Flexible assertive community treatment for individuals with mild intellectual disability or borderline intellectual functioning: client variables associated with treatment outcome

2020 ◽  
Vol 14 (6) ◽  
pp. 199-212
Author(s):  
Laura Neijmeijer ◽  
Hubert Korzilius ◽  
Hans Kroon ◽  
Henk Nijman ◽  
Robert Didden
Keyword(s):  
Treatment Outcome ◽  
Assertive Community Treatment ◽  
Intellectual Functioning ◽  
Demographic Variables ◽  
Community Treatment ◽  
Short Version ◽  
Content Type ◽  
Client Variables ◽  
Borderline Intellectual Functioning ◽  
Dynamic Risk

Purpose Recent research on flexible assertive community treatment (FACT) for individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF) has shown positive results. This paper aims to identify which client variables are associated with treatment outcome of FACT. Design/methodology/approach Analyses were performed on assessments made during a six-year longitudinal study in The Netherlands. Data comprised assessments of 281 clients with at least 2 measurements. Treatment outcome was measured by the learning disability version of the Health of the Nation Outcomes Scales. Demographic variables and dynamic risk variables of the short version of the Dynamic Risk Outcome Scales were selected as potential predictor variables of outcome. Data were analysed using linear mixed models. Findings Limited awareness of the need for treatment, limited treatment motivation and cooperation, limited social skills, impulsivity and substance abuse were significantly associated with worse treatment outcome. None of the demographic variables influenced treatment outcome significantly, and neither did intelligence quotient or having a judicial or civil measure. Research limitations/implications Because of the observational design, no causal inferences can be drawn. Practical implications This study produces guidelines regarding nature and scope of the treatment supply and the competences of professionals working in FACT MID/BIF teams. Originality/value This paper encourages other countries to make assertive outreach available for people with MID/BIF on a larger scale, taking into account the acquired insights.

The SCIA Questionnaire: standards for communities for children and adolescents – a tool for the evaluation of good practices

2019 ◽  
Vol 40 (1) ◽  
pp. 1-15
Author(s):  
Cinzia Guarnaccia ◽  
Anna Maria Ferraro ◽  
Maria Lo Cascio ◽  
Simone Bruschetta ◽  
Francesca Giannone
Keyword(s):  
Children And Adolescents ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Self Report ◽  
Community Treatment ◽  
Short Version ◽  
Therapeutic Communities ◽  
Evaluation Tool ◽  
Content Type

Purpose The purpose of this paper is to present the Italian validation of the standards for communities for children and adolescents (SCIA) Questionnaire, an evaluation tool of communities quality standards, based on the “Service Standards for Therapeutic Communities for Children and Young People – 2nd edition” of the Community of Communities (2009), that enables an empirical, multidimensional and complex evaluation of the therapeutic community (TC) “system”. It is a self-report that sets out and measures variables that allow to get an overview of organisational models and the possible development areas to improve the effectiveness of the protection of child and adolescents in community treatment. The validation and a preliminary analysis to develop a short version of the SCIA are presented. Design/methodology/approach The questionnaire (composed, in the extended form, by 143 items) was administered to 101 community workers, 20 males (19.8 per cent) and 81 females (81.2 per cent) aged between 24 and 61 years (M=36.20, SD=8.4). The analysis of reliability (Cronbach’s α) and a series of exploratory factor analysis allowed to eliminate redundant or less significant items. Findings The short form of the self-report consists of 67 items, divided into seven subscales, which explore different areas of intervention in TCs. Despite the limitations due to the small sample size, the utility of this tool remains confirmed by its clinical use and the development of good operating practices. Originality/value The SCIA Questionnaire responds to the need to adopt empirical variables in the process of evaluation of the communities. The SCIA is also a useful tool for clinical evaluation, as it allows a detailed observation of residential community treatment with children and adolescents that allows to analyse and monitor the structural and organisational aspects and the quality of practices that guide the interventions.

