Reviewing and developing on interventions for managing behavioural and mental health difficulties for people with intellectual disabilities.

Abstract

It has been reported that people that have a diagnosis of an Intellectual Disability (ID) are more likely to experience anxiety and/or depression at some point throughout their lives; with 10–15% of the population anticipated to present with challenging behaviours. National Institute for Health and Care Excellence recommends practitioners to implement a Cognitive Behavioural (CBT) approach when managing symptoms of anxiety and depression, whilst also considering restrictive practices and physical interventions as a ‘last resort’ in manage challenging behaviours. Data reporting the management of challenging behaviours is typically reliant on in-patient data. However, more and more people with ID continue to live and access health and social care within community-based services. Moreover, data regarding referrals to Improving Access to Psychological Therapies (IAPT) where CBT is easily accessible, only 1.37% of the total number of referrals comprised of individuals with ID. Chapter 1 is a systematic review that explore the experiences of staff members, family members and service-users regarding the use of physical interventions in community-based services supporting adults with ID. Six papers were identified and included in an inductive-thematic synthesis. Five key themes were identified, with six sub-themes. Key themes include: staff professional values; negative impact of physical interventions and restrictive practices; service culture; the best interest of staff members, service users, and family members; and the potential of gaining something positive form the implementation of restrictive practices. Chapter 2 is a novel empirical investigation exploring clinicians’ experiences of CBT for people with ID within clinical practice. 15 Clinical Psychologists took part in a semi-structured interview in which four key themes within practitioners’ experiences was identified: challenges of working cognitively, making concepts more concrete, practitioners training and preferences, and the challenges and benefits of involving significant others within therapy. Both chapters of this transcript add to the literature by providing insight into lived experiences of the practices applied to managing behavioural and mental health difficulties that people with ID experience.

Keywords: Intellectual Disabilities; Cognitive Behavioural Therapy; Restraint; Restrictive Practice

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Identifiers

ORCID for Nicky Evans: orcid.org/0009-0006-0535-6411

ORCID for Katy Sivyer: orcid.org/0000-0003-4349-0102

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