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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.

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.

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”.

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.

This paper aims to provide a description of a trauma sensitive intervention for men who have committed sexual offences. The intervention aims to support men to process and make sense of their own experience of trauma before inviting them to acknowledge their role in causing harm to others. The intervention draws on compassion focussed therapy (CFT) as the overarching therapeutic modality.

As part of a service evaluation changes in routine repeat measures completed by service users were analysed prior to joining the intervention and after 12 months of intervention. Service users were encouraged to provide regular feedback relating to their experience of the intervention at regular intervals. This feedback was collated and patterns were identified collaboratively to understand the context for assessed change in the measures.

Prior to the intervention men reported high levels of shame and limited experiences of guilt (as compassion for others). Early findings indicate that men experience less shame and increased experiences of guilt after 12 months. An increase in insight into risk was also evident. Service user feedback pointed towards a more engaging therapeutic style and highlighted the importance of both a collaborative and trauma sensitive approach.

This is the first evaluative description of forensic CFT for sexual offending. Findings offer insight into potential future directions for forensic interventions with this population.

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.

The novel coronavirus and associated mitigation efforts have caused significant increases in stress for adults with intellectual disabilities. Such increases in life stress predict an increased risk of relapse following psychological therapy. This contributes to the high global disease burden of common mental health difficulties. Therefore, this paper aims to explore service user experiences of maintaining gains following therapy within the context of the Covid-19 pandemic.

A mixed-methods evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. Descriptive statistics and effect size calculations were used to examine therapeutic outcomes pre-therapy, post-therapy, and at follow-up. These findings informed a framework analysis of eight semi-structured interviews.

Overall, outcome results improved post-therapy and regressed at follow-up. The framework analysis revealed facilitators to maintenance include a recollection of specific aspects of therapy and the regular utilisation of strategies and resources. Conversely, barriers to maintenance include a recollection focussed on personal outcome, a reliance on social support and an inability to remember therapy.

This is the only study to the authors’ knowledge examining service user experiences of maintaining gains following therapy within the context of Covid-19. It is hoped that these findings will inform further research and be useful for services in preparing service users for discharge as the Covid-19 pandemic continues and moves towards the post-pandemic phase.

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.