Exploring maintaining gains following therapy during the coronavirus pandemic with adults with an intellectual disability

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jack Purrington ◽  
Arthur Nye ◽  
Nigel Beail
Keyword(s):  
Intellectual Disabilities ◽  
Life Stress ◽  
Service User ◽  
Framework Analysis ◽  
User Experiences ◽  
Content Type ◽  
Increased Risk ◽  
Adults With Intellectual Disabilities ◽  
Post Therapy

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.

From reflection to action: a case study of an art psychotherapy group which drew on occupational therapy perspectives

2020 ◽  
Vol 25 (3) ◽  
pp. 197-213
Author(s):  
Ali Coles ◽  
Tom Elliott
Keyword(s):  
Mental Health ◽  
Occupational Therapy ◽  
Service User ◽  
Psychological Outcome ◽  
User Experiences ◽  
Content Type ◽  
Mental Health Difficulties ◽  
Art Psychotherapy ◽  
Post Therapy

Purpose This paper aims to describe service user experiences of an art psychotherapy group which drew on occupational therapy perspectives to help adults with severe and enduring mental health difficulties move forward in their recovery. Design/methodology/approach A case study approach incorporating outcome data was used. The data gathered comprised attendance, facilitators’ clinical notes, photographs of participant artworks, the Psychological Outcome Profiles questionnaire (PSYCHLOPS: www.psychlops.org), a post-therapy feedback form, discussion at post-therapy individual review sessions and participants’ achievements post-group. Findings All but one participant scored the group as “very helpful” or “helpful” and all felt that the group had helped them with the personal aims they had identified. The PSYCHLOPS questionnaire yielded a large average effect size, indicating positive change in terms of problems, functioning and well-being. Participants identified several ways in which the group was helpful, and their artwork and reflections indicate how they used the art making in the group to pursue their recovery goals. The service user experiences and outcomes suggest that this group was effective in facilitating recovery for these adults with severe and enduring mental health difficulties. Originality/value This group was innovative in integrating approaches from the different professional specialisms and the findings encourage further investigation into this way of working.

Telephone-delivered compassion-focused therapy for adults with intellectual disabilities: a case series

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gregg Harry Rawlings ◽  
Kevin Paul Wright ◽  
Keeley Rolling ◽  
Nigel Beail
Keyword(s):  
Intellectual Disabilities ◽  
Case Series ◽  
Well Being ◽  
Psychological Therapy ◽  
Routine Practice ◽  
Content Type ◽  
Compassion Focused Therapy ◽  
Adults With Intellectual Disabilities ◽  
Telephone Therapy ◽  
Post Therapy

Purpose Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID). Design/methodology/approach As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure. Findings Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy. Originality/value To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways.

External sources promoting resilience in adults with intellectual disabilities: A systematic literature review

2020 ◽  
pp. 174462952096194 ◽  
Author(s):  
Femke Scheffers ◽  
Xavier Moonen ◽  
Eveline van Vugt
Keyword(s):  
Social Network ◽  
Literature Review ◽  
Intellectual Disabilities ◽  
Positive Emotions ◽  
Network Support ◽  
Increased Risk ◽  
The Social ◽  
The Face ◽  
External Sources ◽  
Adults With Intellectual Disabilities

Background: Persons with an intellectual disability are at increased risk of experiencing adversities. The current study aims at providing an overview of the research on how resilience in adults with intellectual disabilities, in the face of adversity, is supported by sources in their social network. Method: A literature review was conducted in the databases Psycinfo and Web of Science. To evaluate the quality of the included studies, the Mixed Method Appraisal Tool (MMAT) was used. Results: The themes: “ positive emotions,” “ network acceptance,” “ sense of coherence” and “ network support,” were identified as sources of resilience in the social network of the adults with intellectual disabilities. Conclusion: The current review showed that research addressing sources of resilience among persons with intellectual disabilities is scarce. In this first overview, four sources of resilience in the social network of people with intellectual disabilities were identified that interact and possibly strengthen each other.

Teaching playground behavioural expectations to secondary age students with intellectual disabilities attending a special school

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David Simó-Pinatella ◽  
Marisa Carvalho
Keyword(s):  
Intellectual Disabilities ◽  
Secondary Students ◽  
School Setting ◽  
Special School ◽  
Content Type ◽  
Students With Intellectual Disabilities ◽  
Special Education School ◽  
Adults With Intellectual Disabilities ◽  
Materials Used

Purpose School-wide positive behaviour support (SWPBS) is a proactive behavioural support system that fosters behaviour change in individuals in a school setting. This article aims to present a case example of teaching and reinforcing behavioural expectations in a special school. Design/methodology/approach This case study reflects different steps and materials used before and during the intervention in a special education school with 61 secondary students with intellectual disabilities. An AB design (A – baseline; B – intervention) was used to collect and analyze data. Findings Results suggest that teaching behavioural expectations as a universal measure may be feasible and positively impact school climate. Suggestions and recommendations for implementing SWPBS within a school are provided. Originality/value This case study provides a step-by-step guide illustrating the process of teaching and reinforcing behavioural playground expectations to young adults with intellectual disabilities attending a special school.

