The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities

J Appl Res Intellect Disabil. 2018 Jan;31(1):76-86. doi: 10.1111/jar.12328. Epub 2017 Jan 24.

Abstract

Background: People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear.

Method: Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT.

Results: The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs.

Conclusions: Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access.

Keywords: CBT; IAPT; high-intensity therapists; intellectual disabilities; mental health; therapist confidence.

MeSH terms

  • Cognitive Behavioral Therapy*
  • England
  • Health Services Accessibility
  • Humans
  • Intellectual Disability / psychology*
  • Mental Health Services*
  • Psychotherapy