Search results

This paper aims to describe and evaluate the impact of a compassion-focused therapy (CFT) group for adults with intellectual disabilities (ID).

People with ID are commonly subjected to stigmatising experiences that can contribute to feelings of shame. CFT targets shame and self-criticism by helping people to cultivate self-compassion. There is evidence to suggest that CFT can be meaningfully adapted for people with ID. Qualitative and quantitative data were collected using a mixed-methods design, aiming to gain a rich evaluation of the CFT group. Eight adults with ID were referred by their local community psychology team. An 11-week group protocol was based on materials from previous research. The protocol included the development of a “compassion box”, aiming to make CFT concepts more concrete and tangible. Questionnaires measuring psychological distress, self-compassion and negative social comparisons were completed pre- and post-group. Feedback from participants and carers were collated and facilitators’ observations were recorded.

Questionnaire findings were mixed, and some participants found the measures difficult to understand. Participants’ qualitative feedback and facilitators’ observations suggested that the group created feelings of safety and connectedness whilst facilitating engagement and action with shame and self-criticism. Several participants highlighted the usefulness of the ‘”compassion box”, although some barriers were noted.

This paper provides a rich description of how group CFT can be adapted to meet the needs of adults with ID and is the first study of its kind, to the best of the authors’ knowledge, to evaluate the incorporation of the “compassion box”.

This paper aims to argue that to address those factors that contribute to the probability of offending, the origins of such factors should be understood, and interventions that recognise the functional aspects of criminogenic capacities should be developed.

The paper provides a theoretical basis for trauma sensitive practice by providing an evolutionary understanding of human harmfulness alongside a summary of the impact of adversity and abuse on the developing child.

The paper proposes an overarching framework that uses compassion-focused therapy for risk reducing interventions with men who cause harm to others.

This paper encourages forensic practitioners to develop a trauma aware approach to intervention design and delivery. The paper provides an overview of a compassion-focused therapy as approach to intervention that conceptualises criminogenic capacities within a more holistic and functional framework.

Forensic interventions have been slow to assimilate evidence from adverse childhood experience research and have therefore been limited in their ability to address the functional origins of criminogenic need. This paper offers a framework that allows practitioners to address risk while also allowing individuals to process their own trauma and adversity.

Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID).

As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure.

Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy.

To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways.

This literature review aims to ascertain the outcomes and perspectives of community-based compassion-focused therapy (CFT) for adults with intellectual disabilities.

A comprehensive search of five databases was conducted systematically, with one additional study identified manually, yielding eight relevant studies. Methodological quality was appraised using two tools to account for heterogeneity in study designs.

Two studies conducted a CFT-derived task while six studies conducted full CFT interventions, of which two delivered group interventions. Qualitative findings were favourable towards CFT, though some quantitative outcomes were inconsistent across the literature and with qualitative results. It is concluded that CFT is perceived as valuable and appears to produce positive outcomes for adults with intellectual disabilities. However, larger, randomised control trials are required to establish CFT as an efficacious, evidence-based intervention.

This review provides insight into the outcomes and perspectives of CFT for individuals with an intellectual disability which has not been explicitly explored prior. Therefore, a holistic and specific examination of community-based CFT for individuals with intellectual disabilities is introduced to the literature.

This paper aims to describe a service evaluation study of “Balance” – a National Health Service Tier 2 pilot weight management course delivered in a primary care mental health service. The 12 weekly sessions included dietetic, psychological and behavioural elements underpinned by cognitive behavioural theory and “third-wave” approaches, including acceptance and commitment therapy, compassion-focused therapy and mindfulness.

A mixed-methods design was used in this service evaluation study that included analysis of outcome measures (weight, eating choices, weight-related self-efficacy and mental health) and focus group data (n = 6) analysed using thematic analysis. Eleven clients with a body mass index of 25–40 kg/m² enrolled, and nine clients completed the course. Outcome data were collected weekly with follow-up at three and six months.

Quantitative data analysis using non-parametric Wilcoxon signed-rank tests showed that the group mean weight decreased significantly (p = 0.030) by the end of Balance, but the group mean weight loss was not statistically significant at the three-month (p = 0.345) or six-month (p = 0.086) follow-up. The qualitative results showed that participants valued the course ethos of choice and also welcomed learning new tools and techniques. Balance was very well-received by participants who reported benefitting from improved well-being, group support and developing new weight management skills.

