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24 - The Application of CBT for Adults with Learning Disabilities

from Part Six - Specialist Applications of Cognitive Behavioral Therapy for Anxiety Disorders and Depression

Published online by Cambridge University Press:  06 January 2022

By
Marc Serfaty ,
Matt Broadway-Horner  and
Angela Hassiotis
Edited by
Gillian Todd  and
Rhena Branch
Gillian Todd
Affiliation:
University of East Anglia
Rhena Branch
Affiliation:
University of East Anglia
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Summary

This chapter provides an evidence-based overview of predominantly cognitive behavioral interventions for common mental disorders, that is, anxiety and depression, undertaken in the field of intellectual disabilities (ID). The evidence was generated by reviewing international publications between 1980 and 2020 which identified the use of cognitive behavioral therapy (CBT), including third wave CBT therapies, and was also informed by our extensive clinical practice in the field of ID. The first section provides an outline of the historical and sociological context of psychological therapies and the possible barriers to CBT in an ID population. The chapter includes a summary of how intellectual disabilities, depression, and anxiety disorders are defined. It considers key issues, problems and solutions associated with applying CBT and its associated approaches in an ID population. Finally, two case vignettes introduce the reader to CBT techniques to illustrate ideas that will help clients using CBT to bring about a reduction in self-defeating behaviors. With the aid of a support worker and electronic sources, there is a much broader range of resources to help client and therapist journey and support the therapeutic alliance.

Keywords

psychological therapiesintellectual disabilityCBTcommon mental disorders
Type
Chapter
Information
Evidence-Based Treatment for Anxiety Disorders and Depression
A Cognitive Behavioral Therapy Compendium
 , pp. 507 - 532
Publisher: Cambridge University Press
Print publication year: 2022

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References

Recommended Reading

Beail, N. (2017). Psychological therapies and people who have ID: A report from the Royal College of Psychiatrists and British Psychological Society. Advances in Mental Health and Intellectual Disabilities.Google Scholar
Hassiotis, A., Serfaty, M., Azam, K., Martin, S., Strydom, A., & King, M. (2012). A manual of cognitive behaviour therapy for people with mild learning disabilities and common mental disorders: A training guide to help professional therapists in treating people with communication and cognitive problems in CBT. Camden & Islington NHS Foundation Trust and University College London.Google Scholar
Kroese, S., Dagnan, D., & Loumidis, K. (1997). Cognitive-behaviour therapy for people with learning disabilities. Routledge.Google Scholar
NICE. (2015). Challenging behaviour and learning disabilities: Prevention and interventions for people with learning disabilities whose behaviour challenges. www.nice.org.uk/guidance/indevelopment/gid-cgwave0654Google Scholar
NICE. (2016). Mental health problems in people with learning disabilities: Prevention, assessment and management. www.nice.org.uk/guidance/ng54Google Scholar
Weston, L., Hodgekins, J., & Langdon, P. (2016). Effectiveness of cognitive behavioural therapy with people who have autistic spectrum disorders: A systematic review and meta-analysis. Clinical Psychology Review, 49, 41–54. www.sciencedirect.com/science/article/pii/S027273581630071XGoogle Scholar

