Evaluating the effects of multisystemic therapy for adolescents with intellectual disabilities and antisocial or delinquent behaviour and their parents

Trauma-informed counseling for individuals who have an intellectual developmental disorder: Considerations for mental health counselors

Individuals with an intellectual developmental disorder are four times more likely to have a co-occurring mental health diagnosis, as compared to the general population, and 60%-80% of individuals with IDDs have experienced at least one form of abuse. However, counselors receive little training to adequately help this population. In this article, counseling considerations related to individuals who have intellectual development disorder are discussed, with a particular focus on the presence of trauma in this population. Trauma-focused treatment, potential mental health issues, counseling considerations, general issues related to counseling this population, and common associated mental health experiences among this population are addressed. Specific evidence-based counseling approaches, modifications to counseling, and best practices that can be helpful when counseling this population are presented. Due to the unique challenges that individuals with IDDs face, it is essential that counselors address the counseling and mental health needs of this population.

Family-systems interventions for families of people with an intellectual disability or who are autistic: a systematic review

BACKGROUND

Family-systems interventions have been proposed as one way of supporting families of people with an intellectual disability (ID) or who are autistic. This systematic review aimed to summarise what family-systems interventions have been studied with this population, what evidence there is for their effectiveness and families' experiences of the interventions.

METHODS

The review was preregistered on PROSPERO (CRD42022297516). We searched five electronic databases, identified 6908 records and screened 72 full texts. Study quality was evaluated using the Mixed Methods Appraisal Tool, and a narrative synthesis was used.

RESULTS

We identified 13 eligible articles with 292 participating families. Most studies reported positive effects of the interventions on wellbeing and family relationships, and families reported positive experiences. However, research quality was poor and there are no any sufficiently powered randomised controlled trials demonstrating family-systems interventions' effectiveness for this population.

CONCLUSIONS

There is a need for higher-quality research to establish whether family-systems interventions are beneficial for families of people who have an ID or who are autistic.

"I think they do not know how to lie:" The perceptions of legal support staff about person with intellectual disabilities/autism in Turkish legal system

BACKGROUND

Increased social integration of individuals with intellectual disabilities or autism could may raise their likelihood of interacting with justice system and legal staff.

AIMS

The present article aimed to determine the perceptions of the legal support staff about the individuals with intellectual disabilities or autism.

MATERIALS AND METHODS

In the study, conducted with the phenomenological method, the views of 15 legal support staff were obtained. The study reported what participants perceived and examined whether participants had an accurate understanding of the experiences/support needs of people with intellectual disabilities/autism. The data were analysed with content analysis.

RESULTS

Three themes were determined: (1) Experience of interview with an individual with intellectual disabilities/autism, (2) attitudes of judges, lawyers and other staff, and (3) abuse/trauma.

DISCUSSION

Findings are consistent with literature. Individuals with intellectual disabilities/autism have problems in expressing themselves, also staff do not know them, do not know their features. Studies show that staff often do not know what to do in these interviews.

CONCLUSION

Based on the participant perspectives, it was determined that individuals with intellectual disabilities/autism experienced self-expression problems, interviewees did not understand children/individuals with intellectual disabilities or autism and could exhibit negative attitudes, the children could be abused and traumatised during judicial processes, they were more prone to abuse when compared to their peers, they could be involved in certain events more frequently and could be pushed to crime.

Dutch forensic patients with and without intellectual disabilities: A comparison of demographic, offence, and diagnostic characteristics

BACKGROUND

Patients with an intellectual disability (ID) and offending histories constitute a challenging clinical group. The present study examined commonalities and differences in demographic, diagnostic and offence characteristics in patients with and without intellectual disabilities who were either convicted for violent or sexual offences and who resided in mandated care in the Netherlands.

METHOD

We compared 165 offenders with an ID to 249 offenders without an ID. We compared both groups by type of offence (i.e., sexual versus violent offence) using Mann-Whitney U-test or independent samples t-tests for continuous variables and Chi-square tests for categorical variables.

RESULTS

In general, forensic patients with an ID were younger at admission (U=357, z = -12.668, p < .001), had more prior convictions for violent offences (χ²(1)= 6.175, p = .013) and more prevalent diagnoses of substance abuse disorders (χ²(1)= 9.266, p = .002) than those without an ID. Similar results were found for patients with IDs with sexual offence histories.

CONCLUSION

A clear understanding of distinct characteristics of forensic patients with intellectual disabilities is crucial in understanding (sexual) violent behavior in this population as it mayassistclinicians in prioritizing interventionstrategies.

