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Background: Government strategy indicates that individuals with learning disabilities should have access to adapted psychological therapies. Dialectical behaviour therapy (DBT) is recommended for the treatment of borderline personality disorder (BPD); however, there is little published research regarding whether it can be appropriately adapted for adults with learning disabilities. The research available primarily focuses on measures of behavioural and psychiatric change, with little emphasis on the psychological changes that occur. Materials and Methods: Two case studies are presented that using repertory grid technique, based on personal construct psychology (PCP). Both individuals completed repertory grids prior to, and following, adapted DBT for adults with learning disabilities within a specialist community psychology service in the United Kingdom. Results: The case studies show some of the psychological changes that have occurred within adults with learning disabilities who received adapted DBT within a community psychology service. Changes included altered self-esteem and dilemmas individuals have about themselves. Conclusion: The contrasting case studies demonstrate the complexity and idiosyncrasy of the experiences of individuals with learning disabilities who receive DBT, and discuss how this information can be integrated into clinical practice.

Women’s enhanced medium secure services (WEMSS) is a model of care aimed at providing a more appropriate level of security for women and, in so doing, reducing the number of women in high secure psychiatric services. In 2007, three Department of Health commissioned WEMSS pilots became operational. This study compared the clinical outcomes of women in WEMSS with control women in six standard medium secure services and one high secure service matched on key clinical and risk characteristics, in order to examine their pathways of care. Our findings confirm that the WEMSS pilots were successful in transitioning women from high secure services who had previously been thought unsuitable for medium secure services. However, WEMSS showed no additional clinical benefit, suggesting that these women could be cared for equally well within standard medium secure services. We make recommendations about WEMSS and the future shape of women’s secure care in England. [ABSTRACT FROM PUBLISHER]

Accessible summary Dialectical behaviour therapy ( DBT) can be adapted for individuals with learning disabilities. DBT aims to teach people how to control their feelings, communicate with other people, manage distress and be more self-aware., This article presents the case studies of two adults with learning disabilities who completed DBT and shows how their opinions of themselves and others changed., The results discussed include overall change in construing, changes in self-esteem and changes in dilemmas they had about themselves before DBT., Abstract Background: Government strategy indicates that individuals with learning disabilities should have access to adapted psychological therapies. Dialectical behaviour therapy ( DBT) is recommended for the treatment of borderline personality disorder ( BPD); however, there is little published research regarding whether it can be appropriately adapted for adults with learning disabilities. The research available primarily focuses on measures of behavioural and psychiatric change, with little emphasis on the psychological changes that occur. Materials and Methods: Two case studies are presented that using repertory grid technique, based on personal construct psychology ( PCP). Both individuals completed repertory grids prior to, and following, adapted DBT for adults with learning disabilities within a specialist community psychology service in the United Kingdom. Results: The case studies show some of the psychological changes that have occurred within adults with learning disabilities who received adapted DBT within a community psychology service. Changes included altered self-esteem and dilemmas individuals have about themselves. Conclusion: The contrasting case studies demonstrate the complexity and idiosyncrasy of the experiences of individuals with learning disabilities who receive DBT, and discuss how this information can be integrated into clinical practice. [ABSTRACT FROM AUTHOR]