BackgroundPsychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings.
MethodsA systematic review of peer-reviewed literature published between 1980-2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best-evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions.
ResultsThere is a limited amount of efficacy research that meets the most stringent standards of empirical evidence.
ConclusionsIt is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment.
Matrix of evidence 2
IntroductionWhilst the move from larger scale to community based models of care for people with intellectual disabilities in Scotland has led to an improved quality of life, there is a concern that existing services have difficulty supporting adults with the most serious challenging behaviours Kiernan, 1993;Allen 1999;Stalker and Hunter, 1999; RCP/BPS/RCSLT, 2007;Emerson & Enfield, 2011).Using an evidence base in relation to effective interventions in health and social care is not new.There are a large number of "what works" reports, identifying the best research evidence and benefits of particular interventions used in the management of specific mental health conditions in the UK (e.g.
Royal College of Psychiatrists
The evidence related to pharmacotherapy and psychological treatment is, in general, either lacking or poor. This does not suggest that these treatments are necessarily ineffective but that there is not enough good quality evidence tosupport their usefulness. (Antonacci, Manuel & Davis, 2008) In the absence of a credible evidence base for psychological or psychopharmacological interventions, medication continues to be prescribed widely for challenging behaviour (Cullen, 2000;Ahmed et al, 2000; Verhoeven & Tuinier, 1999;Brylewski & Duggan, 1999;Emerson, Robertson, Gregory et al 2000; Royal College of Psychiatrists, 2006;Emerson & Enfield, 2011).In December 2008 the Scottish Government published "The Matrix -A Guide to delivering evidencebased Psychological Therapies in Scotland". The Matrix was produced to help National Health Service authorities in Scotland to efficiently deliver the range, volume and quality of psychological therapy required for the effective treatment of common mental health problems. This was part of a Matrix of evidence 3 larger, national health improvement initiative to establish and measure waiting time targets from referral to treatment for psychological therapies (Scottish Government, 2011a, 2011b. In 2010 the Scottish Government commissioned a review of effective psychological therapies in relation to adults with intell...