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Kind minds: using the ‘compassionate kitbag’ in a compassion focused therapy group for adults with intellectual disabilities 善心:在智障成人同情治疗小组中使用 "同情工具包
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-12-25 DOI: 10.1108/amhid-07-2023-0024
Andy Busfield, Charlotte Peters, Karen McKenzie
PurposeThis paper aims to describe and evaluate the impact of a compassion-focused therapy (CFT) group for adults with intellectual disabilities (ID).Design/methodology/approachPeople 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.FindingsQuestionnaire 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.Originality/valueThis 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”.
目的本文旨在描述和评估针对智障成人的同情疗法(CFT)小组所产生的影响。心理创伤疗法通过帮助人们培养自我同情来消除羞耻感和自我批评。有证据表明,CFT 可以对智障人士进行有意义的调整。我们采用混合方法设计收集定性和定量数据,旨在对 CFT 小组进行丰富的评估。八名成年智障人士由当地社区心理小组转介。根据以往研究的资料,制定了为期 11 周的小组协议。该方案包括开发一个 "同情箱",旨在使 CFT 的概念更加具体化和有形化。在小组活动前和小组活动后,填写了测量心理困扰、自我同情和负面社会比较的调查问卷。对参与者和照顾者的反馈进行了整理,并记录了主持人的观察结果。参与者的定性反馈和主持人的观察表明,该小组营造了安全感和联系感,同时促进了参与者的参与和行动,消除了羞耻感和自我批评。一些参与者强调了 "同情箱 "的实用性,但也指出了一些障碍。原创性/价值本文对如何调整小组 CFT 以满足智障成人的需求进行了丰富的描述,据作者所知,这是第一项评估 "同情箱 "使用情况的研究。
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引用次数: 0
To say (sexual fetish)… or not to say (sexual fetish). That is the question 说(性癖好)......还是不说(性癖好)。这就是问题所在
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-11-24 DOI: 10.1108/amhid-08-2023-0032
Robert John Searle
Purpose In a recent report the author wrote about a service user, the author was challenged by the service user’s advocate in respect of the author’s use of the term “sexual fetish”. The author was informed of the advocate’s fears in respect of people involved in the service user’s future care and support needs feeling uncomfortable and possibly stigmatising someone having a sexual fetish. Consequently, the author was asked to change their wording from “sexual fetish” to “sensory need”. The purpose of this study/paper aims to highlight best practice regarding the most appropriate wording for individuals with sexual fetishes. Design/methodology/approach A review of the available evidence was ascertained. Findings A review of British Psychological Society guidelines and recent research highlights that what were once called “perversions” must be destigmatised, which will not be achieved if people continue to sweep the term fetish under the metaphorical carpet. Originality/value It is the author’s sincere hope that use of the term “sexual fetish” embraces and normalises people’s sexual fetish and results in heightened awareness and de-stigmatisation of what is essentially a reference to an element of the wonderful and pleasurable world of sexual behaviour.
目的 在作者最近撰写的一份关于一名服务使用者的报告中,服务使用者的代言人对作者使用 "性癖好 "一词提出质疑。作者被告知,代言人担心参与服务使用者未来护理和支持需求的人员会感到不舒服,并可能会对有性癖好的人产生污名化。因此,作者被要求将措辞从 "性癖好 "改为 "感官需求"。本研究/论文旨在强调有关性恋物者最合适措辞的最佳实践。 设计/方法/途径 对现有证据进行回顾。 研究结果 对英国心理学会指南和最新研究的回顾强调,曾经被称为 "变态 "的东西必须去污名化,如果人们继续将恋物癖一词扫入隐喻地毯之下,就无法实现这一目标。 原创性/价值 作者衷心希望,"性癖好 "一词的使用能够包容人们的性癖好,并使之正常化,从而提高人们对性癖好的认识,并消除其污名化。
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引用次数: 0
Project ECHO-AIDD: recommendations for care of adults with intellectual and developmental disabilities echo - aid项目:关于照顾有智力和发育障碍的成人的建议
Q4 PSYCHIATRY Pub Date : 2023-11-01 DOI: 10.1108/amhid-06-2023-0019
Olivia Mendoza, Anupam Thakur, Ullanda Niel, Kendra Thomson, Yona Lunsky, Nicole Bobbette
Purpose This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care. Design/methodology/approach In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations. Findings Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care. Originality/value This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.
