BACKGROUND: The aim of this study was to evaluate the efficacy of psychological therapies for people with intellectual disabilities (IDs) through a systematic review and metaanalysis of the current literature. METHOD: A comprehensive literature search identified 143 intervention studies. Twenty-two trials were eligible for review, and 14 of these were subsequently included in the meta-analysis. RESULTS: Many studies did not include adequate information about their participants, especially the nature of their IDs; information about masked assessment, and therapy fidelity was also lacking. The meta-analysis yielded an overall moderate between-group effect size, g = .682, while group-based interventions had a moderate but smaller treatment effect than individual-based interventions. Cognitivebehaviour therapy (CBT) was efficacious for both anger and depression, while interventions aimed at improving interpersonal functioning were not effectual. When CBT was excluded, there was insufficient evidence regarding the efficacy of other psychological therapies, or psychological therapies intended to treat mental health problems in children and young people with IDs. CONCLUSIONS: Adults with IDs and concurrent mental health problems appear to benefit from psychological therapies. However, clinical trials need to make use of improved reporting standards and larger samples.

Mental health problems affect people with intellectual disabilities (ID) at rates similar to or in excess of the non-ID population. People with severe ID are likely to have persistent mental health problems. In this systematic review (PROSPERO 2015:CRD42015024469), we identify and evaluate the methodological quality of available measures of mental health problems or well-being in individuals with severe or profound ID. Electronic searches of ten databases identified relevant publications. Two reviewers independently reviewed titles and abstracts of retrieved records (n=41,232) and full-text articles (n=573). Data were extracted and the quality of included papers was appraised. Thirty-two papers reporting on 12 measures were included. Nine measures addressed a broad spectrum of mental health problems, and were largely observational. One physiological measure of well-being was included. The Aberrant Behavior Checklist, Diagnostic Assessment for the Severely Handicapped Scale-II and Mood, Interest and Pleasure Questionnaire are reliable measures in this population. However, the psychometric properties of six other measures were only considered within a single study - indicating a lack of research replication. Few mental health measures are available for people with severe or profound ID, particularly lacking are tools measuring well-being. Assessment methods that do not rely on proxy reports should be explored further.

Digital media have increased the accessibility of psychological therapies for the general population, but not for people with intellectual disability (ID),

Aims:The aim was to examine whether specific skills required for cognitive behavioural therapy (CBT) could be taught using a computerised training paradigm with people who have intellectual disabilities (IDs). Training aimed to improve: a) ability to link pairs of situations and mediating beliefs to emotions, and b) ability to link pairs of situations and emotions to mediating beliefs.Method: Using a single-blind mixed experimental design, sixty-five participants with IDs were randomised to receive either computerised training or an attention-control condition.Cognitive mediation skills were assessed before and after training. Results:Participants who received training were significantly better at selecting appropriate emotions within situation-beliefs pairs, controlling for baseline scores and IQ. Despite significant improvements in the ability of those who received training to correctly select intermediating beliefs for situation-feelings pairings, no between-group differences were observed at post-test. Conclusions:The findings indicated that computerised training led to a significant improvement in some aspects of cognitive mediation for people with IDs, but whether this has a positive effect upon outcome from therapy is yet to be established. Prevalence rates of mental health problems among people with intellectual disabilities (IDs) vary widely depending on the diagnostic criteria and assessments used, with recent estimates suggesting that between thirteen and forty percent of people with IDs are affected (Cooper, Smiley, Morrison, Williamson, & Allan, 2007;Deb, Thomas, & Bright, 2001;Emerson & Hatton, 2007). The high prevalence rates, when compared to the general population, can be partly explained by the genetic vulnerability of people with IDs, and disadvantageous life events such as stigmatisation and isolation (Clarke, 2003;Cooper et al., 2007;Emerson & Hatton, 2007;Hulbert-Williams & Hastings, 2008;Reiss & Benson, 1984).Even though people with IDs have an elevated risk of developing mental health problems, the evidence regarding the efficacy of psychological therapies for this population has only been emerging slowly. A recent meta-analysis concluded that cognitive behavioural therapy was at least moderately effective for the treatment of anger regulation problems and depression (Vereenooghe and Langdon, 2013), and previous reviews have also supported the potential benefits of cognitive-behavioural therapy (CBT) for anger management (Hamelin, Travis and Sturmey, 2013;Nicoll, Beail and Saxon, 2013). However, there is insufficient evidence to conclude that psychological treatments for mental health problems amongst people with IDs are empirically validated (Vereenooghe & Langdon, 2013). One of the reasons for this is that people with IDs are thought to have difficulty grasping some of the concepts presented within CBT (Biza Stenfert-Kroese, Dagnan, & Loumidis, 1997), and while suitability criteria for CBT have been described in terms of the potential to form a therapeutic alliance, motivation ...

full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. Results: Training significantly improved ability to discriminate between behaviours, thoughts and feelings pooled together, compared to the attention-control condition, even when controlling for baseline scores and IQ. Large within-group improvements in the ability to identify behaviours and feelings were observed for the training condition, but not the attention-control group. There were no significant between-group differences in ability to identify thoughts, or on cognitive mediation skills. Conclusions:A single session of computerised training can improve the ability of people with IDs to understand and practise CBT tasks relating to behaviours and feelings. There is potential for computerised training to be used as a "primer" for CBT with people with IDs to improve engagement and outcomes, but further development on a specific computerised cognitive mediation tasks is needed.