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Service user views of long-term individual psychodynamic psychotherapy
- Authors:
- MERRIMAN Charlotte, BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(2), June 2009, pp.42-47.
- Publisher:
- Emerald
Long-term psychodynamic psychotherapy is a costly service to provide, but many clinicians believe it is of benefit for people who have learning disabilities and psychological problems. There is also now some evidence for its effectiveness. However, the views of recipients is unknown. In this study, recipients of more than two years of psychodynamic psychotherapy were interviewed about their experiences and views. Themes emerged about the referral process, the experience and the outcome. Areas of strength were identified, as well as areas for improvement. The findings concur with previous findings on group therapy and help inform current and future provision of long-term psychodynamic psychotherapy.
Monitoring change in psychotherapy with people with intellectual disabilities: the application of the Assimilation of Problematic Experiences Scale
- Authors:
- NEWMAN David W., BEAIL Nigel
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(1), 2002, pp.48-60.
- Publisher:
- Wiley
The assimilation model and the assimilation of problematic experiences scale (APES), provide a structured account of changes occurring within psychotherapy. The model proposes that the clients assimilate their problematic experience through the development of schema observable in the psychotherapeutic setting. The model provides a way of describing change in psychotherapy independent of affiliation to a single theoretical school. This paper aims to demonstrate the application of APES methodology to psychotherapy with people with intellectual disabilities. An innovative research procedure is implemented, utilizing transcript and rating procedures in relation to a client and therapist dialogue within psychodynamic psychotherapy. Outcome data is collected from psychometric questionnaires. Quantitative data and qualitative methods are combined to portray results in the format of a single case study. The presented case illustrates assimilation achieved by a client with intellectual disabilities within and across psychotherapy sessions. Outcome data is also provided. This study provides a newly obtained information on the applicability of psychotherapy and the assimilation model in relation to this client group. The outcome data acts as a point of reference with which to examine the nature and validity of APES findings. The present authors argue that process research has a significant role in advancing our understanding of psychotherapy with the people with intellectual disabilities.
Evaluation of a psychodynamic psychotherapy service for adults with intellectual disabilities: rationale, design and preliminary outcome data
- Authors:
- BEAIL Nigel, WARDEN Sharon
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 9(3), 1996, pp.223-228.
- Publisher:
- Wiley
The debate concerning the provision of psychotherapy services for people with intellectual disabilities has moved on from issues of 'relevance' through 'equity' to the current issue of 'effectiveness'. The latter is hard to prove from the available research and clinical literature. Reports on preliminary results from an evaluation of a psychodynamic psychotherapy service for adults with intellectual disabilities. Presents the rationale and design, including details of process and outcome measures, and preliminary results. Issues concerning operationalisation of such a study in normal clinical practice are discussed.
Psychological therapies and people who have ID: a report from the Royal College of Psychiatrists and British Psychological Society
- Author:
- BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 11(1), 2017, pp.24-26.
- Publisher:
- Emerald
Purpose: Over a decade ago “Psychotherapy and learning disabilities” was published by the UK Royal College of Psychiatrists. It was decided by the Royal College and British Psychological Society’s faculties for people who have ID to revise and update this report. The paper aims to discuss these issues. Design/methodology/approach: Experts in the field were invited to make a contribution on their approach covering method, adaptations, service user views and outcomes. Findings: A great deal has changed in the last decade in terms of service development and research resulting in a much wider range of therapies being made available and there being a growing evidence base. Research limitations/implications: Further work needs to be carried out to make such information accessible to carers and service users. Practical implications: The report is a useful resource for professionals involved in the support of the mental health and emotional needs of people who have ID. (Edited publisher abstract)
The dose-effect relationship in psychodynamic psychotherapy with people with intellectual disabilities
- Authors:
- BEAIL Nigel, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.448-454.
- Publisher:
- Wiley
Although there is an established body of evidence attesting to the dose–effect relationship in psychotherapy with non-disabled adults, the issue as to whether such a relationship exists for persons with intellectual disabilities has not been previously examined. Dose–effect essentially concerns the amount of psychotherapy required to produce positive results. The current study used a naturalistic design to examine and compare the outcomes of three groups of participants with co-morbid psychological problems undergoing treatments of differing lengths (i.e. ‘doses’) with psychodynamic psychotherapy. Three measures of psychopathology were completed at assessment and at subsequent eight-session intervals until the conclusion of treatment. Each patient received a 3-month follow-up appointment, at which time the measures were again completed. Three treatment duration groups were subsequently constructed and compared via anova: eight sessions (n = 8), 16 sessions (n = 5) and 24 plus sessions (n = 7). Results were supportive of a dose–effect relationship, in that outcomes were generally equivalent regardless of treatment duration. It is concluded that most change appears to occur in the first eight sessions of treatment, with subsequent outcomes trailing off over time. The clinical implications of the study are discussed in the context of the methodological limitations identified.
Naturalistic evaluation of the effectiveness of psychodynamic psychotherapy with adults with intellectual disabilities
- Authors:
- BEAIL Nigel, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 18(3), September 2005, pp.245-251.