目的本研究旨在描述在一个专注于智力和发育障碍(IDD)成人心理健康的跨专业虚拟教育项目中出现的患者,并提出跨专业的护理建议。设计/方法/方法在本回顾性图表回顾中,使用描述性统计来描述患者。内容分析用于分析跨专业推荐。作者使用了健康、环境、生活经历和精神障碍(H.E.L.P.)框架来概念化和分析这些跨专业建议。研究结果:与IDD成人需求相关的主题是根据hp框架提出的。采取以团队为基础的护理方法,以及确保护理提供者了解健康和社会历史,可能有助于更好地定制护理。创意/价值该项目借鉴了加拿大第一个以这一群体为重点的全国性跨专业和跨部门教育倡议所提供的知识。
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引用次数: 0
Assessing adherence to National Institute for Health and Care Excellence dementia assessment and diagnosis guidelines in adults with intellectual disability: a retrospective cohort study 评估智力残疾成人对国家健康与护理卓越研究所痴呆评估和诊断指南的依从性:一项回顾性队列研究
Q4 PSYCHIATRY Pub Date : 2023-11-01 DOI: 10.1108/amhid-07-2023-0022
Caroline Duncan, Ewan Wilkinson, Sujeet Jaydeokar, Daniel James Acton
Purpose This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations. Design/methodology/approach The study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records. Findings The authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation. Originality/value To the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.
目的探讨成人智障患者痴呆的评估与诊断护理。作者从国家健康与护理卓越研究所(NICE)的标准中选择了建议,这些建议可以在临床记录中得到证明,旨在确定可能与提高对这些建议的依从性相关的特征。研究人群是在2019年1月至2022年12月期间被英国智力残疾服务机构诊断患有痴呆症的智力残疾成年人。从电子病历中提取数据,以证明对选定建议的依从性以及人口统计学和临床特征。作者确定了41个个体。八项建议中平均有六项得到遵守。结构成像支持痴呆亚型诊断的依从性较低(9人,22%)。这可能与被诊断患有血管性痴呆的人的比例低有关(1人,2%),尽管全国的数字是20%。没有人口学或临床特征与依从性记录相关。作者发现在电子病历中诊断性临床编码记录不完整。这可能不利于这一人群,因为他们不能很容易地确定诊断后的支持或资源分配。原创性/价值据作者所知,这是第一个在这一人群中检查NICE指南遵守情况的研究。
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引用次数: 0
Forensic mental health intellectual and developmental disability service: an analysis of referral patterns and comparison with community mental health intellectual disability (MHID) services in Ireland 法医心理健康智力残疾和发育残疾服务:对转诊模式的分析以及与爱尔兰社区心理健康智力残疾服务的比较
Q4 PSYCHIATRY Pub Date : 2023-11-01 DOI: 10.1108/amhid-06-2023-0020
Afwan Abdul Wahab, Calvin Har, Sarah Casey, Hugh Ramsay, Brendan McCormack, Niamh Mulryan, Anita Ambikapathy, Anthony Kearns
Purpose The purpose of this study is to analyse the characteristics of all the referrals to the forensic MHIDD service over the past five years and to compare these characteristics to the cohort of service users attending the three general MHID services based in Dublin which are Service 1, Service 2 and Service 3. Design/methodology/approach This is a cross-sectional study of adults attending the three generic MHID services and the national forensic MHIDD service. The medical files of service users attending the MHID services were reviewed, and data such as age, gender, level of intellectual disability and psychiatric diagnoses were extracted and compiled into a database. The forensic MHIDD service has since its inception maintained a database of all referrals received and reviewed. The characteristics data needed were extracted from the forensic MHIDD database. All these data were then analysed using the Statistical Package for Social Sciences (SPSS). Findings The majority of the three MHID service users were in the moderate to profound range of intellectual disability, while the majority of the cases assessed by forensic MHIDD had normal IQ, borderline IQ and mild intellectual disability with 66.1%. The prevalence of neurodevelopmental disorder, schizophrenia and emotionally unstable personality disorder in the forensic MHIDD is comparable to the three MHID services. The prevalence of depression, bipolar affective disorder (BPAD), anxiety disorder and obsessive-compulsive disorder (OCD) is higher in the three MHID services than in the forensic MHIDD service. Originality/value The FHMIDD received referrals at a greater level of overall ability, with two-thirds of the service users having mild intellectual disability to normal IQ. The prevalence of neurodevelopmental disorder such as ASD and schizophrenia is comparable between the forensic MHIDD and the three MHID services. There is a higher prevalence of depression, BPAD, anxiety disorder and OCD in the three MHID services as compared to the forensic MHIDD service.