Relationship Aspects of Mothers and Their Adolescents with Intellectual Disability as Expressed through the Joint Painting Procedure

The quality of the interaction between mothers and their children with an Intellectual Disability (ID) plays a crucial role in their development and in particular during adolescence. This qualitative study was designed to provide a better understanding of aspects of the relationships between mothers and their adolescents with ID through an art-based tool, the Joint Painting Procedure. The qualitative analysis of six dyads of mothers and adolescents with severe, moderate and mild ID was based on the principles of narrative and phenomenological inquiry. The findings yielded three key themes that emerged from the relational dynamics during the JPP: (1) from dependency to autonomy, (2) the joint painting as a way to foster verbal communication, and (3) playfulness and enjoyment. The JPP appeared to serve as a meaningful art-based assessment of the implicit and explicit aspects of the relationships which evolved during the interaction. The findings underscore the potential of the JPP as a non-verbal, art-based tool that allows researchers and clinicians to learn more about the dynamics of relationships between mothers and their adolescents with ID. It also enables a context where the expression of relational issues can be communicated and even transformed.

Feasibility and potential effectiveness of an intensive trauma-focused treatment programme for families with PTSD and mild intellectual disability

BACKGROUND

Persons with mild intellectual disabilities or borderline intellectual functioning (MID-BIF; IQ 50-85) have a higher risk of being exposed to traumatic events and developing posttraumatic stress disorder (PTSD). EMDR therapy has shown to be applicable, safe and potentially effective for the treatment of PTSD in individuals with MID-BIF. However, in traumatized multi-problem families with MID-BIF and (impending) out of home placement of children, standard PTSD treatment in an outpatient setting may not be appropriate.

OBJECTIVE

To evaluate the feasibility and potential effectiveness of KINGS-ID, a six-week clinical trauma-focused treatment programme consisting of intensive EMDR therapy with parents and children, and parental skills training followed by two weeks of parent support at home.

METHOD

Six families (nine parents of whom six had MID-BIF) and 10 children (all having MID-BIF) participated in the KINGS-ID programme. Seven parents and seven children had PTSD. Data were collected within a single case study design. For each family member data were collected during baseline (three measurements), treatment (seven weekly measurements), posttreatment (three measurements) and at follow-up (three measurements).

RESULTS

None of the family members dropped out. Within the first two treatment weeks all but one child and one parent no longer met PTSD symptom criteria. In both children and parents, trauma-related symptoms and daily life impairment significantly decreased following treatment and in parents a significant decrease in symptoms of general psychopathology and parental stress was found. Results were maintained at six-month follow-up.

CONCLUSIONS

The findings of the current study are promising given that the treatment programme seems to offer new perspectives for traumatized multi-problem families with MID-BIF.

Brief report: Follow-up outcomes of multisystemic therapy for adolescents with an intellectual disability and the relation with parental intellectual disability

Research on follow‐up outcomes of systemic interventions for family members with an intellectual disability is scarce. In this study, short‐term and long‐term follow‐up outcomes of multisystemic therapy for adolescents with antisocial or delinquent behaviour and an intellectual disability (MST‐ID) are reported. In addition, the role of parental intellectual disability was examined.

Outcomes of 55 families who had received MST‐ID were assessed at the end of treatment and at 6‐month, 12‐month and 18‐month follow‐up. Parental intellectual disability was used as a predictor of treatment outcomes. Missing data were handled using multiple imputation.

Rule‐breaking behaviour of adolescents declined during treatment and stabilized until 18 months post‐treatment. The presence or absence of parental intellectual disability did not predict treatment outcomes.

This study was the first to report long‐term outcomes of MST‐ID. The intervention achieved similar results in families with and without parents with an intellectual disability.

Evaluating the effects of multisystemic therapy for adolescents with intellectual disabilities and antisocial or delinquent behaviour and their parents

BACKGROUND

An adaptation of multisystemic therapy (MST) was piloted to find out whether it would yield better outcomes than standard MST in families where the adolescent not only shows antisocial or delinquent behaviour, but also has an intellectual disability.

METHOD

To establish the comparative effectiveness of MST-ID (n = 55) versus standard MST (n = 73), treatment outcomes were compared at the end of treatment and at 6-month follow-up. Pre-treatment differences were controlled for using the propensity score method.

RESULTS

Multisystemic therapy-ID resulted in reduced police contact and reduced rule breaking behaviour that lasted up to 6 months post-treatment. Compared to standard MST, MST-ID more frequently resulted in improvements in parenting skills, family relations, social support, involvement with pro-social peers and sustained positive behavioural changes. At follow-up, more adolescents who had received MST-ID were still living at home.

CONCLUSIONS

These results support further development of and research into the MST-ID adaptation.