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Experiences of service users with a mild intellectual disability or borderline intellectual functioning with Flexible Assertive Community Treatment: a qualitative study
- Authors:
- NEIJMEIJER Laura, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 33(5), 2020, pp.1005-1015.
- Publisher:
- Wiley
Background: In the Netherlands, Flexible Assertive Community Treatment (FACT) teams have been established for people with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and mental health problems or challenging behaviour. Little is known yet about service users’ experiences with FACT. Method: An inductive grounded theory approach was used to explore how service users valued the treatment and their own functioning, and which factors were perceived as supportive. Semi‐structured interviews were held with 15 service users. Results: Most service users highly appreciated the contact with the staff and the practical and emotional support. Persistent involvement, availability and humanity, and respect for autonomy were distinguished as core values in the relationship with the staff. Most service users experienced improvement in time and attributed this to intrapersonal changes and/or less stress in life. Conclusions: From the perspective of service users with MID/BIF, FACT appears to have an added value. (Edited publisher abstract)
Improving outcomes for at-risk youth: findings from the Prodigy Cultural Arts Program
- Authors:
- RAPP-PAGLICCI Lisa, STEWART Chris, ROWE William
- Journal article citation:
- Journal of Evidence-Based Social Work, 9(5), October 2012, pp.512-523.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The Prodigy Cultural Arts Program comprises cultural art classes with a skill based curriculum targeted at at-risk youth and those diverted from the juvenile justice system. The classes are used to build social skills, anger management, and problems solving skills. The programme runs for 8 weeks with the youth attending 3 hours per week. A quasi experimental pre- and posttest was conducted to evaluate programme effects on participant’s mental health symptoms. The sample comprised 140 adolescents aged 8-18 years who entered the programme between March 2007 and March 2008. Most of the sample (77%) had been adjudicated by the state juvenile system. The findings showed a significant reduction in mental health symptoms (particularly for females) and behavioural dysregulation (particularly for males), and increases in academic performance and family functioning. There was also a relationship between decreased mental health symptomology and perceived academic performance. The article concludes that the Prodigy Cultural Arts Program appears to be successful in intervening with youth who present challenges to the juvenile justice system due to the complexity of their mental health symptoms and behavioural regulation difficulties.
Can a self-regulation skills and cultural arts program promote positive outcomes in mental health symptoms and academic achievement for at-risk youth?
- Authors:
- RAPP-PAGLICCI Lisa, STEWART Chris, ROWE William
- Journal article citation:
- Journal of Social Service Research, 37(3), May 2011, pp.309-319.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Self-regulation involves an integrated set of skills drawn from both executive functioning and emotional regulation capabilities. Previous research has demonstrated an association between youth with mental health, behavioural and academic problems and inadequate self-regulation skills. Self-regulation skills programmes and arts-based programmes have separately demonstrated reductions in internalising and externalising disorders and academic difficulties. This study sought to evaluate an after-school programme ‘Prodigy’, which incorporates both arts and self-regulation skills, with regard to changes in mental health symptoms and academic performance. Prodigy is an 8 week programme which offers at-risk youth in Florida the opportunity to participate in classes which use cultural arts as a medium to build self-regulation skills such as social skills, anger management, and problem-solving skills. A quasi-experimental pretest–posttest design was conducted with 108 at-risk adolescents and their parents to evaluate the programme effects. The results demonstrated significant reductions in internalising and externalising mental health symptoms and increases in academic self-efficacy. Positive, but not statistically significant, trends in improved academic achievement were also shown. Future research regarding the potential of arts and self-regulation programmes is discussed.
An evaluation of a community-based basic parenting programme: a two-year follow-up
- Author:
- ROBERTS Deborah
- Journal article citation:
- Community Practitioner, 85(2), February 2012, pp.27-31.
- Publisher:
- Community Practitioners' and Health Visitors' Association
Parenting programmes are central to the British government’s social inclusion agenda, with the aim of breaking the cycle of deprivation for children living in poverty. The aim of this study was to explore the usefulness of the Incredible Years Programme (IYP) as a universal intervention for parents or carers of children with mild-to-moderate behavioural difficulties. The study evaluated the effectiveness of a 12-week community based IYP programme at 2 years post-completion. A total of 57 participants who parented children aged 1-12 years were interviewed, representing 63% of the original sample. The participants completed the same measures of mental health and their child’s behaviour pre- and post-intervention and at 2 year follow-up. They were also asked how life had been since completing the course, if they had found it useful, and what strategies they were still using. The most common theme reported was that the course had helped to change their child's behaviour. The mean average score of child behaviour problems was significantly improved at post-group and this was largely maintained at 2 years. This same pattern was seen for participants' mental health. Of the one-third of the children whose behaviour deteriorated 2 years after the course, two-thirds of these children had experienced adverse life events or had a secondary diagnosis.