本研究的目的是分析过去五年来所有转介到法医MHID服务的特征,并将这些特征与参加都柏林三种一般MHID服务(服务1、服务2和服务3)的服务用户队列进行比较。设计/方法/方法这是一项横断面研究,研究对象是参加三家通用MHID服务机构和国家法医MHID服务机构的成年人。审查了参加MHID服务的服务使用者的医疗档案,提取了年龄、性别、智力残疾程度和精神诊断等数据,并将其汇编到一个数据库中。法医中心自成立以来一直维护一个数据库,记录收到和审查的所有转介案件。从法医MHIDD数据库中提取所需的特征数据。然后使用社会科学统计软件包(SPSS)分析所有这些数据。结果3例MHID服务使用者以中度至重度智力残疾为主,而法医MHID评估的病例以正常智商、边缘性智商和轻度智力残疾为主(66.1%)。法医MHIDD的神经发育障碍、精神分裂症和情绪不稳定型人格障碍的患病率与三种MHID服务相当。抑郁症、双相情感障碍(BPAD)、焦虑症和强迫症(OCD)的患病率在三种MHID服务中高于法医MHID服务。创意/价值本署接受转介的人士整体能力水平较高,其中三分之二的服务使用者有轻度智障至正常智商。神经发育障碍如ASD和精神分裂症的患病率在法医MHID和三个MHID服务之间是相当的。与法医MHIDD服务相比,三种MHID服务中抑郁症、BPAD、焦虑症和强迫症的患病率更高。
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引用次数: 0
Adherence to care and treatment review policy and impact on length of stay 遵守护理和治疗审查政策及其对住院时间的影响
Q4 PSYCHIATRY Pub Date : 2023-10-24 DOI: 10.1108/amhid-07-2023-0023
Lucy Jade Jones, Ceri Woodrow
Purpose The purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment reviews should be offered to people with an intellectual disability and/or autism who are at risk of admission into a mental health hospital. Design/methodology/approach Admission and discharge data was collected across two assessment and treatment units between January 2019 and December 2022. Adherence to the care and treatment review policy was also reviewed as was length of inpatient stay. A retrospective evaluation was conducted. Triangulation of data was collected via the trusts’ electronic patient record system and NHS analytics team. Descriptive statistics, Mann–Whitney U test and a one-way ANOVA with post hoc tests were used in the analysis. Findings An increase in behaviours of challenge and deterioration of mental health were the main reasons for admission. Forty-nine percent (30) of those admitted to the assessment and treatment units accessed a care and treatment review. Care and treatment reviews were more frequently provided for individuals experiencing longer inpatient stays. Originality/value There is limited evidence relating to outcomes and impact of care and treatment reviews. Further research is required to explore effectiveness of care and treatment reviews to understand benefits and appropriately prioritise resource.
本临床审计的目的是审查两个NHS评估和治疗单位对2017年护理和治疗审查政策的遵守情况。应向智力残疾和/或自闭症患者提供护理和治疗审查,这些患者有被送入精神病院的风险。设计/方法/方法在2019年1月至2022年12月期间收集了两个评估和治疗单位的入院和出院数据。对护理和治疗审查政策的依从性以及住院时间的长短也进行了审查。进行回顾性评价。数据的三角测量是通过信托的电子病历系统和NHS分析团队收集的。分析采用描述性统计、Mann-Whitney U检验和单因素方差分析及事后检验。结果挑战行为的增加和心理健康状况的恶化是入院的主要原因。接受评估和治疗单位的人中有49%(30)接受了护理和治疗审查。护理和治疗审查更频繁地提供给经历较长住院时间的个人。原创性/价值与护理和治疗评价的结果和影响相关的证据有限。需要进一步的研究来探索护理和治疗评估的有效性,以了解益处并适当地优先考虑资源。
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引用次数: 0
Universal Needs Based Resource Assessment (UNBRA) an objective approach to evaluate resources needed to support people with intellectual disability in an inpatient setting 基于普遍需求的资源评估(UNBRA)——一种评估住院环境中支持智障患者所需资源的客观方法
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-09-11 DOI: 10.1108/amhid-05-2023-0015
Susanne Meddings, Mahesh M. Odiyoor, Holly Eick, Katie Kavanagh, S. Jaydeokar
PurposeThere are no existing tools to capture resources needed to support people with intellectual disability in an inpatient setting on an individual patient basis. The purpose of this paper is to describe the development of a new tool called Universal Needs Based Resource Assessment (UNBRA).Design/methodology/approachUsing the Delphi method, focus groups were used to generate factors determining resource use. From these, themes were identified, a scoring system was created and the UNBRA tool was developed. This was piloted in two NHS inpatient units and modified following feedback.FindingsThe UNBRA tool holistically assesses resource requirements of an individual with intellectual disability supported in an inpatient setting. It considers ten factors grouped into the six themes of staffing, indirect work, clinical/ multi-disciplinary work, incidents, carer link activity and discharge process. UNBRA scores allow intra- and interpersonal comparison as well as comparison between units and can support resource allocation and operational decision-making.Originality/valueTo the best of the authors’ knowledge, there is no suitable existing tool to capture individual resource requirements of patients in intellectual inpatient settings. The development of the UNBRA tool fills this gap.
