scholarly journals The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities

2017 ◽  
Vol 31 (1) ◽  
pp. 76-86 ◽  
Author(s):  
Hayley Marwood ◽  
Deborah Chinn ◽  
Kenneth Gannon ◽  
Katrina Scior
Keyword(s):  
Intellectual Disabilities ◽  
Cognitive Behavioural Therapy ◽  
High Intensity ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
People With Intellectual Disabilities

scholarly journals Assessment of Anger-Related Cognitions of People with Intellectual Disabilities

2016 ◽  
Vol 44 (5) ◽  
pp. 580-600 ◽  
Author(s):  
Charlotte Richardson ◽  
Stewart Killeen ◽  
Andrew Jahoda ◽  
Rose Christopher ◽  
John Rose ◽  
...  
Keyword(s):  
University Students ◽  
Intellectual Disabilities ◽  
Behavioural Therapy ◽  
Verbal Responses ◽  
Cognitive Components ◽  
Cognitive Behavioural ◽  
Content Analyses ◽  
People With Intellectual Disabilities ◽  
Test Retest Reliability ◽  
Cognitive Dimensions

Background: Interventions for anger represent the largest body of research on the adaptation of cognitive behavioural therapy (CBT) for people with intellectual disabilities. The extent to which the effectiveness of these interventions reflects the behavioural or cognitive components of CBT is uncertain. This arises in part because there are few measures of anger-related cognitions. Method: The Profile of Anger-related Cognitions (PAC) is built around interpersonal scenarios that the participant identifies as personally anger-provoking, and was designed as an extension of the Profile of Anger Coping Skills (PACS). A conversational presentational style is used to approach ratings of anger experienced in those situations and of four relevant cognitive dimensions: attribution of hostile intent, unfairness, victimhood, and helplessness. The PAC, and other measures, including the PACS, was administered to (i) people with ID identified as having problems with anger control (n = 12) and (ii) university students (n = 23); its psychometric properties were investigated and content analyses were conducted of participants’ verbal responses. In a third study, clinicians (n = 6) were surveyed for their impression of using the PAC in the assessment of clients referred for help with anger problems. Results: The PAC had good consistency and test-retest reliability, and the total score on the four cognitive dimensions correlated significantly with anger ratings but not with impersonal measures of anger disposition. The predominant cognitions reported were perceptions of unfairness and helplessness. People with ID and university students were in most respects very similar in both the psychometric analyses and the content analyses of their verbal responses. The PAC had high acceptability both to people with ID and to clinicians. Conclusions: The PAC may be a useful instrument for both clinical and research purposes. Personal relevance and the conversational mode of administration are particular strengths.

Transition to cognitive behavioural therapy from different core professional backgrounds: three grounded theory studies

2020 ◽  
Vol 13 ◽  
Author(s):  
Matthew D. Wilcockson
Keyword(s):  
Grounded Theory ◽  
Clinical Practice ◽  
Coping Strategies ◽  
Cognitive Behavioural Therapy ◽  
High Intensity ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Mandatory Requirement ◽  
The Impact

Abstract Aim: Transition between roles is widely recognised to be a complex process that involves training, socialisation into the new culture, exiting a previous role culture, and dealing with the transition process itself, and dealing with loss of identity and initial incompetence in the new role. Moving from core profession to high intensity (CBT) therapist is an example of such a role transition. As a result, complete transition is not guaranteed, which may affect completeness of learning, and how CBT is practiced post qualification. It is recognised in a number of studies that professional cultures are present in professions such as nursing and counselling, and these professions may have different filters for viewing CBT, and different training needs. Method: A grounded theory analysis (Glaserian) of each of three core professions’ (mental health nurses, counsellors, and an unprofessionalised group) reflective reports (7 per profession) was undertaken, incorporating information from their learning journals throughout the year independently of each other. The reflective reports incorporate reflections on the process of transition and learning, and is a mandatory requirement of the course. Through an inductive process described in the article, a theory of transition was developed for each group. Results: Three different theories of transition are presented. Nurses absorbed knowledge but resisted practice changes, especially being clinically observed. Practice changes occurred through behavioural consequences and cognitive dissonance and reflection is structured and compartmentalised generally. The conflict between counselling and CBT is felt more deeply emotionally but resolved through experiencing ‘self as client’ for most counselling participants. Practice conflicts are mostly resolved with this group, but some ideological ones are not. The KSA group have a relatively smooth transition unaffected by previous experiences. Inability to use previous coping strategies for dealing with distress is influential, inducing crises for the nursing and counselling groups. Implications: Learning is delayed by trying to avoid clinical practice, and excessive identification only with the aspects of CBT that fit with existing identity and practice with nursing and counselling groups. Adaptations to training may be beneficial to enforce observation of practice at an earlier stage to drive change. The nursing role does appear to undermine learning. Reflection does eventually drive the learning process as noted in other studies, but this does not occur spontaneously with nurses or counsellors. Identification with the new role appears influential in a relatively complete change, which is consistent with theory. Recommendations to adopt CBT coping strategies early in the training are made, as is a session of individual support to address profession-based conflicts. Potential implications for the evidence base are noted. Transitional models provide a framework for educators and students. Key learning aims (1) To appreciate the importance of successful role transitions and their effect on future practice. (2) To become familiar with the key issues in transitioning between different core professions and an IAPT high-intensity role. (3) To critically reflect on personal experience in transitioning to cognitive behavioural therapy, and the impact it has had on clinical practice.

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