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Article
Publication date: 17 May 2023

Charlotte Clarke, Nigel Beail and Stephen Kellett

There is little consensus regarding what constitutes an effective therapist when working with adults with intellectual disabilities (ID) who have a mental health problem. This…

Abstract

Purpose

There is little consensus regarding what constitutes an effective therapist when working with adults with intellectual disabilities (ID) who have a mental health problem. This study aims to explore whether clusters of clinical psychologists (CPs) could be differentiated with regards to beliefs as to what defines an effective therapist for adults with ID experiencing psychological distress and seeking treatment.

Design/methodology/approach

Four interviews with CPs and an associated thematic analysis created the 49-item Q-set. These items were then sorted into a forced quasi-normal distribution by N = 27 CPs via an online Q-sorting task.

Findings

Three participant clusters were identified in the principal components analysis that accounted for 49% of the variance. These clusters were labelled the creative collaborator, the reflective expert and the system integrator.

Research limitations/implications

Differences exist regarding beliefs as to what the psychotherapeutic approaches effective therapists working with ID and comorbid mental health problems should take. These differences approximated to preferred psychological therapy models. This study is critiqued to enable future research on this topic to progress.

Originality/value

To the best of the authors’ knowledge, this is the first study to explore what constitutes an effective psychological therapist for people who have ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 17 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 4 August 2022

Charlotte Clarke, Stephen Kellett and Nigel Beail

This paper aims to assess the quality of systematic reviews on the effectiveness of psychological therapy for adults with intellectual disabilities (ID) and mental health…

Abstract

Purpose

This paper aims to assess the quality of systematic reviews on the effectiveness of psychological therapy for adults with intellectual disabilities (ID) and mental health difficulties.

Design/methodology/approach

Four electronic databases were used: Cochrane, PsycINFO, PubMed and Scopus. Studies were included if they were a systematic review focused primarily on psychological therapy for adults with ID and mental health difficulties. Systematic reviews focused on anger were also considered for inclusion. These reviews were rated for quality on the Amstar-2, a quality rating tool designed to evaluate systematic reviews.

Findings

Twelve relevant systematic reviews were identified, which included seven reviews focused primarily on cognitive behavioural therapy, two on psychodynamic therapy and three on third-wave therapies. The AMSTAR-2 indicated that all 12 reviews were of “critically low” quality. Thus, there are significant problems with the evidence base.

Originality/value

To the best of the authors’ knowledge, this is the first systematic review of systematic reviews of the effectiveness of psychological therapies for people who have ID. It provides an overview of the quality of the evidence base into one place.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 16 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 1 February 1993

Stephen Kellett

Team management strategy will become an increasingly importantconcern for organizations as they change to or increase the number ofteams in their structures. The role of the team…

1582

Abstract

Team management strategy will become an increasingly important concern for organizations as they change to or increase the number of teams in their structures. The role of the team leader – as the medium through which teams are managed – needs to be integrated into and become a major aspect of management development programmes. Only through this process can organizations capture the potential which all teams possess and effective teams utilize.

Details

Management Development Review, vol. 6 no. 1
Type: Research Article
ISSN: 0962-2519

Keywords

Article
Publication date: 1 September 2005

Stephen Kellett, Suzanne Clarke and Linda Matthews

Cape and Barkham's practice improvement model (PIM) describes how healthcare systems can be designed to facilitate the usage of self‐generated clinical outcomes in the delivery of…

2025

Abstract

Purpose

Cape and Barkham's practice improvement model (PIM) describes how healthcare systems can be designed to facilitate the usage of self‐generated clinical outcomes in the delivery of subsequent interventions. This article aims to describe the application of the PIM in the implementation of group‐based cognitive‐behavioural therapy, for clients referred from Primary Care with anxiety disorders.

Design/methodology/approach

The groups were evaluated using and pre‐ and post‐intervention design using a variety of validated measures of psychological functioning as part of a wider audit and evaluation system. The conclusions drawn from the audit and evaluation system, in the form of PIMs, were fed‐back into the design of successive groups in the attempt to increase subsequent effectiveness. Group 1 had no PIM applied, group 2 had a single PIM applied and group 3 had two PIMs applied.