References

Ali, A., Hall, I., Blickwedel, J., & Hassiotis, A. (2015). Behavioural and cognitive‐behavioural interventions for outwardly‐directed aggressive behaviour in people with intellectual disabilities. Cochrane Database of Systematic Reviews, (4).Google Scholar
Ali, A., Scior, K., Ratti, V., Strydom, A., King, M., & Hassiotis, A. (2013). Discrimination and other barriers to accessing health care: Perspectives of patients with mild and moderate intellectual disability and their carers. PloS One, 8(8), e70855.Google Scholar
American Psychiatric Association. (2004). Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. www.psychiatryonline.orgGoogle Scholar
American Psychiatric Association. (2010). Practice guideline for the treatment of patients with major depressive disorder. www.psychiatryonline.orgGoogle Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.Google Scholar
Beail, N. (2017). Psychological therapies and people who have ID: A report from the Royal College of Psychiatrists and British Psychological Society. Advances in Mental Health and Intellectual Disabilities.Google Scholar
Bhaumik, S., & Alexander, R. (Eds.). (2020). Oxford textbook of the psychiatry of intellectual disability. Oxford University Press.Google Scholar
Blackburn, I. M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., & Reichelt, F. K. (2001). The revised cognitive therapy scale (CTS-R): Psychometric properties. Behavioural and Cognitive Psychotherapy, 29(4), 431–446.Google Scholar
Bowl, R. (1996). Legislating for user involvement in the United Kingdom: Mental health services and the NHS and Community Care Act 1990. International Journal of Social Psychiatry, 42(3), 165–180.Google Scholar
Boyden, P., Esscopri, N., Ogi, L., Brennan, A., & Kalsy-Lillico, S. (2009). Service users leading the way: Focus group methodology in developing accessible information DVDs with people with learning disabilities. Journal of Intellectual Disabilities, 13(3), 183–194.Google Scholar
Broadway-Horner, M. (2020). TROG: A communication test for service users. Learning Disability Practice, 23(1), 14–16. doi:10.7748/ldp.23.1.14.s13Google Scholar
Broadway-Horner, M., Hassett, A., & Salter, D. (in press). Effect of psychological intervention within minority groups. A mixed methods research synthesis. International Journal of Social Psychiatry.Google Scholar
Brown, F. J., & Hooper, S. (2009). Acceptance and commitment therapy (ACT) with a learning disabled young person experiencing anxious and obsessive thoughts. Journal of Intellectual Disabilities, 13(3), 195–201.Google Scholar
Brown, J. F., Brown, M. Z., & Dibiasio, P. (2013). Treating individuals with intellectual disabilities and challenging behaviors with adapted dialectical behavior therapy. Journal of Mental Health Research in Intellectual Disabilities, 6(4), 280–303.Google Scholar
Brown, M., & Marshall, K. (2006). Cognitive behaviour therapy and people with learning disabilities: Implications for developing nursing practice. Journal of Psychiatric & Mental Health Nursing, 13(2), 234–241.CrossRefGoogle ScholarPubMed
Carr, J. E., Coriaty, S., Wilder, D. A., Gaunt, B. T., Dozier, C. L., Britton, L. N., Avina, C., & Reed, C. L. (2000). A review of ‘noncontingent’ reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities. Research in Developmental Disabilities, 21(5), 377–391.Google Scholar
Cooney, P., Jackman, C., Coyle, D., & O’Reilly, G. (2017). Computerised cognitive-behavioural therapy for adults with intellectual disability: Randomised controlled trial. The British Journal of Psychiatry, 211(2), 95–102.Google Scholar
Cooper, S. A., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). Mental ill-health in adults with intellectual disabilities: Prevalence and associated factors. The British Journal of Psychiatry, 190(1), 27–35.CrossRefGoogle ScholarPubMed
Crenshaw, K. (1990). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43, 1241.CrossRefGoogle Scholar
Dagnan, D., Burke, C., & Davies, J. (2015). IAPT learning disabilities positive practice guide 2015. Foundation for People with Learning Disabilities.Google Scholar
Dagnan, D., Chadwick, P., & Proudlove, J. (2000). Toward an assessment of suitability of people with mental retardation for cognitive therapy. Cognitive Therapy and Research, 24(6), 627–636.CrossRefGoogle Scholar
