A review of cognitive impairments in children with intellectual disabilities: Implications for cognitive behaviour therapy

© 2017 The British Psychological Society Objective: Nearly half of children with intellectual disability (ID) have comorbid affective disorders. These problems are chronic if left untreated and can significantly impact upon future vocational, educational, and social opportunities. Despite this, there is a paucity of research into effective treatments for this population. Notably, one of the most supported of psychological therapies, cognitive behaviour therapy (CBT), remains largely uninvestigated in children with ID. The current review considers the neuropsychological profile of children and adolescents with mild to moderate ID, with a view to informing how CBT might best be adapted for children and adolescents with ID. Method: Narrative review of literature considering the neuropsychological profiles of children and adolescents with ID, with specific focus upon attention, memory, learning, executive functioning, and communication. Studies were identified through SCOPUS, PsycINFO, and PubMed databases, using combinations of the key words ‘intellectual disability’, ‘learning disability’, ‘neuropsychology’, ‘attention’, ‘learning’, ‘memory’, ‘executive function’, ‘language’, and ‘reading’. Results: Children with ID have significant deficits in attention, learning, memory, executive functions, and language. These deficits are likely to have a negative impact upon engagement in CBT. Suggestions for adapting therapy to accommodate these wide ranging deficits are proposed. Conclusions: There are multiple cognitive factors which need to be considered when modifying CBT for children who have ID. Furthermore, research is required to test whether CBT so modified is effective in this population. Practitioner points: Clinical implications. Effective ways of providing cognitive behavioural therapy (CBT) to children with intellectual disability (ID) is unclear. This study provides a framework of potential adaptations for clinical practice As rates of mental illness for children with intellectual disability are high, and rates of treatment provision low, it is hoped that the recommendations provided in this study will encourage more mental health practitioners to provide CBT to children with ID. Limitations. These recommendations are based only upon neuropsychological literature. Trialling the effectiveness of an adapted form of CBT for children and adolescents with ID is required. There are varying causes of intellectual disability, with differences in cognitive profiles. The utility of the recommendations made here may vary according to specific aetiologies

Potential for children with intellectual disability to engage in cognitive behaviour therapy: the parent perspective.

BACKGROUND:This study aimed to obtain the opinions of parents and carers of children with intellectual disability (ID) as to whether cognitive behaviour therapy (CBT) could be useful for their children. METHODS:A mixed qualitative and quantitative method was employed. Twenty-one carers of children aged 10 to 17 having borderline to moderate intellectual functioning responded to an online questionnaire. Participants were provided with information about CBT and asked to respond to open-ended questions. Quantitative data pertained to questions about their child's ability to identify and describe thoughts, feelings and behaviours. Thematic analysis of responses was conducted using an inductive method of identifying themes from the qualitative data collected. RESULTS:Five themes emerged from the qualitative analysis: Emotional Attunement (i.e. parent's understanding and recognition of their child's emotions), Role of the Therapist (i.e. ways therapists could facilitate the intervention), Role of the Parent (i.e. ways parents could engage in the therapy process), Anticipated Obstacles (i.e. what may get in the way of the therapy) and Suggested Adaptations for Therapy (i.e. how CBT can be adapted to suit the needs of children with ID). Seventy-six per cent agreed that their child would be able to engage in CBT with assistance. CONCLUSIONS:The majority of parents believed that CBT is an intervention that children with ID could engage in, provided the therapy is adapted, and the therapist accommodates their needs

Treatment of substance abuse in dual diagnosis

Interventions for substance use–related problems are limited for individuals with intellectual disability (ID). This is problematic, as the lack of interventions can lead to substance use initiation, progression of substance use into substance use disorder, poorer outcomes of treatment, and stigmatization of individuals with dual diagnosis. Additionally, staff who work with individuals with ID and addiction treatment lack resources to effectively help substance use in individuals with ID. Nevertheless, there has been an increase in studies assessing the feasibility and outcomes of interventions for substance use and abuse in individuals with ID. This chapter reviews psychological and pharmacological interventions for individuals with dual diagnosis of substance abuse and ID

Cognitive Behaviour Therapy for People with Intellectual Disabilities—How Far Have We Come?

© 2020, Springer Nature Switzerland AG. This review paper reflects on the existing literature on cognitive behaviour therapy for adults, adolescents and children with intellectual disabilities. People with intellectual disabilities have high rates of comorbid mental health disorders, but low rates of accessing treatments with limited treatment options available to them. Historically, they have been excluded from cognitive-based therapies such as cognitive behaviour therapy. However, recent research has shown that people with mild to moderate intellectual disabilities do have the capacity to engage in cognitive-based interventions. The review highlights the progress that has been made in the field of adapting CBT for people with intellectual disabilities, as well as the current gaps in the literature and suggestions for future research

COVID-19 and the impact on gambling, sex, and pornography use and addictions

COVID-19 has had a far-reaching impact on people around the world, and the consequences of the pandemic along with the subsequent lockdown orders have had a significant effect upon mental health and well-being. This pandemic time has been particularly challenging for those with preexisting addictions and those at moderate or high risk of developing addictions. This current chapter focuses on the impact that COVID-19 has had on the ways in which people engage with gambling, sex, and pornography, with a particular focus on how those with behavioral addictions may have been impacted. Although the research into the impacts of the pandemic on these behaviors and addictions is limited, preliminary literature suggests that significant changes in addictive behaviors have been noted around the world

