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Background: Psychological interventions need to be adapted for use with people with intellectual disabilities to ensure they are engaging, accessible and effective. Co-design allows the experiences of service users and stakeholders to actively shape and develop interventions, to ensure their accessibility., Method: An adapted model of Experience Based Co-Design (EBCD) was used to co-develop a novel, mental imagery-based psychological intervention for people with mild to moderate intellectual disabilities and anxiety. Involvement in EBCD was evaluated for people with intellectual disabilities and stakeholders using both quantitative and qualitative methods., Results: Numerous concrete and specific intervention adaptations arose and were implemented. Our findings indicated that all participants were able to engage fully with EBCD, and that participants found the process a positive experience., Conclusions: EBCD has likely resulted in a more accessible and engaging intervention which can be now tested within a larger study., (© 2025 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Using inclusive research methods with people with intellectual disabilities is increasingly common. A recent consensus statement identified key elements when conducting and reporting inclusive research with people with intellectual disabilities. This review identifies the range of health and social care research topics using inclusive research methodologies, systematically appraises the involvement of researchers with intellectual disabilities, and identifies facilitators and barriers to inclusive research. Researchers' experiences of engaging with inclusive research are synthesised., Method: Seventeen empirical studies focused upon inclusive health and social care research were identified. The associated inclusive research methodologies employed, and the stages in which researchers with intellectual disabilities were involved, along with the experiences of researchers with and without intellectual disabilities were synthesised., Results: Papers focused on a broad range of health and social care topics and largely employed qualitative or mixed-methods designs. Researchers with intellectual disabilities were frequently involved with data collection, analysis and dissemination. Facilitators of inclusive research comprised sharing power, team working, having sufficient resources and making research methodologies accessible., Conclusions: Researchers with intellectual disabilities are involved in a wide range of methodologies and research tasks. How the added value of inclusive research is measured and its impact on outcomes, require consideration., (© 2023 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Objective: The aim of this systematic review and meta-analysis (PROSPERO 2020 CRD42020169323) was to evaluate the efficacy of psychological therapy for people with intellectual disabilities., Method: A comprehensive literature search yielded 22,444 studies which were screened for eligibility. Studies were eligible for inclusion if a psychological therapy was delivered to people with intellectual disabilities compared to a group who did not receive the therapy. Thirty-three controlled trials were eligible for inclusion in the review, with 19 included within a DerSimonian-Laird random effects meta-analysis. Subgroup analysis was completed by clinical presentation, and by comparing randomised trials to non-randomised trials, and group-based to individually delivered psychotherapy., Results: Following the removal of outliers, psychological therapy for a range of mental health problems was associated with a small and significant effect size, g = 0.43, 95% CI [0.20, 0.67], N = 698. There was evidence of heterogeneity and bias due to studies with small sample sizes and a lack of randomisation. Non-randomised studies were associated with a large effect size, g = 0.90, 95% CI [0.47, 1.32], N = 174, while randomised studies were associated with a small effect size, g = 0.36, 95% CI [0.17, 0.55], N = 438, excluding outliers. Individually delivered psychological therapy was associated with a small and non-significant effect size, g = 0.32, 95% CI [-0.01, 0.65], N = 146, while group-based interventions were associated with a small and significant effect size, g = 0.37, 95% CI [0.05, 0.68], N = 361, again, excluding outliers. Psychological therapy for anger was associated with a moderate effect size, g = 0.60, 95% CI [0.26, 0.93], N = 324, while treatment for depression and anxiety was associated with a small and non-significant effect size, g = 0.38, 95% CI [-0.10, 0.85], N = 216, after outliers were removed., Conclusions: Studies are fraught with methodological weaknesses limiting the ability to make firm conclusions about the effectiveness of psychological therapy