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Accessible Summary: People with intellectual disabilities who have limited, or no verbal communication can be involved in research.Ethnographic observations and interview techniques can work together with photovoice.More research needs to be completed directly involving people with intellectual disabilities. Background: Inclusive research requires adapting methodologies to meet the needs of people with all degrees of intellectual disabilities. However, it must also balance this with the requirements of academic research. Building from previous research a study was completed to illustrate how photovoice could not only be adapted to meet the needs of people with intellectual disabilities who have limited or no verbal communication but to also explore how they express their identity. Methods: A qualitative multiple case study method was used to explore identity expression amongst three participants with intellectual disabilities and limited or no verbal communication. The methodology integrated ethnographic observations, photovoice and interview techniques. Findings: Integrating the ethnographic observations, photovoice and interview techniques offered families and carers the opportunity to become curious about participants' identities, and this methodology was considered valuable in getting to know more about the person. Conclusions: It is hoped that through conducting research that directly involves people with intellectual disabilities, more creative and inclusive methods can be explored, verified and applied across various research contexts. [ABSTRACT FROM AUTHOR]

Background. People with intellectual disabilities (ID) experience similar or even higher rates of mental health problems than the general population and there is a need to develop appropriate treatments. Cognitive behaviour therapy (CBT) is effective for a wide range of disorders in the general population. However, there is some evidence that people with ID may lack the cognitive skills needed to take part in CBT. Aims. To test if people with ID can learn skills required for CBT, specifically the ability to distinguish between thoughts, feelings, and behaviours and to link thoughts and feelings (cognitive mediation). Method. A randomized independent groups design was used to examine the effect of training in CBT on two tasks measuring CBT skills. Thirty-four adults with ID were randomly allocated to the experimental condition (N = 18) or to the control condition (N = 16). CBT skills were assessed blind at baseline and after the intervention. Results. The training led to significant improvements in participants' ability to link thoughts and feelings, and this skill was generalized to new material. There was no effect of training on participants' ability to distinguish amongst thoughts, feelings, and behaviours. People with ID can, therefore, learn some skills required for CBT. This implies that preparatory training for CBT might be useful for people with ID. The results might be applicable to other groups who find aspects of CBT difficult. [ABSTRACT FROM AUTHOR]

While sexual and other forms of abuse constitute significant problems with people with intellectual disability (ID), there is limited evidence to guide psychologists working with this population. The research involved a qualitative, interview‐based study of six clinical psychologists' views on supporting people with ID who experienced abuse. Four topics relating to service provision were explored using thematic analysis (Braun & Clark, 2006). Five overarching themes were identified. These were (1) therapeutic adaptations and creativity, (2) invalidation and exclusion, (3) too many "catch all" approaches, (4) absence of supports, and (5) mixed attitudes in approaching abuse. In the absence of a sufficient evidence base, there is great variance in therapeutic supports offered to individuals with an abuse history. A number of issues, such as the importance of supervision, the potential for acquiescence, and the need for greater definition of the role of psychologists and staff are discussed. [ABSTRACT FROM AUTHOR]

Accessible summary: Two young men who have learning disabilities became mentally ill. They said that they had been hurt by their carers. They said that the carers hit them and made them have sex with them.They had post‐traumatic stress disorder, which made them scream, cry, hurt themselves and have frightening nightmares.They were helped by a Mental Health of Learning Disabilities Team. They talked to a psychologist which helped them to understand what happened to them.Talking to the psychologist helped them to get better. They could do the things that they enjoyed again. The therapy took 2 years.This paper writes about new and better ways to help people who have learning disabilities recover when someone has hurt them or frightened them. Background: This is the second of two papers describing a case study of two young men with complex learning disabilities. They presented with severe trauma‐related mental distress following alleged sexual, emotional and physical abuse. This paper concerns the psychological intervention and support provided for them and their families over a period of 2 years. There is a lack of research, guidance and evaluated therapeutic models for the assessment and treatment of people with complex learning and communication needs following abuse. Methods: In this case, therapeutic interventions were modified from systemic and narrative therapies and interpersonal psychotherapy. Creative techniques included acting, drawing and walks to develop a therapeutic relationship, to experience affect in a contained and safe way and to support the development of coherent narratives. Results: Recovery moved through stages of remembering and recounting, understanding and assimilating and improved mental well‐being and coping strategies. Conclusions: Modified models of therapy proved effective and further research recommended. The personal strengths and family support of the men were critical in progressing recovery. [ABSTRACT FROM AUTHOR]

