CFT & people with intellectual disabilities
| DOI | https://doi.org/10.1108/AMHID-07-2017-0030 |
| Published date | 02 January 2018 |
| Date | 02 January 2018 |
| Pages | 44-56 |
| Author | Mark Hardiman,Corrina Willmoth,James J. Walsh |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
CFT & people with intellectual disabilities
Mark Hardiman, Corrina Willmoth and James J. Walsh
Abstract
Purpose –The purpose of this paper is to assess the effects of compassion-focussed therapy (CFT) on
anxiety in a small sample of adults with intellectual disability.
Design/methodology/approach –A mixed-methods design was employed. Participants(n ¼3) completed
questionnairemeasures of anxiety and self-compassion on three occasions:pre-intervention,post-intervention
and, at three monthsfollow-up. Post-intervention,they also took part in recordedinterviews that were analysed
using interpretive phenomenological analysis. Findings were then synthesised to develop a comprehensive
understandingof their overall experience.
Findings –Final data synthesis revealed five themes: participant anxiety decreased (reliable for all
participants); the faulty self; improved positive compassionate attitudes; increased sense of common
humanity; and mindful distraction techniques.
Research limitations/implications –This research paper offers in-depth analysis of three participants’
experiences rather than reporting in less detail about a larger number of participants. The self-compassion
scale required considerable support and reasonable adaptation to be used with these clients.
Originality/value –Onlytwo other studieshave exploredthe use of CFT withpeople withintellectual disabilities.
Keywords Anxiety, Interpretative phenomenological analysis, Mixed methods,
Compassion-focussed therapy, Glasgow anxiety scale, Reliable change
Paper type Research paper
Introduction
Approximately 1.2 million people in the UK are thought to have mild to moderate intellectual
disability (Department of Health, 2001). In a large-scale assessment of mental health among
those with mild intellectual disability in the catchment area of the Greater Glasgow Health Board
in 2002-2004, the overall point prevalence rate for anxiety disorders (excluding specific phobias)
was 6 per cent (Cooper et al., 2007). A smaller study in 2001 suggested a rate of 6.6 per cent for
anxiety and phobic illness combined based on diagnosis by trained psychiatrists using
standardised interviews (Deb et al., 2001).
One approach to supporting people experiencing high anxiety is compassion-focussed therapy
(CFT; Gilbert, 2010b; Welford, 2010). Compassion has been conceptualised by the Gilbert
(2010a) as “an openness to the suffering of others with a commitment to relieve it”, a definition
which is mirrored within CFT. Self-compassion has been found to be negatively associated with
anxiety (MacBeth and Gumley, 2012; Neff et al., 2007a) and neuroticism (Neff et al., 2007b) and
positively linked to well-being (Baer et al., 2012; Zessin et al., 2015).
Gilbert (2010a, b) adopts a more therapeutically oriented approach incorporating the evolutionary
theory and neuroscientific perspectives on self-compassion, proposing three emotion-regulating
sub-systems: threat, soothing and drive (Gilbert, 2010c). The first of these detects threats and
prepares us to deal with them using a range of adapted responses including fight, flight, freeze,
submission or demobilisation. Threats may be real or perceived, may function on a physical or
psychological level, and may be triggered externally or internally (Gilbert, 2010b). Operating on a
“better safe than sorry”principle, the threat sub-system gives rise to many fundamental emotions
such as fear and anxiety (Gilbert, 2010c). The soothing sub-system is designed to deliver
contentment, defined by Gilbert (2010b) as “[…] a form of being happy with the way things are and
feeling safe […]”(p. 48). Finally, the drive system is designed to generate positive feelings that
Received 12 July 2017
Revised 4 November 2017
14 November 2017
Accepted 17 November 2017
Mark Hardiman is a Chartered
Counselling Psychologist and
Corrina Willmoth is a
Counselling Psychologist, both
at the Department of Learning
Disabilities Service, Norfolk
Community Health and Care,
National Health Service Trust,
Norwich, UK.
James J. Walsh is a Principal
Lecturer in Psychology at the
School of Psychology,
University of East London,
London, UK.
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VOL. 12 NO. 1 2018, pp.44-56, © Emerald Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-07-2017-0030
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