PTSD in adults with intellectual disabilities: stabilisation during inpatient stay

2014 ◽  
Vol 8 (4) ◽  
pp. 237-247 ◽  
Author(s):  
Trine Lise Bakken ◽  
Vibeke Gjersoe ◽  
Espen Matre ◽  
Tone Kristiansen ◽  
Arvid Ro ◽  
...  

Purpose – The purpose of this paper is to describe and discuss interventions of stabilisation of emotions and behaviour in adults with post-traumatic stress disorder (PTSD). This topic is understudied in persons with intellectual disability. Design/methodology/approach – The aim of this study was to investigate interventions of stabilisation in persons with more severe intellectual disability; 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 treatment of the patients was collected through case files, observations, and interviews. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. Findings – Six main areas of stabilisation of emotions and behaviour were identified: validation, anxiety relief, treatment of depressed mood, increased mastering of daily activities, protection against anxiety triggers, and facilitated staff communication. Protection from anxiety triggers seems to be a core element of milieu therapy interventions. Interventions for neurotypical PTSD patients, such as exposure therapy may be contraindicated for patients with more severe intellectual disabilities. Originality/value – Research on interventions of stabilisation towards adults with more severe intellectual disabilities is still in its infancy. The case reports may help milieu therapists to facilitate interventions towards patients with moderate or severe intellectual disabilities.

2014 ◽  
Vol 8 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Trine Lise Bakken ◽  
Arvid Nikolai Kildahl ◽  
Vibeke Gjersøe ◽  
Espen Matre ◽  
Tone Kristiansen ◽  
...  

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.


2016 ◽  
Vol 38 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Emily A. B. Lacey ◽  
Billy T. Ogletree ◽  
Tracie Rice ◽  
Amy Rose

This brief clinical exchange article supports the use of milieu training (MT) as a communication treatment option for adults with severe intellectual disabilities (SID). It examines aspects of MT that appear well matched to the communication and other abilities of adults with SID. It also provides an argument that MT is not unlike functional communication training (FCT), an intervention frequently and successfully used with adults with SID. In addition, Developing Communicative Interactions (DCI), one little-known framework that advocates for MT use with this population, is briefly introduced. Finally, a clinical example is provided that illustrates the application of MT with one adult with SID. The article concludes with comments for clinicians charged with communication treatment for this special population.


2015 ◽  
Vol 9 (2) ◽  
pp. 90-98 ◽  
Author(s):  
Alastair L. Barrowcliff ◽  
Gemma A. L Evans

Purpose – The purpose of this paper is to provide a detailed description of an adapted Eye-Movement Desensitisation and Reprocessing (EMDR) intervention in the treatment of chronic Post-Traumatic Stress Disorder (PTSD) in an individual with moderate-severe Intellectual Disability (ID), blindness, and Mucopolysaccharidosis Hunters Syndrome. Design/methodology/approach – A case study reporting on the implementation of an eight phase EMDR approach adapted for intellectual and sensory requirements. The intervention involved a series of preparatory meetings and four sessions of EMDR. Findings – The intervention was successful in ameliorating most symptoms attributed to a PTSD presentation. Research limitations/implications – The availability of the full breadth of treatment options for PTSD as indicated in National Institute for Health and Care Excellence (2005) is questionable in clinical practice with individuals with ID. Appropriate investment in research determining the most efficacious interventions for this clinical population is required. Originality/value – This case study addresses issues of complexity in respect of the assessment and treatment of trauma in an ID population. It raises a number of important social/research questions in addition to providing a high level of detail in regard to the adaptations required to deliver EMDR for a complex individual whilst retaining fidelity to the standard treatment model.


2017 ◽  
Vol 46 (8) ◽  
pp. 1475-1492 ◽  
Author(s):  
Hannah Meacham ◽  
Jillian Cavanagh ◽  
Amie Shaw ◽  
Timothy Bartram

Purpose The purpose of this paper is to examine how HRM practices enhance and/or impede the employment, participation, and well-being of workers with intellectual disabilities in three hotels located in Australia. Design/methodology/approach The research employs a case study methodology, including interviews with three HR managers, three department managers, 17 workers with intellectual disabilities, and focus groups of 16 supervisors and 24 work colleagues. Findings The research found that the opportunities to participate in work are driven primarily by developing a social climate that enables social cohesion through the altruistic motives of managers/supervisors and reciprocal relationships. Originality/value The findings lend support for the importance of both formal and informal HR practices, such as inclusive recruitment and selection, mentoring, and training and development, as well as individualised day-to-day support provided by supervisors and colleagues, to improve the participation and well-being of workers with an intellectual disability.


