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Psychotherapy with persons with intellectual disabilities: a review of effectiveness research
- Authors:
- PROUT H. Thompson, BROWNING Brooke K.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(5), 2011, pp.53-59.
- Publisher:
- Emerald
This review aims to provide an update on the effectiveness of psychotherapy with persons with intellectual disabilities. It summarises the conclusions of other reviews published in the last ten years, including a recent review by the authors. There is evidence that psychotherapy with persons with intellectual disabilities is at least moderately effective. There is also evidence of effectiveness of psychotherapy across child and adolescent and adult age groups. A range of therapeutic interventions are effective and a spectrum of problems can be addressed via psychotherapy. However the authors found relatively little relevant research literature and noted a lack of methodologically sound and rigorous studies. They suggest there is a need for well-designed studies, particularly randomised controlled trials, better specification of treatments (e.g. manualised), better outcome measures, and clearer specification of diagnostic categories within the intellectual disability population.
Structured observational research in services for people with learning disabilities
- Author:
- MANSELL Jim
- Publisher:
- NIHR School for Social Care Research
- Publication year:
- 2011
- Pagination:
- 31p.
- Place of publication:
- London
The authors review structured observational research, primarily in services for people with learning disabilities. Observational research is of particular value where people using services are unable to answer interviews or questionnaires about their experiences, and where proxy respondents may not be sufficiently accurate sources of data. The review illustrates the use of observational data in assessing and improving the quality of services. Drawing on the published research evaluating services for people with learning disabilities, it deals with the question of what to observe and how to define it so that the information gathered is valid and reliable. It discusses sampling in order to obtain representative information, considers the practical steps that have to be taken in order to make observations in services, and, using examples from the research literature, it shows how to analyse and present observational data.
Respite and parental relinquishment of care: a comprehensive review of the available literature
- Authors:
- NANKERVIS Karen L., ROSEWARNE Andrea C., VASSOS Maria V.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(3), September 2011, pp.150-162.
- Publisher:
- Wiley
Families often have to relinquish care of a family member with a disability. The disabled person is often placed in respite care until suitable permanent accommodation is organised or they are able to return home. This literature review examined the issues associated with the need for urgent respite and how this need may link to relinquishment of care. Findings indicated that many families and carers feel that their respite needs are not being met and that certain individual and family characteristics are associated with need for urgent respite (such as severe disability, poor support, and carer distress). Relinquishment involving other client groups' suggests increased requests for respite being an early warning sign for relinquishment. It also notes that challenging behaviours, poor coping and lack of support, dire financial concerns, and carer distress are factors that often lead to relinquishment. Interventions such as active support and cognitive behavioural therapy can support families who are considering relinquishment or have relinquished care. Empirically based information regarding relinquishment of care involving people with intellectual disabilities is limited. The authors urge further research into this issue to aid the identification of strategies to more effectively support families.
Deinstitutionalization and quality of life of individuals with intellectual disability: a review of the international literature
- Authors:
- CHOWDHURY Monali, BENSON Betsey A.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(4), December 2011, pp.256-265.
- Publisher:
- Wiley
Deinstitutionalisation of individuals with intellectual disabilities is based on the idea that quality of life (QOL) will improve after being moved from institutions to community-based care settings. This international review investigated whether this assumption has become a reality now that the policy of deinstitutionalisation has progressed in many countries. Fifteen studies were examined that assessed QOL as an outcome of community living following deinstitutionalisation. Findings suggested that relocation had a general positive impact on life quality of participants. However, many of the studies found that improvements were most prominent shortly after the move. Participants continued to have low levels of community integration, and there was evidence that healthcare needs were not adequately met in the community. The role of service providers was indicated as vital in the continued development of participants' life quality. The authors concluded that additional research is required to identify the factors that are critical in improving QOL in community-based care.
Massage as therapy for persons with intellectual disabilities: a review of the literature
- Authors:
- CHAN Jenny Sau-Lai, TSE Sonny Hing-Min
- Journal article citation:
- Journal of Intellectual Disabilities, 15(1), March 2011, pp.47-62.
- Publisher:
- Sage
- Place of publication:
- London
People with intellectual disabilities are vulnerable to psychological stress and anxiety. When these cannot be vented adequately, behavioural problems may arise. To address this, massage therapy has frequently been applied to induce relaxation. This review investigated the efficacy of massage therapy on relaxation and reduction of challenging behaviours. A database search was conducted which uncovered a total of 64 articles, of which 7 met all inclusion criteria. These studies were evaluated in terms of: number of participants; study setting; methodology; intervention pattern; outcome measure of the intervention; and major results. Findings revealed that evidence-based research demonstrating the effectiveness of massage therapy in supporting clinical practice is extremely limited. Case study designs, large amounts of qualitative data and small sample sizes meant that the therapeutic effect of massage therapy could not be substantiated. The authors concluded that future studies with randomised clinical trials or of experimental design are developed.
