Psychotherapy Treatment Outcome Research in Adults With ID: Where Do We Go From Here?

• Published in: Clinical psychology (New York, N.Y.) N.Y.), 2024-09, Vol.31 (3), p.394-404
• Main Authors: Witwer, Andrea N., Rosencrans, Margaret E., Held, Megan K., Cobranchi, Chelsea, Crane, Jill, Chapman, Richard, Havercamp, Susan M.
• Format: Article
• Language: English
• Subjects: Cognitive Behavior Therapy; Human; Intellectual Development Disorder; Mental Health; Psychotherapy; Scientific Rigor; Treatment Guidelines; Treatment Outcomes
• ISSN: 0969-5893; 1468-2850
• DOI: 10.1037/cps0000053

The value of practice and treatment guidelines in improving mental health care is well established; however, no such guidelines exist for the mental health treatment of adults with intellectual disability. An essential step in the composition of guidelines is broad and careful consideration of the relevant empirical literature. The purpose of this systematic review was to identify efficacious and effective treatment practices for individuals with intellectual disability and co-occurring psychiatric disorders. The search across three databases (PubMed, PsycINFO, Embase) resulted in 37 studies that met inclusion criteria. The methodological rigor and study designs were evaluated to identify research gaps. The methodological strength of each study was rated on four indicators, participant characterization, intervention description, outcome measures, and statistical analyses. Only 13.5% of the studies reviewed were randomized controlled trials; 54.1% were quasi-experimental (either with pre/post interventions or use of non-randomized waitlist control, and 24.3% used some type of case series design. The majority of studies were from a cognitive behavioral orientation. While studies varied in scientific rigor, no one study was rated highly on all four indicators. Implications for future research and practice are discussed. Public Health Significance StatementSignificant barriers to mental health treatment for adults with ID continue to persist. Contributing to this is clinicians' reported lack of training, resources, and knowledge to serve individuals with ID. In order to address this, it is imperative that clinicians and researchers are aware of the state of research in this area, both its advancement over the past 20 years as well as the persisting gaps. This systematic review updates the current state of the literature, paying particular attention to the advancements in use of outcome measures and manualized treatments and the persist challenges related to diagnostic assessment and sample characterization.