Cognitive-Behavioural Therapy (CBT) in people with a disability

The effective use of cognitive-behavioural therapies for people with intellectual disability requires the input of highly skilled clinicians who have experience working with people with an intellectual disability, as it is possible for the therapy to result in increased distress and worsening mental illness if not used appropriately. Some treatment programmes may also need adaptation or modification for the needs of this particular client group. However, in the hands of a skilled professional, cognitive- behavioural therapy can be used in anger management, anxiety disorders, panic and phobic disorders, depression, obsessive-compulsive disorders, and (with very skilled clinicians) psychosis. Where cognitive behavioural therapy is used for a person with an intellectual disability, the person must be able to vocalise or express their thoughts or emotions, and to understand more complex concepts such as guilt and remorse. Therefore it is a more appropriate therapy for clients with a mild intellectual disability rather than for those with moderate to severe disabilities.  There are also likely to be homework tasks which may require modification for people with literacy or comprehension problems.  Staff working with clients with an intellectual disability may be asked to monitor the actions and emotions of the person in a systematic manner in order to assist the therapist in assessing the usefulness of certain interventions.