Findings

The introduction of the single PIM for group 2 increased the effectiveness of clinical outcomes, while for group 3, the introduction of two PIMs increased effectiveness again in comparison to group 1, but not in comparison to group 2.

Practice implications

The results indicate that the active use of feedback of outcomes from interventions conducted can be utilised to design and then evaluate the application of resultant PIMs. This represents attempts to introduce and operationalise the concept of continuous quality improvement in the delivery of a clinical service.

Originality/value

The evaluation of PIMs is in its practical and methodological infancy and this initiative represents the first attempt to utilise PIMs in the design of Primary Care psychological services.

Details

Clinical Governance: An International Journal, vol. 10 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 1 December 2007

Carolyn McNally, Nigel Beail and Stephen Kellett

This study explored the experiences of detention under the Mental Health Act (1983) of people with learning disabilities. Semi‐structured one‐to‐one interviews (N = 7) were…

354

Abstract

This study explored the experiences of detention under the Mental Health Act (1983) of people with learning disabilities. Semi‐structured one‐to‐one interviews (N = 7) were analysed using interpretative phenomenological analysis. Participants had mild learning disabilities and had been detained under the Mental Health Act in England for compulsory assessment and treatment within a two‐year period prior to the study. A number of valuable insights emerged, including: the impact of perceived lack of control over self, experiences of vulnerability/powerlessness/ victimisation (both prior to and following detention), participant's sense of care versus punishment; the development of ‘role’ within the mental health system and attribution of blame. The study helps expand the current literature on experiences of people with learning disabilities from their perspective, identifies the possible emotional impact of detention and indexes the range of coping styles elicited between participants in the face of detention.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 4
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 10 December 2009

Stephen Kellett, Nigel Beail, Alick Bush, Graham Dyson and Mark Wilbram

Single case experimental design (SCED) has a long, well‐respected tradition in evaluating the effectiveness of behavioural interventions for people with learning disabilities and…

Abstract

Single case experimental design (SCED) has a long, well‐respected tradition in evaluating the effectiveness of behavioural interventions for people with learning disabilities and challenging behaviours. However, shift the focus to other psychological modalities (such as psychodynamic psychotherapy) or differing presenting problems (such as interpersonal problems) and the use of SCED methodologies is severely curtailed. This paper describes the application of SCED methodologies in the evaluation of treatment of three clients: the psychodynamic psychotherapy of hypochondriasis in an A/B design, psychodynamic psychotherapy of ambulophobia in an A/B design, and cognitive‐behavioural therapy of anger and aggression in a shifting criterion design. Visual and statistical analysis of the time series data revealed that the hypochondriasis and the anger cases responded to treatment, whereas the ambulophobia case showed some deterioration during the intervention. The cases are discussed in terms of the strengths and weaknesses of the methodologies applied and the relative merits of accruing SCED evidence in the evaluation of the plethora of psychological modalities now being made available to learning disabled clients.

Details

Advances in Mental Health and Learning Disabilities, vol. 3 no. 4
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 14 December 2021

Shonagh Leigh and Jason Davies

This paper aims to provide practitioners with a brief but comprehensive review of the current evidence base for psychological treatment approaches used in the UK that may be…

Abstract

Purpose

This paper aims to provide practitioners with a brief but comprehensive review of the current evidence base for psychological treatment approaches used in the UK that may be useful for stalking therapies.

Design/methodology/approach

A rapid evidence assessment was conducted on papers (post the UK Protection from Harassment Act, 1997) that discuss treatments of stalking (with or without a conviction) and associated offences/disorders. Therapies reviewed were Acceptance and Commitment Therapy, Cognitive Analytic Therapy, Cognitive Behavioural Therapy, Dialectical Behaviour Therapy and Schema Therapy. Searches for Mentalization-Based Therapy and Psychodynamic Therapy in relation to stalking were also performed but yielded no results that met inclusion criteria.

