Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 10 of 61
Compassion-focused therapy groups for people with intellectual disabilities: an extended pilot study
- Authors:
- GOAD Elisabeth Jane, PARKER Kayleigh
- Journal article citation:
- Journal of Intellectual Disabilities, 25(4), 2021, pp.661-679.
- Publisher:
- Sage
- Place of publication:
- London
People with intellectual disabilities who experience mental health difficulties often have high levels of self-criticism and shame. Compassion-focused therapy is a therapeutic modality effective in working with such feelings. This article follows on from a previous compassion-focused therapy group study exploring the impact of two compassion-focused therapy-based groups on how participants felt about themselves. Utilizing a mixed method design, the study illustrated that participants experienced higher levels of compassion and, overall, saw themselves more favourably by the end of the groups. They were also able to understand the basic concepts of compassion-focused therapy which reinforced previous study findings, suggesting that it is adaptable and clinically useful for people with intellectual disabilities. (Edited publisher abstract)
The use of therapeutic untruths by staff supporting people with an intellectual disability who display behaviours that challenge
- Authors:
- MCKENZIE Karen, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.28-35.
- Publisher:
- Wiley
Background: Therapeutic untruths (TU) are used in dementia services to de‐escalate distressing situations. The present authors explored the use of TU by care staff supporting people with an intellectual disability who displayed behaviours that challenged. Method: Data were collected from 126 staff (female = 72.2%; mean age = 41.9 years, SD = 10.7) via an online survey in relation to three areas: responses to three scenarios, reported use of different forms of TU and ratings of perceived effectiveness of, and level of comfort using, each type. Results: 96% of participants reported using TU themselves and observing their colleagues doing likewise. Models that included perceived effectiveness of, and level of staff comfort with using, different TU were significant, although only perceived effectiveness significantly independently contributed to the model. Conclusion: The use of TU was common, with levels consistent with those found in dementia services. The limitations and implications of the findings are discussed. (Edited publisher abstract)
The effectiveness of sensory integration therapy to improve functional behaviour in adults with learning disabilities: five single-case experimental designs
- Authors:
- URWIN Rosalind, BALLINGER Claire
- Journal article citation:
- British Journal of Occupational Therapy, 68(2), February 2005, pp.56-66.
- Publisher:
- Sage
Describes a research project using a single-case experimental design (A-B-A) aiming to explore the impact of sensory integration therapy (SIT) on level of engagement and maladaptive behaviour (measured through timed scores) and function (using Goal Attainment Scaling, GAS) for 5 learning disabled adults with tactile sensory modulation disorder. Each phase lasted 4 weeks and consisted of 24 measurements. Individually tailored SIT was given twice weekly for 4 weeks during the intervention phase (B), immediately prior to each individual's participation in his or her prescribed horticulture task. The changes between phases in engagement, maladaptive behaviours and function scores, measured as the difference between baselines and intervention, were analysed visually and statistically for each participant. The intervention produced significant improvements in engagement for participant 4, with a highly significant deterioration in scores for all 5 on withdrawal of SIT. All participants' maladaptive behaviour decreased significantly on the introduction of SIT. Although there was no significant change to GAS scores for 4 participants, participant 4's score improved significantly with SIT, whose withdrawal resulted in highly significant deterioration in GAS scores for participants 1, 2, 4 and 5. This study may be the first to suggest that SIT is effective in improving functional performance in adults with a learning disability with a tactile sensory modulation disorder.
“I don’t wanna be mad and sad”: using individual systemic therapy to help manage anger and low mood in an adult with a learning disability
- Author:
- BIRDSEY Nicola
- Journal article citation:
- British Journal of Learning Disabilities, 49(2), 2021, pp.179-190.
