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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)
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)
Quality of diagnosis and treatment plans after using the ‘diagnostic guideline for anxiety and challenging behaviours’ in people with intellectual disabilities: a comparative multiple case study design
- Authors:
- PRUIJSSERS Addy, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(4), 2016, pp.305-316.
- Publisher:
- Wiley
Background: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. Materials and Methods: A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. Results: The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Conclusions: Working with the ‘Diagnostic Guideline for Anxiety and CB’ leads to improved diagnoses and treatment plans compared with care as usual. (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)
Psychological and other non-pharmacological interventions in services for people with learning disabilities and dementia
- Author:
- DODD Karen
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 4(1), March 2010, pp.28-36.
- Publisher:
- Emerald
This article describes the current research regarding people with learning disabilities who develop dementia. The author notes that current interest has largely focused on epidemiology, prevalence, assessment and diagnosis, and that there has been less focus on care issues and interventions. Currently, there is a lack of research material, but a growing number of books and resource packs are addressing these issues. The author suggests that psychological and non-pharmacological approaches are useful in services for people with learning disabilities and dementia, but must be delivered in line with a clear conceptual framework of dementia that aids staff in understanding what is happening to the person with dementia and the effect of their care and responses. This paper outlines the most commonly used approaches, including developing an understanding of dementia, anxiety and stress reduction, life story work, reminiscence, reality orientation and validation techniques, helping peers to understand dementia, other therapeutic approaches, and understanding behaviour and dementia care mapping and their impact on the well-being of people with learning disabilities and dementia and the people who support them.
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.
Outcome evaluation of bereavement groups for adults with intellectual disabilities
- Authors:
- STODDART Kevin P., BURKE Lillian, TEMPLE Valerie
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(1), 2002, pp.28-35.
- Publisher:
- Wiley
Individuals with intellectual disabilities respond to loss in similar ways to other individuals. Bereavement interventions, whether provided individually or in a group, need to be planned according to the person's understanding, presenting symptoms, psychological functioning and support system. Measuring the effectiveness of such interventions is critical in order to increase our knowledge of useful interventions for this population. The present authors discuss individual and group bereavement therapy, and outline the goals and approaches used in their bereavement groups for adults with intellectual disabilities. Individuals referred for bereavement group therapy were interviewed and assessed prior to their participation in the group. Measures of depression, anxiety, and knowledge of death and bereavement issues were administered before and after group participation. Scores for depression were significantly lower following group participation. However, scores for anxiety were mild and not significantly reduced. The participants' understanding and knowledge of the bereavement process did not improve significantly. When those with single and dual diagnosis were considered separately, those with a dual diagnosis experienced a significant decrease in depression, while those with a single diagnosis did not. Furthermore, depression scores for those with a dual diagnosis were generally higher. The preliminary investigation of therapeutic outcomes for bereavement group intervention suggests little change in anxiety and knowledge of death/bereavement issues, but significant improvement in symptoms of depression for participants, particularly those with a dual diagnosis. The weaknesses of the present study are discussed along with possible improvements for future studies.