Only one client attended all sessions of the group, and it is possible that missed sessions impacted effectiveness. Some of the weight change data collected at the six-month follow-up was self-reported (n = 4), which could reduce data reliability. Focus group participants were aware that Balance was a pilot with a risk that the group would not be continued. As the group wanted the pilot to be extended, the feedback may have been positively skewed. A small sample size limits interpretation of the results. A group weight management intervention, including dietetic, psychological and behavioural elements, underpinned by cognitive behavioural theory was well-received by service users and effective for some. Commissioners and service users may have different definitions of successful outcomes in weight management interventions.

Longer-term support and follow-up after Tier 2 weight management interventions may benefit service users and improve outcomes.

The paper contributes to a small but growing evidence base concerned with the design and delivery of weight management interventions. Areas of particular interest include: a gap analysis between the course content and National Institute for Health and Care Excellence clinical guidelines, participants’ views on the most impactful course features and recommendations for course development. The results also show a disconnect between evidence-based guidelines (mandatory weight monitoring), participants’ preferences and clinicians' experience. The difference between client and commissioner priorities is also discussed.

The purpose of this paper is to determine the effectiveness of an adapted compassion-focused therapy (CFT) group treatment programme for individuals with an intellectual disability (ID), specifically aimed to help address maladaptive conceptualisations of masculinity.

Outcome measurements were competed at pre- and post-group and the effectiveness of the intervention were assessed using a Wilcoxon signed ranks test.

Findings demonstrated that the treatment group showed significant differences in their “gender role conflict” subscales including the Success, Power, Control and “Restrictive Affectionate Behavior Between Men” subscales; however, no significant differences were found on the Restrictive Emotionality or Conflicts Between Work and Leisure subscales. Furthermore, no significant differences were found on participants psychological well-being, psychological distress, anxiety, self-compassion or quality of life measures.

Limitations include that a lack of qualitative information regarding outcomes, a lack of control group and a small number of participants may have impacted the outcome of the research.

The Men’s Masculinity group had a positive impact on the participant’s sense of success, power and control, so it could be considered that this group enabled participants to feel more powerful and in control of their difficulties which is associated with the “drive” system of CFT.

Overall, this study adds to the small but growing literature that supports using CFT groups as a stand-alone psychological intervention when working with people with an ID.

The purpose of this paper is to describe practices associated with compassion focussed therapy (CFT) in a secure forensic setting for men with a learning disability and personality disorder. The values of this model for both therapeutic work and the organisation of residential practices in a secure setting are considered.

The paper presents a conceptual discussion of the use of CFT with an offender population.

The paper describes the use of CFT as a framework for working with offenders with an intellectual disability and personality disorder. The paper discusses the organisation of service practices alongside more formal therapeutic interventions.

CFT offers a unique integrated model for working with offenders. The core CFT model invites staff teams to consider the safety seeking aspects of challenging behaviours and to understand these behaviours in the context of evolved threat processing mechanisms. The focus on emotional processing that is central to the model invites services to develop deep understanding of the functions of violence and other offending behaviours and to balance work in these areas alongside the development of capacities that offer individuals methods for effective emotional regulation.

The paper provides a unique discussion point for the organisation of forensic services for this population. The consideration of the wider social context of offender rehabilitation in terms of the residential settings, and the juxtaposition of this with formal treatments is rarely considered.

This paper aims to outline the human capacity for harmfulness and details the role of trauma and adversity in the consolidation of harmful capacities.

The paper is a theoretical overview and offers a rationale for developing more trauma sensitive practices.

The paper proposes compassion focussed therapy (CFT) as an overarching approach to organising interventions.

The paper invites practitioners to develop a holistic approach to forensic interventions incorporating a collaborative formulation and personal objectives for service users.

CFT and trauma informed approaches to working with risk are relatively new in the forensic field. This paper provides a rationale for the further development of such approaches within forensic settings.

The purpose of this paper is to assess the effects of compassion-focussed therapy (CFT) on anxiety in a small sample of adults with intellectual disability.

A mixed-methods design was employed. Participants (n=3) completed questionnaire measures of anxiety and self-compassion on three occasions: pre-intervention, post-intervention and, at three months follow-up. Post-intervention, they also took part in recorded interviews that were analysed using interpretive phenomenological analysis. Findings were then synthesised to develop a comprehensive understanding of their overall experience.

Final data synthesis revealed five themes: participant anxiety decreased (reliable for all participants); the faulty self; improved positive compassionate attitudes; increased sense of common humanity; and mindful distraction techniques.

This research paper offers in-depth analysis of three participants’ experiences rather than reporting in less detail about a larger number of participants. The self-compassion scale required considerable support and reasonable adaptation to be used with these clients.

Only two other studies have explored the use of CFT with people with intellectual disabilities.

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK.

This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author.

The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity.

The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions.

A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes.

This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.