Accessible summary: Cognitive Behavioural Therapy (CBT) can help individuals with learning disabilities and anxiety.A group was run to help people to manage their anxiety and to feel better.At the end participants and their supporters fed back their experiences of the group and filled in questionnaires to measure their anxiety and psychological distress.The group seems to reduce people's anxiety.This report adds to a growing body of existing literature demonstrating some benefits of CBT for people with learning disabilities and anxiety. Background: Existing studies show mixed results of the effectiveness of CBT for people with learning disabilities and anxiety. Method: A CBT group was run for people with learning disabilities and anxiety, who attended with a supporter. Qualitative interviews were conducted post‐group and analysed using thematic analysis. Standardised questionnaires measuring anxiety, psychological distress and overall functioning were administered at pre‐ and post‐group, and at follow‐up. Results: Participants' anxiety decreased overall post‐group, which remained largely at follow‐up. The group and the supporters' involvement was helpful. Both supporters and participants recalled coping strategies that were presented in the group. Three out of four participants found attending a group challenging initially. The supporters seem to have specific expectations about the impact of the group. Conclusions: The results of the study are consistent with the existing, growing body of evidence which supports the use of CBT for people with learning disabilities and anxiety. [ABSTRACT FROM AUTHOR]

Accessible Summary: Two young men who have learning disabilities were students at a college. While they were there, they were sexually abused by people who were meant to care for them.When they tried to tell people, some people would not listen. Some people listened but could not understand them.They became mentally ill because of the abuse. Then, some people started to listen and help them tell their stories. Then, the police and the courts said that the two young men could not give evidence in court because of their learning disabilities.This paper matters because it writes about ways to protect people with learning disabilities from people who abuse them. We need to try and help people who have been abused to tell their stories. We need to make sure those stories are listened to. Two young men disclosed emotional, sexual and physical abuse while attending college and living with Shared Lives carers in the UK. This paper provides a narrative account of the period when the two men were exposed to the abuse, the disclosures, the investigation and the legal and safeguarding investigation outcomes. A second paper describes the therapeutic response and outcomes for the men. A review of the literature on abuse and learning disabilities highlights the difficulties in conducting research in this area. Authors find significant barriers exist to disclosing abuse and to being believed. Prosecutions are rare despite evidence that abuse may be widespread towards people with learning disabilities. This paper considers the narrative experience of the two young men, the barriers they faced to being heard and believed and how their personal accounts were discounted and eventually lost to the investigation. Lessons for practice are considered for learning disability mental health and social care professionals, education, police and legal services. Further research suggestions are made. [ABSTRACT FROM AUTHOR]

Background: This study investigated the use of a Compassion‐Focused Therapy (CFT) group as a psychological intervention for a group of adults with an intellectual disability with a range of psychological issues. Method: Four clients attended the group, which was facilitated by three trainee Clinical Psychologists. The group consisted of 8 weekly sessions. Findings: Standardised outcome measures showed an increase in psychological well‐being and self‐compassion for all participants postintervention. Two participants showed an increase in psychological distress, while two participants reported decreases in this area. Scores on measures of self‐criticism fell for two participants, increased for one participant and showed no change for one participant. Qualitative interviews were conducted with postgroup with all group members (clients and facilitators). Thematic analysis identified two superordinate themes relating to the accessibility of the group content, and interpersonal aspects of the group. Conclusion: The results suggest that clients enjoyed and benefitted from the group. Challenges, such as lack of carer involvement, were identified, and recommendations for future CFT groups are made. Accessible Summary: Some people who find it hard to be kind to themselves can be helped by a therapy called Compassion‐Focused Therapy (CFT). Some studies show that CFT might help people with an intellectual disability.We ran a group to see if CFT helped people with intellectual disabilities to feel better and think kinder thoughts about themselves.We asked people what they thought about the group. We asked them to fill in some questionnaires to see if they felt better.The group seemed to help people. People with intellectual disabilities and people running the group enjoyed going to it.CFT might be a useful treatment for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background The dearth of literature regarding how or when to intervene when an adult with intellectual disability is bereaved may impede clinical practice; this study therefore aimed to explore the current clinical psychology response, so as to enhance understanding of the role of the profession in supporting grief within this population. Method A collective case study design was used. Data for six persons with intellectual disability, including interviews with parentally bereaved persons and involved staff members, were integrated into individual case stories for cross-case synthesis. Results Data were analysed using thematic analysis. Five overarching themes illustrated that the clinical psychology role is broadly distributed and identified potentially complicating factors such as 'gatekeeping' and 'staff uncertainty.' Conclusions A model of bereavement supports reflecting that by Read ( Learning Disability Practice, 8, 2005, 31) is being approximated in clinical practice; further research is required to determine how best to implement this, and whether this meets the true needs of the population. [ABSTRACT FROM AUTHOR]

