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Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

  • Patricia Cooney (a1), Catherine Jackman (a2), David Coyle (a3) and Gary O'Reilly (a4)
Abstract
Background

Despite the evidence base for computer-assisted cognitive–behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.

Aims

To evaluate the utility of a CBT computer game for adults who have an intellectual disability.

Method

A 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.

Results

A significant group x time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.

Conclusions

As the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.

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Copyright
Corresponding author
Patricia Cooney, School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. Email: patricia.cooney@ucdconnect.ie
Footnotes
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Declaration of interest

P.C., C.J., D.C. and G.O.'R. designed the computerised CBT program, Pesky Gnats: The Feel Good Island, used in the present study. None of the authors receives any income from the program, which is owned by Handaxe, a community interest company run on a not-for-profit basis.

Footnotes
References
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1 Cooper, S-A, Smiley, E, Morrison, J, Williamson, A, Allan, L. Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. Br J Psychiatry 2007; 190: 2735.
2 Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Chatterji, S, Lee, S, Ormel, J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc 2009; 18: 2333.
3 Koslowski, N, Klein, K, Arnold, K, Kösters, M, Schützwohl, M, Salize, HJ, et al. Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis. Br J Psychiatry 2016; 209: 469–74
4 National Institute for Health and Care Excellence. Mental Health Problems in People with Learning Disabilities: Prevention, Assessment and Management (NICE guideline NG54). NICE, 2016 (https://www.nice.org.uk/guidance/ng54).
5 Willner, P, Rose, J, Jahoda, A, Kroese, BS, Felce, D, Cohen, D, et al. Group-based cognitive–behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomised controlled trial. Br J Psychiatry 2013; 203: 288–96.
6 Hassiotis, A, Serfaty, M, Azam, K, Strydom, A, Blizard, R, Romeo, R, et al. Manualised individual cognitive behavioural therapy for mood disorders in people with mild to moderate intellectual disability: a feasibility randomised controlled trial. J Affect Disord 2013; 151: 186–95.
7 Lindsay, WR, Tinsley, S, Beail, N, Hastings, RP, Jahoda, A, Taylor, JL, et al. A preliminary controlled trial of a trans-diagnostic programme for cognitive behaviour therapy with adults with intellectual disability. J Intellect Disabil Res 2015; 59: 360–9.
8 National Institute for Health and Care Excellence. Depression in Adults: Recognition and Management (Update) (NICE Clinical Guideline 90). NICE, 2016 (https://www.nice.org.uk/CG90).
9 den Brok, WLJE, Sterkenburg, PS. Self-controlled technologies to support skill attainment in persons with an autism spectrum disorder and/or an intellectual disability: a systematic literature review. Disabil Rehabil Assist Technol 2015; 10: 110.
10 Vereenooghe, L, Gega, L, Reynolds, S, Langdon, PE. Using computers to teach people with intellectual disabilities to perform some of the tasks used within cognitive behavioural therapy: a randomised experiment. Behav Res Ther 2016; 76: 1323.
11 Tanis, ES. Palmer S, Wehmeyer M, Davies DK, Stock SE, Lobb K, et al. Self-report computer-based survey of technology use by people with intellectual and developmental disabilities. Intellect Dev Disabil 2012; 50: 5368.
12 O'Reilly, G, Cooney, P, Jackman, C, Coyle, D. Pesky Gnats: The Feel Food Island. A CBT computer Game to Assist Adults who have an Intellectual Disability with Anxiety or Depression. Handaxe ClC, 2015.
13 O'Reilly, G, Coyle, D. Pesky gNATs. A CBT Computer Game to Assist Young People with Anxiety or Low Mood. Handaxe ClC, 2015.
14 O'Reilly, G, Coyle, D. The Pesky gNATs App. Handaxe ClC, 2015.
15 Beck, AT, Haigh, EA. Advances in cognitive theory and therapy: the generic cognitive model. Annu Rev Clin Psychol 2014; 10: 124.
16 Mindham, J, Espie, C. Glasgow Anxiety Scale for people with an Intellectual Disability (GAS-ID): development and psychometric properties of a new measure for use with people with mild intellectual disability. J Intellect Disabil Res 2003; 47: 2230.
17 Cuthill, FM, Espie, CA, Cooper, S-A. Development and psychometric properties of the Glasgow Depression Scale for people with a Learning Disability Individual and carer supplement versions. Br J Psychiatry 2003; 182: 347–53.
18 Brooks, M, Davies, S, Twigg, E. A measure for feelings – using inclusive research to develop a tool for evaluating psychological therapy (Clinical Outcomes in Routine Evaluation-Learning Disability). Br J Learn Disabil 2013; 41: 320–9.
19 Faul, F, Erdfelder, E, Buchner, A, Lang, A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behav Res Methods 2009; 41: 1149–60.
20 Cohen, J. Statistical Power Analysis for the Behavioral Sciences (2nd edn). Erlbaum, 1988.
21 Carr, A. What Works with Children, Adolescents, and Adults? A Review of Research on the Effectiveness of Psychotherapy. Routledge, 2009.
22 Higgins, JP, Altman, DG, Gøtzsche, PC, Jüni, P, Moher, D, Oxman, AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928.
23 Rosnow, RL, Rosenthal, R. Computing contrasts, effect sizes, and counternulls on other people's published data: general procedures for research consumers. Psychol Methods 1996; 1: 331.
24 Jacobson, NS, Truax, P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991; 59: 12.
25 Vereenooghe, L, Langdon, PE. Psychological therapies for people with intellectual disabilities: a systematic review and meta-analysis. Res Dev Disabil 2013; 34: 4085–102.
26 O'Reilly, G, Coyle, D, Tunney, C. Even Buddhist monks use a gong: a mindfulness skills programme for young people delivered through the “Mindful Gnats” computer game and App. Int J Game-Based Learning (IJGBL) 2016; 6: 3951.
27 Beck, JS. Cognitive Behavior Therapy: Basics and Beyond. Guilford Press, 2011.
28 Vygotsky, LS. Mind in Society: The Development of Higher Psychological Processes. Harvard University Press, 1978.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

  • Patricia Cooney (a1), Catherine Jackman (a2), David Coyle (a3) and Gary O'Reilly (a4)
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