Advances in Mental Health and Intellectual Disabilities最新文献

{"title":"Telephone-delivered compassion-focused therapy for adults with intellectual disabilities: a case series","authors":"G. Rawlings, K. Wright, K. Rolling, N. Beail","doi":"10.1108/AMHID-12-2020-0035","DOIUrl":"https://doi.org/10.1108/AMHID-12-2020-0035","url":null,"abstract":"\u0000Purpose\u0000Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID).\u0000\u0000\u0000Design/methodology/approach\u0000As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure.\u0000\u0000\u0000Findings\u0000Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy.\u0000\u0000\u0000Originality/value\u0000To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41290580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotic prescribing for patients with intellectual disabilities and challenging behaviours","authors":"Bushra Elhusein, Y. Eltorki, O. Abdallah, M. E. Tahir","doi":"10.1108/amhid-11-2020-0030","DOIUrl":"https://doi.org/10.1108/amhid-11-2020-0030","url":null,"abstract":"\u0000Purpose\u0000Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar.\u0000\u0000\u0000Design/methodology/approach\u0000This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured.\u0000\u0000\u0000Findings\u0000This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices.\u0000\u0000\u0000Originality/value\u0000This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47337586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing trauma-informed care: using psychodynamic concepts to help staff respond to the attachment needs of survivors of trauma","authors":"E. Rye, Joanna Anderson, M. Pickard","doi":"10.1108/amhid-12-2020-0033","DOIUrl":"https://doi.org/10.1108/amhid-12-2020-0033","url":null,"abstract":"\u0000Purpose\u0000Many referrals to our mental health of learning disability service focus on concerns about behaviours that present risks to the referred person and to those around them, including support workers. If the referred person has good verbal ability, psychological therapy may be requested and offered, but the person may find it too difficult to engage for a number of reasons. Even when they do engage in therapy, the authors recognise the importance of helping staff better understand their attachment needs. This paper aims to demonstrate an innovative approach to helping staff provide Trauma-Informed Care (TIC).\u0000\u0000\u0000Design/methodology/approach\u0000The authors developed a training programme for support workers using psychodynamic concepts, such as splitting, transference and counter-transference, to help them develop insight into the processes that get enacted during their work. In this paper the authors have generally used the term “care staff”, recognising that an important aspect of the role of those staff is to provide care within an attachment framework; as well as support to maximise independence.\u0000\u0000\u0000Findings\u0000The feedback from staff who have attended has been very positive, both at the time and later. Staff who have attended have talked to multidisciplinary colleagues about the impact their learning has had on their ability to work with service users who present great challenges, in the context of their trauma histories.\u0000\u0000\u0000Originality/value\u0000The importance of providing TIC is gaining traction across varied settings. The authors are in the process of developing both qualitative and quantitative research programmes to evaluate this approach to increasing TIC for adults with learning disabilities, reducing staff burn out and placement breakdown.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49125549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Hagerman’s behavioral phenotype for fragile X syndrome among men with intellectual disability","authors":"Jacques Bellavance, M. Diane, Catherine Mello","doi":"10.1108/amhid-09-2020-0020","DOIUrl":"https://doi.org/10.1108/amhid-09-2020-0020","url":null,"abstract":"\u0000Purpose\u0000The behavioral phenotype of fragile X syndrome (FXS) and intellectual disability (ID) proposed by Hagerman et al. (2009) was primarily based on data from male children and teens. The purpose of this study was to promote a better understanding of how this condition manifests in adults.\u0000\u0000\u0000Design/methodology/approach\u0000A total of 18 men of FXS were paired with men with Down syndrome on the basis of age and level of ID. A screening checklist was created on the basis of existing scales and the Hagerman et al. (2009) behavioral phenotype and completed by care providers.\u0000\u0000\u0000Findings\u0000Five of the 12 features of the phenotype were significantly more present among men with FXS than in men with Down syndrome.\u0000\u0000\u0000Originality/value\u0000This study provides partial confirmation for Hagerman et al.’s (2009) behavioral phenotype of FXS among men with moderate ID and identified some traits that warrant further investigation.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42574103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling referrals to a trauma support service: needs and outcomes for staff working in a secure adult developmental disorder pathway","authors":"E. Webb, A. Greenwood, Abbey Hamer, V. Sibley","doi":"10.1108/AMHID-02-2021-0007","DOIUrl":"https://doi.org/10.1108/AMHID-02-2021-0007","url":null,"abstract":"\u0000Purpose\u0000Forensic health-care workers are frequently exposed to behaviours that challenge and traumatic material, with notably high levels in developmental disorder (DD) services. The provision of support is key in alleviating distress and improving work functioning. This paper aims to incite clarity on whether staff in DD services are more likely to access trauma support. The prevailing needs and outcomes for this population are also explored.\u0000\u0000\u0000Design/methodology/approach\u0000Data was extracted retrospectively from a database held by an internal trauma support service (TSS) for staff working in a secure psychiatric hospital. Overall, 278 permanent clinical staff accessed the TSS between 2018 and 2020, 102 (36.7%) of whom worked in an adult DD forensic inpatient service.