Reductions in aggression and violence following cognitive behavioural anger treatment for detained patients with intellectual disabilities

Cognitive behavioural anger treatment for adults with intellectual disabilities: effects of therapist experience on outcome

BACKGROUND

Anger has been shown to be associated with aggression and violence in adults with intellectual disabilities in both community and secure settings. Emerging evidence has indicated that cognitive behavioural anger treatment can be effective in reducing assessed levels of anger and violent behaviour in these patient populations. However, it has been suggested that the effectiveness of these types of interventions is influenced by the experience and training of the therapists.

METHOD

In this service evaluation study, the pre- and post-treatment and 12-month follow-up assessment scores of 88 detained in-patient adults with intellectual disabilities and forensic histories who received cognitive behavioural anger treatment were examined in order to investigate whether participants' responsiveness to treatment was associated with treatment being delivered by qualified versus unqualified therapists.

RESULTS

Overall significant reductions in self-reported measures of anger disposition and anger reactivity were found with no significant time × therapist experience interaction effects. However, the patients treated by qualified therapists improved significantly on measures of anger control compared with those allocated to unqualified therapists.

CONCLUSIONS

Male and female detained patients with intellectual disabilities and forensic histories can benefit from an individual cognitive behavioural anger treatment intervention delivered by qualified and unqualified therapists, but therapist experience may be important in supporting patients to develop more complex anger control coping skills.

The effect of acceptance and commitment therapy orientated anger management training on anger ruminations and impulsivity levels in forensic psychiatric patients: A randomized controlled trial

PURPOSE

This study aimed at determining the effect of acceptance and commitment therapy (ACT) orientated anger management training on levels of anger rumination and impulsivity in people receiving forensic mental healthcare.

DESIGN AND METHODS

This was a randomized controlled study. The research data were collected between July 2018 and February 2019. The personal information form, Anger Rumination Scale, and Barratt Impulsiveness Scale were used for data collection.

FINDINGS

Total scores on the Barratt Impulsiveness and Anger Rumination Scales were significantly lower in the experimental group than in the control group (p < 0.001).

PRACTICE IMPLICATIONS

This study adds to existing evidence on the provision of anger management training, offering an evidence-based solution along with necessary knowledge and skills for use by forensic psychiatric nurses.

A review of the frequency and nature of adaptations to cognitive behavioural therapy for adults with Intellectual Disabilities

BACKGROUND

There is increasing evidence that cognitive behavioural therapy (CBT) can be effective for people with intellectual disabilities. The aim of this review was to report the nature and frequency of adaptations reported in studies of CBT for people with intellectual disabilities.

METHOD

This review updated and extended a previous review by (Whitehouse et al. 2006, J Appl Res Intellect Disabil, 19, 55), which used a framework of adaptations developed by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Adaptations included simplification, language, activities, developmental level, use of directive style, flexible methods, involve caregivers, transference/countertransference and disability/rehabilitation approaches. A search identified peer-reviewed papers that reported individual CBT informed psychological interventions for people with an Intellectual Disability.

RESULTS

The search identified 23 studies which met the inclusion criteria for review. Studies reported the majority of the categories of adaptation described by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365).

CONCLUSIONS

The results suggest that the framework of adaptations needs further development to increase sensitivity in identifying and categorizing adaptations of CBT. Increased, systematic reporting of adaptations to studies of CBT with people with intellectual disabilities is recommended.

Disconnected lives: Women with intellectual disabilities in conflict with the law

BACKGROUND

Women with intellectual/developmental disabilities in conflict with the law experience childhood trauma, substance abuse and intimate partner violence but continue to have difficulty accessing appropriate therapeutic services, both within correctional settings and upon discharge. The aim of this study is to explore women's service needs and to critically assess whether the available services are meeting their identified needs.

METHOD

Semi-structured interviews were conducted with 16 women with intellectual/developmental disabilities who were in the Special Needs Unit of a women's correctional centre from December 2014 to March 2015.

RESULTS

Women with intellectual/developmental disabilities struggle to manage the impact of intergenerational trauma, exacerbated by issues of substance abuse and addiction, poor coping skills and minimal education, all of which impact their sense of well-being.

CONCLUSIONS

This study highlights the need for increasing trauma treatment for women with intellectual/developmental disabilities, and emphasizes the need for accessible intervention to facilitate coping, trauma processing and community integration.