The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities

Abstract

Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access.

Trauma‐informed care: A qualitative study exploring the views and experiences of professionals in specialist health services for adults with intellectual disabilities

“…Our findings also echo previous research which suggested that it is common practice to make reasonable adjustments and modifications to existing treatment protocols to meet specific needs, including the needs related to intellectual disability and health (see Barrowcliff & Evans, ; Carrigan & Allez, ; Fernando & Medlicott, ; Marwood, Chinn, Gannon, & Scior, ). It was evident that while clinicians were usually able to make reasonable adjustments to enable adults with mild‐to‐moderate intellectual disability to engage in treatment, this was more difficult for those with more complex and severe intellectual disability and required alternative and more creative ways to ensure delivery of interventions due to deficits in the persons communication.…”

Delivering cognitive behavioural therapy to advanced cancer patients: A qualitative exploration into therapists' experiences within a UK psychological service

“…Previous research has identified the rigidity of the service as a reason for patient non‐attendance at IAPT with participants reporting a lack of choices regarding appointment time and difficulties fitting appointments into their lives (Marshall et al, ). Similar findings have been observed in people with learning difficulties where a lack of flexibility in appointment scheduling and discharge policies within IAPT services were observed to be too constraining (Marwood et al, ). Cancer patients are likely to have a number of medical appointments, which, in addition to the side effects of some cancer treatments, may make attending weekly IAPT appointments challenging.…”

“…Specifically, supervision with someone with experience in delivering therapy to advanced cancer patients. This finding is supported by Marwood et al () who explored the experience of therapists delivering CBT to people with learning disabilities in which therapists expressed a need for specialist supervision when delivering therapy. Additionally, Naylor et al () suggested that IAPT workers working with physically ill patients require on‐going supervision with professionals, such as clinical health psychologists, with experience of working with the same patient group.…”

“…Therapists suggested a better understanding of the challenges faced by this population, such as near death awareness. Similarly, therapists in other qualitative research suggested that specialist training, such as the training therapists received for the CanTalk trial, is important for therapists delivering therapy to individuals with learning disabilities (Marwood et al, ; Shankland & Dagnan, ). Therapist competence has additionally been found to be associated with improved therapy outcomes, with more competent therapists having better patient outcomes (Kuyken & Tsivrikos, ).…”

“…… I would rather than, the patient being seen in IAPT, especially busy IAPT, I would see it as more, rather than IAPT, a specialised service, where they do employ CBT therapist but is not as an IAPT it's more a specialised, you know, could be maybe in, in the hospital … (T07) (Marwood et al, 2017;Shankland & Dagnan, 2015). Therapist competence has additionally been found to be associated with improved therapy outcomes, with more competent therapists having better patient outcomes (Kuyken & Tsivrikos, 2009).…”