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Group-based cognitive-behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomised controlled trial
- Authors:
- WILNER Paul, et al
- Journal article citation:
- British Journal of Psychiatry, 203(4), 2013, pp.288-296.
- Publisher:
- Cambridge University Press
A cluster-randomised trial of group-based 12-week cognitive-behavioural therapy (CBT), which took place in day services for people with intellectual disabilities and was delivered by care staff, was evaluated to assess its effectiveness as an intervention for anger management in people with intellectual disabilities. Participants were 179 service users identified as having problems with anger control randomly assigned to either anger management or treatment as usual. Participants were recruited from services in parts of Scotland, England and Wales. Assessments were conducted before the intervention, and at 16 weeks and 10 months after randomisation. The intervention had only a small, and non-significant, effect on participants’ reports of anger on the Provocation Index, the primary outcome measure. However, keyworker Provocation Index ratings were significantly lower in both follow-up assessments, as were service-user ratings on another self-report anger measure based on personally salient triggers. Both service users and their keyworkers reported greater usage of anger coping skills at both follow-up assessments and keyworkers and home carers reported lower levels of challenging behaviour. The intervention provides evidence of the effectiveness of a CBT intervention for this client group and demonstrates that the staff who work with them can be trained and supervised to deliver such an intervention with reasonable fidelity. (Edited publisher abstract)