目的没有现有的工具来获取在住院环境中以个体患者为基础支持智障患者所需的资源。本文的目的是描述一种名为基于普遍需求的资源评估(UNBRA)的新工具的开发。设计/方法/方法使用德尔菲方法,焦点小组被用来生成决定资源使用的因素。从中确定了主题,建立了评分系统,并开发了UNBRA工具。这在英国国家医疗服务体系的两个住院单位进行了试点,并根据反馈意见进行了修改。发现UNBRA工具全面评估住院环境中智障患者的资源需求。它考虑了十个因素,分为六个主题,即人员配备、间接工作、临床/多学科工作、事故、护理人员联系活动和出院过程。UNBRA评分允许内部和人际比较以及单位之间的比较,可以支持资源分配和运营决策。独创性/价值据作者所知,目前还没有合适的工具来捕捉智力住院患者的个人资源需求。UNBRA工具的开发填补了这一空白。
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引用次数: 0
A survey of therapists’ experience of ending therapy with people with intellectual disabilities 一项关于治疗师结束对智障人士的治疗经验的调查
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-07-21 DOI: 10.1108/amhid-04-2023-0012
Yasmine Dunn, S. Summers, D. Dagnan
PurposeA range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy practice that have not yet been considered in depth. This study aims to report the results of an online survey of the practice of therapists working with people with intellectual disabilities in managing endings in therapy.Design/methodology/approachThirty-one therapists working with people with intellectual disabilities responded to an online survey. The data were analysed using reflexive thematic analysis.FindingsThree superordinate themes were identified: Theme 1 was “preparing for a therapeutic ending” with subordinate themes of “planning early”, “providing boundaries” and “validating feelings”; Theme 2 was “providing a therapeutic ending”, with subordinate themes of “a collaborative decision” and “fostering growth”; and the third theme was “post-ending issues” in which participants acknowledged a “spectrum of emotion”, and, in the case of difficult endings, a sense of “unfinished business”.Originality/valueThis is the first systematic exploration of therapy endings as described by therapists working with people with intellectual disabilities. The authors discuss implications for practice and further areas of research.
目的探讨与智障人士治疗相关的一系列适应和治疗过程;然而,仍有一些治疗实践领域尚未深入研究。本研究的目的是报告一项在线调查的结果,该调查是关于治疗师在治疗中处理智障患者的结局的实践。设计/方法/方法31位治疗智障人士的治疗师参与了一项在线调查。使用反身主题分析对数据进行分析。研究发现:主主题1为“治疗性结局的准备”,次主题为“早期计划”、“提供界限”和“确认感受”;主题2为“提供治疗性结局”,次主题为“合作决策”和“促进成长”;第三个主题是“结局后的问题”,参与者承认自己有“一系列的情绪”,而在艰难结局的情况下,他们会有一种“未了之事”的感觉。原创性/价值这是第一次系统地探索治疗结局,正如治疗智障人士的治疗师所描述的那样。作者讨论了对实践和进一步研究领域的影响。
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引用次数: 0
The effectiveness of positive behaviour support in reducing challenging behaviour and increasing quality of life for individuals with intellectual disability 积极行为支持在减少智力残疾患者的挑战性行为和提高生活质量方面的有效性
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-06-14 DOI: 10.1108/amhid-03-2023-0007
K. Dewey, Sean Evans, Sarah Horsley, Ellis Baker
PurposeIntensive support teams (ISTs) are often poorly understood, despite reports of their effectiveness in managing behaviour that challenges for individuals with an intellectual disability. This paper aims to contribute to the understanding of ISTs through evaluating one IST’s process and their use of positive behaviour support (PBS) as an intervention.Design/methodology/approachParticipants were obtained from the ISTs discharge database, and pre- and post-intervention data from these participants was used for analysis.FindingsThree-paired sample t-tests found that there were significant differences between pre- and post-scores on the behaviour problem inventory, Health of the Nation Outcomes Scale for people with Learning Disabilities and periodic service reviews, which measure quality of targeted, individualised support. This indicates that challenging behaviour frequency and severity were lower post-intervention, quality of life improved post-intervention and staff teams implemented recommended strategies more consistently by the end of the intervention.Originality/valueThis service evaluation captured data over seven-year period, which helps to contribute to the understanding of the effectiveness of ISTs and the PBS framework.