Dagnan, D., Pulford, H., Cathers, R., & Jahoda, A. (2016). Using questions in cognitive therapy with people with intellectual disabilities. Behavioural and Cognitive Psychotherapy, 44(4), 499–503.Google Scholar
Department of Health. (1990). National Health Service and Community Care Act 1990. www.legislation.gov.uk/ukpga/1990/19/contentsGoogle Scholar
Department of Health. (2009). IAPT learning disabilities: Positive practice guide. NHS England.Google Scholar
Department of Health. (2018). Learning disabilities: Applying All Our Health. www.gov.uk/government/publications/learning-disability-applying-all-our-health/learning-disabilities-applying-all-our-healthGoogle Scholar
Derogatis, L. R., & Fitzpatrick, M. (2004). The SCL-90-R, the Brief Symptom Inventory (BSI), and the BSI-18. In Maruish, M. E. (Ed.), The use of psychological testing for treatment planning and outcomes assessment: Instruments for adults (pp. 1–41). Lawrence Erlbaum Associates.Google Scholar
Driessen, E., & Hollon, S. D. (2010). Cognitive behavioral therapy for mood disorders: Efficacy, moderators and mediators. Psychiatric Clinics, 33(3), 537–555.Google Scholar
Emerson, E., & Hatton, C. (2007). Mental health of children and adolescents with intellectual disabilities in Britain. The British Journal of Psychiatry, 191(6), 493–499.Google Scholar
Emerson, E., Glover, G., Turner, S., Greig, R., Hatton, C., Baines, S., … & Welch, V. (2012). Improving health and lives: The learning disabilities public health observatory. Advances in Mental Health and Intellectual Disabilities, 6(1), 26–33.Google Scholar
Emerson, E., Fortune, N., Aitken, Z., Hatton, C., Stancliffe, R., & Llewellyn, G. (2020). The wellbeing of working-age adults with and without disability in the UK: Associations with age, gender, ethnicity, partnership status, educational attainment and employment status. Disability and Health Journal, 100889.Google Scholar
Esdale, L., Jahoda, A., & Pert, C. (2015). Coping with criticism and praise. American Journal on Intellectual and Developmental Disabilities, 120(3), 258–268.CrossRefGoogle ScholarPubMed
Gilson, S. F., & Depoy, E. (2000). Multiculturalism and disability: A critical perspective. Disability & Society, 15(2), 207–218.Google Scholar
Haddock, G., Lobban, F., Hatton, C., & Carson, R. (2004). Cognitive-behaviour therapy for people with psychosis and mild intellectual disabilities: A case series. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 11(4), 282–298.Google Scholar
Haddock, K., & Jones, R. S. (2006). Practitioner consensus in the use of cognitive behaviour therapy for individuals with a learning disability. Journal of Intellectual Disabilities, 10(3), 221–230.Google Scholar
Hassiotis, A. (1999). Psychodynamic psychotherapy in intellectual disabilities: Theory and practice revisited. Journal of Learning Disabilities for Nursing, Health and Social Care 3, 106–109.Google Scholar
Hassiotis, A., Serfaty, M., Azam, K., Strydom, A., Blizard, R., Romeo, R., Martin, S., & King, M. B. (2012). A manual of cognitive behaviour therapy for people with mild learning disabilities and common mental disorders: A training guide to help professional therapists in treating people with communication and cognitive problems in CBT. Camden & Islington NHS Foundation Trust and University College London.Google Scholar
Hassiotis, A., Serfaty, M., Azam, K., Strydom, A., Blizard, R., Romeo, R., Martin, S., & King, M. (2013). Manualised individual cognitive behavioural therapy for mood disorders in people with mild to moderate intellectual disability: A feasibility randomised controlled trial. Journal of Affective Disorders, 151(1), 186–195.Google Scholar
Hassiotis, A., Serfaty, M., Azam, K., Strydom, A., Martin, S., Parkes, C., Blizard, R., & King, M. (2011). Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): A pilot randomised controlled trial. Trials, 12(1), 95.CrossRefGoogle Scholar
Hayes, S. C., & Hofmann, S. G. (2017). The third wave of cognitive behavioral therapy and the rise of process‐based care. World Psychiatry, 16(3), 245.Google Scholar