- Publisher:
- Wiley
People with learning disabilities have historically been overlooked in research investigating the efficacy of therapeutic interventions, despite the increased prevalence of mental health difficulties among this population. As it is not uncommon for individuals with learning disabilities to be part of different relational systems (including access to a range of services), it seems logical to consider wider systems when seeking to understand difficulties that individuals may experience. While it is encouraging that there is growing interest in the use of systemic interventions for people with learning disabilities, there is limited peer-reviewed research exploring psychological difficulties from a systemic lens. This paper seeks to address the gap in literature by presenting a case where individual systemic therapy is used to help an adult with a learning disability to manage low mood and anger. The paper documents the therapist's clinical decision-making and learning from this case, with the hope that it encourages others to consider systemic interventions for people with learning disabilities in future. (Edited publisher abstract)
The use of Intensive Interaction within a Positive Behavioural Support framework
- Authors:
- McKIM Jules, SAMUEL Judith
- Journal article citation:
- British Journal of Learning Disabilities, 49(2), 2021, pp.129-137.
- Publisher:
- Wiley
Background: Positive Behavioural Support (PBS) provides an overarching framework for supporting quality-of-life improvements for people who use challenging behaviour. Rapport, or the lack of it, is well understood as a setting factor for some challenging behaviours. Intensive Interaction is an approach that, among other possible outcomes, can develop rapport and feelings of safety, security and connection. Method: Within an NHS Trust, the Intensive Interaction Service works in partnership with the Intensive Support Team. We present case descriptions of people who used challenging behaviour and received Intensive Interaction support. Changes are described using staff and family interview data. The Intensive Interaction techniques that helped develop rapport at each PBS phase are described. Results: Intensive Interaction was used in all PBS phases. It played a role in preventing placement breakdown for one individual. Conclusion: Intensive Interaction should be considered at initial assessment within PBS so that immediate and important improvements can be made to the person's social and communication experience. It is hoped that Intensive Support Services and all PBS practitioners will use it. (Edited publisher abstract)
Compassion-focused therapy for trauma in people with intellectual disabilities: a conceptual review
- Authors:
- COWLES Megan, RANDLE-PHILLPS Cathy, MEDLEY Andrew
- Journal article citation:
- Journal of Intellectual Disabilities, 24(2), 2020, pp.212-232.
- Publisher:
- Sage
- Place of publication:
- London
Trauma exposure and post-traumatic stress disorder are more prevalent in people with intellectual disabilities (PWID) than in the general population, yet the evidence base for trauma interventions in this population is sparse. Compassion-focused therapy (CFT) may be particularly well-suited to PWID for a number of reasons, including its adaptability to different developmental levels. PWID are more likely to have issues with self-relating (e.g. shame and self-criticism) and attachment than the general population, two issues that are compounded by trauma and which CFT explicitly seeks to address. Furthermore, compassion-focused approaches emphasize cultivating a sense of safeness while empowering people to make behavioural changes; this is particularly pertinent to PWID who have been traumatized and may feel unsafe and disempowered. An overview of CFT and its application to trauma are given, as well as some case studies using CFT with PWID. (Publisher abstract)
Significant therapy events with clients with intellectual disabilities
- Authors:
- WILLS Sarah, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(5-6), 2018, pp.173-183.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore significant events in psychotherapy with clients with intellectual disabilities (IDs). Design/methodology/approach: Four therapy dyads, each consisting of one client and one therapist, were recruited. Following the brief structured recall procedure (Elliott and Shapiro, 1988), semi-structured interviews focused on helpful events in psychotherapy, using video of particular sessions as a stimulus to help prompt recall of that session. Findings: Using interpretative phenomenological analysis, five super-ordinate themes were identified: “The Uniqueness of the Therapeutic Relationship”; “Using adaptations to Express Emotions”; “Client Behaviour/Therapist Behaviour”; “Hope and Paternalism”; and “Meaning-Making”. The results provide additional evidence that significant therapy events occur for clients with IDs. Furthermore, the research enabled insights to be gained about the process of therapy for this client group and for exploration of therapeutic factors that may be involved in facilitating a significant therapy event. Research limitations/implications: This study highlights the need for therapists to work in such a way as to facilitate significant events in therapy. Whilst this study was a necessary first step, owing to the non-existence of research in this area, the sample size and qualitative design may limit any wider generalisation of the findings. Originality/value: Significant events have not previously been explored in psychotherapy with clients with IDs. This research could therefore make an important contribution to our understanding of the process of psychotherapy for this client group. (Publisher abstract)
Intellectual disabilities: a systemic approach
- Editors:
- BAUM Sandra, LYNGGAARD Henrik, (eds.)
