The Development of a Measure of Confidence in Delivering Therapy to People with Intellectual Disabilities

Abstract

There is increasing emphasis on people with intellectual disabilities receiving services from mainstream mental health services. There is no research describing the experiences and outcomes of people with intellectual disabilities receiving mainstream talking therapy services. The confidence that clinicians have in working with people with intellectual disabilities may be a barrier to them receiving mainstream services. The Therapy Confidence Scale-Intellectual Disabilities is a psychometrically sound scale for measuring the confidence of therapists in working with people with intellectual disabilities and is a useful outcome measure for training clinicians to work with people with intellectual disabilities.

Training therapists to work with people with intellectual disability in Improving Access to Psychological Therapies (IAPT) services

“…Based on 64 people who completed the scale at pre‐training in this study, Cronbach's Alpha for the scale was 0.94; the data in this study do not overlap with the data reported in Dagnan et al. (). A five‐item General Therapy Self‐Efficacy Scale (Dagnan et al., ) using five items adapted from the General Self‐Efficacy Scale (GSE; Schwarzer & Jerusalem, ) where the general statement of problem was adapted to represent a general clinical problem. The scale was used to provide a measure of general clinical efficacy against which to compare the specific intellectual disability therapy confidence scale.…”

“…The following measures were all completed by participants pre‐training, immediately post‐training and at 3‐month follow‐up. The Therapy Confidence Scale–Intellectual Disabilities; (TCS‐ID; Dagnan et al., ). This is a 14‐item scale that describes the confidence of therapists in working with people with intellectual disabilities.…”

“…() and describe stages in engaging people in therapy, from forming a therapeutic alliance, carrying out assessments, formulating, adapting interventions and enabling a positive end to therapy. The TCS‐ID has a single‐factor structure accounting for 62% of the variance, Cronbach's Alpha for the scale is 0.93, test–retest reliability is 0.83, and the scale has been shown to be sensitive to change following training (Dagnan et al., ). Based on 64 people who completed the scale at pre‐training in this study, Cronbach's Alpha for the scale was 0.94; the data in this study do not overlap with the data reported in Dagnan et al.…”

“…Most of the research examining the experience of people with intellectual disabilities in mainstream settings is concerned with inpatient settings, and most clinicians working in mainstream mental health services report little or no specific training on working with people with intellectual disabilities (Werner, Stawski, Polakiewicz, & Levav, ); however, there are few accounts of training for mainstream talking therapists in working with people with intellectual disabilities. Dagnan, Masson, Cavagin, Thwaites, and Hatton () describe the development of the Therapy Confidence Scale for therapists working with people with intellectual disabilities (TCS‐ID). As part of the development of the scale, they describe its use with four groups of therapists, three primary care therapy services (totalling 50 people) and one secondary care service (10 people).…”

Putting the C into CBT: Cognitive challenging with adults with mild to moderate intellectual disabilities and anxiety disorders

“…In summary, this paper takes a step towards addressing the clinical challenge of modifying cognitive challenging for adults with ID. Elucidation of cognitive therapeutic techniques is needed (Sams et al, ; Sturmey, ; Taylor et al, ), particularly when many clinicians report the least amount of confidence in identifying effective therapeutic strategies for adults with ID, compared with more general therapy skills (Dagnan, Masson, Cavagin, Thwaites, & Hatton, ). This paper suggests that CBT‐ID can be beneficial for anxiety disorders, and modified cognitive challenging using the materials presented is feasible for adults with mild ID.…”