Huntington, D. D., & Bender, W. N. (1993). Adolescents with learning disabilities at risk? Emotional well-being, depression, suicide. Journal of Learning Disabilities, 26(3), 159–166.Google Scholar
Jahoda, A. (2017). Symposium: Beat-It: The process and outcomes of large scale randomised control trial of behavioural activation compared to guided self-help for people with intellectual disabilities and depression. Journal of Mental Health Research in Intellectual Disabilities, 10, 152–153.Google Scholar
Jahoda, A., Dagnan, D., Stenfert Kroese, B., Pert, C., & Trower, P. (2009). Cognitive behavioural therapy: From face to face interaction to a broader contextual understanding of change. Journal of Intellectual Disability Research, 53(9), 759–771.CrossRefGoogle ScholarPubMed
Jahoda, A., Hastings, R., Hatton, C., Cooper, S. A., Dagnan, D., Zhang, R., … & Melville, C. (2017). Comparison of behavioural activation with guided self-help for treatment of depression in adults with intellectual disabilities: A randomised controlled trial. The Lancet Psychiatry, 4(12), 909–919.Google Scholar
Joint Commissioning Panel for Mental Health. (2013). Guidance for commissioners of mental health services for people with learning disabilities.Google Scholar
Jones, N. P. (2019). The 6Cs. In Learning to Care E-Book: The Nurse Associate (p. 74).Google Scholar
Joyce, T., Globe, A., & Moody, C., (2006). Assessment of the component skills for cognitive therapy in adults with intellectual disability. Journal of Applied Research in Intellectual Disabilities, 19(1), 17–23.Google Scholar
Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M. J., Cropley, T. G., Hosmer, D., & Bernhard, J. D. (1998). Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing photo therapy (UVB) and photochemotherapy (PUVA). Psychosomatic Medicine, 60(5), 625–632.Google Scholar
Kirkland, J. (2005). Cognitive‐behaviour formulation for three men with learning disabilities who experience psychosis: How do we make it make sense? British Journal of Learning Disabilities, 33(4), 160–165.Google Scholar
Kolb, A. Y., & Kolb, D. A. (2012). Experiential learning theory. In Encyclopedia of the Sciences of Learning (pp. 1215–1219). Springer US.Google Scholar
Kushlick, A., Trower, P., & Dagnan, D. (1997). Applying cognitive-behavioural approaches to the carers of people with learning disabilities who display challenging behaviour. In Kroese, B., Dagnan, D., & Loumidis, K. (Eds.), Cognitive-behaviour therapy for people with learning disabilities (pp. 141–161). Routledge.Google Scholar
Lichstein, K. L., Riedel, B. W., & Grieve, R. (1994). Fair tests of clinical trials: A treatment implementation model. Advances in Behaviour Research and Therapy, 16(1), 1–29.Google Scholar
Linehan, M. (2014). DBT skills training manual. Guilford Publications.Google Scholar
Linehan, M. M., Heard, H. L., & Armstrong, H. E. (1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry, 50(12), 971–974.Google Scholar
Marwood, H., & Hewitt, O. (2012). Evaluating an anxiety group for people with learning disabilities using a mixed methodology. British Journal of Learning Disabilities, 41(2), 150–158.Google Scholar
McCabe, M. P., McGillivray, J. A., & Newton, D. C. (2006). Effectiveness of treatment programmes for depression among adults with mild/moderate intellectual disability. Journal of Intellectual Disability Research, 50(4), 239–247.Google Scholar
McGillivray, J. A., & Kershaw, M. (2015). Do we need both cognitive and behavioural components in interventions for depressed mood in people with mild intellectual disability? Journal of Intellectual Disability Research, 59(2), 105–115.Google Scholar
McGillivray, J. A., McCabe, M. P., & Kershaw, M. M. (2008). Depression in people with intellectual disability: An evaluation of a staff-administered treatment program. Research in Developmental Disabilities, 29(6), 524–536.CrossRefGoogle ScholarPubMed
Mencap, R. (2012). Death by indifference: 74 deaths and counting, a progress report 5 years on. www.mencap.org.ukGoogle Scholar
Meyer, I. H. (1994). Prejudice and pride: Minority stress and mental health in gay men.Google Scholar
Michael, J., Richardson, A., Marks, B., & Oakes, B. (2008). Healthcare for all: The independent inquiry into access to healthcare for people with learning disabilities. Tizard Learning Disability Review, 13(4), 28.Google Scholar
