Cognitive Behavioral Therapy for Depressed Adults With Mild Intellectual Disability: A Pilot Study

Abstract

Background There is a paucity of research on psychosocial treatments for depression in adults with intellectual disability (ID). In this pilot study, we explored the efficacy of a group CBT treatment that involved a caregiver component in adults with mild ID with a depressive disorder. Method Sixteen adults with mild ID and a depressive disorder participated in a 10-week group CBT treatment and 8 adults with mild ID with a depressive disorder served as a treatment as usual (TAU) control group. Adults with mild ID and caregivers completed measures of depressive symptoms, behavior problems, and social skills at pre-treatment, post-treatment, and a 3-month follow-up. Adults with mild ID also completed a series of tasks to measure their understanding of the principles of cognitive therapy pre- and post-treatment. Results The CBT group demonstrated significant decreases in depressive symptoms and behavior problems from pre-treatment to post-treatment and these effects were maintained at a 3-month follow-up. The CBT group demonstrated significant improvements in their ability to infer emotions and thoughts based on various situation-thought-emotion pairings from pre-treatment to post-treatment. Conclusions Findings indicate that adults with mild ID with a depressive disorder benefitted from a group CBT treatment with a caregiver component. Moreover, adults with mild ID appeared to benefit, at least in part, from the cognitive therapy components of the treatment, in addition to the behavior therapy components.

Measures of readiness for cognitive behavioural therapy in people with intellectual disability: A systematic review

“…Most were of cross sectional design (N= 7). Four employed randomised experimental designs and one (Hartley et al, 2015) used a non-randomised pre-post design. (Joyce, Globe, & Moody, 2006) to 88 (Oathamshaw & Haddock, 2006).…”

“…the Behaviour Thought Feeling Questionnaire (BTFQ) (Oathamshaw & Haddock, 2006) asks respondents to identify if a prompt word or sentence is a thought, feeling or behaviour. It was used in three studies (Hartley et al, 2015;Oathamshaw & Haddock, 2006;Vereenooghe et al, 2016). The Thought Feeling Behaviour task (TFB) (Quakley et al, 2004) asks participants to identify the thought, behaviour and feeling elements of a set of standardised sentences about a person's reaction to scenarios.…”

“…It was used in two studies (Bruce, Collins, Langdon, Powlitch, & Reynolds, 2010;Sams et al, 2006). Both measures have been scored as a single total, reflecting ability to recognise thoughts/feelings/behaviours as a whole (Bruce et al, 2010;Hartley et al, 2015;Vereenooghe et al, 2016) or as three separate subscales reflecting ability to recognise thoughts, feelings or behaviours separately (Oathamshaw & Haddock, 2006;Sams et al, 2006;Vereenooghe et al, 2016). A clear theoretical rationale was not given for either scoring method.…”

“…This measure has been used in six studies in pencil and paper (Dagnan et al, 2000;Hartley et al, 2015;Joyce et al, 2006;Oathamshaw & Haddock, 2006) and…”

“…Whether scores on measures change in the process of CBT has only been examined in one study assessed as of low quality (Hartley et al, 2015). Recognition of cognitive mediation (Dagnan et al, 2000), but not the BTFQ was found to change over the course of a CBT group intervention for people with intellectual disabilities, which also reduced depressive symptomatology.…”