Do video reviews of therapy sessions help people with mild intellectual disabilities describe their perceptions of cognitive behaviour therapy?
Letting clients watch and comment on their own CBT clips uncovers worries you can fix before they quit.
01Research in Context
What this study did
Twelve adults with mild intellectual disability watched short clips of their own CBT sessions. Right after each clip they told the therapist what they liked, disliked or did not understand.
The team called the steps the Burford Reviewing Process. It took one short meeting and needed only a laptop.
What they found
Every client gave clear, useful feedback. They named parts that helped them and parts that still felt hard.
The staff learned that some clients feared speaking up in group and others wanted more picture aids.
How this fits with other research
Peters et al. (2013) asked clients the same questions in interviews and heard the same themes: warmth matters and gains may fade. The video method simply speeds up the talk.
Dai et al. (2023) pooled nine small CBT studies for anxiety and found weak but positive effects. Our 2012 case series shows one reason the effects stay small: we rarely ask clients what they think mid-treatment.
Levin et al. (2014) ran an eight-session CBT pain programme and saw gains vanish after one month. Their clients never reviewed session tapes, so staff missed early signs of drift.
Why it matters
You can add a ten-minute video review to any CBT session. Pause the tape, ask "What helped? What was tough?" Clients with mild ID give answers you can use the same day. The step costs nothing and may stop dropout.
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Record today’s session, then spend ten minutes next visit playing two key clips and asking the client what landed and what did not.
02At a glance
03Original abstract
BACKGROUND: This study examined the potential of a retrospective video reviewing process [Burford Reviewing Process (BRP)] for enabling people with intellectual disabilities to describe their experiences of cognitive behaviour therapy (CBT). It is the first time that the BRP, described in this paper, has been used with people with intellectual disabilities and the aim was to assess the feasibility of the procedure and gain a picture of the information it might yield. METHODS: Using the BRP, 12 clients reviewed tapes of their fourth and ninth CBT sessions and six reviewed the fourth session only. All reviews were audio recorded for later verbatim transcriptions of clients' comments. Reviews and transcriptions were conducted by non-clinical researchers. Thematic analysis was applied to the transcripts by a researcher who was not CBT-trained. RESULTS: All clients were able to follow the instructions for the BRP. Three broadly based themes encapsulated their responses - how they felt about themselves, how they felt the therapist was helping and how CBT was helping. A fourth theme referred to comments on issues that were currently troubling clients, which were prompted by watching the video but did not refer to actual events on screen. CONCLUSIONS: The BRP seems a feasible approach with this client group and gave insights into their feelings and opinions on CBT. Clinical implications of the results and the potential for further developments are discussed.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01450.x