Accessible Summary People with learning disabilities talked about what it was like to move out of hospital. People talked about how important their relationships with other people were. People wanted to feel comfortable with new members of staff so that they felt safe and happy in their new home. People talked about how moving out of hospital changed how they thought about themselves. When they were in hospital, people sometimes thought that they were “bad.” But after they moved, some people started to think that they were a different person. It is important for everyone to think about how they talk to people when they are in hospital, and when they have moved out. People can do really well living in their own home, rather than in hospital. Abstract: Background: People with learning disabilities are moving out of hospitals as part of the Transforming Care programme, although thus far their views on how they have experienced this have not been researched. Materials and Methods: A qualitative design was used to explore how people with learning disabilities experienced moving as part of Transforming Care. Eleven people took part in semi‐structured interviews; they were supported by Key Support People (n = 9) who knew them well. A social constructionist Grounded Theory approach was used in analysis. Results and Discussion: People reported that their relationships with other people, including friends, family and staff, played a significant role in how they experienced the move. Moving was also an opportunity for people to shift their ideas about who they were as a person and opened up a wider array of stories about their identity. Conclusions: A number of recommendations are discussed, relevant for staff working in this field to support positive transitions out of hospital. [ABSTRACT FROM AUTHOR]

Accessible summary The Five Ways to Well-being is a document produced by the government which gives advice about things people can do to improve how they feel. These five things are being with people, being active, noticing things around you, to keep learning and giving to others., We taught a group of adults with learning disabilities how to do these five things. We had ten sessions which lasted 2 h each., We did not find that people felt better after the ten sessions, but we did find that they noticed more things around them which may help improve their well-being. People found the group useful., Abstract Background: The 'Five Ways to Well-being' document presents five ways in which people in the general population may be able to improve their well-being. This study evaluates the use of a 'Five Ways to Well-being' group in a population of people with learning disabilities. Materials and Methods: Twelve participants who attend a day support service engaged in a ten-week group programme based on the Five Ways to Well-being. Scores on the Rosenberg Self-Esteem Scale and Short Warwick-Edinburgh Mental Well-being Scale provided a baseline, and scores at the first, middle and final session were entered into repeated measures analysis of variance or nonparametric equivalents. Results: Scores suggest there was no difference between baseline and final session on either of these scales ( P > 0.05). There was a significant difference between baseline and final session on a clinician-devised measure of well-being of the aims of the group (F(2,18) = 3.6, P = 0.049), and this effect is likely to be carried by an increase in the group's use of mindfulness skills. Qualitative feedback suggests that the group was useful and prompted changes in participants' well-being. Conclusions: Participants found the group useful, and scores suggest an increase in mindfulness practice, but there is no evidence that running a Five Ways to Well-being group with people with learning disabilities will improve their well-being. However, this was not a clinical group of people with mental health concerns, and conclusions cannot be made about the usefulness of the model in this population. [ABSTRACT FROM AUTHOR]

Accessible Summary: The authors aimed to find out whether staff found team formulation helpful and whether staff felt it changed their work with service users.Twenty‐eight staff members working on the assessment and treatment unit were asked to complete a questionnaire about team formulation.Most staff found formulation meetings to be helpful (80%) and felt that formulation meetings improved how they work with service users (86%).These findings suggest team formulation may improve staff approach and the care and support service users receive in hospital. Background: Research suggests that the use of team formulation within mental health services may improve staff understanding of service users' difficulties and increase team empathy and reflection. The aim of this evaluation was to investigate staff perceptions of team formulation within an assessment and treatment unit for individuals with learning disabilities. Specifically, the authors aimed to investigate whether staff found team formulation helpful and whether staff felt it impacted their work with service users. Materials and Methods: A survey was completed using a cross‐sectional questionnaire design. Twenty‐eight staff members working on the assessment and treatment unit were asked to complete an anonymous questionnaire about team formulation meetings. Results: The response rate was 54%. The majority of staff agreed that they found formulation meetings to be helpful (80%) and that formulation meetings positively impacted how they work with service users (86%). The most common theme arising from staff responses concerning the most helpful aspects of formulation meetings was "gaining a greater understanding of service users." Conclusions: The findings from this evaluation show that the majority of respondents felt team formulation was helpful and had a positive impact on their work with service users. These findings support the use of team formulation within mental health and learning disabilities services. Future research could investigate the impact of team formulation on service user well‐being and outcomes. [ABSTRACT FROM AUTHOR]