Meta-analysis of deinstitutionalisation adaptive behaviour outcomes: research and clinical implications
- Authors:
- HAMELIN Jeffrey P., et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 36(1), March 2011, pp.61-72.
- Publisher:
- Taylor and Francis
In this study, a targeted meta-analysis is conducted on adaptive behaviour outcome studies examining individuals with intellectual disability. Database searches identified 351 potentially relevant articles, and 23 studies were finally selected and compared. A table summarises the characteristics and outcomes for the studies included. 16 were American in origin, 4 were Australian, 2 were Canadian, and one originated in the UK. The article presents and discusses the results of the analysis, noting that the data from the analysis clearly illustrated the general habilitative effects associated with deinstitutionalisation and community living. The authors concluded that adaptive skills and behaviours are instrumental in the successful adjustment of individuals with intellectual disability to new environments and responsibilities. They suggest that more research is needed to identify specific factors that augment habilitation for adults with intellectual disabilities living in the community.
Vulnerability to depression in adolescents with intellectual disabilities
- Authors:
- KIDDLE Hannah, DAGNAN Dave
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(1), January 2011, pp.3-8.
- Publisher:
- Emerald
This paper provides a selective review of developmental risk factors relating to depression in typically developing adolescents and considers how the life experiences and the social context of adolescents with intellectual disability may increase their sensitivity to identified risk factors for depression. A number of factors are highlighted as important in the development of mental health problems including attachment, child temperament and parenting behaviour, and a number of risk factors specific to depression, including genetic vulnerability, parental depression, negative life events and peer relations. Many of these experiences are particularly prevalent in the lives of young people with intellectual disabilities. These include experience of the social stigma attached to intellectual disability, increased exposure to negative life-events, social and emotion recognition deficits, and increased rates of parental stress and associated depression. These life experiences and consequent increased susceptibility to risk factors may help explain the higher rate of depression in adolescents with intellectual disability. The authors suggest that a consideration of developmental factors and their interaction with the person’s social environment may offer a possible framework for prevention and early intervention with adolescents with intellectual disabilities.
The quantitative measurement of family quality of life: a review of available instruments
- Authors:
- HU X., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(12), December 2011, pp.1098-1114.
- Publisher:
- Wiley
Family quality of life (FQOL) is a central outcome of service delivery for disabled people and their families. This review investigated the difference in approaches between families with children with learning disabilities and other families and identified recommendations to improve the measurements of FQOL in the disability field. A search of 25 databases was conducted, and 16 measurement tools on FQOL, family well-being and family satisfaction used in the disability field, healthcare field and general family studies published in journals from 1980 to 2009 were included. Three themes emerged: description of the primary purpose and theoretical basis; identification of the tool's respondents, domains, response formats and scoring strategies to assess family systems; and summarisation of available psychometric information. The authors concluded that as family researchers continue to conceptualise and theorise about FQOL, they should also promote the refinement of FQOL measurements and consider the implications from instruments used in the family fields from the following aspects: domains of FQOL; units of analysis; response format; scoring choice; and psychometric evaluation. Implications for future research are discussed.
Preventing abuse in accommodation services: from procedural response to protective cultures
- Authors:
- ROBINSON Sally, CHENOWETH Lesley
- Journal article citation:
- Journal of Intellectual Disabilities, 15(1), March 2011, pp.63-74.
- Publisher:
- Sage
- Place of publication:
- London
This paper considers the dominant policy and practice approaches of Australian disability accommodation services with respect to the abuse and neglect of people with learning disabilities, and questions the effectiveness of these approaches. The paper reviews international literature and provides practice examples to help develop a framework of current research, policy and practice in this area. Findings show that dominant policy and practice approaches do not give adequate consideration to the prevention and protection of people from harm, focusing primarily on responding to individual instances of maltreatment. Managerial, compliance-based systems may be deflecting attention from recognizing and responding more effectively to abuse and neglect at individual, systemic and structural levels. The current dominant approach fails to develop a culture of prevention and protection for people with intellectual disability. The authors concluded that some systemic and structural preconditions are set which make abuse and neglect less preventable.
Maltreatment of children with developmental disabilities: an ecological systems analysis
- Authors:
- ALGOOD Carl L., et al
- Journal article citation:
- Children and Youth Services Review, 33(7), July 2011, pp.1142-1146.
- Publisher:
- Elsevier
This research review aimed to understand the risk factors for maltreatment of children with developmental disabilities. Using the Bronfrenbrenner's ecological systems framework, the authors examine how socio-demographic characteristics influence or inhibit maltreatment of children with disabilities. Characteristics tested included: age, gender, and special education; micro-systems such as parent-child relationship and domestic violence; exo-systems such as parenting stress, parents' social support, and area of residence; and macro-systems level such as culturally defined parenting practices. Overall, the literature suggested that the risk factors for abuse of children with disabilities must be examined ecologically. In conclusion, the authors present implications for practice and policy for maltreated children with developmental disabilities.