Treating Individuals With Intellectual Disabilities and Challenging Behaviors With Adapted Dialectical Behavior Therapy

Abstract

Approximately one third of adults with intellectual and developmental disabilities have emotion dysregulation and challenging behaviors (CBs). Although research has not yet confirmed that existing treatments adequately reduce CBs in this population, dialectical behavior therapy (DBT) holds promise, as it has been shown to effectively reduce CBs in other emotionally dysregulated populations. This longitudinal single-group pilot study examined whether individuals with impaired intellectual functioning would show reductions in CBs while receiving standard DBT individual therapy used in conjunction with the Skills System (DBT-SS), a DBT emotion regulation skills curriculum adapted for individuals with cognitive impairment. Forty adults with developmental disabilities (most of whom also had intellectual disabilities) and CBs, including histories of aggression, self-injury, sexual offending, or other CBs, participated in this study. Changes in their behaviors were monitored over 4 years while in DBT-SS. Large reductions in CBs were observed during the 4 years. These findings suggest that modified DBT holds promise for effectively treating individuals with intellectual and developmental disabilities.

Increasing Emotion regulation skills with dialectical behavior therapy skills training: A single-case study on an elementary school student with borderline intellectual functioning

“…This result supports the findings of a previous study about DBT effectivity among individuals with intellectual disability. Furthermore, the results supported the original hypothesis that DBT is not only effective for adolescents and adults (Brown et al, 2013;Charlton & Dykstra, 2011;Florez & Bethay, 2017) but also for school-aged children with intellectual disability. These outcomes can be achieved by adapting the module, as suggested by McNair et al (2016) that DBT skills training requires some basic modifications to meet the needs of a client with intellectual disability.…”

“…Previous research demonstrated the effectivity of DBT skills training in adults and adolescents with intellectual disability (Brown et al, 2013;Charlton & Dykstra, 2011;Florez & Bethay, 2017), but DBT skills training has not yet been proven effective in school-age children. Given the importance of emotion regulation skills in children with BIF, DBT skills training in this population should be validated.…”

“…The intangible concept of dialectical perspective is challenging for clients with intellectual disability to understand; therefore, using DBT to this population, including BIF, requires some modifications. The modifications are (1) simplified language and concept and increased visual aids, (2) increased feedback, exercise, and repetition, (3) short duration in each session, and (4) environmental support (Brown et al, 2013;Charlton & Dykstra, 2011;Dykstra & Charlton, 2003;McNair, Woodrow, & Hare, 2016).…”

Dialectical Behaviour Therapy [DBT] with People with Intellectual Disabilities: A Systematic Review and Narrative Analysis

“…; Brown et al . ) and a further study reported on using DBT in secure services (Morrissey & Ingamells ).…”

Factors of behavioural problems and types of housing of persons with intellectual disability

“…Kao moguća objašnjenja ove pojave mogu se prihvatiti stavovi Deba i saradnika koji se odnose na faktore bitne za smanjenje doze ili prekid upotrebe psihotropnih lekova: dugoročni efekat upotrebe ovih medikamenata, društveni, edukativni i zdravstveni faktori i uticaj okruženja (Deb et al, 2009). Pored navedenih rezultata ističemo da je grupa autora utvrdila da životni period može biti značajan faktor za upešnost korigovanja problema u ponašanju osoba sa IO i da se kod mlađih osoba pozitivni efekti tretmana postižu brže u odnosu na starije (Brown et al, 2013).…”