Research Issues in Cognitive Therapy

Readiness for Cognitive Therapy in People with Intellectual Disabilities

“…Another way of moving towards a less ad hoc , more rational approach to cognitive therapy for people with intellectually disabilities is to develop procedures that make explicit the modifications, which may be radical, that are deployed in order to tailor standard therapies to the needs of the individual client. The distinction between cognitive distortions and cognitive deficits (Kendall 1985; Dagnan & Lindsay 2004) offers a useful framework for analysing individual needs, as the usual problem in applying cognitive therapy to people with intellectual disabilities is that cognitive deficits must be overcome before the standard procedures for dealing with cognitive distortions can be applied effectively. An analysis of the specific deficits that each modification is intended to compensate has the advantage that it not only identifies clearly the modifications that are needed, but also stipulates precisely why they are needed (Willner & Goodey 2006).…”

“…Third, the A–B–C model can be presented in the format of a self‐management task, which is much easier for a person with an intellectual disability to comprehend. Cognitive dysfunctions are of two types, deficits and distortions (Kendall 1985); unlike cognitive therapies, which aim to identify and correct distortions in the contents of thoughts, assumptions and beliefs, self‐management techniques typically aim to address deficits in the processes by which information is acquired and processed (Dagnan & Lindsay 2004). R was a young woman who was referred with paranoid delusions, accompanied by severe distress and obsessional behaviours intended to decrease the perceived threat.…”

“…In particular, in the cases described by Willner (2004) and Willner & Goodey (2006) the clients had significant difficulties in spontaneously accessing adaptive cognitions; and in order to overcome this problem, adaptive cognitions were supplied by the therapist (and their rehearsal was prompted by carers). This represents a dilution of the ‘guided exploration’ component of cognitive therapies, in favour of a self‐instructional approach, where self‐instruction is applied to cognitions, rather than behaviour (Dagnan & Lindsay 2004).…”

“…Some published assessment instruments offer the opportunity to evaluate the extent to which potential therapy clients possess the basic skills for cognitive work (Reed & Clements 1989; Dagnan et al. 2000), and this assessment can be used to guide the therapeutic approach (Dagnan & Lindsay 2004). However, the decision whether or not to offer cognitive therapy should never be based solely on a client's performance on these cognitive‐ability tests, which were developed for research, rather than clinical decision‐making purposes.…”

Interaction of Cognitive Distortions and Cognitive Deficits in the Formulation and Treatment of Obsessive–Compulsive Behaviours in a Woman with an Intellectual Disability

“…Similar issues arise when CBT is used with children, and a useful distinction has been drawn in this context between cognitive deficits, which are deficiencies in the processes by which information is acquired and processed, and cognitive distortions, which are inaccuracies in the content of thoughts, assumptions and beliefs (Kendall 1985). This distinction is also helpful in relation to the needs of people with intellectual disabilities (Dagnan & Lindsay 2004). Cognitive distortions are the target of conventional CBT approaches such as cognitive therapy (Beck 1976) or rational–emotive therapy (Ellis 1973).…”