Identification of PTSD in adults with intellectual disabilities in five patients in a specialised psychiatric inpatient unit

2014 ◽  
Vol 8 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Trine Lise Bakken ◽  
Arvid Nikolai Kildahl ◽  
Vibeke Gjersøe ◽  
Espen Matre ◽  
Tone Kristiansen ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Practical Implication ◽  
Case Reports ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Traumatic Experiences ◽  
Content Type ◽  
Psychiatric Inpatient Unit ◽  
Severe Intellectual Disabilities ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to describe and discuss assessment of post-traumatic stress disorder (PTSD) in adults with intellectual disabilities. Existing research in this area encompasses case studies, and includes, for the most part, persons with mild intellectual disabilities. Design/methodology/approach – The aim of this study is to investigate symptom presentation and subsequent identification of PTSD in persons with more severe intellectual disabilities; i.e. persons with moderate or severe intellectual disabilities. Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included. Information about the patients was collected through case files and interviews with key informants: family, milieu therapists, and caregivers in community settings, and observations through inpatient admission. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. The five patients all met criteria for PTSD according to the Diagnostic Manual – Intellectual Disability. Findings – Previously, it was not suspected that the five patients suffered from PTSD, although they had experienced terrifying incidents. All patients displayed severe changes in behaviour, which may have overshadowed symptoms of PTSD. PTSD in persons with more severe intellectual disabilities may be interpreted as challenging behaviour, or other psychiatric disorders such as psychosis. Research limitations/implications – The limitation of the study is the small number of participants. Practical implications – Practical implication is linked to clinical practice related to identification of PTSD in persons with intellectual disabilities. Originality/value – The paper may encourage more research into how PTSD can be identified in persons with moderate and severe intellectual disabilities. The case reports may help clinicians to look for traumatic experiences in persons with intellectual disabilities who have experienced terrifying incidents.

Short communication: reliability and validity of the UKU Side Effect Rating Scale for adults with intellectual disabilities

2016 ◽  
Vol 10 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Anne Louise Tveter ◽  
Trine Lise Bakken ◽  
Jan Ivar Røssberg ◽  
Egon Bech-Pedersen ◽  
Jørgen G. Bramness
Keyword(s):  
Side Effects ◽  
Focus Group ◽  
Intellectual Disabilities ◽  
Side Effect ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Medical Doctor ◽  
Face Validity ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose – The UKU side effect rating scale for adults with intellectual disabilities (UKU-SERS-ID) was developed to detect side effects among patients with intellectual disabilities (ID). The purpose of this paper is to examine the reliability and face validity of the UKU-SERS-ID. Design/methodology/approach – UKU-SERS-ID comprises 35 items. In total, 22 patients with ID were included from two specialized services for adults with ID and comorbid mental illness. All patients were rated on three different occasions by three clinicians; two nurses and one medical doctor. Reliability was estimated with Cohen’s κ. A focus group discussed the face validity of the items comprising the UKU-SERS-ID. Findings – Respectively ten (nurse-nurse scores) and eight (nurse-doctor scores) items were considered difficult to score due to low prevalence of the symptoms. For the other items the reliability was acceptable. Through discussion in a focus group, with the reliability scores in mind, only one of the items of the UKU-SERS-ID was discarded. Practical implications – The authors have developed a feasible side effect instrument for clinical practice. It is easy to score and relevant regarding important side effects. Originality/value – The UKU-SERS-ID seems to be a feasible tool. Further investigations are mandatory in order to gain knowledge about distribution and phenomenology of side effects from psychotropic medication for individuals with ID.

Community dialectical behaviour therapy for emotionally dysregulated adults with intellectual disabilities

2014 ◽  
Vol 8 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Aubrey Baillie ◽  
Sean Slater
Keyword(s):  
Intellectual Disabilities ◽  
Detailed Examination ◽  
Outcome Data ◽  
Lessons Learned ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Client Group ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for.