Mediators and moderators of change in adjustment following intervention for children exposed to intimate partner violence
- Authors:
- GRAHAM-BERMANN Sandra A., et al
- Journal article citation:
- Journal of Interpersonal Violence, 26(9), June 2011, pp.1815-1833.
- Publisher:
- Sage
An intervention programme for children aged 6 to 12 exposed to interpersonal violence (IPV) had previously been found to be successful in reducing their internalising and externalising behaviour problems. The intervention comprised 2 components: the Kids’ Club and the mother’s Parenting Empowerment Program. This study sought to evaluate the factors that may contribute to the efficacy of this intervention. Both fixed and modifiable risk factors that predicted change in children’s adjustment after the intervention were identified and tested. The study sample comprised 180 children, 120 who had participated in the intervention programme and a comparison group of 60. All mothers and children were interviewed before the intervention and after the 10-week programme. The results found a significant relationship between the extent of exposure to IPV, gender, change in mothers’ mental health, and change in child adjustment. Among fixed factors, length of exposure to violence was found to moderate the relationship between the amount of the child’s and mother’s participation in the intervention and change in child adjustment, specifically internalising behavioural problems. Among the modifiable risk factors, change in mother’s mental health, specifically symptoms of posttraumatic stress, was found to mediate the relationship between the amount of intervention participation and change in child adjustment. These findings can be used to inform and enhance evidence-based clinical services for children exposed to IPV.
The coping with unusual experiences for children study (CUES): a pilot randomized controlled evaluation of the acceptability and potential clinical utility of a cognitive behavioural intervention package for young people aged 8–14 years with unusual ex...
- Authors:
- JOLLEY Suzanne, et al
- Journal article citation:
- British Journal of Clinical Psychology, 57(3), 2018, pp.328-350.
- Publisher:
- Wiley
Objectives: Health care guidelines recommend psychological interventions for childhood unusual experiences that are associated with distress or adverse functional impact (UEDs), based on adult, rather than child‐specific, evidence. This is a report of the first randomized controlled evaluation of the acceptability and potential clinical utility of cognitive behavioural therapy for childhood UEDs (CBT‐UED). Design: Pilot randomized controlled trial. Methods: Participants aged 8–14 years were recruited from referrals to community services for children with emotional/behavioural problems and screened for self‐reported UEDs. Results: Of around 1,000 referrals over 36 months, 304 (30%) were identified to the research team, 174 (57%) were successfully contacted, 110 (63%) consented to screening, 96 (87%) attended a screening assessment, and 51 (53%) reported UEDs. Forty‐nine (96%) consented to randomization to either CBT‐UED (9–12 weekly sessions of 40–50 min, adjunctive to usual care, n = 24) or treatment‐as‐usual/waitlist control (TAU/WL, n = 25). Childhood internalizing emotional symptoms (e.g., feeling ‘nervous’/'scared’/’tearful’/’worried’/'sick’; proposed primary outcome), UEDs, depression, anxiety, and childhood psychopathology (secondary outcomes) were measured at baseline, at 12 weeks, and, where therapy was ongoing but incomplete (<12 sessions) at 12 weeks, at end‐of‐treatment (EOT). Twenty‐two CBT‐UED participants (92%) attended ≥5 sessions. Forty‐four participants (90%) completed 12‐week assessments (CBT‐UED, n = 21/24, 88%; TAU/WL, n = 23/25, 92%). Preliminary findings were encouraging for emotional symptoms and UEDs, but otherwise mixed. Conclusions: Retention, screening, and consent rates were as anticipated; recruitment took longer than planned. Trial procedures were acceptable to young people, their families, and clinicians. Therapy exceeded 12 weeks, but was well‐received, with no serious adverse events attributed to participation. Further evaluation is needed. (Edited publisher abstract)
Improving mental health and lifestyle outcomes in a hospital emergency department based youth violence intervention
- Authors:
- DeMARCO Jeffrey, et al
- Journal article citation:
- Journal of Public Mental Health, 15(3), 2016, pp.119-133.
