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The experiences of adults with intellectual disabilities attending a mindfulness‐based group intervention
- Authors:
- CROOM Sarah, et al
- Journal article citation:
- British Journal of Learning Disabilities, 49(2), 2021, pp.162-178.
- Publisher:
- Wiley
Background: A growing body of research supports the efficacy of mindfulness-based intervention programmes (MBPs) for people with intellectual disabilities. Existing literature calls for focus on the experiences of people with intellectual disabilities participating in MBPs. Materials and Methods: This study explored the experiences of nine adults with intellectual disabilities attending an eight-week group MBP delivered within the community. Two audio-recorded group discussions and seven semi-structured interviews were thematically analysed. Results: Themes were as follows: participants’ experience of the group as a meaningful and enjoyable activity; opportunities for socialisation, sharing, friendship and support; the significance of participant–facilitator relationships; and how participants understood and experienced the mindfulness exercises and concepts. Conclusions: Some understanding of mindfulness was evident, and participants demonstrated an ability to engage in mindfulness exercises. Findings inform the development of effective MBPs for people with intellectual disabilities. (Edited publisher abstract)
Use of ECT in patients with an intellectual disability: review
- Authors:
- COLLINS Jessica, HALDER Neel, CHAUDHRY Nasim
- Journal article citation:
- Psychiatrist (The), 36(2), February 2012, pp.55-60.
- Publisher:
- Royal College of Psychiatrists
Although adults with an intellectual disability display a higher prevalence of psychiatric disorders than in the general adult population, the existing literature on the use of electroconvulsive therapy (ECT) in patients with an intellectual disability is limited. This review examined articles on ECT published before March 2010. All age ranges, severity of disability and diagnoses were included. The review found 72 case reports, a retrospective chart review study and other reviews, but no controlled studies. Seventy nine per cent of patients showed a positive outcome following ECT. Complications were seen only in 13% and there were no reports of cognitive decline. Thirty two per cent of patients relapsed following ECT, and the majority were maintained with medication at follow-up (71%). Obstacles to its use include diagnostic difficulties, ethical and legal issues, a lack of objective measurements and uncertainty about its safety in this population. The authors concluded that ECT was a valuable treatment for this patient group and should be considered earlier as opposed to as a last resort.
Building bridges to housing for homeless adults with intellectual and developmental disabilities: outcomes of a cross‐sector intervention
- Authors:
- REID Nadine, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.16-27.
- Publisher:
- Wiley
Background: Adults with intellectual and developmental disabilities (IDD) have high rates of homelessness. This observational study evaluates Bridges to Housing, a cross‐sector intervention offering immediate access to housing and supports to this population in Toronto, Canada. Methods: Twenty‐six participants, enrolled between April 2016 and December 2017, were assessed at baseline, six and 12 months post‐enrolment. Descriptive statistics and generalized linear modelling evaluated quality of life (QOL) and service needs outcomes. Twenty‐one service users and providers participated in semi‐structured interviews between August 2017 and June 2018 to elicit their experiences of the intervention, which were analysed thematically. Results: Twelve months post‐enrolment, 24 participants were successfully housed and reported increased QOL scores (F(2,43) = 13.73, p = <.001) and decreased perceived unmet service needs (Wald χ2(2) = 12.93, p = .002). Individual‐, intervention‐ and system‐level characteristics facilitated housing stability in this population. Conclusions: Cross‐sector approaches can improve outcomes for homeless adults with IDD and may have an important role in supporting this marginalized population. (Edited publisher abstract)
Understanding and responding to behaviour that challenges in intellectual disabilities: a handbook for those who provide support
- Editors:
- OSGOOD Tony, BAKER Peter
- Publisher:
- Pavilion Publishing
- Publication year:
- 2019
- Pagination:
- 200
- Place of publication:
- Hove
- Edition:
- 2nd ed.