\u0000\u0000\u0000Findings\u0000Staff working in DD services were over-represented in referrals to the TSS with a greater number of referrals per bed in DD services than in non-DD services (0.94 vs 0.33). DD staff were comparatively more likely to access support for non-physical, psychologically traumatic experiences. Psychological needs and outcomes following support were comparable between staff across services.\u0000\u0000\u0000Practical implications\u0000The findings highlight the more frequent need for trauma support of staff in forensic inpatient DD settings. Embedding a culture of safety and openness, and establishing appropriate and responsive models of staff support reflect key priorities for inpatient DD health-care providers, for the universal benefit of the organisation, workforce and service users.\u0000\u0000\u0000Originality/value\u0000This study offers novel insight into levels of access to support for staff working with people with DDs.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43573730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drawing in not encouraging away: systemic team formulation to support the trauma-informed care of a lady with intellectual disabilities, in the context of COVID-19","authors":"Nicola Gregson, C. Delaney","doi":"10.1108/AMHID-12-2020-0032","DOIUrl":"https://doi.org/10.1108/AMHID-12-2020-0032","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to present a case study using a systemic team formulation approach, in the context of supporting a women with intellectual disabilities with a history of trauma.\u0000\u0000\u0000Design/methodology/approach\u0000A reflective stance is used to describe the process of assessment, hypothesising, formulation and intervention in a single case study design.\u0000\u0000\u0000Findings\u0000Feedback from care staff suggests that they found a team formulation approach helpful to improve their understanding of the service user they support.\u0000\u0000\u0000Practical implications\u0000The paper discusses how systemic team formulation can draw on trauma-informed care principles in the context of supporting an individual with an intellectual disability. Future research should aim to replicate the approach for findings to be applied more broadly. COVID-19 has meant clinical working has had to be adapted, clinicians should carefully consider how collaborative and meaningful work can continue to be facilitated within the current parameters.\u0000\u0000\u0000Originality/value\u0000This case study contributes to the literature in the use of systemic team formulation interventions within an intellectual disability context, drawing on trauma-informed care principles and reflecting on adapted working within the COVID-19 pandemic.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44538652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Links of socio-emotional context on performance in categorization task of adults with moderate to severe intellectual disabilities","authors":"S. Igier, Valérie Pennequin","doi":"10.1108/AMHID-10-2020-0026","DOIUrl":"https://doi.org/10.1108/AMHID-10-2020-0026","url":null,"abstract":"\u0000Purpose\u0000Studies on intellectual disabilities describe difficulties at the cognitive level but little about the other factors that can impact the individual’s performance. The aim of this research was thus to assess the effects of the socio-emotional context on the performance of adults with intellectual disabilities in a cognitive task. The main hypothesis was that people with intellectual disabilities will not have the cognitive ability to see the socioemotional environment as a potential resource, and that they could not use it to mobilize their cognitive resources to try and improve their performance and adopt more positive behavior.\u0000\u0000\u0000Design/methodology/approach\u0000A total of 32 people with moderate to severe intellectual disabilities were recruited. They performed a categorization task and were then given their results. Throughout the test, the psychologist observed the participants’ behavior and, more specifically, their emotional expressions, their pro-social behavior and their respect for social rules.\u0000\u0000\u0000Findings\u0000The results support the hypotheses, with better performance among participants who adopted pro-social behaviors, respected the rules and displayed positive emotional expressions. These results highlight the central role played by others in the ability of adults with intellectual disabilities to adapt to a given situation.\u0000\u0000\u0000Research limitations/implications\u0000This study was conducted by a psychologist, which could have biased the relationship with the participants. A complementary study is in progress to measure the effects.\u0000\u0000\u0000Practical implications\u0000These findings have implications for cognitive remediation tasks aimed at mobilizing the cognitive resources of adults with intellectual disabilities.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the only study to evaluate the role of the socio-emotional environment on the performance of adults with intellectual disabilities.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41772083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We can still feel good: evaluation of the I can feel good programme second edition in a low secure unit","authors":"S. Ashworth, C. Robinson, Donna Harrison, Natalie Brotherton","doi":"10.1108/AMHID-08-2020-0019","DOIUrl":"https://doi.org/10.1108/AMHID-08-2020-0019","url":null,"abstract":"\u0000Purpose\u0000This paper aims to present the process of reviewing, adapting and evaluating, the second edition of the I Can Feel Good programme (Ashworth et al., 2018) and adapted DBT programme facilitated at a low-security psychiatric hospital for men with intellectual disability. Through the presentation of programme development, evaluation and revision, a more thorough and transparent understanding of the process involved can be disseminated.