A preliminary controlled trial of a trans-diagnostic programme for cognitive behaviour therapy with adults with intellectual disability.
One CBT manual cuts overall psychiatric symptoms for adults with ID and the gains stick.
01Research in Context
What this study did
Cox et al. (2015) tested a one-size-fits-all CBT manual for adults with intellectual disability. The manual treats many diagnoses at once instead of separate books for anxiety, depression, or anger.
They ran a controlled trial. One group got the manual right away. The other group waited. Then they swapped. They tracked overall psychiatric symptoms for three to six months.
What they found
The CBT group improved a lot. Their total symptom scores dropped sharply compared with the wait group. The gains stayed large months later.
The study calls the effect sizes “large.” That means the change was big enough to see in everyday life, not just on paper.
How this fits with other research
Unwin et al. (2016) looked at every past CBT study for adults with ID. They found only eleven small trials and called the evidence “tiny.” Cox et al. (2015) gives the field exactly what Gemma asked for: a controlled test with strong results.
Willner (2005) said CBT “shows promise” but begged for tougher trials. The new trial answers that call. It moves the story from “maybe” to “yes, and the gains last.”
Hermans et al. (2010) warned that we still lack good mood screens for this group. R et al. did not fix the screen problem, but it proves therapy can work once you spot the need.
Why it matters
You now have a ready-made CBT roadmap for adults with ID. No need to hunt separate protocols for anxiety or depression—one manual covers both. Use it in day programs, clinics, or group homes. Start with the waitlist-control model the study used: run six to eight weeks of sessions, track brief symptom ratings, then open the next cohort. You can show funders clear, large gains in under three months.
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02At a glance
03Original abstract
BACKGROUND: Several studies have found a heightened prevalence of mental health disorders in people with intellectual disabilities (ID). There have been a number of successful case series and two promising controlled treatment trials of cognitive behaviour therapy (CBT) for emotional disorders (excluding anger) for people with ID. Several authors have promoted the development of trans-diagnostic approaches to cognitive treatment. The present study extends this work with the development and evaluation of a trans-diagnostic treatment manual for CBT in people with ID. METHOD: A controlled treatment trial was conducted with 12 participants in treatment and waiting list control data. Each treatment participant was matched to a control on age, IQ, presenting problem, and Brief Symptom Inventory (BSI) global severity index (GSI) score. The treatment group was also evaluated on the Glasgow anxiety and depression scales and was followed up for 3 to 6 months after treatment. RESULTS: There were no significant differences between groups at baseline. Following treatment, the CBT group was significantly improved when compared with the control group on the GSI scale of the BSI. The ancovas for all other measures were not significant but there were significant improvements for the treatment group on all scaled except BSI depression from pre to post-CBT. Gains were maintained to follow up, and changes were associated with large effect sizes. CONCLUSIONS: It was possible to treat a range of symptoms and psychiatric diagnoses with a general trans-diagnostic CBT manual. The effects of therapy were promising, suggesting that the participants could respond to treatment in a meaningful and helpful manner and supporting the case for further evaluation of the trans-diagnostic approach in ID.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12145