Trauma-focussed cognitive-behaviour therapy for people with mild intellectual disabilities: outcomes of a pilot study
| DOI | https://doi.org/10.1108/AMHID-05-2016-0008 |
| Published date | 05 September 2016 |
| Pages | 299-310 |
| Date | 05 September 2016 |
| Author | Biza Stenfert Kroese,Sara Willott,Frances Taylor,Philippa Smith,Ruth Graham,Tara Rutter,Andrew Stott,Paul Willner |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Trauma-focussed cognitive-behaviour
therapy for people with mild intellectual
disabilities: outcomes of a pilot study
Biza Stenfert Kroese, Sara Willott, Frances Taylor, Philippa Smith, Ruth Graham, Tara Rutter,
Andrew Stott and Paul Willner
The authors affiliations can be
found at the end of this article.
Abstract
Purpose –Trauma-focussed cognitive-behaviour therapy (TF-CBT) is the most effective treatment for
post-traumatic stress disorder (PTSD). Individuals who present with complex PTSD are among the most
complex and challenging patients seen by intellectual disability psychology and psychiatry services. The
purposeof this paper is to study TF-CBTintervention for peoplewith intellectual disabilitiesand complex PTSD.
Design/methodology/approach –Three groups of adults with intellectual disabilities (ID) presenting with
complex PTSD (n ¼3, n ¼5 and n ¼4) were treated using a 12-week manualised intervention adapted from a
procedure routinely used in adult mental health services. Participants completed the Impact of Event Scale as
adapted for people with intellectual disabilities (IES-ID) before and after the intervention, and interviews
conducted to ascertain their experiences of the group were analysed using interpretative phenomenological
analysis (IPA).
Findings –The ten participants who completed the intervention showed a 27 per cent decrease in median
Impact of Event Scale Intellectual Disabilities scores, equivalent to a medium effect size (d ¼0.50).
Five themes were identified from the interviews: being listened to; it is nice to know you are not the only one;
being in a group can be stressful; the importance of feeling safe; achieving and maintaining change.
Participants also provided constructive feedback to promote improvements to the manual.
Research limitations/implications –A feasibility study followed by methodologically robust clinical trials is
now needed to establish the effectiveness of the intervention and its utility in clinical practice.
Practical implications –This small study has confirmed the potential of TF-CBT as an intervention for
extremely vulnerable individuals with ID who present with complex PTSD.
Social implications –The findings indicate that a group intervention is both feasible for and acceptable to
adults with ID.
Originality/value –To date, no study has investigated the effectiveness and feasibility of a TF-CBT group
intervention for adults with mild ID.
Keywords Intellectual disability, Interpretative phenomenological analysis, IPA,
Complex post-traumatic stress disorder, Impact of Event Scale, Trauma-focussed cognitive-behaviour therapy
Paper type Research paper
Introduction
People with intellectual disabilities (ID) are more often hospitalised and institutionalised than their
peers: there are an estimated 3,400 NHS-funded hospital beds for people with ID in the UK
(Department of Health, 2012) costing an estimated £320 million. There is extensive evidence that
adverse life events are traumatising in this population (Wigham et al., 2011, 2014; Hall et al.,
2014). Institutionalized people with ID, in particular, are a complex group with associated
Received 10 May 2016
Revised 28 September 2016
Accepted 3 October 2016
DOI 10.1108/AMHID-05-2016-0008 VOL. 10 NO. 5 2016, pp.299-310, © Emerald Group Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
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PAGE299
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