\u0000\u0000\u0000Design/methodology/approach\u0000The programme lasted approximately 14 months and covered all four modules. N = 5, all-male, ages ranged between 23 and 57 years old. All detained under the MHA (1983) with a primary diagnosis of Mild ID with comorbid psychiatric diagnoses including mental illness, autism spectrum disorders and personality disorder. To evaluate routine effectiveness a pre-post comparison within groups design was used. A standardised GAS approach provided a template to score the degree to which identified goals were achieved over the intervention for participants.\u0000\u0000\u0000Findings\u0000Wilcoxon signed-rank tests were used due to data not meeting parametric assumptions regarding normal distribution. Except for the mindfulness module, all modules saw pre to post programme psychometric results in the desired direction, evidencing skills acquisition. Coping in crisis and managing feelings modules outcomes neared statistical significance, with the module of people skills demonstrating statistical significance (p < 0.05).\u0000\u0000\u0000Originality/value\u0000Upon examination of the results, it appears as though the second edition pilot programme, displayed initially promising results. The clinical and statistical aspects of the programme are explored, in the hope that clinicians may consider the programme’s application and utility within various clinical contexts, in addition to gaining insight into the process of programme development and refinement.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45162821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glasgow anxiety scale for people with an intellectual disability (GAS-ID): validation for Spanish population","authors":"Mercedes H. Nuñez-Polo, M. Alonso-Rodríguez, A. Dolado, J. Ayuso-Mateos, A. Martorell","doi":"10.1108/AMHID-10-2020-0022","DOIUrl":"https://doi.org/10.1108/AMHID-10-2020-0022","url":null,"abstract":"\u0000Purpose\u0000Anxiety disorder is a common mental health problem in people with intellectual disabilities. Although this affects their quality of life, in Spain, there are no validated tools to evaluate the symptomatology of anxiety in people with intellectual disabilities. The aim of this study is to validate the Glasgow Anxiety Scale for people with an intellectual disability (GAS-ID) in the Spanish population.\u0000\u0000\u0000Design/methodology/approach\u0000The Spanish version of the GAS-ID was produced by back translation and was administered to 120 adults with intellectual disabilities. The psychometric analyses included internal consistency using the Cronbach’s alpha coefficient, inter-rater and test-retest reliability were determined using intra class correlation and Pearson correlation coefficients and, finally, factor analysis with Varimax rotation to confirm the construct validity of the questionnaire.\u0000\u0000\u0000Findings\u0000Cronbach’s alpha was 0.86 for the overall questionnaire. The intraclass correlation coefficient showed a good level of agreement in both test-retest (0.90) and inter-rater (0.91) analysis and the Pearson correlation showed a good significance in all dimensions and in the total scale. Varimax rotation factor analysis revealed four well-defined factors.\u0000\u0000\u0000Originality/value\u0000The GAS-ID is a feasible and reliable instrument for assessing anxiety symptoms in adults with mild and moderate intellectual disabilities, offering better diagnoses and therefore a more accurate treatment for the Spanish population with intellectual disabilities.\u0000","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46226869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring how to deliver videoconference-mediated psychological therapy to adults with an intellectual disability during the coronavirus pandemic","authors":"G. Rawlings, C. Gaskell, K. Rolling, N. Beail","doi":"10.1108/AMHID-06-2020-0014","DOIUrl":"https://doi.org/10.1108/AMHID-06-2020-0014","url":null,"abstract":"Purpose: The novel coronavirus and associated restrictions have resulted in mental health services across the UK having to adapt how they deliver psychological assessments and interventions The purpose of this paper is to explore the accessibility and prospective acceptability of providing telephone and videoconference-mediated psychological interventions in individuals with intellectual disabilities Design/methodology/approach: As part of a service evaluation, a mixed-methods questionnaire was developed and completed by clients who had been referred for psychological therapy at an adult intellectual disabilities’ community health service in the north of England All clients were assessed using the Red/Amber/Green (RAG) system by a consultant clinical psychologist for risk and potential suitability for indirect service delivery given their ability and needs Findings: Overall, 22 clients were invited to take part, of which, only seven (32%) were accepting of telephone or videoconference-mediated psychological therapy Most of the clients were unable to engage in video-conference therapy and therefore, only suitable for phone therapy This paper presents the remaining findings and discusses the clinical implications and unique considerations for intellectual disability services drawing on the existing literature Originality/value: This is the first paper that the authors are aware of, examining videoconference-mediated psychological therapy in this population It is hoped the data will be used to help inform practice or policy when using such therapeutic approaches in adults with an intellectual disability © 2021, Emerald Publishing Limited","PeriodicalId":44693,"journal":{"name":"Advances in Mental Health and Intellectual Disabilities","volume":"15 1","pages":"20-32"},"PeriodicalIF":1.1,"publicationDate":"2021-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44024981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}