Findings

There is currently a severely limited evidence base for the efficacy of the psychological treatment of stalking behaviours. Some interventions show promise although a multifaceted, formulation-based approach is likely to be required.

Practical implications

Future research would benefit from robust studies focused on stalking with long-term efficacy follow-ups.

Originality/value

To the best of the authors’ knowledge, this is the first rapid evidence review of psychological treatments that directly address stalking behaviour.

Details

The Journal of Forensic Practice, vol. 24 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 27 February 2023

Kashmir Goddard, Jane Montague and James Elander

This study aims to reflect on ways that the experiences of vulnerable users of drug and alcohol services can inform social work practice and policy to improve treatment engagement…

Abstract

Purpose

This study aims to reflect on ways that the experiences of vulnerable users of drug and alcohol services can inform social work practice and policy to improve treatment engagement and mitigate negative responses to interventions.

Design/methodology/approach

The research used semi-structured interviews and photovoice in an interpretative phenomenological analysis of the experiences of people in treatment for drug or alcohol problems whose child was the subject of a Child Protection or Child in Need order.

Findings

The research gave insights into participants’ experiences of loss of control, unfairness and stigma. Participants described how they felt powerless in the social services system and were afraid to be open and honest with practitioners for fear of having their children removed.

Practical implications

The research highlighted the need for more training and professional development for social work practitioners to address power imbalance issues, and the need to promote non-threatening professional practice that removes penalties for disclosure of substance use, enabling substance users who are parents to be more honest about their drug use.

Social implications

The research showed the value of phenomenological methods for investigating sensitive issues with vulnerable users of treatment services in a way that can inform policy and practice.

Originality/value

This paper explores ways that phenomenological research with vulnerable, hard-to-reach participants can produce insights about the potential benefits of social work practice that is non-threatening and encourages greater openness and honesty among substance users who are parents.

Details

Drugs, Habits and Social Policy, vol. 24 no. 1
Type: Research Article
ISSN: 2752-6739

Keywords

Article
Publication date: 1 June 1992

A.D. Stephen and A. Wise

In a study of fat‐spreading habits of children, it was found thatmost children were already spreading by the age of five years and thattheir habits did not appear to change during…

Abstract

In a study of fat‐spreading habits of children, it was found that most children were already spreading by the age of five years and that their habits did not appear to change during the age range of five‐11 years. Few factors were found to explain individual differences in amount spread on bread, but families choosing spreads for spreadability may encourage a greater amount of spread, children copying others may use more, and children having difficulty using knives may use less spread than others.

Details

Nutrition & Food Science, vol. 92 no. 6
Type: Research Article
ISSN: 0034-6659

Keywords

Article
Publication date: 1 June 1930

The Library Association of Ireland issued last month the first number of An Leabharlann, their new official journal. The title, for those of us who do not speak the language of…

Abstract

The Library Association of Ireland issued last month the first number of An Leabharlann, their new official journal. The title, for those of us who do not speak the language of Erin, means The Library. It is an extremely interesting venture which will be followed by librarians on the mainland with sympathetic curiosity. In particular our readers would be interested in the first of a series of articles by Father Stephen J. Brown, S.J., on Book Selection. The worthy Father lectures on this subject at University College, Dublin, in the Library School. It is mainly concerned with what should not be selected, and deals in vigorous fashion with the menace of much of current published stuff. No doubt Father Brown will follow with something more constructive. Mr. T. E. Gay, Chairman of the Association, discusses the need for a survey of Irish libraries and their resources. We agree that it is necessary. The Net Books Agreement, the Council, Notes from the Provinces, and an article in Erse—which we honestly believe that most of our Irish friends can read—and an excellent broadcast talk on the Library and the Student by Miss Christina Keogh, the accomplished Librarian of the Irish Central Library, make up a quite attractive first number. A list of broadcast talks given by members of the Association is included.

Details

New Library World, vol. 33 no. 1
Type: Research Article
ISSN: 0307-4803

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