Manualised Individual Cognitive Behavioural Therapy for mood disorders in people with mild to moderate intellectual disability: A feasibility randomised controlled trial

Hassiotis, Angela; Serfaty, Marc; Azam, K; Strydom, André; Blizard, Robert; Romeo, Renée; Martin, Sue; King, Michael

doi:10.1016/j.jad.2013.05.076

Cited by 67 publications

(95 citation statements)

References 47 publications

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“…Preliminary evidence suggests that cognitive behavioral therapy (CBT) can significantly reduce anger (see Vereenooghe et al, 2013 for review) and may also reduce depressive symptoms in adults with ID (e.g., Dagnan & Chadwick, 1997; Hassiotis et al, 2013; McCabe, McGillivrary, and Newton, 2006). CBT is a goal-oriented, short-term, therapy that combines behavior therapy, which is focused on learned behaviors and how the environment impacts these behaviors (O'Leary, Daniel, & Wilson, 1975), and cognitive therapy, which is focused on problematic beliefs, which are posited to mediate emotional and behavioral reactions (Beck, 1995; Ellis, 1977).…”

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confidence: 99%

“…However, only a handful of studies, often consisting of single case reports, have evaluated the effectiveness of CBT for depression in adults with mild ID. These studies reported decreases in depressive symptoms following CBT (Dagnan & Chadwick, 1997; Hassiotis et al, 2013; Lindsay & Olley, 1998), when necessary adaptations were used including simplifying language, checking understanding, real life examples, and visual materials. In one of the largest studies to date, Hassiotis et al (2013) examined the efficacy of an individualized 16 week CBT program in adults with mild to moderate ID who had symptoms of a mood disorder (depression or anxiety) as compared to a treatment as usual control group (n = 16).…”

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confidence: 99%

“…These studies reported decreases in depressive symptoms following CBT (Dagnan & Chadwick, 1997; Hassiotis et al, 2013; Lindsay & Olley, 1998), when necessary adaptations were used including simplifying language, checking understanding, real life examples, and visual materials. In one of the largest studies to date, Hassiotis et al (2013) examined the efficacy of an individualized 16 week CBT program in adults with mild to moderate ID who had symptoms of a mood disorder (depression or anxiety) as compared to a treatment as usual control group (n = 16). Although not statistically significant, there was a trend toward improvement in depressive symptoms based on self-report using the Beck Depression Inventory Youth (Beck Youth Inventories, 2005).…”

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confidence: 99%

“…Previous CBT treatments for depressive disorders have involved only the adult with ID (e.g., Dagnan & Chadwick, 1997; Hassiotis et al, 2013; McCabe et al, 2006), however, CBT treatments for other conditions (e.g., anger) in adults with ID have involved caregivers at a more minor level (Taylor, Navoac, Gillmer, Robertson, & Thorne, 2011). The inclusion of caregivers in CBT treatments may enhance treatment effects and was voiced as being important by caregivers and mental health and disability service providers in our focus groups and interviewers (see CBT Treatment section).…”

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confidence: 99%

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

Hartley

Esbensen

Shalev

et al. 2015

Journal of Mental Health Research in Intellectual Disabilities

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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.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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

Hartley

Esbensen

Shalev

et al. 2015

Journal of Mental Health Research in Intellectual Disabilities

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“…The majority of studies included within our meta-analysis aimed to provide cognitive-behavioural therapy for anger and aggression, while only three studies (Hassiotis et al, 2013;McCabe et al, 2006;McGillivray et al, 2009) aimed to treat depression, with an associated effect size calculation of, g ¼ 0.742.…”

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confidence: 99%

Commentary on “The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review”

Langdon

2015

Tizard Learning Disability Review

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Purpose -The purpose of this paper is to provide a commentary on "The use of cognitive-behaviour therapy to treat depression in people with learning disabilities: a systematic review". Design/methodology/approach -Drawing on the literature, as well as both clinical and research experience, some reasons are outlined for the lack of attention given to psychological therapies to treat depression amongst people with intellectual disabilities (IDs). Findings -More research is needed, but existing evidence is promising regarding the effectiveness of adapted cognitive-behaviour therapy for depression amongst people with IDs. Originality/value -The commentary draws attention to the scope for developing a range of effective cognitive, behavioural and cognitive-behavioural treatments.In 2013, we undertook a meta-analysis of psychological therapies, concluding that cognitive-behavioural therapy appeared to be efficacious when used with people who have intellectual disabilities (IDs), reporting an overall effect size, g ¼ 0.682 (Vereenooghe and Langdon, 2013). The majority of studies included within our meta-analysis aimed to provide cognitive-behavioural therapy for anger and aggression, while only three studies (Hassiotis et al., 2013;McCabe et al., 2006;McGillivray et al., 2009) aimed to treat depression, with an associated effect size calculation of, g ¼ 0.742.Historically, "talking therapies" have often been seen as inappropriate for people with IDs, with many making reference to Bender (1993), who wrote about people with IDs being viewed with "therapeutic disdain". Such a stigmatising view is exceptionally inappropriate, and while there has been a slow increase in the number of studies examining whether cognitive-behavioural therapy is beneficial for people with IDs, we still do have some way to go before we have a robust evidence base.There are a variety of reasons why psychological therapy research with people who have IDs has lagged behind similar research with people who do not have IDs. Many may still think that "talking" psychological therapies are unlikely to benefit some people with IDs because they may have difficulty understanding the concepts taught. In order to improve accessibility, adaptations are often made, including the simplification of therapeutic methods, the use of

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Mood Disorders

Sturmey¹,

Didden²

2014

Evidence‐Based Practice and Intellectual Disabilities

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Manualised Individual Cognitive Behavioural Therapy for mood disorders in people with mild to moderate intellectual disability: A feasibility randomised controlled trial

Cited by 67 publications

References 47 publications

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

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

Commentary on “The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review”

Mood Disorders

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