A matched group (N=114) between high errors and no error conditions on the MFD was examined in a population of borderline and mild mental retardates. Matched variables were sex, Full Scale IQ, and age. The MFD, PIAT, and the WAIS-R were administered to all subjects. Results on achievement tests showed that the mild mental retardation subjects with high errors on the MFD had lower achievement scores on the PIAT compared to the non-error group. The non-error group performed at a higher level on the Picture Arrangement, Vocabulary, Math, and Reading Comprehension. Borderline retardation subjects showed no significant differences between error and non-error groups on the PIAT and WAIS-R. these conclusions indicate that the MFD is a more sensitive indicator of intelligence differences than of organicity differences. [ABSTRACT FROM AUTHOR]

The article presents a study which tested the role of a child modulator, an investigator, and coordinator of services for learning disabled children. Ninety regular thirds and fourth-grade children with average intelligence were selected from a population of 1,030 children on the basis of low scores on the Pupil Rating Scale sad at least one of four Metropolitan Achievement subtests and were assigned randomly to one of three groups. The results showed teacher ratings and achievement score changes for all groups with the modulation group superior only in teacher ratings of Personal-Social behavior.

Recent arguments against the use of intrusive behavioral interventions in the treatment of handicapped people are examined. The anti-aversive position was found to be based on assumptions about the negative impact of aversive procedures, and to consider only a small subset of the variables that should be taken into account when treatment decisions are made. A preliminary application of formal decision-analysis techniques that have been developed in response to other controversial technologies had at number of benefits including: (a) sharpening the distinction between scientific and social criteria; (b) sensitizing decision-makers and scientists to the range of costs, risks, and benefits associated with treatment decisions: and (c) identifying critical areas of research. Decision-analysis techniques were found to be helpful in directing scientists and policy-makers towards more informed decision-making. [ABSTRACT FROM AUTHOR]

This article presents information related to the experimental variation of the mode of reproduction of the Bender-Gestalt stimuli by mental retardates. A report by writers R.M. Allen and G.H. Frank has concluded that children of average and higher intelligence have improved in some aspects of reproducing the Bender Visual Motor Gestalt Test (2) model designs. Each S was administered the B-U test under two conditions: The usual method or the control condition and the modified or experimental method. In the latter condition, the S copied each model design separately on a field identical in size, shape and axial orientation to the stimulus field, viz., a 4 by 6-inch card.

Accessible summary Network Training is a way that helps people to understand behaviour like hurting people or breaking things, called 'challenging behaviour'., Network Training is where lots of people meet up to think about the person showing challenging behaviour., We did Network Training to help understand the behaviours of a boy who has a learning disability. His support workers, teachers and doctors came to think about what was making him show challenging behaviours., The people who came to the training thought that it was useful., Abstract Background: Network Training is an intervention that draws upon systemic ideas and behavioural principles to promote positive change in networks of support for people defined as having a learning disability. To date, there are no published case studies looking at the outcomes of Network Training. Materials and Methods: This study aimed to investigate the impact of Network Training on a network of support for a boy labelled as having learning disabilities and challenging behaviour, including sexually harmful behaviour. Participants in the Network training completed two questionnaires; one designed for this study and The Challenging Behaviours Attributions Scale at two baseline points and following the intervention. Results: Network Training led to positive changes in the confidence, understanding, strengths focus and joint working of the individual's network. There was no significant change in participants' CHABA scores. Conclusion: This case study provides preliminary evidence that Network Training may be of benefit to children labelled as having learning disabilities, and merits further investigation. [ABSTRACT FROM AUTHOR]

Accessible summary The tree of life group is based on ideas from narrative therapy., Narrative therapy is about using stories about ourselves to understand how we make sense of our lives., We ran a tree of life group for women with learning disabilities., In the group, people drew trees to show different things that were important in their lives., People liked hearing about each others' lives and hearing what other people liked about their trees., Abstract Background: This study describes how a specific narrative therapy approach called 'the tree of life' was adapted to run a group for women with learning disabilities. The group consisted of four participants and ran for five consecutive weeks. Materials and Methods: Participants each constructed a tree to represent their lives and presented their tree to the group who responded with positive feedback and affirming statements. This led to discussion about overcoming the storms of life and a celebration of the journey the group had been through together. Key Results: Although no change was found on quantitative measures of well-being and self-esteem, participants reported benefitting from the peer support and social connectedness that the group offered, particularly in relation to themes of loss and change in their lives. Conclusions: 'The tree of life' approach has potential value as an intervention for people with learning disabilities. The benefits and challenges of this approach within the context of working with people with learning disabilities are discussed. [ABSTRACT FROM AUTHOR]