An accessible and practical handbook for people who are supporting children and adults with learning or developmental disabilities and/ or autism who display behaviour that challenges. Based on research, policy and latest practice, it reflects changes that have taken place since the previous edition, in particular the values and approach of Positive Behaviour Support. Contents include: assessing behaviour that challenges, building a good rapport, keeping people safe, learning new ways of behaving, and working with families. Case studies are included. The hand book will be relevant for professionals, support workers, students and family members. (Edited publisher abstract)
Adults with intellectual disabilities: case studies using everyday technology to support daily living skills
- Authors:
- GOLISZ Kathleen, et al
- Journal article citation:
- British Journal of Occupational Therapy, 81(9), 2018, pp.514-524.
- Publisher:
- Sage
Introduction: Adults with intellectual developmental disorders may have difficulties undertaking activities of daily living. This study aimed to identify changes in independence in activities of daily living following learning support using individualised everyday technologies. Method: A double-baseline case study design explored the use of everyday technology applications and devices to support functional performance of three men aged 32, 33, and 55 years, with mild to moderate intellectual disabilities. Performance of selected tasks was video-recorded and analysed on four occasions for each participant. Baselines were recorded twice before intervention to ensure the participant’s performance of the selected task was consistent. The intervention video was recorded at the midpoint of the participant’s engagement in the study. Post-intervention video was recorded approximately 1 month after the intervention ended. Results: All three participants’ functional performance of an activity of daily living task improved in accuracy and efficiency as cues from support workers were gradually faded. After the learning support ceased, technology continued to provide environmental support of participants’ ongoing independence and efficient performance of the activity. Conclusion: Everyday technology applications and devices can be utilised together with a guided and structured client-centred approach and task-specific training with individuals with disability and learning difficulties. (Edited publisher abstract)
Intellectual disabilities and ACT: feasibility of a photography-based values intervention
- Authors:
- BOULTON Natalie Elizabeth, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(1), 2018, pp.11-21.
- Publisher:
- Emerald
Purpose: There is limited evidence regarding clinical effectiveness of therapeutic interventions for people with intellectual disabilities (ID). Previous research has highlighted challenges regarding adaptation of Acceptance and Commitment Therapy (ACT) for people with ID. Central to ACT is a focus on living in congruence with individual core values. The concept of values is abstract and difficult for people with a limited verbal understanding to comprehend, and yet this approach holds much promise for people with ID. The paper aims to discuss these issues. Design/methodology/approach: The current study outlines the adaptations undertaken to facilitate making the concept of values more accessible to people with ID. It also explores the feasibility of the adapted approach to the values component. Findings: This trial has shown that it is possible to isolate a single component of ACT and adapt it for use with people with ID. The findings highlight the potential feasibility of a value-based approach for people with ID augmented through the use of participant-produced photography to enhance conceptual understanding of the values component of ACT. Research limitations/implications: Findings were reliant on self-report data, which may result in inaccurate reporting and may be influenced by social demands. Given the diverse and unique presentations of people with ID, the inclusion and exclusion criteria limits the extent to which the current findings may be generalised to people with ID more widely.Practical implications: Participant-produced photography may be directly applied to clinical practice, with implied benefits of improving access to, and meaningful engagement with psychological therapies for people with ID. Development of (and ability to articulate) a readily available and easily accessible values system, during times of adversity, represents a key implication arising from the current trial. Originality/value: The current study shows that people with intellectual disability can be helped to appreciate abstract concepts such as personal core values. It also shows the potential to work through the medium of personal photography to explore the feasibility of the adapted approach to the values component – potentially a logical preliminary step towards an ACT-ID evidence base. To the authors’ knowledge, this novel approach is the first of its kind in the ID literature. (Edited publisher abstract)
Working with persons with an intellectual disability: the transferential process between therapist and client and the systems they inhabit
- Authors:
- COTTER Padraig, HOLLWEY Sara, CARR Alan
- Journal article citation:
- Tizard Learning Disability Review, 22(3), 2017, pp.136-143.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to appraise “transference” and “countertransference” when working with people with intellectual disabilities (PWID). Design/methodology/approach: A review of the literature was conducted, followed by a discussion. Findings: No research articles were found. Potential reasons for this are discussed. Historical influence, complexity of the topic and resistance among professionals may be contributing factors. Despite this, these phenomena are important for several reasons. These include the high levels of trauma these clients experience; the manner in which they have been marginalised by mainstream society; the strong likelihood of PWID evoking difficult countertransference from therapists; and the myriad of coping mechanisms and defences that these clients may employ. Research limitations/implications: Research is needed to further current understanding of these issues. Practical implications: An awareness of these issues amongst practitioners and other key members of a PWID’s system is important. Originality/value: This is the first review and commentary on these issues. (Publisher abstract)
Understanding the implementation process of a multi-component health promotion intervention for adults with intellectual disabilities in Sweden
- Authors:
- SUNDBLOM Elinor, BERGSTROM Helena, ELLINDER Liselotte Schafer
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 28(4), 2015, pp.296-306.