2017 ◽  
Vol 8 (4) ◽  
pp. 201-211 ◽  
Author(s):  
Rose White ◽  
Katherine Lister ◽  
Kristian Northend ◽  
Stephen Moore ◽  
Kelly Rayner

Purpose People with intellectual disabilities (ID) can be vulnerable to developing mental health problems. It has been found that participating in regular exercise can help to improve emotional well-being, both in typically developing people and those with ID. The purpose of this paper is to investigate the experiences of community clients with ID who have engaged in a football training programme, and the perceived impacts on attitudes, mood and behaviour. Design/methodology/approach Interviews with seven patients from generic or forensic community ID services were conducted. The transcripts were analysed using interpretative phenomenological analysis. Findings Two master themes were identified from the interviews, “Striving” and “Togetherness”. Originality/value The most important factors related to taking part in the football programme were the social, emotional and personal growth associated with being part of a team and general enjoyment of being part of something. Although aspects of football knowledge and physical fitness were still evident, their impact seemed to be less significant. The experience of football was overwhelmingly positive.


Author(s):  
Sarah Ashworth ◽  
Krista Jansen ◽  
Lydia Bullock ◽  
Paul Mooney

Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.


2014 ◽  
Vol 8 (6) ◽  
pp. 351-353 ◽  
Author(s):  
Iona Campbell

Purpose – The purpose of this paper is to describe a medical student's experience of undergraduate teaching in intellectual disabilities. Design/methodology/approach – This paper presents the reflections of a medical student on the undergraduate intellectual disability teaching. It describes experiences of a placement in this field, and how it may influence future practice. Findings – It is apparent that exposure to intellectual disability training in the undergraduate curriculum can be limited. Much of the work in this area highlights the negative consequences of this when it comes to medical care for individuals with intellectual disabilities. This paper proposes that positive changes may be achieved, by providing medical students with more training in this area. Originality/value – By reflecting on an individual experience through medical school, this paper highlights the positive impact that teaching on intellectual disability can have on medical students, suggesting its value in the undergraduate curriculum.


2016 ◽  
Vol 30 (2) ◽  
pp. 17-25 ◽  
Author(s):  
Krystyna Gawlik ◽  
Anna Zwierzchowska ◽  
Barbara Rosołek ◽  
Diana Celebańska ◽  
Katarzyna Moczek

Abstract Introduction: Obesity is a common health problem among adults people with intellectual disabilities. The aim of the present study was to determine the prevalence of obesity among people with moderate and severe intellectual disabilities by gender, age and degree of disability. Material and methods: The study group comprised 194 individuals with moderate and severe intellectual disability, aged 20 to 50 years. They were all participants of an occupational therapy workshop. Measurements of height and body weight, waist and hip circumference were conducted. BMI and WHR were calculated. A double-classification ANOVA was carried out to compare outcomes by age and gender. Analysed parameters were standardised by gender and age. Standardised variables were subject to comparative analysis (one-way ANOVA) with respect to the level of disability. Results: Over a half of the examined individuals exhibited excessive weight gain. Obesity was found in almost 30% of our female participants while among male participants this proportion equalled 19.4%. Waist circumference (p≤0.008) and WHR (p≤0.001) differed significantly between men and women, women had android obesity more often. Conclusions: Obesity appears to be a common problem among people with intellectual disabilities; to a greater extent among women. Gender was a factor determining the type of obesity since android obesity was more commonly diagnosed in women. The prevalence of obesity did not seem to be associated with age.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kamilla Klefbeck

PurposeThis research explores lesson study as a way to enhance the quality of teaching for pupils with learning disabilities and autism spectrum disorder by observing changes to one pupil's (Wilma) active educational participation. The study also investigates if and in what ways the professional development impacted teaching practices.Design/methodology/approachFive teachers met with the author on four occasions. Between these meetings, the teachers delivered the lessons they had planned together. The author video recorded the meetings to discern how the teachers' expressions developed. The author shared their thoughts with another researcher to enable an interrater validity examination.FindingsThe implementation of the lesson study vehicle enabled the teachers to transform their thinking from mainly focusing on pupils' deficiencies to instead focusing on their strengths. A relationship was found between teachers' understanding of central coherence, their skills in adapting received instructions and pupils' abilities to process and contextualize information or discern the whole picture.Research limitations/implicationsResearch that involves teachers in the learning process emphasizes the relation between teachers’ thinking and their potential to enable the contextualized inclusion of pupils with learning disabilities.Originality/valueThis research offers important insights into how school-day navigation for pupils with severe intellectual disability and autism can be understood through the lens of variation theory; the teachers' repeated and adjusted use of the frame on the schedule strip enabled Wilma to discern what would happen next during the school day.


2021 ◽  
pp. 174462952110371
Author(s):  
Gerd Ahlström ◽  
Eva Flygare Wallén ◽  
Magnus Tideman ◽  
Marianne Holmgren

The aim of this study was to describe the social care provided for different age groups of people with intellectual disability, 55 years or above, and to investigate the association between such care and frailty factors for those with diagnosed level of intellectual disabilities. Descriptive and logistic regression analyses were used. Commonest forms of social care among the 7936 people were Residential care, Daily activities and Contact person. Home help and Security alarm increased with age. The frailty factors significantly associated with increased social care were age, polypharmacy and severe levels of intellectual disabilities. Persons most likely to be in residential care were in the age group 65–79 with polypharmacy and severe disability. The results indicate a need for further research of how frailty factors are considered in social care and longstanding medication, especially then severe intellectual disability hinders communication. A national strategic plan for preventive interventions should be developed to ensure the best possible healthy ageing.


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