Psychological therapies for people with intellectual disabilities: An updated systematic review and meta-analysis

Tapp, Katherine; Vereenooghe, Leen; Hewitt, Olivia; Scripps, Emma; Gray, Kylie Megan; Langdon, Peter E.

doi:10.1016/j.comppsych.2023.152372

Cited by 21 publications

(8 citation statements)

References 68 publications

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“…Moreover, even in general (Tapp et al . 2023) or in other therapeutic approaches such as cognitive behavioural therapy (Graser et al . 2022), recent meta‐analyses also found comparably small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

“…Previously published studies on trauma therapy with the examined target group report comparable (Karatzias et al 2019) or even smaller case numbers, so that this study, with the necessary caution, can still contribute to the progress in knowledge in this area. Moreover, even in general (Tapp et al 2023) or in other therapeutic approaches such as cognitive behavioural therapy (Graser et al 2022), recent meta-analyses also found comparably small sample sizes.…”

Section: Limitations Of the Studymentioning

confidence: 99%

See 1 more Smart Citation

Trauma treatment using Narrative Exposure Therapy adapted to persons with intellectual disabilities or severe chronic mental disorders – a randomised controlled pilot study with an embedded observational study

Mayer

Elbing

Ostermann

2023

J intellect Disabil Res

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BackgroundDespite an increased likelihood of experiencing traumatic events and increased vulnerability, there are only few publications on trauma therapy for persons with intellectual disabilities (IDs). This pilot study for the first time investigates the feasibility and effectiveness of Narrative Exposure Therapy (NET) within this target group modified by Plain Language.MethodsA group of n = 10 participants with ID dual diagnoses and another group of n = 5 participants with severe and chronic mental disorders were separately stratified and randomised, then forming together an intervention group (n = 7) and a waiting list control group (n = 8). All participants were treated with NET attuned to their communication abilities by using Plain Language. Primary outcome was the post‐traumatic stress measured with the Post‐Traumatic Symptom Scale‐10 before and after the intervention. In addition, the Adverse Childhood Experience Index was used for diagnostic purposes. Data were analysed using t‐test for repeated measures and analysis of covariance.ResultsNarrative Exposure Therapy and the randomised controlled trial study proved to be successfully conductible with participants with IDs in a congregated residential service. Although the corresponding effect size was high (partial eta square = 0.188), the between‐group difference was not significant (P = 0.12). Analysis of the observational study resulted in a highly significant improvement for participants with IDs (P < 0.001; Hedges' g = 2.36) and in a significant improvement in participants with severe and chronic mental disorders (P < 0.013; Hedges' g = 1.52). Additionally, the participants with IDs show a significantly better reduction of symptom burden (P = 0.03; partial eta square = 0.327).ConclusionsThe results provide a first evidence for a possible and successful implementation of NET modified in Plain Language for persons with IDs and complex mental health support needs. Completeness in responding to the items of Post‐Traumatic Symptom Scale‐10 and Adverse Childhood Experience Index indicates the suitability of these instruments for both groups of participants. Although the group difference in the randomised controlled trial failed to achieve statistical significance mainly due to the small sample size, the results of the embedded observational study are promising for the conduct of further studies with the modified NET.

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Section: Discussionmentioning

confidence: 99%

Section: Limitations Of the Studymentioning

confidence: 99%

Trauma treatment using Narrative Exposure Therapy adapted to persons with intellectual disabilities or severe chronic mental disorders – a randomised controlled pilot study with an embedded observational study

Mayer

Elbing

Ostermann

2023

J intellect Disabil Res

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“…While there has been a lot of research into people with learning disabilities experiences of mental health services (Whittle et al, 2019) and therapies that target and reduce symptoms (Tapp et al, 2023), less attention has been paid to people's experiences of personal recovery. This is important because knowing what supports personal recovery can give peer supporters more information about how to help.…”

Section: Personal Recovery and Peer Support For People With Disabilitiesmentioning

confidence: 99%

Peer support by and for people with learning disabilities

Ali,

Allum,

Vassell

et al. 2023

Brit J Learn Disabil

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BackgroundThe emphasis of mental health services has changed to become more recovery focussed and is increasingly looking towards new roles such as peer support as a part of service provision (NHSE, 2019). However, services for people with learning disabilities and mental health difficulties have lagged behind with people with lived experience mainly involved in research and consultation to services rather than delivering interventions.MethodsThis article is based on four workshops held as part of a patient and public involvement and engagement (PPIE) consultation on a research study being developed to promote access to recovery colleges for people with learning disabilities. The workshops included three peer supporters with learning disabilities. In the article we describe our groups experiences and views on mental health, recovery and peer support.FindingsOur group discussed our views on mental health, what recovery means and the impact of peer support on us. We also discussed the skills people need to do peer support and the support they need from others to do these roles well.ConclusionsWe thought that peer support for people with learning disabilities can challenge stigma and help people with difficult experiences such as low self esteem and loneliness. Staff supporting people with learning disabilities may benefit from more training to implement peer support. More research on the kinds of peer support that are on offer for people with learning disabilities is needed.

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“…People with intellectual disabilities experience higher levels of mental health difficulty than the general population (Mazza et al , 2020); psychological therapies are a first-line treatment for such mental health difficulties in the general population (Kendrick et al , 2022). However, there is less evidence of equivalent therapy effectiveness for adults with intellectual disabilities (Tapp et al , 2023), and research continues to explore effectiveness and necessary adaptations to therapy for people with intellectual disabilities in many therapeutic models (Surley and Dagnan, 2019; McNair et al , 2017; Himmerich, 2020). Whilst a range of adaptations and therapy processes have been explored, there remain many areas of therapy practice that have not yet been considered in depth.…”

Section: Introductionmentioning

confidence: 99%

A survey of therapists’ experience of ending therapy with people with intellectual disabilities

Dunn,

Summers,

Dagnan

2023

AMHID

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Purpose A range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy practice that have not yet been considered in depth. This study aims to report the results of an online survey of the practice of therapists working with people with intellectual disabilities in managing endings in therapy. Design/methodology/approach Thirty-one therapists working with people with intellectual disabilities responded to an online survey. The data were analysed using reflexive thematic analysis. Findings Three superordinate themes were identified: Theme 1 was “preparing for a therapeutic ending” with subordinate themes of “planning early”, “providing boundaries” and “validating feelings”; Theme 2 was “providing a therapeutic ending”, with subordinate themes of “a collaborative decision” and “fostering growth”; and the third theme was “post-ending issues” in which participants acknowledged a “spectrum of emotion”, and, in the case of difficult endings, a sense of “unfinished business”. Originality/value This is the first systematic exploration of therapy endings as described by therapists working with people with intellectual disabilities. The authors discuss implications for practice and further areas of research.

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Psychological therapies for people with intellectual disabilities: An updated systematic review and meta-analysis

Cited by 21 publications

References 68 publications

Trauma treatment using Narrative Exposure Therapy adapted to persons with intellectual disabilities or severe chronic mental disorders – a randomised controlled pilot study with an embedded observational study

Trauma treatment using Narrative Exposure Therapy adapted to persons with intellectual disabilities or severe chronic mental disorders – a randomised controlled pilot study with an embedded observational study

Peer support by and for people with learning disabilities

A survey of therapists’ experience of ending therapy with people with intellectual disabilities

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