Background Despite repeated calls for research on the efficacy and effectiveness of psychotherapy with people with intellectual disabilities there has been little progress in this area. This paper reports a naturalistic study of the effectiveness of individual psychodynamic psychotherapy provided in routine clinical practice. Method The study was an open trial design with a 3-month follow-up period. Widely available and used psychotherapy outcome measures were adopted, but administered in an assisted completion format at intake, outcome and follow-up. Data were analyzed using repeated measures ANOVA. Effect sizes were also computed.
ResultsThe results show statistically significant reductions in recipients' levels of psychological distress and
The debate concerning the provision of psychotherapy services for people with intellectual disabilities has moved on from issues of 'relevance' through 'equity' to the current issue of 'effectiveness'. The latter is hard to prove from the available research and clinical literature. In this paper we report preliminary results from an evaluation of a psychodynamic psychotherapy service for adults with intellectual disabilities. We present the rationale and design, including details of process and outcome measures, and preliminary results. Issues concerning operationalisation of such a study in normal clinical practice are discussed. Preliminary results suggest good outcome and so we seek to enable other service-providers to take account of our plans in designing similar studies.
Background Although there is an established body of evidence attesting to the dose-effect relationship in psychotherapy with non-disabled adults, the issue as to whether such a relationship exists for persons with intellectual disabilities has not been previously examined. Dose-effect essentially concerns the amount of psychotherapy required to produce positive results. Method The current study used a naturalistic design to examine and compare the outcomes of three groups of participants with co-morbid psychological problems undergoing treatments of differing lengths (i.e. 'doses') with psychodynamic psychotherapy. Three measures of psychopathology were completed at assessment and at subsequent eight-session intervals until the conclusion of treatment. Each patient received a 3-month follow-up appointment, at which time the measures were again completed. Three treatment duration groups were subsequently constructed and compared via anova: eight sessions (n = 8), 16 sessions (n = 5) and 24 plus sessions (n = 7). Results Results were supportive of a dose-effect relationship, in that outcomes were generally equivalent regardless of treatment duration. Conclusion In short, most change appears to occur in the first eight sessions of treatment, with subsequent outcomes trailing off over time. The clinical implications of the study are discussed in the context of the methodological limitations identified.
Different modes of psychotherapy can be an effective form of treatment for a range of mental health problems. Psychotherapy provision in the NHS is organised in a variety of ways, with patient entry to various modes of therapy determined by a range of factors including evidence‐based guidelines and patient or referrer preference. The methods by which patients arrive at a particular mode of psychotherapy are largely unreported. This paper aims to describe this process in one UK NHS psychotherapy service offering cognitive behavioural and psychoanalytic psychotherapy, and provides data to inform a discussion on the theoretical congruence of these allocation decisions.
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