Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

Abstract

Despite the evidence base for computer-assisted cognitive-behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.To evaluate the utility of a CBT computer game for adults who have an intellectual disability.A 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.A significant group × time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.As the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.

A systematic review of cognitive behavioural therapy for anxiety in adults with intellectual disabilities

“…Cooney et al . () report a treatment group of 24 of whom 13 people were presenting with anxiety only and four with ‘comorbid’ anxiety and depression.…”

Digital mental health and intellectual disabilities: state of the evidence and future directions

“…An adapted version of a computerised psychological intervention for anxiety and depression has been tested in a controlled trial of adults with mild–moderate intellectual disability 35. The programme, Pesky Gnats: The Feel Good Island ,36 delivers simplified cognitive-behavioural therapy (CBT) concepts as a social story with different game characters teaching different core skills, and is used in sessions alongside a therapist.…”

Computer‐assisted cognitive behavioural therapy: The experiences of adults who have an intellectual disability and anxiety or depression

“…To the authors’ knowledge, this is the first application of cCBT for this population. Outcomes from the pilot randomized controlled trial (RCT) evaluation of the prototype CBT computer game are promising as it led to clinically significant change maintained at 3‐month follow‐up for the treatment of anxiety symptoms (Cooney, Jackman, Coyle, & O’ Reilly, ). On the other hand, the intervention did not demonstrate a significant reduction in depression symptoms.…”