for people with intellectual disabilities. Improved reporting standards, appropriately powered and well-designed trials, and greater consideration of the nature and degree of adaptations to therapy are needed to minimise bias and increase the certainty of conclusions., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: Mental imagery is important in the development and maintenance of psychological disorders and well-being but has been neglected in people with intellectual disabilities. A detailed idiographic analysis of the lived experience of mental imagery in this population is presented., Design: This qualitative study uses interpretative phenomenological analysis (IPA). It involved inclusive research methods with people with intellectual disabilities and other stakeholders (including family members, advocates, support workers and intellectual disability service managers)., Methods: Ten individual semi-structured interviews were conducted with people with mild-moderate intellectual disabilities. Participants were opportunistically sampled through organisations providing community services to people with intellectual disabilities in the UK. Two men and eight women (mean age 43 years) participated. Interviews were audio-recorded and analysed using IPA., Results: People with intellectual disabilities are able to experience a range of rich and detailed mental images across all sensory modalities. Participants reported changes in affect based on mental imagery, and an ability to experience both spontaneous and deliberate mental images. The emotional saliency of the object of mental imagery appeared to influence participants' ability to engage with imagery. A number of adaptations make mental imagery more accessible and easier to report. The ability of people with intellectual disabilities to experience vivid mental imagery has important clinical implications for the use of a range of mental imagery interventions with this population., Conclusions: The need to consider mental imagery interventions for this population, and how these can be adapted to ensure accessibility is a priority for people with intellectual disabilities and psychological disorders., (© 2022 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Mental imagery is recognised for its role in both psychological distress and wellbeing, with mental imagery techniques increasingly being incorporated into psychological interventions. In this systematic review and narrative synthesis (PROSPERO 2021: CRD42021240930), we identify and evaluate the evidence base for the phenomenon and phenomenology of mental imagery in people with intellectual disabilities, to ascertain the applicability of such interventions for this population. Electronic searches of nine databases and grey literature identified relevant publications. Two reviewers independently assessed titles and abstracts of retrieved records (n = 8609) and full-text articles (n = 101) against eligibility criteria. Data were extracted and quality appraised. Forty-onepapers met our eligibility criteria. The quality and designs were variable. Mental imagery was facilitated through ensuring participants understood tasks, providing opportunity to rehearse tasks (including using concrete prompts) and using scaffolding to help participants elaborate their responses. People with intellectual disabilities can engage with mental imagery, with appropriate adaptations, although the associated phenomenology has not been thoroughly investigated. Mental imagery interventions may be useful for people with intellectual disabilities with appropriate modifications., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: This study investigated the use of a Compassion-Focused Therapy (CFT) group as a psychological intervention for a group of adults with an intellectual disability with a range of psychological issues. Method: Four clients attended the group, which was facilitated by three trainee Clinical Psychologists. The group consisted of 8 weekly sessions. Findings: Standardised outcome measures showed an increase in psychological well-being and self-compassion for all participants postintervention. Two participants showed an increase in psychological distress, while two participants reported decreases in this area. Scores on measures of self-criticism fell for two participants, increased for one participant and showed no change for one participant. Qualitative interviews were conducted with postgroup with all group members (clients and facilitators). Thematic analysis identified two superordinate themes relating to the accessibility of the group content, and interpersonal aspects of the group. Conclusion: The results suggest that clients enjoyed and benefitted from the group. Challenges, such as lack of carer involvement, were identified, and recommendations for future CFT groups are made.

