Assertiveness and problem-solving training for mildly mentally retarded persons with dual diagnoses.

Davison et al. (1991) tested two social skills lessons for adults with mild intellectual disability and other mental health needs. Half the group learned assertiveness skills. Half learned problem-solving steps. A third group learned both skills in the same hour.

The team used an alternating-treatments design. Each adult rotated through the three lesson types. Trainers measured real-life use of the skills, self-reported distress, and caregiver ratings of daily living skills.

All three lesson plans worked. Adults spoke up more often, solved everyday problems faster, and felt less upset. Caregivers noticed better adaptive behavior at home.

The big surprise: the combined package did no better than assertiveness alone or problem-solving alone. Teaching both skills in one session simply took more time for the same gain.

Boudreau et al. (2015) asked the same question with group CBT for depression. They also found that a combined cognitive-plus-behavioral module beat wait-list, but the combo did not beat either part alone. The pattern holds across decades and target skills.

van Nieuwenhuijzen et al. (2009) looked younger. Teens with mild ID in residential care knew assertive solutions yet still acted out. Their data extend the 1991 findings: knowing the skill is only step one; practice in real settings is still needed.

Petry et al. (2007) offer a different path. Their review shows antidepressants help fewer than half of dually-diagnosed adults with aggression. M et al. give a non-drug option that works for most, filling the gap left by modest drug effects.

You can run either assertiveness or problem-solving lessons and still see social gains in adults with mild ID and mental health needs. Pick the module that best matches the person’s current life goal: speaking up to peers or fixing daily hassles. Start with short, single-skill groups to save staff time, then add booster sessions only if data stall.