Abstract
BackgroundSeveral studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT). Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations) in people with ID. Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. To date, two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID. However, there is no individual manualised programme for anxiety or depression in people with intellectual disabilities. The aims of the study are to determine the feasibility of conducting a randomised controlled trial for CBT in people with ID. The data will inform the power calculation and other aspects of carrying out a definitive randomised controlled trial.MethodsThirty participants with mild ID will be allocated randomly to either CBT or treatment as usual (TAU). The CBT group will receive up to 20 hourly individual CBT over a period of 4 months. TAU is the standard treatment which is available to any adult with an intellectual disability who is referred to the intellectual disability service (including care management, community support, medical, nursing or social support). Beck Youth Inventories (Beck Anxiety Inventory & Beck Depression Inventory) will be administered at baseline; end of treatment (4 months) and at six months to evaluate the changes in depression and anxiety. Client satisfaction, quality of life and the health economics will be secondary outcomes.DiscussionThe broad outcome of the study will be to produce clear guidance for therapists to apply an established psychological intervention and identify how and whether it works with people with intellectual disabilities.Trial registrationISRCTN: ISRCTN38099525
Highlights
Several studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT)
It has been suggested that psychotherapy in general is not effective in people with ID [5,6,7,8,9]
This is possibly due to long-held assumptions that people with ID have insufficient intellectual capacity to use talking therapies as well as a lack of instruments to measure change in symptoms, “therapeutic disdain” [10], a reluctance to work collaboratively and to understand the mental world of the patient [11]
Summary
Several studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT). Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations) in people with ID. Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. Two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID. The level of psychopathology in people with intellectual disabilities (ID) is higher than in the general population [1] with depression, anxiety and mixed affective disorder being the commonest diagnoses. Recent limited evidence suggests that at least a year’s psychodynamic orientated therapy with adults across the range of intellectual disability leads to positive outcomes in improving emotional intelligence [12]
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