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Background: This study investigated differences in the clinical and demographic characteristics of individuals with intellectual disabilities delayed in assessment and treatment hospitals versus individuals who were not delayed. The study further investigated the clinical outcomes of the individuals whose discharge from the hospital was delayed. Method: This was a cohort study using secondary data collected from patient records. Variables included age, ethnicity, levels of deprivation, areas of origin, diagnoses, and the provision of a care and treatment review. A comparison was made between individuals who became delayed despite being clinically ready for discharge and those who were discharged on time. Findings: Individuals with severe intellectual disabilities were more likely to experience delayed discharge from hospital (p = 0.001). Similarly, people who were admitted to hospitals away from their home areas were also more likely to experience delayed discharge (p < 0.001). There were no significant differences between the delayed and nondelayed groups for other factors such as age, deprivation or ethnicity. Individuals who experienced a delay in discharge did not experience an increased rate of adverse incidents compared to the period of active treatment and clinical improvements were maintained during the period of delay. There were low rates of completion of care and treatment reviews before admission, although people who were delayed were more likely to have received a review during admission (78.8% vs. 27.1%). Conclusion: It is important for clinicians and service development leads to be aware that people who are admitted away from their home area and people with severe intellectual disabilities may be at higher risk of experiencing significantly delayed discharge from the hospital. More broadly, many people remained in hospital for a substantial length of time after being assessed as clinically ready for discharge. Due to the low rates of completion before admission, the expansion of community‐based care and treatment reviews should also be explored. While people did not suffer increased rates of adverse incidents during their extended stay, their liberty was still restricted, hence there should be a focus on effective community provision. The current model of relying on the willingness of independent providers to support the care of complex individuals requires significant reform. Accessible summary: Some people stay in learning disability hospitals longer than they need to. This is because they do not have a home or a care team in their community.People with more severe disabilities, and people who are in a hospital a long way from home are more likely to stay in the hospital longer than they need to.Services need to make changes so that people with extra needs can be supported well at home. [ABSTRACT FROM AUTHOR]

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.

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]

The present study uses personal construct theory and the repertory grid technique to examine staff views of individual clients with a diagnosis of anorexia nervosa, in particular those clients who purge and restrict. Fourteen members of nursing staff, both qualified and non-qualified, participated in the research. The results suggest that the 14 members of staff interviewed did construe clients who purge and clients who restrict in markedly different ways. The theoretical implications of this finding are discussed. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Clients with anorexia who purge and those who restrict may present with different needs. • The care package may therefore need to be altered. • The study supports a differentiation between Anorexia Nervosa subtypes. [ABSTRACT FROM AUTHOR]