Moore, D. G., & George, R. (2011). ACORNS: A tool for the visualisation and modelling of atypical development. Journal of Intellectual Disability Research, 55(10), 956–972.Google Scholar
Morley, S. (2017). Single case methods in clinical psychology: A practical guide. Routledge.CrossRefGoogle Scholar
NICE. (2009). Depression in adults: Recognition and management. www.nice.org.uk/CG90Google Scholar
NICE. (2011). Generalised anxiety disorder and panic disorder in adults: Management. www.nice.org.uk/CG113Google Scholar
NICE. (2015). Challenging behaviour and learning disabilities: Prevention and interventions for people with learning disabilities whose behaviour challenges. www.nice.org.uk/guidance/indevelopment/gid-cgwave0654Google Scholar
NICE. (2016). Mental health problems in people with learning disabilities: Prevention, assessment and management. www.nice.org.uk/guidance/ng54Google Scholar
NICE. (2017). Learning disability: Identifying and managing mental health problems. www.nice.org.uk/guidance/qs142Google Scholar
NICE (2018). Mental health problems in people with learning disabilities: Overview. http://pathways.nice.org.uk/pathways/mental-health-problems-in-people-with-learning-disabilitiesGoogle Scholar
Nicoll, M., Beail, N., & Saxon, D. (2013). Cognitive behavioural treatment for anger in adults with intellectual disabilities: A systematic review and meta‐analysis. Journal of Applied Research in Intellectual Disabilities, 26(1), 47–62.Google Scholar
Novaco, R. W. (2003). The Novaco Anger Scale and Provocation Inventory: NAS-PI. Western Psychological Services.Google Scholar
Open University. (2019). Timeline of learning disability history. www.open.ac.uk/health-and-social-care/research/shld/timeline-learning-disability-historyGoogle Scholar
Otte, C. (2011). Cognitive behavioural therapy in anxiety disorders: Current state of the evidence. Dialogues in Clinical Neurosciences 13, 413–421.Google Scholar
Pankey, J., & Hayes, S. C. (2003). Acceptance and commitment therapy for psychosis. International Journal of Psychology and Psychological Therapy, 3(2), 311–328.Google Scholar
Prout, H. T., & Nowak-Drabik, K. M. (2003). Psychotherapy with persons who have mental retardation: An evaluation of effectiveness. American Journal on Mental Retardation, 108(2), 82–93.2.0.CO;2>CrossRefGoogle ScholarPubMed
Reid, S. C., Kauer, S. D., Hearps, S. J., Crooke, A. H., Khor, A. S., Sanci, L. A., & Patton, G. C. (2011). A mobile phone application for the assessment and management of youth mental health problems in primary care: A randomised controlled trial. BMC Family Practice, 12(1), 131.Google Scholar
Robertson, J. P., & Collinson, C. (2011). Positive risk taking: Whose risk is it? An exploration in community outreach teams in adult mental health and learning disability services. Health, Risk & Society, 13(2), 147–164.Google Scholar
Rose, J., Loftus, M., Flint, B., & Carey, L. (2005). Factors associated with the efficacy of a group intervention for anger in people with intellectual disabilities. British Journal of Clinical Psychology, 44(3), 305–317.Google Scholar
Rose, N., O’Brien, A., & Rose, J. (2007). Investigating staff knowledge and attitudes towards working with adults with learning disabilities and mental health difficulties. Advances in Mental Health and Learning Disabilities, 1(3), 52–59.Google Scholar
Royal College of Psychiatrists. (2004). Psychotherapy and learning disability. Council report CR116. Royal College of Psychiatrists.Google Scholar
Royal Society for Mentally Handicapped Children and Adults. (2007). Death by indifference: Following up the Treat Me Right! report. Mencap.Google Scholar
Sams, K., Collins, S., & Reynolds, S. (2006). Cognitive therapy abilities in people with learning disabilities. Journal of Applied Research in Intellectual Disabilities, 19(1), 25–33.Google Scholar
Scott, K., Hatton, C., Knight, R., Singer, K., Knowles, D., Dagnan, D., Hastings, R. P., Appleton, K., Cooper, S. A., Melville, C., & Jones, R. (2019). Supporting people with intellectual disabilities in psychological therapies for depression: A qualitative analysis of supporters’ experiences. Journal of Applied Research in Intellectual Disabilities, 32(2), 323–335.Google Scholar
