Putting the C into CBT: Cognitive challenging with adults with mild to moderate intellectual disabilities and anxiety disorders

Concussion is a frequent injury in many sports and is also common in para athletes. However, there is a paucity of concussion research related to para sport, and prior International Concussion in Sport (CIS) consensus papers have not substantively addressed this population. To remedy this and to improve concussion care provided to para athletes, the concussion in para sport (CIPS) multidisciplinary expert group was created. This group analysed and discussed in-depth para athlete-specific issues within the established key clinical domains of the current (2017) consensus statement on CIS. Due to the onset of the COVID-19 pandemic, the group held all meetings by video conferencing. The existing Sport Concussion Assessment Tool 5 (SCAT5) for the immediate on-field and office-based off-field assessment of concussion was evaluated as part of this process, to identify any para athlete-specific concerns. Regular preparticipation and periodic health examinations are essential to determine a baseline reference point for concussion symptoms but pose additional challenges for the interpreting clinician. Further considerations for concussion management for the para athlete are required within the remove, rest, reconsider and refer consensus statement framework. Considering return to sport (RTS), the 2017 CIS consensus statement has limitations when considering the RTS of the para athlete. Case-by-case decision making related to RTS following concussion is imperative for para athletes. Additional challenges exist for the evaluation and management of concussion in para athletes. There is a need for greater understanding of existing knowledge gaps and attitudes towards concussion among athlete medical staff, coaches and para athletes. Future research should investigate the use and performance of common assessment tools in the para athlete population to better guide their clinical application and inform potential modifications. Concussion prevention strategies and sport-specific rule changes, such as in Para Alpine Skiing and Cerebral Palsy Football, also should be carefully considered to reduce the occurrence of concussion in para athletes.

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“… 16 While CBT may be used in para athletes with intellectual impairment, the process by which this occurs may need to be adapted. 17 18 …”

Section: Concussion Management For Para Athletesmentioning

confidence: 99%

Concussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group

et al. 2021

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“…According to the research reviewed in a meta-analysis by Vereenooghe and Langdon[ 65 ], CBT could be a potentially effective treatment for anger and depression (with better outcomes in individual over group-based interventions). Roberts and Kwan[ 66 ] found that CBT significantly reduced anxiety in adults with mild to moderate ID as measured by self, proxy, and clinician reported outcome measures.…”

Section: Empirically Supported Psychological Treatmentsmentioning

confidence: 99%

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

Gómez¹,

Navas²,

Verdugo³

et al. 2021

WJP

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This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability (ID) at all stages of their life. We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population, along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems. We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID. The review is structured around the three generations of therapies: Applied behavior analysis ( e.g. , positive behavior support), cognitive behavioral therapies ( e.g. , mindfulness-based cognitive therapy), and contextual therapies ( e.g. , dialectical behavior therapy). We conclude with some recommendations for professional practice in the fields of ID and psychiatry.

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“…Recently, cognitive behaviour therapy (CBT) has been identified as an effective treatment for adults with mild to moderate ID and comorbid depression, anxiety and anger (e.g. Hassiotis et al ; Osugo & Cooper ; Roberts & Kwan ; Vereenooghe & Langdon ). While similar trials have not been conducted among children with ID, CBT could be a treatment option for children with ID, provided adaptations are made (Hronis et al ).…”

Section: Introductionmentioning

confidence: 99%

Potential for children with intellectual disability to engage in cognitive behaviour therapy: the parent perspective

Hronis

Roberts

et al. 2019

J intellect Disabil Res

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Background This study aimed to obtain the opinions of parents and carers of children with intellectual disability (ID) as to whether cognitive behaviour therapy (CBT) could be useful for their children. Methods A mixed qualitative and quantitative method was employed. Twenty-one carers of children aged 10 to 17 having borderline to moderate intellectual functioning responded to an online questionnaire. Participants were provided with information about CBT and asked to respond to open-ended questions. Quantitative data pertained to questions about their child's ability to identify and describe thoughts, feelings and behaviours. Thematic analysis of responses was conducted using an inductive method of identifying themes from the qualitative data collected. Results Five themes emerged from the qualitative analysis: Emotional Attunement (i.e. parent's understanding and recognition of their child's emotions), Role of the Therapist (i.e. ways therapists could facilitate the intervention), Role of the Parent (i.e. ways parents could engage in the therapy process), Anticipated Obstacles (i.e. what may get in the way of the therapy) and Suggested Adaptations for Therapy (i.e. how CBT can be adapted to suit the needs of children with ID). Seventy-six per cent agreed that their child would be able to engage in CBT with assistance. Conclusions The majority of parents believed that CBT is an intervention that children with ID could engage in, provided the therapy is adapted, and the therapist accommodates their needs. A. Hronis et al. • CBT for children with intellectual disability A. Hronis et al. • CBT for children with intellectual disability A. Hronis et al. • CBT for children with intellectual disability VOLUME 64 PART 1 JANUARY 2020 Data S1 Supporting information Data S2 Supporting information Journal of Intellectual Disability Research A. Hronis et al. • CBT for children with intellectual disability

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Putting the C into CBT: Cognitive challenging with adults with mild to moderate intellectual disabilities and anxiety disorders

Cited by 18 publications

References 45 publications

Concussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group

Concussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

Potential for children with intellectual disability to engage in cognitive behaviour therapy: the parent perspective

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