Background: Sepsis is a common cause of death within the general population and the third most common cause of death for people with a learning disability, suggesting an increased vulnerability or different trajectory within this population. Despite this, there is currently no research into the direct lived experiences of people with a learning disability who develop and recover from sepsis. Methods: Semi-structured interviews were conducted with 3 people with a learning disability (average age of 44.7, range of age 33 to 68) who experienced sepsis and 5 carers (1 familial and 4 professional carers) (average age of 48.8, range of age 43 to 58) who had supported an individual with a learning disability while they had sepsis. Sepsis was caused by a range of physical health problems. Face-to-face semi-structured interviews were conducted, transcribed and analysed using thematic analysis. Findings: Six main themes were identified: chronic and acute pre-existing health conditions, experiences within the hospital setting, physical recovery, mental recovery, returning to a normal life and the implications of sepsis. The findings highlighted some of the ongoing difficulties for people with intellectual disabilities in accessing timely healthcare provision and the ongoing mental health problems, even after physically recovering from sepsis. People with a learning disability have more comorbid health conditions which may compound the longer-term effects of sepsis. Conclusion: Future research should be conducted with people with learning disabilities about their experiences shortly after recovery from sepsis, to mitigate the effects of memory difficulties in recalling experiences.

Background: Transition to adulthood is an important time for young people and may be a particularly challenging time for people with intellectual disabilities. However, there has been little research in the UK regarding the experiences of parents who have son or daughter with an intellectual disability transitioning to adulthood. Method: The study used interpretive phenomenological analysis to explore the lived experiences of ten parents who had a son or daughter (aged 18-25 years) with an intellectual disability. Half of the sample also had a diagnosis of autism. Results: Three superordinate themes were generated from the data: (a) Transition: The Good, the Bad and Unknown; (b) Striving for Independence; and (c) Supporting the Supporters. Parents experienced many difficulties and uncertainty related to their role, their son/daughter's independence, navigating services for their son/daughter and accessing support for themselves. Conclusions: Increased collaboration and consistency from statutory services is required in addition to providing emotional support to parents and facilitating parent support networks.

Objectives: The objectives of this mixed methods study are to (1) investigate the knowledge and skills of mainstream psychiatrists in managing patients with Intellectual Disability (ID) and comorbid mental health disorders, (2) assess their perception of the quality and accessibility of services for this population, and (3) establish the local implementation of the Green Light Toolkit. Method: We surveyed mainstream psychiatrists in the Thames Valley region working in general adult, forensic, and older adult services, to ascertain their opinions about their knowledge and skills in managing patients with ID and comorbid mental disorder, as well as quality and accessibility of services. We compared our findings with previous UK and international research. Results: Respondents mirrored views expressed in earlier studies that inpatient care should be provided in dedicated units for people with ID, rather than general adult inpatient wards. Limited resources, training and competence, and lack of collaborative working were highlighted as key barriers to provision of effective care. Conclusion: Psychiatrists broadly support a specialist service model for people with ID. In the UK, specialist psychiatric services for people with ID have been delivered through inpatient and community services, but there is a current shift towards integrating ID with mainstream service models. Participants expressed concern that mainstream services fail to meet the mental health needs of this patient group, and lead to increased patient vulnerability. The Green Light Toolkit was not well known or used within services. A number of ways of improving collaborative care between services are suggested.

Background: This paper reports quantitative and qualitative follow-up data from three participants who attended a Dialectical Behaviour Therapy (DBT) group for people with an intellectual disability. Materials and Methods: Quantitative data regarding psychological well-being, psychological distress (measured using the Psychological Therapies Outcome Scales; PTOS) and quality of life (measured using the Health of the Nation Outcome Scales--Learning Disability; HONOS-LD) are reported for pre-group, post-group and at 6-month and 2-year follow-up. Interviews were conducted with participants post-group and at 2-year follow-up. Data were analysed using thematic analysis. Results: Improvements in scores on measures of psychological well-being, psychological distress and quality of life appear to be maintained at 6-month follow-up, but scores at 2-year follow-up suggest a return to baseline. Qualitative self-report data suggest a number of interesting ways participants adapted and individualised techniques from the group, as well as suggesting possible barriers to maintaining change in the longer term. Conclusions: Clinical implications are considered to improve effectiveness of similar interventions, as well research implications in order to improve knowledge about the longer term impact of group DBT interventions.

Background: A growing body of evidence supports the use of Dialectic Behaviour Therapy with people with an intellectual disability. Various adaptation have been used in studies exploring the efficacy of this intervention. Method: A Dialectic Behaviour Therapy DBT skills training group was attended by people with an intellectual disability and their support staff. Standardised measures of psychological well-being, overall functioning and psychological distress were taken before and after the group and at 4 months follow-up. Qualitative interviews were conducted and analysed using thematic analysis. Results: Results suggested an improvement in all areas for three of the four participants, which were largely maintained at follow-up. Conclusions: This study adds to the growing literature supporting the use of DBT with people with an intellectual disability. The role of support workers in supporting generalisation of skills is considered. Ideas for improving the quality of future studies are considered.