scholarly journals Treatment Outcome in Patients Receiving Assertive Community Treatment

2009 ◽  
Vol 46 (4) ◽  
pp. 330-336 ◽  
Author(s):  
H. E. Kortrijk ◽  
C. L. Mulder ◽  
B. J. Roosenschoon ◽  
D. Wiersma
Keyword(s):  
Treatment Outcome ◽  
Assertive Community Treatment ◽  
Community Treatment

Comparing STATIC-99R and STABLE-2007 between persons with and without intellectual disabilities

2019 ◽  
Vol 10 (3) ◽  
pp. 58-68
Author(s):  
Monique Delforterie ◽  
Jan Willem van den Berg ◽  
Betto Bolt ◽  
Teunis van den Hazel ◽  
Leam Craig ◽  
...  
Keyword(s):  
Risk Factors ◽  
Comparison Group ◽  
Significant Proportion ◽  
Mild Intellectual Disability ◽  
Problem Solving Skills ◽  
Content Type ◽  
Dynamic Risk Factors ◽  
Borderline Intellectual Functioning ◽  
Sexual Offenses ◽  
Dynamic Risk

Purpose While there is a significant proportion of people with a mild intellectual disability (MID) or borderline intellectual functioning (BIF) who commit sexual offenses, little research has focused on the risk factors for sexual recidivism in people with MID-BIF. The purpose of this paper is to compare the scores on the STATIC-99R and STABLE-2007 between persons with sexual offense histories with and without MID-BIF. Design/methodology/approach Data using the STATIC-99R and STABLE-2007 were collected in 85 male patients divided into an MID-BIF group (IQ 50–85, n=50) and comparison group (IQ>95, n=35). Findings The MID-BIF group and comparison group did not differ significantly on the static risk factors and total score of the STATIC-99R. However, of the 13 dynamic risk factors of the STABLE-2007, the MID-BIF group scored significantly higher on the items Impulsive acts, Poor problem solving skills and Lack of concern for others, while the comparison group scored significantly higher on the item Deviant sexual preference. Originality/value The higher score on a number of dynamic risk factors for patients with MID-BIF could partly be explained by the characteristics associated with MID-BIF. Although dynamic criminogenic risk factors which are usually identified as targets for treatment appear the same for people with and without MID-BIF who commit sexual offenses, adaptations to the modality of treatment will still need to be made for people with MID-BIF.

Awareness and accessibility of the Dutch mental health care system for people with borderline intellectual functioning or mild intellectual disabilities

2018 ◽  
Vol 12 (3/4) ◽  
pp. 114-120 ◽  
Author(s):  
Jannelien Wieland ◽  
Mascha ten Doesschate
Keyword(s):  
Mental Health ◽  
Health Care ◽  
The Netherlands ◽  
Mental Health Care ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Intellectual Functioning ◽  
Content Type ◽  
Borderline Intellectual Functioning ◽  
High Prevalence

Purpose In The Netherlands, curative mental health care and supportive care for people with an intellectual disability (ID) are organised in separate domains. Prevalence of mental health problems is known to be high among people with borderline intellectual functioning (BIF) or mild intellectual disabilities (MID). By contrast, according to recent findings, prevalence of BIF and MID is high among patients in mental health care (17.5–58 per cent). In The Netherlands, a new quality standard of care (QSOC) on mental health care for people with BIF or MID is developed. It is designed to supplement existing guidelines on mental health care so that they can be used appropriately in people with BIF or MID and meant for use in both mental health care organisations (MHCO) as in organisations for ID care. To a large extent, the QSOC should describe the existing practice. This paper aims to discuss these issues. Design/methodology/approach To assess the existing practice in current mental health care for people with BIF or MID in The Netherlands, the authors examined the views and accessibility of MHCO on the mental health care for patients with and IQ<85. In addition, the authors reviewed published criteria for in- and exclusion of all 39 top clinical mental health care departments for criteria on BIF or (mild) ID. Findings The authors found there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. Dutch MHCO estimate the prevalence of BIF and MID among their patients to be around 30 per cent. Nonetheless, most MCHO surveyed (76 per cent) indicated they do not routinely estimate or measure IQ among their patients and 53 per cent of MHCO indicated not having knowledge and expertise on the dual diagnoses of mental health problems and BIF or MID. Fitting in with the new QSOC most of the MHCO (59 per cent) agreed on the statement in the survey that professionals should be able to treat patients with BIF or ID and all but one of the MHCO stated to have some form of collaboration with an institute for ID care. Originality/value The authors concluded there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. The new QSOC on mental health care for people with BIF or MID can help improve accessibility and quality of mental health care for these patients.

