Study finds solution to improving anger control in people with intellectual disabilities

A team of researchers, led by a Swansea University Professor, have discovered that anger control in people with intellectual disabilities may be improved using group-based cognitive behaviour therapy (CBT), which aims to change the way that people think about their problems and how they behave in difficult situations.

The new study, published online by the British Journal of Psychiatry, provides evidence of the effectiveness of CBT for people with intellectual disabilities.

Many people with intellectual disabilities find it hard to control their anger. This often leads to aggression, and can have serious consequences such as being excluded from mainstream services.

The team of researchers set out to evaluate the effectiveness of group-based CBT for people with intellectual disabilities. They recruited 179 participants for the study, all of whom had been identified as having problems with anger control. Half of them received CBT sessions every week for 12 weeks. The sessions were delivered by care workers who had been trained to act as lay therapists. The rest of the participants did not receive therapy until after the end of the study, and acted as a control group.

Just before the study began, all participants completed self-assessments to measure how they would respond to hypothetical or real, potentially anger-provoking situations. They were reassessed after 16 weeks and again after 10 months. The keyworkers and home carers were also asked to assess each participant’s ability to cope with anger-provoking situations and their behaviour.

The researchers found that the participants receiving therapy did not report a significant reduction in their anger responses to hypothetical triggers but they did report a decrease in their anger response to real triggers, and their keyworkers reported that their anger had decreased significantly compared with the controls, at both the 16 week and 10 month follow-ups.

Both the participants who received therapy and their keyworkers reported that they were better at using anger coping skills. The participants’ keyworkers and home carers also reported lower levels of challenging behaviour in those who had received therapy.

Swansea University Professor Paul Willner said: “CBT is the treatment of choice for common mental health problems, and widening access to CBT is seen as a major policy priority. However, the delivery of CBT to people with intellectual disabilities is underdeveloped, and there is limited evidence of its effectiveness for this client group.

“Our study clearly shows that group-based CBT was effective in improving anger control by people with intellectual disabilities. The CBT intervention also decreased challenging behaviour, as rated by both keyworkers and home carers. Overall, this study provides evidence of the effectiveness of CBT for this client group, and demonstrates that the staff who work with people with intellectual disabilities can be trained and supervised to deliver such therapy effectively.”

Reference

Willner P, Rose J, Jahoda A, Kroese BS, Felce D, Cohen D, MacMahon P, Stimpson A, Rose N, Gillespie D, Shead J, Lammie C, Woodgate C, Townson J, Nuttall J and Hood K. Group-based cognitive-behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomised controlled trial.  

  • The PaperGroup-based cognitive–behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomised controlled trial’ will be published online by the British Journal of Psychiatry is available at  http://bjp.rcpsych.org/content/early/recent