- Publisher:
- Emerald
Purpose: Current government policy aims to tackle youth anti-social behaviour and its psychological and social impacts. Given an increased likelihood that young victims of crime are also likely to engage in aggressive or deviant behaviour and to have psychological and social difficulties, interventions are needed which access vulnerable youth with adverse lifestyles to increase well-being and reduce offending. The current project utilised a hospital emergency department (ED) as an appropriate location to identify and interact with youth victims of violent crime; to support key lifestyle risk and mental health difficulties; and build resilience. The purpose of this paper is to use a youth work paradigm, to target vulnerable youth in a health setting at a crisis point where intervention may have a higher chance of uptake. Design/methodology/approach: The study applied a quasi-experimental, longitudinal design. Using the strengths and difficulties questionnaire and the “What Do You Think” component of the ASSET risk assessment, data were collected from 120 youth aged 12-20, at baseline with 66 youth who successfully completed the programme with assessments at baseline and follow-up, at an average of 14 weeks. Findings: There was significant reduction in both psychological problems and lifestyle risk at follow-up. Research limitations/implications: These findings support the government initiative to intervene in youth violence in healthcare settings. Challenges revolve around increasing participation and greater formalisation of the intervention. Originality/value: The youth work led violence intervention in the ED is successfully tackling psychological problems and lifestyle risk following injury. (Publisher abstract)
Firesetting: psychopathology, theory and treatment
- Authors:
- GANNON Theresa A., PINA Afroditi
- Journal article citation:
- Aggression and Violent Behavior, 15(3), May 2010, pp.224-238.
- Publisher:
- Elsevier
This paper systematically reviews the characteristics of adult arsonists, and the etiological features of arson. In particular, it pays attention to current research available as to the core traits and psychopathological features required to understand arsonists, and the classificatory systems and etiological theories developed to understand it. This assessment of current research suggests that clinical knowledge and practice relating to arson is extremely immature relative to other areas of forensic-clinical psychology. The paper concludes that there are very few etiological theories available to guide consulting clinicians in this area, and little information available specifying the exact criminogenic needs related to arsonists, or how these needs compare to other offender groups. The considerable lack of contemporary treatment programmes designed to target arson behaviour is also noted. The paper ends by highlighting core areas for future research and treatment progression.
Single case experimental evaluations of psychodynamic and cognitive-behavioural psychotherapy: examples of methods and outcomes
- Authors:
- KELLET Stephen, et al
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(4), December 2009, pp.36-44.
- Publisher:
- Emerald
Single case experimental design (SCED) is a well established tradition in evaluating the effectiveness of behavioural interventions for people with learning difficulties and behavioural problems. However, the use of SCED is severely hampered once the focus is shifted to other psychological modalities such as psychodynamic psychotherapy, or differing presenting problems such as interpersonal problems. This paper examines the application of single case experimental design methodologies in the evaluation of treatment for three particular clients. Case one describes the psychodynamic psychotherapy of hypochondriasis in an A/B design. Case two describes the psychodynamic psychotherapy of ambulophobia in an A/B design. Case three describes a cognitive-behavioural therapy of anger and aggression in a shifting criterion design. Statistical analysis of the data shows the hypochondriasis and anger cases responded to treatment, whereas the ambulophobia case shows a degree of deterioration during the intervention. Discussing each case in turn, the strengths and weaknesses of the methodologies are explained, and the relative merits of SCED in accruing evidence in the evaluation of the plethora of psychological modalities are now being made available to clients with learning disabilities.
Group and individual cognitive behavioural interventions for anger
- Authors:
- ROSE John, ROSE David
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(4), December 2009, pp.45-50.
- Publisher:
- Emerald
There is growing evidence for the positive effect of anger treatment programmes, which aim to reduce aggression in people with learning disabilities. Provided in both group and individual formats, the differential efficacy of these approaches has yet to be assessed. This paper studies 62 individuals with learning disabilities and inappropriately expressed anger, and these individual were assigned to either group or individual treatment or a waiting list control, depending on the availability of treatment options – 23 participants completed group treatment, 18 received individual treatment, and 21 were included in a waiting list control group. Assessed both before and after treatment using anger provocation inventory, the participant’s results are examined by the authors. Improvements were found in the scores obtained from the anger inventory for both group and individual treatments, compared to the control group, using statistical analysis. There was no particular difference between the group treatments or individual treatments. These results, replicating previous findings, suggest that both group and individual cognitive behavioural interventions are effective treatment options for people with learning disabilities, but do not support either method of delivery in preference to the other. Limitations of the data are also discussed by the authors.