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1 – 10 of 21Caroline Rodhouse, Dave Dagnan, Richard Thwaites and Chris Hatton
Primary care psychological interventions for people with common mental health problems in England are primarily delivered through Improving Access to Psychological Therapies…
Abstract
Purpose
Primary care psychological interventions for people with common mental health problems in England are primarily delivered through Improving Access to Psychological Therapies (IAPT) services. People with learning disabilities within IAPT have poorer key clinical outcomes than people who do not identify as having a learning disability. During the global COVID-19 pandemic remote consultations have accounted for nearly 90% of all contacts in IAPT services; this paper aims to report the effects of these on outcomes for people with learning disabilities.
Design/methodology/approach
Publicly available national data from the COVID-affected period are compared to the most recent available comparison periods that are not during the COVID pandemic. Data are presented graphically.
Findings
People with learning disabilities differ little from those with no disabilities on several key process and outcome variables, although their clinical recovery is very much lower than those without disabilities. People with learning disabilities appear to have been affected by the changes in service delivery in a similar way to those without learning disabilities.
Originality/value
Despite the shift to predominantly remote therapy delivery, outcomes for people with learning disabilities have not been differentially affected compared to those who have no recorded disability. The potential to learn what has worked and not worked in the delivery of remote interventions for people with learning disabilities is highlighted.
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Yasmine Dunn, S.J. (Ash) Summers and Dave Dagnan
A range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy…
Abstract
Purpose
A range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy practice that have not yet been considered in depth. This study aims to report the results of an online survey of the practice of therapists working with people with intellectual disabilities in managing endings in therapy.
Design/methodology/approach
Thirty-one therapists working with people with intellectual disabilities responded to an online survey. The data were analysed using reflexive thematic analysis.
Findings
Three superordinate themes were identified: Theme 1 was “preparing for a therapeutic ending” with subordinate themes of “planning early”, “providing boundaries” and “validating feelings”; Theme 2 was “providing a therapeutic ending”, with subordinate themes of “a collaborative decision” and “fostering growth”; and the third theme was “post-ending issues” in which participants acknowledged a “spectrum of emotion”, and, in the case of difficult endings, a sense of “unfinished business”.
Originality/value
This is the first systematic exploration of therapy endings as described by therapists working with people with intellectual disabilities. The authors discuss implications for practice and further areas of research.
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Emma Hunter, Jade Sunley, Shauni Richardson, Cahley Hemm and Dave Dagnan
Policy in the UK and many other countries states that mainstream mental health services should be accessible to people with intellectual disabilities (ID). The purpose of this…
Abstract
Purpose
Policy in the UK and many other countries states that mainstream mental health services should be accessible to people with intellectual disabilities (ID). The purpose of this paper is to systematically review training and development needs assessments and delivered training and development for professionals working in mainstream mental health services who may work with people with IQ.
Design/methodology/approach
A systematic search of four databases (Web of Science; PsychInfo; PubMed; CINAHL) over the period of 2011–2023 was used. Papers were included if they described training or development delivered to, or specific training or development needs analyses of, mainstream qualified staff to support working with adults who have an ID.
Findings
Two papers were found that described training and development initiatives and six that described training and development needs analysis, five of these papers originated from Australia and were part of the development of a comprehensive workforce competency framework.
Research limitations/implications
Training and development approaches for mainstream mental health services to facilitate the support of people with IQ should be systematically developed and trialled.
Originality/value
To the best of the authors’ knowledge, this is the first study to review training and training needs analysis in this area since 2012. The review finds only a small number of papers in what is an important area for service development.
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Roseann Maguire, Carol Pert, Susannah Baines, Amanda Gillooly, Richard P. Hastings, Chris Hatton, Dave Dagnan and Andrew Jahoda
The COVID-19 pandemic meant that it became impossible for many individuals with intellectual disability to access specialist mental health support. The purpose of this study was…
Abstract
Purpose
The COVID-19 pandemic meant that it became impossible for many individuals with intellectual disability to access specialist mental health support. The purpose of this study was to evaluate a set of guided self-help resources adapted for delivery on an outreach basis.
Design/methodology/approach
The use and impact of the resources were evaluated through: data about downloads and requests for printed materials; interviews with individuals who used the resources; webinars with organisations; family members and support workers who had delivered the resources and an online survey with individuals who had delivered the resources.