- Publisher:
- Karnac
- Publication year:
- 2006
- Pagination:
- 228p., bibliog.
- Place of publication:
- London
The application of systemic ideas and principles in working with people with intellectual disabilities, their families and their service systems, has grown over the last decade in the UK. This book, for the first time, brings together the writings of a group of practitioners who have been using this approach in their clinical practice. It is hoped it will inspire others to try out different ways of working with people with intellectual disabilities and their wider systems, so that they can have the choice of a wide range of therapeutic approaches. It is also hoped that systemic practitioners who are unfamiliar with this client group might give consideration to extend their practice to also work with people with intellectual disabilities.
We can still feel good: evaluation of the I can feel good programme second edition in a low secure unit
- Authors:
- ASHWORTH Sarah, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 15(2-3), 2021, pp.33-45.
- Publisher:
- Emerald
Purpose: This paper aims to present the process of reviewing, adapting and evaluating, the second edition of the I Can Feel Good programme (Ashworth et al., 2018) and adapted DBT programme facilitated at a low-security psychiatric hospital for men with intellectual disability. Through the presentation of programme development, evaluation and revision, a more thorough and transparent understanding of the process involved can be disseminated. Design/methodology/approach: The programme lasted approximately 14 months and covered all four modules. N = 5, all-male, ages ranged between 23 and 57 years old. All detained under the MHA (1983) with a primary diagnosis of Mild ID with comorbid psychiatric diagnoses including mental illness, autism spectrum disorders and personality disorder. To evaluate routine effectiveness a pre-post comparison within groups design was used. A standardised GAS approach provided a template to score the degree to which identified goals were achieved over the intervention for participants. Findings: Wilcoxon signed-rank tests were used due to data not meeting parametric assumptions regarding normal distribution. Except for the mindfulness module, all modules saw pre to post programme psychometric results in the desired direction, evidencing skills acquisition. Coping in crisis and managing feelings modules outcomes neared statistical significance, with the module of people skills demonstrating statistical significance (p < 0.05). Originality/value: Upon examination of the results, it appears as though the second edition pilot programme, displayed initially promising results. The clinical and statistical aspects of the programme are explored, in the hope that clinicians may consider the programme’s application and utility within various clinical contexts, in addition to gaining insight into the process of programme development and refinement. (Edited publisher abstract)
A qualitative study of the practice‐related decision‐making of intensive interaction practitioners
- Authors:
- FIRTH Graham, GLYDE Megan, DENBY Gemma
- Journal article citation:
- British Journal of Learning Disabilities, 49(2), 2021, pp.117-128.
- Publisher:
- Wiley
Background: This study looked to investigate the sometimes conscious and sometimes intuitive decision-making processes of Intensive Interaction practitioners. More specifically, this study set out to develop a rich description of how practitioners make judgements when developing a dynamic repertoire of Intensive Interaction strategies with people with severe or profound learning difficulties and/or autism, how this decision-making process is enacted in practice and what issues inform such decisions. Materials and Methods: This research followed a “Template Analysis” qualitative methodology, informed by semi-structured interviews with 13 experienced Intensive Interaction Practitioners (who had completed the Intensive Interaction Coordinators course as administered by the Intensive Interaction Institute). The participants included the following: speech and language therapists, parents, teachers, residential care staff and managers, and a clinical psychologist. Results: The findings of this study indicate why and how certain decisions are made by experienced practitioners before, during and after engagement in Intensive Interaction. Such decision-making is indicated as sometimes being intuitive in nature, sometimes more conscious, sometimes moving between the two cognitive states as differing issues arise. Practitioner decision-making was focused on a number of issues, including specific learning or care “agendas”; practitioner confidence and knowledge; environmental considerations; individual learner characteristics and behaviour; learner attention, “attunement” and arousal levels; building a shared “repertoire”; and issues of available time. Conclusions: The issue of how novice Intensive Interaction practitioners may best be supported to more quickly and confidently develop improved Intensive Interaction practices is discussed, proposing the development of a cyclical process of experiential learning and supported reflection. (Edited publisher abstract)