Cognitive therapy for depression with individuals with intellectual disabilities

Abstract

The increase in research into psychopathology in people with intellectual disability has recently spread to include depression. Several reports have appeared on the assessment of depression in the client group and there is a pressing need for research into treatment of depression in people with intellectual disability. The present paper reviews cognitive behaviour therapy for depression and reports on its adaptation for people with intellectual disability. Two case studies of individuals with mild intellectual disability illustrate the clinical applications. All the elements of cognitive behaviour therapy for depression were maintained and simplified. Both subjects were able to monitor their feelings of depression and subject 2 monitored the frequency of suicidal thoughts. Improvements were seen in both cases on the Zung Depression Inventory and daily monitoring of depressive feelings.

The Glasgow Social Self‐Efficacy Scale—a new scale for measuring social self‐efficacy in people with intellectual disability

“…The Zung Depression Scale (Zung, 1965) was chosen because it has been adapted for people with intellectual disability (adapted Zung; Kazdin et al, 1983) and is commonly used in research with this population Lindsay et al, 1993). It has 19 questions with yes/no answers covering a range of depressive symptoms-for example 'Morning is when I feel best'.…”

“…Lindsay, Michie, Baty, Smith, and Miller (1994) and Reynolds & Baker (1988) reported high correlation between measures of depression, which included cognitive items. In addition, the clinical application of cognitive techniques in this client group has begun to be demonstrated for a range of conditions (Chiodo & Maddux, 1985;Howells, Rogers, & Wilcock, 2000;Lindsay, Neilson, & Smith, 1998), including depression (Lindsay, Howells, & Pitcaithly, 1993). These studies suggest that cognitive factors can be assessed in people with intellectual disability with sufficient reliability for clinical use.…”

Diagnosis and treatment of depression in patients with mental retardation

“…However, the use of psychotherapy has been suggested in the mildly retarded [34], and there is at least one article suggesting that a modification of cognitive therapy was efficacious in two depressed mentally retarded individuals [35]. Regarding biological treatments, Puri et al [36] and Kessler [37] reported on sparse literature suggesting that electroconvulsive therapy (ECT) is efficacious in depressed mentally retarded individuals.…”

Management of people with challenging behaviour

“…The success of CBT as an effective intervention has encouraged clinicians and researchers to investigate and apply its techniques in a wide range of clinical problems; these include depression (for a review, see Watkins & Williams, 1998), panic (Clark et al, 1994), psychotic symptoms (Garety et al, 1994) and personality disorder (Nelson-Gray & Farmer, 1999). More recently, the efficacy of CBT as a treatment for adults with mild learning disability has been established (Lindsay et al, 1993), although, to date, sample sizes have been small.…”