Behavioural indicators of responsible gambling consumption

‘Responsible gambling’ is an ambiguous and contested concept that nonetheless underpins the vast majority of government, industry and public health efforts to minimise the harm from gambling. Following an earlier emphasis on responsible provision of gambling (RPG) which focused on providing gambling products, environments and policies that promote safe gambling behaviour, responsible consumption of gambling (RCG) now emphasises the need for consumers to regulate and restrain their own behaviours. This shift in emphasis has attracted substantial criticism for its location of the ‘problem’ within individual gamblers, for being stigmatising and unhelpful for people experiencing gambling problems, and for ignoring responsibilities of governments and gambling operators to provide and promote gambling in ways that prevent or minimise harm. The current study is not driven by a particular stance on this issue, nor does it promote a particular viewpoint. Its focus on RCG should not be interpreted as endorsing the idea that consumers carry most responsibility for responsible gambling (RG). Instead, the study takes a pragmatic approach in recognising that RCG is now the dominant paradigm driving harm minimisation efforts in Australia and elsewhere. Gamblers are urged to ‘gamble responsibly’, but no accepted definition, foundation principles or behavioural indicators of RCG exist. The aim of this study, therefore, was to develop a preliminary set of behavioural indicators of RCG – that is, the first set of commonly understood behavioural markers associated with gambling responsibly. It must be stressed that the behavioural indicators developed in this study are preliminary, and will require validation in subsequent research. We also emphasise that, while developing and promoting a validated set of behavioural indicators of RCG can provide muchneeded consumer guidelines on how to ‘gamble responsibly’, this represents just one type of strategy for behavioural change. The public health literature promotes the use of a broad range of strategies to optimise behavioural change, such as regulation, policy, law, reducing availability, price controls, and restrictions on marketing; these broader strategies are not considered further in this report

The relationship between gambling and depression

This chapter discusses the relationship between depression and gambling behavior. We show that depression is in fact prevalent and even a risk factor for problem gambling. We discuss factors underlying the development of comorbid depression and problem gambling. This review builds on Blaszczynski and Nower (2002)‘s model on the role of existing mood disorders and depression as risk factor for problem gambling, as has been corroborated by several studies. Finally, we discuss implications for the treatment of depression in reducing problem gambling

Assessing the confidence of Australian mental health practitioners in delivering therapy to people with intellectual disability

© AAIDD. Research supports the use of psychological therapies among people with mild to moderate intellectual disability (ID). One barrier to people with ID accessing psychological treatments is the confidence of mental health practitioners. This article explores the confidence of Australian clinicians in providing therapy to people with ID. One hundred and fifty-two psychologists and counselors in Australia completed a survey exploring self-reported confidence when working with clients who have ID and mental health difficulties. Clinicians were most confident with generic counseling skills, but less confident with elements of assessments and interventions. The use of treatment protocols was endorsed as helpful particularly among those with low confidence. This highlights the need for dissemination of treatment guides and training to help increase clinician confidence

The Polish Peasant and the Sixth Life Course Principle

In life course studies five principles guide social science researchers: (1) the principle of human development and aging, (2) the principle of human agency, (3) the principle of historical time and space, (4) the principle of timing, and (5) the principle of linked lives. We propose a sixth principle: life course tempo explicitly depends on other life course principles especially the external principles of (2), (3), and (5). Tempo changes may have sociological and psychological consequences. To demonstrate the sixth principle at work, we analyze a sample of the peasant letters both to and from America in Thomas and Znaniecki’s The Polish Peasant in Europe and America, the pioneer life history study of Polish immigrants in early 20th century. Two types of tempo change in transition into first marriage are evident in the letters, waiting/postponement and haste, which resulted from changed historical time and space and reorganized human agency of the immigrants. Thus, this research is inspired by Thomas and Znaniecki’s work on the Polish peasant and Znaniecki’s methodology and in turn uses the Polish peasant letters as data

What Behaviours and Cognitions Support Responsible Consumption of Gambling? Results from an Expert Survey

© 2017, Springer Science+Business Media, LLC. This study analysed expert views on (1) the adequacy of the current promotion of responsible gambling, (2) the practicality and worth of developing an evidence-based set of responsible gambling consumption behaviours and cognitions and (3) the relative importance of behaviours and cognitions promoted as supporting responsible consumption of gambling. Experts (N = 107) rated the importance of 61 behaviours and cognitions, distilled from a systematic literature review and content analysis of 30 websites, and grouped into seven categories. Behaviours and cognitions considered most important for problem gamblers related to ensuring gambling is affordable, limiting persistence at gambling, and using help and support. Those for at-risk gamblers related to understanding gambling, ensuring gambling expenditure is affordable, and keeping gambling in balance. For non-problem gamblers, important behaviours and cognitions related to understanding gambling, keeping gambling in balance, and positive motivations for gambling. Current promotion of responsible gambling was considered inadequate. Efforts to develop, validate and promote evidence-based responsible gambling consumption behaviours and cognitions can build on those identified in this research