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.
Objective: This study evaluated the feasibility of the Fearless Me! program, an online cognitive behavioral therapy (CBT) program for children with intellectual disability (ID) and anxiety.Method: Twenty-one adolescents with mild to moderate ID participated in ten sessions of the therapist-assisted Fearless Me! program, combining face-to-face group sessions and an online component. A case series design was adopted to assess anxiety symptoms at baseline, throughout intervention, and postintervention. Feasibility of the measures, intervention, and trial design were considered. Results: The measures were appropriate and sensitive to changes in anxiety, whereas the need for attention to factors influencing parent's completion of them was identified. Reliable Change Index and visual analyses of results indicated reductions in anxiety, particularly for older adolescents with heightened levels of anxiety at baseline.Conclusions: This is one of the first CBT programs for adolescents with ID, and provides preliminary evidence of adapted CBT as a feasible treatment. K E Y W O R D S child and adolescent anxiety disorders, child and adolescent mood disorders, cognitive behavioral therapy, intellectual disability, online therapy J. Clin. Psychol. 2019;75:919-932. wileyonlinelibrary.com/journal/jclp Overall, this case series is an important first step in exploring how CBT can be adapted for young people with ID and mental health disorders, and provides an alternate to behavioral interventions. Further group and individual trials of adapted CBT and the Fearless Me! program is warranted, along with treatment component analyses to determine the most important active ingredients of CBT for children and adolescents with ID.
ORCIDAnastasia Hronis
A significant proportion of those with eating disorders (EDs) do not respond to first‐line treatments. This systematic review was conducted to identify whether personality disorders (PDs)/traits predict or moderate ED treatment outcomes and whether these outcomes were differentially influenced by ED or PD diagnostic subtypes, or treatment approach. A comprehensive systematic literature search was conducted using the PRISMA guidelines. A total of seven randomised controlled trials (RCTs) plus four follow‐up studies were reviewed investigating the impact of PD and PD traits on treatment outcomes for EDs. The majority indicated that PD had some impact on treatment outcomes. Outcome measures and time‐point measurements varied across studies. Included studies suggested that bulimia nervosa treatment outcomes were not hindered by co‐morbidity of borderline PD; however, psychiatric impairment remained high at post‐treatment and follow‐up. Cluster C PDs were found to negatively impact treatment outcomes for binge ED and attrition rates for anorexia nervosa. Included studies suggested that interventions that addressed aspects of personality pathology showed greater main effects for ED treatment outcomes. There is an urgent need for future RCTs on ED treatments to include routine measures of core personality features to allow their impacts to be more thoroughly examined and for psychotherapies to be tailored accordingly.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.