- Publisher:
- Wiley
Background: There is a need to better understand implementation processes of health interventions. This study describes the implementation of a multicomponent intervention to improve diet and physical activity among adults with intellectual disabilities, viewed from the perspectives of staff and managers. Materials and Methods: All health ambassadors (n = 12), appointed among staff and managers (n = 5) taking part of a health intervention in community residences in Sweden, were interviewed with a focus on barriers and facilitators regarding implementation of the intervention. Data were analysed using content analysis. Results: The overarching theme describes the importance of supporting motivation for change among managers, caregivers and residents. The experiences of the implementation process are described in four main categories: intervention characteristics, individual commitment, organizational capacity and societal factors. Conclusion: The implementation can be facilitated by a programme meeting perceived needs, a flexible and participatory approach, external input and an extensive preparation phase. (Publisher abstract)
The circumstances and impact of injuries on adults with learning disabilities
- Authors:
- FINLAYSON Janet, et al
- Journal article citation:
- British Journal of Occupational Therapy, 77(8), 2014, pp.400-409.
- Publisher:
- Sage
Introduction: People with learning disabilities experience higher rates of injury compared to the general population, but little is known about the circumstances and perceived impact of these injuries on people with learning disabilities themselves. Method: Content analysis was conducted from interviews with 113 adults with learning disabilities who had at least one injury in a 12–month period. Qualitative interviews were conducted with ten adults with learning disabilities (and their carers where appropriate) who had experienced serious or frequent injury or frequent falls with or without injury in a 12–month period. Findings: The most commonly reported contributory factors for injuries and/or falls were related to physical health status (for example, epilepsy) and the environment (for example, walking/banging into furniture or stairs/steps). In terms of perceived impact, the development of fear of walking outdoors unsupported or fear of crossing a road were highlighted. The non-use and misuse of assistive technology was also highlighted as a concern. Conclusion: These findings demonstrate that occupational therapists have a key role to play in tailoring injury and fall prevention strategies and interventions for people with learning disabilities. In particular, environmental assessment and monitored use of assistive technology is important. (Publisher abstract)
An evaluation of an emotion regulation programme for people with an intellectual disability
- Authors:
- McWILLIAMS Jenna, et al
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 35(3), 2014, pp.105-118.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the effectiveness of the Transformers programme on individual's use of appropriate emotion regulation strategies. Design/methodology/approach: Five people with an intellectual disability participated in the Transformers programme and took part in the current study. The intervention was evaluated using the Profile of Anger Coping Skills (PACS) and incident reports. The PACS was completed by participants and their caregivers. Findings: The majority of participants demonstrated increases in self- and caregiver-reported use of appropriate emotion regulation strategies following their involvement in the Transformers programme. However, treatment gains were not always maintained at follow-up. Three of the participants also exhibited fewer incidents of challenging behaviour after taking part in the programme. Originality/value: Overall, the results provide preliminary support for the continued use of the Transformers programme with people with an intellectual disability who have emotion regulation difficulties. It is recommended that further research be carried out with a larger sample size, a control group, and a longer follow-up period. (Publisher abstract)