Psychological therapies for people with intellectual disabilities: comments on a matrix of evidence for interventions in challenging behaviour.
High-quality proof for talk-based therapies in ID is still scarce—use the evidence map and favor ABA where solid data exists.
01Research in Context
What this study did
Whitehouse et al. (2014) hunted for gold-standard studies on talking or play therapies that calm problem behavior in people with intellectual disabilities.
They screened every systematic review they could find and built a big evidence map.
The map shows how strong the proof is for each therapy so clinicians can pick the best-supported tool.
What they found
The map is mostly blank.
High-quality randomized trials for psychological therapies in ID are scarce.
Most reviews rest on tiny, weak studies, so we still don’t know which talk-based tools truly work.
How this fits with other research
Bush et al. (2021) gives the opposite news: behavior-analytic studies for kids under eight now count as “evidence-based” for communication and daily-living skills.
The 2014 map calls psychological therapy evidence scarce; Bush et al. (2021) shows ABA evidence has since grown and meets today’s standards.
Hattier et al. (2011) and Perez et al. (2015) echo the same gap: whether the pill is an antipsychotic or a CBT group, the trials are small and sloppy.
Together the reviews say, “Pick ABA for skill building; for talk therapy or meds, demand stronger data before you sign off.”
Why it matters
When a family asks for non-drug help, you can show them the map.
If the box is empty, explain that we rely on clinical experience while we wait for better trials.
Push funders to run bigger RCTs so next year’s map has more green squares.
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02At a glance
03Original abstract
BACKGROUND: Psychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings. METHODS: A systematic review of peer-reviewed literature published between 1980 and 2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best-evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions. RESULTS: There is a limited amount of efficacy research that meets the most stringent standards of empirical evidence. CONCLUSIONS: It is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment.
Journal of intellectual disability research : JIDR, 2014 · doi:10.1111/j.1365-2788.2012.01646.x