Shaw, B. F., Elkin, I., Yamaguchi, J., Olmsted, M., Vallis, T. M., Dobson, K. S., … & Imber, S. D. (1999). Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Journal of Consulting and Clinical Psychology, 67(6), 837.CrossRefGoogle ScholarPubMed
Singh, N. N., Lancioni, G. E., Karazsia, B. T., Winton, A. S., Myers, R. E., Singh, A. N., Singh, A. D., & Singh, J. (2013). Mindfulness-based treatment of aggression in individuals with mild intellectual disabilities: A waiting list control study. Mindfulness, 4(2), 158–167.Google Scholar
Singh, N. N., Lancioni, G. E., Winton, A. S., Singh, A. N., Adkins, A. D., & Singh, J. (2011). Can adult offenders with intellectual disabilities use mindfulness-based procedures to control their deviant sexual arousal? Psychology, Crime & Law, 17(2), 165–179.Google Scholar
Smith, J. D. (2012). Single-case experimental designs: A systematic review of published research and current standards. Psychological Methods, 17(4), 510.Google Scholar
Spek, A. A., Van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial. Research in Developmental Disabilities, 34(1), 246–253.Google Scholar
Stenfert Kroese, B., & Rose, J. L. (2011). Mental health services for adults with learning disabilities. The Judith Trust.Google Scholar
Tarrier, N., Taylor, K., & Gooding, P. (2008). Cognitive-behavioral interventions to reduce suicide behavior: A systematic review and meta-analysis. Behavior Modification, 32(1), 77–108.Google Scholar
Taylor, D. J., & Pruiksma, K. E. (2014). Cognitive and behavioural therapy for insomnia (CBT-I) in psychiatric populations: A systematic review. International Review of Psychiatry, 26(2), 205–213.Google Scholar
Taylor, J. L., Novaco, R. W., Gillmer, B. T., Robertson, A., & Thorne, I. (2005). Individual cognitive‐behavioural anger treatment for people with mild‐borderline intellectual disabilities and histories of aggression: A controlled trial. British Journal of Clinical Psychology, 44(3), 367–382.Google Scholar
Vereenooghe, L., & Langdon, P. E. (2013). Psychological therapies for people with intellectual disabilities: A systematic review and meta-analysis. Research in Developmental Disabilities, 34(11), 4085–4102. doi: 10.1016/j.ridd.2013.08.030Google Scholar
Vereenooghe, L., Reynolds, S., Gega, L., & Langdon, P. E. (2015). Can a computerised training paradigm assist people with intellectual disabilities to learn cognitive mediation skills? A randomised experiment. Behaviour Research and Therapy, 71, 10–19.CrossRefGoogle ScholarPubMed
Wechsler, D. (1955). Wechsler Adult Intelligence Scale. Psychological Corporation.Google Scholar
Whitehouse, R. M., Tudway, J. A., Look, R., & Kroese, B. S. (2006). Adapting individual psychotherapy for adults with intellectual disabilities: A comparative review of the cognitive-behavioural and psychodynamic literature. Journal of Applied Research in Intellectual Disabilities, 19(1), 55–65.Google Scholar
Willner, P., & Goodey, R. (2006). Interaction of cognitive distortions and cognitive deficits in the formulation and treatment of obsessive-compulsive behaviours in a woman with an intellectual disability. Journal of Applied Research in Intellectual Disabilities, 19(1), 67–73.Google Scholar
Willner, P., Jahoda, A., Rose, J., Stenfert-Kroese, B., Hood, K., Townson, J. K., Nuttall, J., Gillespie, D., & Felce, D. (2011). Anger management for people with mild to moderate learning disabilities: Study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff. Trials 12, 36.Google Scholar
Willner, P., Jones, J., Tams, R., & Green, G. (2002). A randomized controlled trial of the efficacy of a cognitive‐behavioural anger management group for clients with learning disabilities. Journal of Applied Research in Intellectual Disabilities, 15(3), 224–235.Google Scholar
Willner, P., & Tomlinson, S. (2007). Generalization of anger‐coping skills from day‐service to residential settings. Journal of Applied Research in Intellectual Disabilities, 20(6), 553–562.Google Scholar
Woods, H., & Thomas, D. (2003). Working with people with learning disabilities: Theory and practice. Jessica Kingsley Publishers.Google Scholar

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