With the deinstitutionalization movement in Canada, healthcare professionals are caring for a greater number of individuals with intellectual disability ( ID) in their practices, and inevitably require additional training to provide this care. Queen's University has responded to this need and developed an innovative educational course promoting interprofessional education ( IPE) and interprofessional practice ( IPC) as it relates to ID curriculum and healthcare provision. This study measured healthcare students' change in knowledge, skills, and attitudes toward individuals with ID and how it affected their readiness for interprofessional care. Subjects were graduate students from the fields of medicine, nursing, clinical psychology, occupational therapy, and physiotherapy. Course curriculum developed used a blended teaching approach with a combination of online learning, lectures, team-based problem solving, and client interviews. Evaluation was completed on 247 students, utilizing a pre-post course questionnaire addressing content areas of knowledge, skills, and attitude, and by analyzing individual professional differences. Significant differences were found, indicating improvements in student knowledge and skills for the majority of disciplines after course participation. A positive trend was found in outcome responses for student attitudinal change, ranging from neutral to positive attributions about individuals with ID. Authors note improvements in student learning and positive attitudinal change following an educational course concerning optimal healthcare and collaborative practice in ID. They propose that an interprofessional blended training curriculum for future healthcare professionals can foster best practice and quality service for this currently underserved population. [ABSTRACT FROM AUTHOR]

Background The current study investigated how ideas and models from the 'New Genetics' and associated fields of developmental neuroscience and behavioural phenotypes are perceived by clinical psychologists working with people with intellectual and developmental disabilities (IDD). As well as examining the take-up and influence of such ideas, it also examines barriers, both personal and institutional, to the widespread adoption of such concepts and research findings in services for people with IDD. Methods A Q-methodology study was undertaken with 31 qualified and 16 trainee clinical psychologists in the North West of England using a specifically developed 81-item Q set. Results Three factors were identified and labelled Integration of social and medical models, Social model of disability is more helpful and Genetic advances in conflict with recognising the value of people with IDD. Conclusion There was a lack of consensus in clinical psychologists working with people with IDD, with amount and type of professional experience affecting the factor loadings, which may need to be considered in developing clinical applications of genetic IDD research. [ABSTRACT FROM AUTHOR]

Accessible Summary Adults with learning disabilities sometimes find it hard to cope when someone they care about dies., This report talks about an 8-week group that was run to help four adults with learning disabilities cope with their bereavements., We asked group members to fill in questionnaires and talked to them about what they liked and did not like about the group., Everyone found it helpful to share their experiences and learn new ways of coping with their bereavements., Summary This study evaluates the usefulness of a bereavement group for four adults with learning disabilities. Drawing on the work of Boyden et al. (2009), the current authors planned and facilitated an 8-week group, held in the local community. Qualitative and quantitative feedback was collected from participants, which indicated that they valued the group as a safe and useful space to talk about their bereavements and to learn skills to manage difficult emotions. This study reports and reflects on the process of establishing the group, developing the session plans, delivering the intervention and collecting feedback. [ABSTRACT FROM AUTHOR]

Accessible Summary We held a group for people with Learning Disabilities who were overweight and unhappy about being so., The group ran for 9 weeks. It lasted 2 h and four adults came to the group., The group talked about how they felt about their bodies, why they ate and why it is sometimes hard to choose healthy food over unhealthy food. It helped people learn to accept their body size and shape., Summary The Clinical Psychology Service and the Dietetic and Nutrition Service for People with Learning Disabilities in Birmingham shared concerns about the effectiveness of services offered to service users who were overweight. In an effort to gain more understanding of the issues from a service user perspective and to ultimately provide more effective services, a body awareness group was established, structured according to the ' Health at Every Size' model. Four adults with learning disabilities attended a total of nine sessions held once a week for a period of 2 h. Topics were presented to the group in the form of group discussions or group activities, which included: personal and social attributions towards body shape and size; self-esteem; physical eating vs. emotional eating; relationship with food (e.g. understanding of choosing junk food over healthier options); negative messages people tell themselves about eating and factors that prevent people from engaging in a healthier lifestyle. This study aims to report the process of designing and facilitating the ' Body Awareness Group' and to critically review observations and findings in an effort to gain greater understanding of the role of food in this context. [ABSTRACT FROM AUTHOR]

