A randomised controlled feasibility study of interpersonal art psychotherapy for the treatment of aggression in people with intellectual disabilities in secure care

Abstract

Background Rates of aggression in inpatient secure care are higher than in other psychiatric inpatient settings. People with intellectual disabilities in secure care require adapted psychological treatments. Interpersonal art psychotherapy incorporates the use of creative art making approaches by participants, thus reducing sole reliance upon verbal interactions during psychotherapy for people who may have communication difficulties. During interpersonal art psychotherapy, participants are individually supported by their therapist to consider how they conduct relationships. This includes the influence and impact of interpersonal issues resulting in repeated patterns of conflict. The key feasibility objectives were to assess recruitment and retention rates, follow-up rates and trial procedures such as randomisation, allocation and identifying any practical or ethical problems. In addition, a preliminary ‘signal’ for the intervention was considered and an indicative sample size calculation completed. The acceptability of a potential third trial arm attentional control condition, mindful colouring-in, was assessed using four single-case design studies and a UK trial capacity survey was conducted. Methods Adult patients with intellectual disabilities in secure care were recruited and randomised to either interpersonal art psychotherapy or delayed treatment in this multi-site study. Outcomes were assessed using weekly observations via the Modified Overt Aggression Scale and a range of self-report measures. Within study reporting processes, qualitative interviews and a survey were completed to inform trial feasibility. Results Recruitment procedures were successful. The target of recruiting 20 participants to the trial from multiple sites was achieved within 8 months of the study opening. All participants recruited to the treatment arm completed interpersonal art psychotherapy. Between-group differences of interpersonal art psychotherapy versus the delayed treatment control showed a ‘signal’ effect-size of .65 for total scores and .93 in the verbal aggression sub-scale. There were no amendments to the published protocol. The assessment of key feasibility objectives were met and the trial procedures were acceptable to all involved in the research. Conclusion This study suggested that a randomised controlled trial of interpersonal art psychotherapy is acceptable and feasible. Trial registration ISRCTN14326119 (Retrospectively Registered).

Assessing the Feasibility of a Multicenter Transition Intervention Model Across Adolescent Secure Services in England (MOVING FORWARD): Protocol for a Feasibility Cluster Randomized Controlled Trial

“…The proposed developing intervention is based on previous effectively established and implemented intervention models, including cognitive behavior therapy (CBT), parent-child interaction therapy, attachment-based therapy, social skills training (SST), and psychoeducational elements, which target self-efficacy and management of mental health and conduct problems tailored around goal-oriented approaches. SST and CBT group-based interventions are particularly effective in young people with autism [ 10 ]. Elements from these well-established approaches will contribute to behavior change in young people in secure care via upskilling them and building a goal-oriented approach toward their discharge.…”

Measuring working alliance and technical alliance from the perspective of healthcare professionals working with people with mild intellectual disabilities: adaptation, factor structure and reliability

“…The perspective of professionals is important, as their attitudes and choices impact the quality of care (Pelleboer-Gunnink et al 2021). Hackett et al (2020) used the therapist version of the WAI-SF within a small exploratory study that sought to determine the feasibility of interpersonal art therapy for adults with mild IDs and anger problems, without further exploring the psychometric properties of this measurement.…”

“…Hackett et al . ( 2020 ) used the therapist version of the WAI‐SF within a small exploratory study that sought to determine the feasibility of interpersonal art therapy for adults with mild IDs and anger problems, without further exploring the psychometric properties of this measurement.…”

Correction to: A randomised controlled feasibility study of interpersonal art psychotherapy for the treatment of aggression in people with intellectual disabilities in secure care

“…Following publication of the original article [ 1 ], the authors reported an error in author 3’s last name. The correct last name should be “Aafjes-van Doorn” instead of Aafjes-van Doorm.…”