The Adult Attachment Projective Picture System: a pilot study of inter-rater reliability and face validity with adults with intellectual disabilities

2018 ◽  
Vol 12 (2) ◽  
pp. 57-66 ◽  
Author(s):  
Deanna Gallichan ◽  
Carol George
Keyword(s):  
Intellectual Disabilities ◽  
Adult Attachment ◽  
Clinical Utility ◽  
Reliability And Validity ◽  
Clinical History ◽  
Face Validity ◽  
Rater Reliability ◽  
Content Type ◽  
Adult Attachment Projective ◽  
Adults With Intellectual Disabilities

Purpose The purpose of this paper is to assess whether the Adult Attachment Projective (AAP) Picture System is a reliable and face valid measure of internal working models of attachment in adults with intellectual disabilities (ID). Design/methodology/approach The AAPs of 20 adults with ID were coded blind by two reliable judges and classified into one of four groups: secure, dismissing, preoccupied, or unresolved. Inter-rater reliability was calculated using κ. Six participants repeated the assessment for test-retest reliability. Two independent experts rated ten cases on the links between the AAP analysis and the clinical history. Findings There was significant agreement between AAP judges, κ=0.677, p<0.001. Five out of six participants showed stability in their classifications over time. The majority of expert ratings were “good” or “excellent”. There was a significant inter-class correlation between raters suggesting good agreement between them r=0.51 (p<0.05). The raters’ feedback suggested that the AAP had good clinical utility. Research limitations/implications The inter-rater reliability, stability, face validity, and clinical utility of the AAP in this population is promising. Further examination of these findings with a larger sample of individuals with ID is needed. Originality/value This is the first study attempting to investigate the reliability and validity of the AAP in this population.

scholarly journals Resilience in children and young people with intellectual disabilities: a review of literature

2017 ◽  
Vol 11 (3) ◽  
pp. 86-97
Author(s):  
Raghu Raghavan ◽  
Edward Griffin
Keyword(s):  
Young People ◽  
Intellectual Disabilities ◽  
Personal Attributes ◽  
Journal Articles ◽  
Children And Young People ◽  
Content Type ◽  
Increased Risk ◽  
On Line ◽  
Poor Outcomes ◽  
The Individual

Purpose Building the resilience of children with intellectual disabilities (ChID) can help reduce the personal, social and economic costs associated with mental ill health among such children. The purpose of this paper is to review the research evidence on resilience in ChID and to suggest areas for further research. Design/methodology/approach Journal articles published in the last 20 years were searched in on-line databases to find potential papers for this review. The inclusion criteria were to search for published journal articles covering the theme of resilience in ChID and their families. All identified titles and abstracts were screened which resulted in 50 articles. These were scrutinised more thoroughly and 34 remaining articles were selected for review. Findings Resilience is a dynamic process involving interactions between various risk and protective processes both internal and external to the individual that act to mediate the influences of adverse life events. Five key themes were identified within the literature which helped to form a picture of the current understanding of resilience among ChID and their careers. These were increased risk factors associated with ID, the role of personal attributes on resilience, family and resilience, schooling and resilience, and cultural factors which enhance resilience. Originality/value Despite the consistency with which poor outcomes for ChID have been reported there is little investigation of the specific causes, contributory factors and processes that might improve them. This paper contributes to greater understanding of resilience factors for children and young people with ID and provides areas for further research.

scholarly journals Service user experiences of mentalisation-based treatment for borderline personality disorder

2017 ◽  
Vol 22 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Diarmaid Ó. Lonargáin ◽  
Suzanne Hodge ◽  
Rachael Line
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Interpretative Phenomenological Analysis ◽  
Service User ◽  
Borderline Personality ◽  
Individual Therapy ◽  
Future Research ◽  
User Experiences ◽  
Content Type ◽  
The Uk

Purpose Previous research indicates that mentalisation-based treatment (MBT) is an effective therapeutic programme for difficulties associated with borderline personality disorder (BPD). The purpose of this paper is to explore service user experiences of the therapy. Design/methodology/approach Seven adults (five female and two male), recruited via three NHS trusts, were interviewed. Participants were attending intensive out-patient MBT for BPD between 3 and 14 months. Data were analysed using interpretative phenomenological analysis. Findings Participants experienced the group component of MBT as challenging and unpredictable. They highlighted developing trust as key to benefitting from MBT. This was much more difficult to achieve in group sessions than in individual therapy, particularly for those attending MBT for less than five or six months. The structure of MBT generally worked well for participants but they identified individual therapy as the core component in achieving change. All participants learned to view the world more positively due to MBT. Practical implications Enhanced mentalisation capacity may help address specific challenges associated with BPD, namely, impulsivity and interpersonal difficulties. MBT therapists are confronted with the ongoing task of creating a balance between sufficient safety and adequate challenge during MBT. Potential benefits and drawbacks of differing structural arrangements of MBT programmes within the UK are considered. Originality/value Learning about service user perspectives has facilitated an enhanced understanding of experiences of change during MBT in addition to specific factors that may impact mentalisation capacity throughout the programme. These factors, in addition to implications for MBT and suggestions for future research, are discussed.

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