Accessible Summary We want to know what people with learning disabilities think about working with clinical psychologists., We interviewed eight people with learning disabilities about their experience of seeing a clinical psychologist., We summarised all the information we got from the interviews to share it with other professionals and with service users., We used the information to make our psychology service more helpful for our service users., We want to include the views of people with learning disabilities in planning our psychology service., Summary Clinical psychologists are well placed to work with people with learning disabilities given the high prevalence of psychiatric disorders in this population and the specialist training undertaken by psychologists. The evidence for psychological interventions in learning disabilities is scarce compared to the evidence for mainstream psychological interventions. This is because of the methodological issues in conducting quantitative research. A way forward to add to the evidence is to use qualitative methods to investigate the views of people with learning disabilities. The aim of the present study was to explore the views of eight people with learning disabilities about their experiences of working with clinical psychologists. Thematic analysis revealed three themes from the narratives: the therapeutic relationship, change and the expectations/perceptions of participants about clinical psychologists. When developing the quality of clinical psychology services for people with learning disabilities, providers should consider the views of people with learning disabilities in accordance with government policy. Limitations of the study are highlighted and further research suggested. [ABSTRACT FROM AUTHOR]

This study examines whether alexithymia relates to specific interpersonal problems, based on data collected in a sample of mental health outpatients (N = 404) and a student sample (N = 157). Linear regression analysis, in which the effects of group, gender, and age were controlled, indicated that two interpersonal problems were significantly and reliably related to alexithymia: cold/distant and nonassertive social functioning. The theoretical relevance of the results for attachment and psychoanalytic theory is indicated, as well as implications of the findings for clinical practice. © 2006 Wiley Periodicals, Inc. J Clin Psychol 63: 109–117, 2007. [ABSTRACT FROM AUTHOR]

Vietnam Veterans with severe post-traumatic stress disorder often report the following combat experiences: a leader's betrayal of ‘what's right,’ lost responsiveness to claims outside a tiny circle of combat-proven comrades, grief and guilt for a dead special comrade, lust for revenge, renunciation of homecoming, feeling ‘already dead,’ going berserk, dishonoring the enemy, and atrocities. These elements are all in Homer's Iliad account of Achilles, allowing the reader to witness them as they happen, so to speak. Homer's view of healing and regained humanity is discussed in relation to the Iliad's final scene. The Iliad offers a cross-cultural look at men in battle, and raises questions about some assumptions in American military culture, particularly regarding grief and the need to degrade the enemy to make men fight. Betrayal of ‘what's right’ and the berserk state are suggested as key pathogens for PTSD in combat soldiers. [ABSTRACT FROM AUTHOR]

Vietnam combat veterans suffering from post-traumatic stress disorder (PTSD) who had requested treatment through a special VA-sponsored PTSD treatment program were evaluated using the Diagnostic Interview Schedule (DIS). Based on the DIS, 91.12% of the sample had a lifetime diagnosis of substance abuse or dependence and this was, by far, the most frequent co-diagnosis in the sample. The most common reason for patients not completing the treatment program was for use of illegal substances or alcohol while in the program, even though they were aware that to do so meant that they would be either discharged or transferred to another unit. The percentage of other co-diagnoses, and an estimate of currentness for all Axis I diagnoses were also presented on the sample of 102 patients. It was determined that for this population, the symptoms of substance abuse were chronic and were inextricably intertwined with PTSD symptoms and with the initial stressor (combat). Treatment process implications were discussed. [ABSTRACT FROM AUTHOR]

This study investigated the comparability between three ‘amazingly’ short forms of the WAIS-R (a dyad, trial, and tetrad) suggested by Kaufman, Ishikuma, and Kaufman-Packer (1991) and the complete battery among a sample of 114 educable mentally handicapped adolescents. Results indicate that the short forms are highly correlated with the complete battery Full Scale IQs, and all three short forms yielded scores, on average, within 2 points of the complete battery. Analyses at an individual level revealed that more than 90% of the sample fell within 3 SEM (9 points) of the FSIQ for all three short forms. Overall results are consistent with previous studies and support the use of these ‘amazingly’ short forms. [ABSTRACT FROM AUTHOR]

Self-injurious movements, common in persons diagnosed with Tourette syndrome, or mental retardation, are typically difficult to eliminate. The author considers the possibility that certain self-injurious movements are involuntary phenomena. An anatomical analysis of high-frequency movements in a patient with severe head slapping is presented by tracing the muscles and nerves involved. The median nerve innervates muscles that bring the hand/arm to the head and also muscles that control this patient's other frequent movements, viz., pill-rolling, thumb-gouging, wrist-flapping, and pinching the neck or cheek. Other patients underwent similar investigation: one who headbangs, one who hits out repetitively, and one with non-injurious stereotypic movements. An anatomical explanation suggests that certain self-injurious, aggressive, and stereotypic movements are involuntary muscle contractions that reflect abnormal innervation along specific nerves. [ABSTRACT FROM AUTHOR]

