Trauma‐Specific Treatment for Individuals With Intellectual and Developmental Disabilities: A Review of the Literature From 2008 to 2018

Abstract

Background: Individuals with intellectual and developmental disabilities (IDD) are at increased risk for adverse experiences and developing posttraumatic stress disorder (PTSD). However, trauma and PTSD in this population are frequently underdiagnosed and undertreated. Despite the availability of multiple types of trauma-specific treatments for the general population, there is a gap in understanding these collective interventions within the IDD literature. Specific Aims: The aim of this article was to conduct a review of the peer-reviewed literature on trauma-specific treatment and IDD published from 2008 to 2018. Method: A systematic search of online databases was conducted using Academic Search Premier, MEDLINE, PsycARTICLES, and Social Work Abstracts. A quality appraisal was conducted on the studies included in the review. Findings: Twelve articles described four types of trauma-specific treatments: child-parent psychotherapy, exposure therapy, trauma-focused cognitive behavior therapy, and eye movement desensitization and reprocessing therapy. All studies demonstrated that the interventions were well tolerated and associated with improvement in trauma symptoms. Eight studies demonstrated sustained improvement at follow-up, ranging from 6 weeks to 5 years. Discussion: Research on trauma-specific treatments among individuals with IDD continues to present with methodological limitations yet provides considerations for future practice and a foundation for future research.

Violent Recidivism and Adverse Childhood Experiences in Forensic Psychiatric Patients With Impaired Intellectual Functioning

“…Contrary to the findings of previous studies (Keesler, 2020; P. M. Sullivan & Knutson, 2000), we found no direct effect of ACE on ID. This indicates that forensic psychiatric patients who experienced more ACE have an equal chance of belonging to the ID group as those who experienced no or less ACE.…”

“…Furthermore, individuals with ID are not only at higher risk of being violent toward others but are also often victims of violence themselves (Hassiotis et al, 2019;Keesler, 2020;Kunst et al, 2011). Exposure to adverse childhood experiences (ACE) can be attributed to a combination of characteristics of their disability and impaired family functioning due to that disability (Wigham & Emerson, 2015).…”

Community Inclusion for People with Intellectual and Developmental Disabilities

“… Interventions & practices have often originated in the general population & have lacked sensitivity to disability identity and culture. As such, they frequently require adaptations to be effective (Andrews et al, 2019;Keesler, 2020).  The efficacy of disability services in facilitating community inclusion is unclear due an absence of evaluation & research.…”

“…Notably, both social work and the field of IDD have called for greater emphasis on best practices and EBP (Schalock et al, 2017;Thyer & Myers, 2011). For people with IDD, interventions and practices have often originated in the general population, and as such, they have lacked sensitivity to disability culture and therefore warrant adaptations to be effective (Andrews et al, 2019;Keesler, 2020). Schalock et al (2017) identified the importance of EBP in IDD services and emphasized a multi-systems framework with implications of various factors (e.g., support staff strategies and opportunities for participation) for individual outcomes.…”

Trauma‐specific treatment among individuals with intellectual/developmental disabilities: A case series with progressive counting

“…The experiences and outcomes in this study may differ from those among therapists with different levels of expertise with trauma treatment, PC, or intellectual/developmental disabilities. Research examining trauma treatment among people with intellectual/developmental disabilities has often noted a lack of strategies to ensure treatment fidelity (Byrne, 2020; Keesler, 2020). To bolster the reliability and validity of the intervention, this study integrated a standardised training, had a single therapist (which can remove variability associated with multiple therapists), implemented a protocol checklist for the therapist to self‐monitor, included monthly team meetings, and ongoing consultation with the training expert.…”