT) service. It is aimed at those who work in, commission, or refer to the Improving Access to Psychological Therapies (IAPT) services. The guide outlines the reasonable adjustments that are recommended to ensure that people with learning disabilities get the maximum benefit from treatment within an IAPT service. Areas discussed include: service models, changes to referral and access pathways; screening; adjustments to mainstream IAPT pathways; assessment; adaptations to treatment and interventions; and making information accessible. Practical examples are included to show how some teams have made reasonable adjustments to support access to IAPT service. The guide also covers the importance of training and developing the workforce and provides key points for commissioners of IAPT services consider to ensure that mainstream services effectively meet the needs of people with learning disabilities. (Edited publisher abstract)
Narrative therapy in a learning disability context: a review
- Author:
- MCPARLAND James
- Journal article citation:
- Tizard Learning Disability Review, 20(3), 2015, pp.121-129.
- Publisher:
- Emerald
Purpose: Narrative therapy is aligned with government priorities for learning disabilities as it promotes inclusion and seeks to empower. While research on narrative therapy in learning disability services is emerging, it has not been critically evaluated. This paper aims to identify, summarise and critique the extant literature that has explored narrative therapy for adults with learning disabilities, and to consider the implications for research and clinical practice. Design/methodology/approach: A literature search identified seven relevant case studies that described individual narrative therapy interventions for adults with learning disabilities. A qualitative review of these studies was carried out. Findings: Overall, the reviewed studies offer tentative evidence for the short-term usefulness of narrative therapy for difficulties with anger and qualitative benefits for ritualistic behaviour, social anxiety and stealing behaviour. Research limitations/implications: A number of methodological issues are identified, particularly concerning the use of outcome measures and the generalisability of findings. The research is limited due to a reliance on case study evidence and outcome measures that lack validity and reliability. Both larger scale and more robust research, and high quality practice-based evidence, are required. Originality/value: This paper provides an up-to-date, comprehensive review of the literature on narrative therapy for people with learning disabilities that will be of use to clinicians providing therapeutic support and to people commissioning such services. (Edited publisher abstract)
Cognitive behavioural therapy for anxiety in a man with autism spectrum disorder, intellectual disability, and social phobia
- Author:
- WRIGHT Kevin Paul
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(5), 2013, pp.284-292.
- Publisher:
- Emerald
Purpose: This paper evaluates the effectiveness of cognitive-behavioural therapy (CBT) in the treatment of social anxiety with a 19-year-old man with intellectual disabilities (ID) and autistic spectrum disorders. Design/methodology/approach: The intervention was evaluated using an A-B single case design. An idiosyncratic measure was developed to measure anxiety symptoms on a daily basis. The brief symptom inventory (BSI; Derogatis, 1975) measured symptom patterns across nine psychological dimensions and was administered at initial assessment, pre-intervention and post-intervention. Findings: Visual and statistical analysis of the data showed that anxiety severity dramatically reduced throughout the course of therapy, reaching and maintaining zero and this was statistically significant. Data seemed to show that sudden gains in the reduction of anxiety severity occurred during the relaxation and cognitive phases of intervention. This sudden gain coincided with an increase in daily activities, and exposure to more anxiety provoking events which was also statistically significant. Global anxiety scores, as measured by the BSI, showed a notable reduction at post-treatment. Originality/value: This paper demonstrates that CBT can bring about meaningful improvements in the treatment of anxiety in people with ID and autism and suggests that further exploration with the wider population is needed. (Publisher abstract)
Living with stigma and the self-perceptions of people with mild intellectual disabilities
- Authors:
- JAHODA Andrew, et al
- Journal article citation:
- Journal of Social Issues, 66(3), September 2010, pp.521-534.
- Publisher:
- Wiley
Drawing on two case studies from a larger study, this article illustrates how people with mild or moderate learning disabilities experience and deal with stigma. It illustrates that even when individuals have difficulty expressing their views verbally, their actions can provide evidence of how they struggle to establish or maintain positive social identities – sometimes at the cost of their mental health. The implications of these and other findings are discussed in relation to social constructionist theories of self-perception. This in turn will be linked to a discussion about the kind of support that might be required by people with intellectual disabilities, and how stigma might increase vulnerability to emotional and other problems.
Use of a narrative therapy approach with a man with a learning disability: an alternative to cognitive behavioural therapy
- Authors:
- FOSTER Chloe, BANES Jonathan
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(1), March 2009, pp.52-55.
- Publisher:
- Emerald
This case study presents and evaluates the effectiveness of a psychological intervention based on a narrative therapeutic approach. Paul is a man with a mild learning disability who was referred for treatment for anxiety and anger. Following difficulties in engaging him in a cognitive behavioural intervention, a narrative approach was initiated. By placing Paul as an expert in his own life, the approach was intended to assist him to access his strengths and resources and encourage him to view himself as separate from the problem he labelled ‘Anger’. Quantitative data indicated that there was a reduction in feelings of anxiety and increased feelings of well-being. Subjectively, Paul reported making steps towards achieving five therapeutic goals, including feeling more in control of ‘Anger’. It was concluded that, with modifications to standard techniques, a narrative therapeutic approach offers a promising alternative to CBT for people with learning disabilities.