A quantitative single case study is presented to illustrate how an early intervention program treated a depressed mother with mental retardation and her infant son. Drawing upon an ecological model of development, the case study utilized a multimethod, longitudinal approach to assess the infant's developmental competence and attachment status, the mother's history and current emotional and intellectual functioning, mother-infant social transactions, and components of the family's social ecology. Measures were administered during a baseline period, systematically repeated throughout the l-year period of intervention, and repeated at the conclusion of treatment. The treatment consisted of individual therapy sessions for the mother. The infant was present in these sessions in order to make the interaction problems immediately salient and therefore more easily explored in the therapeutic relationships. The findings indicated increased maternal and infant competence and more adaptive patterns of mother-infant social transaction. Therapeutic issues in providing preventive intervention to this high-risk population of mothers and infants are discussed. [ABSTRACT FROM AUTHOR]

The article presents information about the recent advances made in screening the emotionally maladjusted people. Psychologists had not been unaware of the problem and early in the war (April 25, 1917). R.S. Woodworth had been appointed by the American Psychological Association as chairman of a committee on Emotional Fitness for Warfare. In the postwar period the untried method was used widely in schools and industry with inconclusive results. Recent developments in the word association test by F.L. Goodenough (who utilizes homonyms) and by A.T. Tendler (who has developed certain indexes for distinguishing neurotic from psychotic performance) are good examples of the new type of screening test required.

The impressions that laypeople have of particular treatment procedures presumably affect the acceptance and application of those procedures. Previous research suggests that behavioral therapies are perceived less favorably than humanistic therapies. In this study, mental health professionals' and university students' reactions to behavioral and humanistic therapy labels were measured along specific dimensions (e.g., warmth, effectiveness) of evaluation. Results indicated that both students and professionals perceived humanistic therapies as warmer and more friendly, but behavior therapies were rated as more effective. Thus, both behavioral and humanistic therapies are sometimes perceived favorably, but from different perspectives. Implications for community applications are discussed. [ABSTRACT FROM AUTHOR]

An obituary for Alan Clarke, a clinical psychologist, is presented.

Accessible summary For a long time, people tried to stop women with intellectual disabilities from knowing about sex and from having sex., We talked to some women with intellectual disabilities to find out what they thought about sex., Many of the women told us that they thought sex is bad and that they should not do it., We want people to be able to help women with intellectual disabilities to feel confident to make choices about sex., Summary There is very little literature concerning how women with intellectual disabilities conceptualise their sexuality or develop a sexual identity. Semi-structured interview schedules were used to guide interviews with 10 women with intellectual disabilities. Thematic analysis was used to analyse the interview transcripts. Many of the women could not conceptualise themselves as sexual beings, and they tended to regard sex as a dirty and inappropriate activity for them. They generally believed that other people prohibited them from engaging in sexual activity. The women often considered themselves to be of little value, and the majority had no clear sense of identity. It is incumbent upon services to find the means to empower women with intellectual disabilities to acknowledge, welcome and take control of their own sexuality. [ABSTRACT FROM AUTHOR]

The article presents an attempt to develop and test alternate criteria for the interpretation of Benton Visual Retention Test (BVRT) scores in order to decrease the false positive rate. Revised criteria for the interpretation of BVRT scores led to a decrease in false positives with no increase in the false negative rate. It was recommended that each clinical setting empirically validate Benton's suggested criteria and, if they prove inadequate, attempt to revise the criteria to meet better the specific needs of their own setting.

