The White Paper 'Valuing People' [Department of Health (DoH) (2001) Valuing people: a new strategy for learning disability for the 21st century, London, HMSO]indicates that people with a learning disability need to become more actively involved in the decisions that affect their lives. This includes being offered active choices in access to health services. Psychologists, therefore, need to think about how to give people with learning disabilities enough relevant information in an accessible way to promote informed consent to treatment. This study investigates how much information adults with mild and moderate learning disabilities understand about psychology services, before and after watching a video designed to explain what seeing a psychologist entails. The video was shown to 19 participants at a local Social Education Centre. Participants' knowledge increased significantly after watching the video. They were able to answer questions about its content better when asked after short sections of the video when presented, rather than after an uninterrupted presentation.
Despite a dramatic increase in the number of treatment studies for adolescent major depressive disorder in the past 15 years, the majority being clinical trials of medications and cognitive behavioral therapy, response rates have been modest and remission rates low. Moreover, most positive responders posttreatment have many residual symptoms, significant functional impairment, and high rates of relapse. There is a need for the development of new, more effective interventions to treat this severe, chronic condition that usually persists into adulthood with poor long-term outcomes. Findings from preliminary treatment studies suggest that exercise may have the potential to be efficacious as a monotherapy or as part of a combined treatment for adolescent major depressive disorder. This review summarizes the findings and analyzes the design flaws of randomized trials of exercise to treat adolescent depression, offering recommendations on how to design more methodologically sound studies with an emphasis on subject selection criteria; issues related to control conditions, types of diagnostic interviews, and measures needed to establish the diagnosis of depression; types of exercise treatments; and appropriate outcome measures. Future studies of exercise to treat and prevent adolescent major depressive disorder need to be comparable to stateof-the-art treatment studies of pharmacotherapy and cognitive behavioral therapy in this population to more accurately determine its efficacy and potential public health benefits.
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