- Publisher:
- Wiley
This study used an open trial design with a 3-month follow-up period. Widely available and used psychotherapy outcome measures were adopted, but administered in an assisted completion format at intake, outcome and follow-up. Data were collected on teh completed treatment and follow-up for 20 people. Data were analyzed using repeated measures ANOVA. Effect sizes were also computed. The results show statistically significant reductions in recipients' levels of psychological distress and interpersonal problems and an increase in self-esteem. Effect sizes were modest to large. The study shows that adults with intellectual disabilities can benefit from individual psychotherapy provided in routine clinical practice. The method has obvious limitations because of its uncontrolled, open trial design. However, the study had a recipient group that represents the client population and thus has greater generalisability to clinical practice. This study also provides some suggestions for routine audit and evaluation exercises and more rigorous designs.
From denial to acceptance of sexually offending behaviour: a psychodynamic approach
- Author:
- BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(5), 2013, pp.293-299.
- Publisher:
- Emerald
Purpose: Offenders who have intellectual disabilities like any one else may deny their offence. This paper reports a case study of a man who admitted his offence and them accepted probation with a condition of treatment. However, when he attended treatment he denied the offence. Thus do those providing treatment send them back into the criminal justice system or work with them try and help them accept what they have done and provide appropriate treatment to help them reduce future risk of offending. Design/methodology/approach: In this case study the assimilation model was used to understand the process of change and monitor change through exploratory psychotherapy. The psychotherapeutic model was psychodymnamic. Findings: The client demonstrated gains through the stages of the model toward acceptance of his problematic behaviour and continued to work on this through further psychotherapy. Originality/value: The assimilation model offers a useful approach to monitor change in psychotherapy; but especially when the client does not accept the problem the rest of the world feels they have. (Publisher abstract)
Service user satisfaction with individual psychotherapy for people with intellectual disabilities
- Authors:
- KHAN Mahbub Munir, BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(5), 2013, pp.277-283.
- Publisher:
- Emerald
Purpose: Psychological therapies are increasingly being made available to adults with intellectual disabilities. However, little is known about service user satisfaction with this type of intervention. The aim was to ascertain quantitative and qualitative data on user satisfaction with the psychological therapy they had received. Design/methodology/approach: In total, 20 recipients of psychological therapy completed the Satisfaction with Therapy and Therapist Scale – Revised (STTS-R; Oei and Shuttleword, 1999) and the Experience of Service Questionnaire (Commission for Health Improvement, 2002). The scales were adapted for language and administered in an assisted completion format by an independent researcher after a course of psychological therapy had been completed. Descriptive statistics were used to analyse the quantitative data and thematic analysis was used to analyse the qualitative data. Findings: Generally, recipients were highly satisfied with their therapist and the therapy they received. Originality/value: The results confirm previous findings from two small-scale qualitative studies. Service user satisfaction is a key quality outcome measure and can be collated in routine practice for people with intellectual disabilities. The collation of qualitative responses in addition to quantitative measures is important to enable the expression of dissatisfaction and greater detail in order to inform service improvement. (Publisher abstract)
Recidivism following psychodynamic psychotherapy amongst offenders with intellectual disabilities
- Author:
- BEAIL Nigel
- Journal article citation:
- British Journal of Forensic Practice, 3(1), April 2001, pp.33-37.
- Publisher:
- Emerald
Reports on a study of recidivism rates following psychotherapy amongst male offenders with intellectual disabilities. The recipients were 18 men who had been diverted to the clinical psychology service for adults with intellectual disabilities from the criminal justice system. Thirteen participated in treatment and five refused it during assessment. Participants were followed up for 4 years after treatment. Of the 13 who completed treatment two re-offended. All five of the men who refused treatments re-offended. In view of the preliminary nature of these findings they are discussed in relation to methodological issues and future research.
Exploring maintaining gains following therapy during the coronavirus pandemic with adults with an intellectual disability
- Authors:
- PURRINGTON Jack, NYE Arthur, BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 15(6), 2021, pp.253-268.
- Publisher:
- Emerald
Purpose: The novel coronavirus and associated mitigation efforts have caused significant increases in stress for adults with intellectual disabilities. Such increases in life stress predict an increased risk of relapse following psychological therapy. This contributes to the high global disease burden of common mental health difficulties. Therefore, this paper aims to explore service user experiences of maintaining gains following therapy within the context of the Covid-19 pandemic. Design/methodology/approach: A mixed-methods evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. Descriptive statistics and effect size calculations were used to examine therapeutic outcomes pre-therapy, post-therapy, and at follow-up. These findings informed a framework analysis of eight semi-structured interviews. Findings: Overall, outcome results improved post-therapy and regressed at follow-up. The framework analysis revealed facilitators to maintenance include a recollection of specific aspects of therapy and the regular utilisation of strategies and resources. Conversely, barriers to maintenance include a recollection focussed on personal outcome, a reliance on social support and an inability to remember therapy. Originality/value: This is the only study to the authors’ knowledge examining service user experiences of maintaining gains following therapy within the context of Covid-19. It is hoped that these findings will inform further research and be useful for services in preparing service users for discharge as the Covid-19 pandemic continues and moves towards the post-pandemic phase. (Edited publisher abstract)