The use of psychometrics to assess the mental health of people with mild intellectual disabilities is a developing field of clinical and methodological interest. The available measures however tend to be few in number, with an even smaller minority progressing through the required rigorous psychometric development process. An assessment and potential outcome measure that has begun to be employed with people with intellectual disabilities is the Brief Symptom Inventory. This study examines the construct validity of the inventory through an exploratory factor analysis, with a sample of 335 intellectually disabled participants. Eight clear and interpretable factors emerged from the factor analysis with a high degree of overlap being apparent with the original factor solution. Such factor findings do not compromise the extant composite and global psychometric measures of the inventory, namely the global severity index, positive symptom distress index and positive symptom total. The results are discussed in the context of the apparent need for conducting confirmatory factor analysis as the next stage in the psychometric evaluation and clinical evolution of the Brief Symptom Inventory. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Residential transitions have long been recognised as challenging for people with learning disabilities and can be packed with problem stories. Narrative Therapy practices have the potential to centre the voice of people with learning disabilities; to enable alternative stories to be told; and to shine a light on their own and their support system's resources for change. Methods: Colin, a 36‐year‐old man with Down syndrome and a learning disability, met with the first author for nine sessions. Narrative Therapy practices (also drawing on systemic ideas) were used, including the Tree of Life, Outsider Witness Practice, Therapeutic Documentation and Definitional Ceremony. Feedback from Colin and the staff team was gathered through qualitative and quantitative means. Findings: Colin was keen to share his life stories and explored ideas about his "new life", wanting to "stay strong" and "stay happy". Staff noted an improvement in household stress and perceived ability to support Colin. An improvement in quality of life was also demonstrated with a self‐report questionnaire. Conclusions: By acknowledging the power of language, narrative practices offer tools to help people with learning disabilities and their support system in making sense of and navigating important life transitions. Accessible summary: People with learning disabilities sometimes struggle when they move to a new home away from their family.Narrative Therapy can help people with learning disabilities adapt to a new life.Narrative Therapy can help people tell their life stories using the picture of a tree called a 'Tree of Life'.This 'Tree of Life' can be shared with the new staff team helping people with learning disabilities.The new staff team will get to know them better and how best to support them. [ABSTRACT FROM AUTHOR]

Accessible Summary: Some clients in learning disability services have problems in their relationships with people. Some clients with learning disability have broken the law and live in hospital. For clients in hospital, treatment can be learning about managing behaviour, feelings and relationships.  This treatment is given by different professionals. This treatment is important to help stop these clients getting into trouble with the police again. An important part of treatment is to help clients understand their experiences in relationships. This case study is about Oliver, and how psychologists and an art therapist worked together to help him.​ Abstract: Background: Clients with attachment issues are over‐represented in learning disability services. Forensic inpatient services are no exception. Treatment pathways comprise multidisciplinary interventions, and skills‐based treatments are considered vital to recovery and maintenance of prosocial and adaptive behaviour and reduction in risk. An important aspect of treatment is the psychological intervention to enable clients to understand their early experiences and the way this may have impacted on later relationships and behaviour. Without exploring the difficult early lives that many clients in forensic inpatient services have experienced, skills‐based treatments and attempts to facilitate discharge may not be effective. Materials and methods: This case study presents the theoretical background of attachment, autism, learning disability and sexual offending that informed the collaborative multidisciplinary psychological treatment offered to one man with learning disabilities and autism in a secure forensic setting. Results: The introduction of Art Psychotherapy enabled the client to explore his history and the potential internal barriers to his therapeutic progress. Issues of safety and belonging, previously unexplored with this man, were uncovered and these themes were incorporated into his risk formulation and treatment plan. Conclusions: The paper reflects on the specific contribution of Art Psychotherapy in specialist services, and the importance of the collaborative relationship between the Art Psychotherapist and the ward Multi‐Disciplinary Team. [ABSTRACT FROM AUTHOR]

Background Involving ID service users in risk decision making necessitates consideration of an individual's ability to assess the implications and associated risks and thus make an informed choice. This calls for research on service users' awareness and understanding of risk management (RM). Method Thirteen people in a residential ID service who were reviewed under the risk management process (RMP) participated in the research. Thematic analysis explored participants' knowledge and understanding of risk management to establish ability to make informed choice. Results Two main meta-themes (lack of awareness about RM and awareness about RM) and four meta-themes (extent of RM awareness, locus of control, compliance and empowerment) emerged. Nine of 13 participants demonstrated some knowledge and awareness of RM and wanted to contribute to the RMP, despite not being consulted about or given the opportunity to be involved in RM. Conclusions The majority of service users in this sample had some awareness of the purpose of RM and could make partially informed decisions about whether they would like to be involved in the RMP. The findings highlight the need for professionals to actively attempt to involve ID service users in the management of their own risk. [ABSTRACT FROM AUTHOR]

Although neuroleptic medications are frequently used to treat the aggressive behavior of persons with mental retardation, little empirical support exists for their efficacy. In the ease study reported here, the beta-blocker propranolol was used to treat the aggressive behavior of a 23-year-old woman with severe menial retardation Initiation of treatment was correlated with a dramatic decrease in aggression and a less pronounced improvement in self-injurious behavior (SIB). An increase in resting heart-rate was associated with a significant increase in aggression, and progressive increases in propranolol dosage were correlated with reductions in heart rate and in significant behavioral improvement. Consideration of propranolol as a less intrusive, and possibly more effective, pharmacologic treatment for the aggressive behavior of persons with mental retardation is discussed. [ABSTRACT FROM AUTHOR]