目的强化支持团队(IST)通常不太为人所知,尽管有报道称其在管理智障患者行为方面的有效性。本文旨在通过评估IST的过程及其使用积极行为支持(PBS)作为干预措施,有助于理解IST。设计/方法/方法从ISTs出院数据库中获得参与者,并使用这些参与者的干预前和干预后数据进行分析。结果三项配对样本t检验发现,在行为问题清单、学习障碍者国家健康结果量表和定期服务审查(衡量有针对性的个性化支持的质量)的前后得分之间存在显著差异。这表明,干预后具有挑战性的行为频率和严重程度较低,干预后生活质量得到改善,工作人员团队在干预结束时更一致地实施了建议的策略。独创性/价值这项服务评估收集了七年的数据,有助于理解IST和PBS框架的有效性。
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引用次数: 0
Waiting for psychological therapy during the covid-19 pandemic: experiences of adults with an intellectual disability 新冠肺炎大流行期间等待心理治疗:智障成年人的经历
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-06-14 DOI: 10.1108/amhid-08-2022-0028
Rebecca Baxter, G. Rawlings, L. Yates, N. Beail
PurposeMeasures introduced to mitigate the spread of coronavirus-19 (COVID-19) may have contributed to an increase in waiting times for face-to-face psychological treatments. As adults with intellectual disabilities (ID) are more likely to encounter barriers when accessing remote therapies, it is important they receive appropriate support while waiting. To understand what care is needed, this service evaluation [aimed to] explored the experiences of service users with ID who have waited for treatment during the pandemic.Design/methodology/approachSeven individuals who had been waiting for psychological therapy during the COVID-19 pandemic, which included those waiting longer than the national health service target of 18 weeks, were interviewed. Data were analysed using framework analysis.FindingsThe following four key themes were identified: waiting has been “painful”, related to how service users continued to experience difficulties whilst they waited; tolerating the wait, highlighted that individuals understood the reasons for waiting; use of coping strategies where service users identified both internal and external strategies they had used to cope; and support and contact from the learning disability team, related to how individuals experienced the support they received from the service.Originality/valueTo the best of the authors’ knowledge, this service evaluation is the first to explore the experiences of service users with ID waiting for psychological therapy during the Covid-19 pandemic. Results guide suggestions on improving support whilst they are waiting to help prevent further decline.
目的为缓解冠状病毒肺炎(新冠肺炎)的传播而采取的措施可能导致了面对面心理治疗等待时间的增加。由于智障成年人在获得远程治疗时更容易遇到障碍,因此他们在等待时获得适当的支持很重要。为了了解需要什么样的护理,这项服务评估[旨在]探索在疫情期间等待治疗的ID服务用户的经历。设计/方法/方法在新冠肺炎大流行期间等待心理治疗的7人,其中包括等待时间超过国家卫生服务目标18人的人 周,接受了采访。使用框架分析对数据进行了分析。发现以下四个关键主题被确定:等待是“痛苦的”,与服务用户在等待时如何继续经历困难有关;容忍等待,强调个人理解等待的原因;使用应对策略,其中服务用户确定了他们用来应对的内部和外部策略;以及学习障碍团队的支持和联系,涉及个人如何体验到他们从服务中获得的支持。原创/价值据作者所知,本次服务评估首次探讨了新冠肺炎大流行期间ID服务用户等待心理治疗的经历。结果指导了在他们等待时改善支持的建议,以帮助防止进一步下降。
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引用次数: 0
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Advances in Mental Health and Intellectual Disabilities
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