Background: Recent government policy has focused on reducing the number of people with a learning disability receiving treatment for challenging behaviour or mental health difficulties in hospitals (including in assessment and treatment units; ATU). People with a learning disability should be supported to remain in their community when receiving support for challenging behaviour or mental health difficulties whenever possible. Methods: This study considered a novel intervention based on person-centred planning practice, which aimed to coordinate a person's support, identify outstanding needs and increase communication. This intervention intended to reduce rates of inpatient admission, and support the person to remain in their community, whilst ensuring their needs are met. This intervention was assessed by considering the number of people admitted to the inpatient services before and after the intervention, the length of inpatient admissions before and after the intervention, and by analysing qualitative feedback from participants in the intervention. Results: "Planning Live" meetings were held for 102 people. Forty-five meetings were held retrospectively following an emergency admission. Following the 'Planning Live' meeting, five people had a planned admission and 52 people did not have an inpatient admission. The median length of inpatient stay fell from 143.5 days before the introduction of "Planning Live" to 66 days (a statistically significant reduction). Qualitative feedback shows that the process was largely seen as helpful by professionals, families and individuals taking part in the meetings. Conclusions: The results suggest this person-centred intervention contributed towards a reduction in the amount of time individuals stayed in hospital. However, the total number of hospital admissions rose following the intervention.

Background: More people with a learning disability are becoming parents. Little is known about the lived experiences of the children who have a parent with a learning disability. Methods: This study uses interpretative phenomenological analysis (IPA) to understand the lived experiences of people who have a parent with a learning disability. Five people who have a parent with a learning disability were asked about their experiences of being parented and their childhood more generally. Results: Four themes emerged from the interviews: 1) "Fitting in" within the wider family system, 2) The parental relationship and the impact of disability, 3) A difficult childhood and 4) Resilience. Conclusions: These findings are compared with the existing literature, and similarities and emerging findings are noted. Implications for services when supporting families with a parent who has a learning disability are discussed. Additional ideas about areas that require additional research are identified.

Accessible summary: Cognitive Behavioural Therapy (CBT) can help individuals with learning disabilities and anxiety.A group was run to help people to manage their anxiety and to feel better.At the end participants and their supporters fed back their experiences of the group and filled in questionnaires to measure their anxiety and psychological distress.The group seems to reduce people's anxiety.This report adds to a growing body of existing literature demonstrating some benefits of CBT for people with learning disabilities and anxiety. Background: Existing studies show mixed results of the effectiveness of CBT for people with learning disabilities and anxiety. Method: A CBT group was run for people with learning disabilities and anxiety, who attended with a supporter. Qualitative interviews were conducted post‐group and analysed using thematic analysis. Standardised questionnaires measuring anxiety, psychological distress and overall functioning were administered at pre‐ and post‐group, and at follow‐up. Results: Participants' anxiety decreased overall post‐group, which remained largely at follow‐up. The group and the supporters' involvement was helpful. Both supporters and participants recalled coping strategies that were presented in the group. Three out of four participants found attending a group challenging initially. The supporters seem to have specific expectations about the impact of the group. Conclusions: The results of the study are consistent with the existing, growing body of evidence which supports the use of CBT for people with learning disabilities and anxiety. [ABSTRACT FROM AUTHOR]

Research addressing people with intellectual disabilities’ experiences of mental health problems has mainly focused on the perspectives of family members or professionals, or has been driven by service evaluation. Few studies have sought the views of people with intellectual disabilities about their own mental health experiences. This study explored the experiences of eight adult participants with mild intellectual disabilities who self-identified as having experienced anxiety, depression, and/or psychosis. Participants completed semi-structured interviews and data was analyzed using interpretative phenomenological analysis (IPA). Four superordinate themes emerged: distress, fear and isolation; damaging impact of relationships and people; negative view of self; and the challenge of “getting my sparkle back.” The themes identified in the participants’ accounts of their mental health experiences are discussed in relation to clinical and research implications. [ABSTRACT FROM PUBLISHER]