Barriers for homeless with dual diagnosis: lessons learned from intensive mobile psychosocial assertive community treatment program

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tara Rava Zolnikov ◽  
Michael Hammel ◽  
Frances Furio ◽  
Brandon Eggleston
Keyword(s):  
Data Analysis ◽  
Effective Treatment ◽  
Dual Diagnosis ◽  
Treatment Program ◽  
Assertive Community Treatment ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Secondary Data Analysis ◽  
Community Treatment ◽  
Content Type

Purpose Dual diagnosis is a term that describes the co-occurrence of mental health disorders or illness and substance use or abuse disorders. Because this co-occurrence results in multiple diseases, layers of treatment are often needed to successfully create positive change in the individual. The purpose of this study is to explore factors of treatment that could facilitate improvements in functionality and quality of life for those with a dual diagnosis. Design/methodology/approach A secondary data analysis, using both quantitative and qualitative data, was completed. Secondary analysis is an empirical exercise that applies the same basic research principles as studies using primary data and has steps to be followed, including the evaluative and procedural steps commonly associated with secondary data analysis. Documentation data from the intensive mobile psychosocial assertive community treatment program was gathered for this analysis; this program was used because of the intensive and community-based services provided to patients with a dual diagnosis. Findings The major findings from this secondary analysis suggested that significant barriers included “denial” (e.g. evasion, suspension or avoidance of internal awareness) of diagnoses, complicated treatment and other barriers related to housing. Ultimately, these findings provided greater insight into potential effective treatment interventions for people living with a dual diagnosis. Originality/value This study adds to the growing body of literature showing that patient-centered care allows for more effective treatment and ultimately, improved health outcomes.

Borderline intellectual functioning and neurodevelopmental disorders: prevalence, comorbidities and treatment approaches

2015 ◽  
Vol 9 (5) ◽  
pp. 275-283 ◽  
Author(s):  
Angela Hassiotis
Keyword(s):  
Neurodevelopmental Disorders ◽  
Service Use ◽  
Intellectual Functioning ◽  
Rapid Review ◽  
Mild Intellectual Disability ◽  
Treatment Approaches ◽  
Content Type ◽  
Borderline Intellectual Functioning ◽  
Previous Review ◽  
Evidence Summary

Purpose – The purpose of this paper is to provide a synthesis of the literature on the topic of developmental framework and health comorbidities of children and adults with borderline intellectual functioning (BIF) and neurodevelopmental disorders. Design/methodology/approach – A rapid review of the literature and hand searching of relevant papers from 1999 to 2015 was carried out. Totally, 21 papers were identified covering a range of perspectives from neurodevelopmental trajectories to prevalence, treatment and service use. Findings – All papers were utilised and complemented a previous review which, however, had not covered the aspect of treatment approaches for this population. As a group they appear to have distinctly different profiles from people with mild intellectual disability and of peers with average intelligence. Practical implications – The evidence summary indicates an ongoing interest by the international scientific community in the topic of BIF. This group are often lost in the health system and may not receive appropriate care given their unique clinical profile. More should be done to increase clinicians’ awareness of their health needs. Originality/value – The paper adds substantially to a previous review of the topic. An international collaboration may help to increase the profile of this work and lead to further changes in the care these individuals receive across the diagnostic and treatment spectrum.

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