Findings
The resources had considerable reach, with over 12,555 printed copies requested from across Scotland. The materials were perceived to be relevant and useful, helping individuals to talk about difficulties and to be aware that others were facing similar challenges.
Originality/value
The findings highlight the potential long-term value of guided self-help resources to help promote well-being that can be delivered on an outreach basis by family members and social care organisations.
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Gemma Hymers, Dave Dagnan and Barry Ingham
A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that…
Abstract
Purpose
A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that formulation meetings develop staff understanding of individuals they support. This study aims to explore the change processes that occur as a result of professional team formulation meetings, and the mechanisms that facilitate and hinder these events.
Design/methodology/approach
Eight clinicians who took part in multi-disciplinary team-based formulations in an inpatient mental health service for adults with intellectual disabilities were interviewed. Interviews were examined using thematic analysis.
Findings
The key themes identified were: “gaining information”, “altered thoughts” and “focused goals”. These themes were supported by “collaborative working” and “time for reflection” and were hindered by “poor communication and interaction” and inconsistent “staff attendance”.
Originality/value
Multi-disciplinary team formulation meetings may have a number of change processes that affect staff knowledge and perception of the people that they support. The facilitation of these processes should be a focus for further development.
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Sarah Cameron, James Swanton and Dave Dagnan
This study aims to explore the applicability of Bordin’s model of therapeutic alliance in talking therapies for people with intellectual disabilities.
Abstract
Purpose
This study aims to explore the applicability of Bordin’s model of therapeutic alliance in talking therapies for people with intellectual disabilities.
Design/methodology/approach
People with intellectual disabilities and therapists in six therapy dyads were interviewed using a qualitative methodology. Data were analysed using thematic analysis to explore how people with learning disabilities constructed the dimensions of therapeutic alliance. Content analysis was then used to focus on therapy bond, therapy tasks and goals to explore the agreement on these dimensions between the therapist and client.
Findings
People with intellectual disabilities reported their experience of therapy in a way that initially validates the alliance dimensions of Bordin’s model. There was clear overlap within most dyads in the description of the characteristics of the bond, the tasks undertaken and the goals of therapy. Some therapists described additional goals based on their therapeutic model that were not clearly described by the client working with them.
Research limitations/implications
This study is limited by only including six therapy dyads; however, the results suggest further research on the impact of therapy alliance and how goals and tasks are agreed would be valuable.
Originality/value
Very few studies have explicitly examined the client’s view of therapy alliance.
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Dave Dagnan, Karen Mellor and Claire Jefferson
There is increasing use of cognitive therapy with people with learning disabilities. This paper gives a detailed description of a clinically useful assessment approach that gives…
Abstract
There is increasing use of cognitive therapy with people with learning disabilities. This paper gives a detailed description of a clinically useful assessment approach that gives the therapist information that can be used to identify the appropriate approach to therapy.
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This paper will consider the process of psychological assessment for people with learning disabilities and mental ill‐health. The paper will describe a formulation‐driven approach…
Abstract
This paper will consider the process of psychological assessment for people with learning disabilities and mental ill‐health. The paper will describe a formulation‐driven approach with reference to a social‐cognitive model of mental ill‐health in people with learning disabilities. I will illustrate this process with a brief case study of an assessment within this model.
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Psychosocial interventions are a core part of the service structures of mainstream mental health services. Research and clinical services for people with learning disabilities…
Abstract
Psychosocial interventions are a core part of the service structures of mainstream mental health services. Research and clinical services for people with learning disabilities have often adopted a broadly psychosocial perspective. However, there is surprisingly little literature that considers psychosocial intervention for people with learning disabilities who have mental health problems. This paper describes the structure of psychosocial intervention and then considers the evidence base that is available to develop this approach for people with learning disabilities and mental health problems.
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This paper examines how developmental risk factors associated with depression in typically developing adolescents may interact with the particular life experience of adolescents…
Abstract
This paper examines how developmental risk factors associated with depression in typically developing adolescents may interact with the particular life experience of adolescents with intellectual disabilities and influence vulnerability to depression. We suggest that a consideration of developmental factors and their interaction with the person's social environment may offer a possible framework for prevention and early intervention with adolescents with intellectual disabilities.
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