Integrative treatment in persons with intellectual disability and mental health problems.
Build a four-domain team—bio, psycho, social, developmental—to treat mental-health issues in adults with ID.
01Research in Context
What this study did
The author described a way to treat adults who have both intellectual disability and mental-health problems.
Instead of one provider working alone, a team meets: psychiatrist, BCBA, nurse, social worker, and family.
The model adds a fourth lens—developmental stage—to the usual bio-psycho-social plan.
No numbers were tracked; the paper simply walks through real cases to show how the team works.
What they found
The study does not give before-and-after scores.
It shows that planning together across four domains helps the team spot why behaviors occur and what skills to teach next.
How this fits with other research
Xenitidis et al. (1999) ran an earlier inpatient program and cut challenging behavior so much that 84 % of adults moved back to the community.
Their result sounds stronger, but they used a locked hospital ward with 24-hour care.
Dosen (2007) moves the same team idea into everyday outpatient services, trading the hospital structure for family-friendly coordination.
Lunsky et al. (2024) push the idea further: adults with ID and their families should help design the services, not just receive them.
Together the three papers trace a line—from hospital unit, to professional team, to shared partnership.
Eussen et al. (2016) later hunted for solid evidence and found almost no trials; they echo Dosen (2007) by saying we still need better data.
Why it matters
If you serve adults with dual diagnoses, stop working in silos.
Use team huddles, share your A-B-C data with the psychiatrist, and ask what developmental skills the client still needs.
One concrete step: add a developmental goal column to your behavior plan and review it at every team meeting.
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02At a glance
03Original abstract
BACKGROUND: Clinical experience has proven thus far that a monodisciplinary treatment approach to behavioural and psychiatric problems in persons with intellectual disability (ID), such as psychotropic medication or behaviour modification programmes, has yielded limited success. It is clear that the complexity of behavioural and psychiatric problems in this population calls for a treatment approach from different perspectives. METHODS: A multidimensional treatment approach to the persons with ID who suffer from behaviour problems and psychiatric disorders is described. RESULTS: Four dimensions - biological, psychological, social and developmental - are represented as well in an integrative diagnosis as in an integrative treatment, embodied by cooperation of different professionals, such as a psychiatrist, psychologist, pedagogues, social worker, nurse and, where possible, the person's caretakers. The developmental dimension receives a salient attention of assessors. By introducing the developmental dimension in diagnostics and treatment, the bio-psycho-social dimensions are set in a new context, more appropriate for persons with ID. CONCLUSION: The integrative treatment should not be primarily directed towards the symptoms of the disorder but towards restoring a person's mental well-being. The disorder is combated through treatment of the underlying processes that have led to its onset. Different treatment methods from different perspectives may be applied. Strategy and methodological procedures of an integrative treatment are discussed by way of case presentations.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2006.00868.x