Effectiveness and cost-effectiveness of guided self-help for depression for autistic adults: the Autism Depression Trial (ADEPT-2) - protocol for a multicentre, randomised controlled trial of a remotely delivered low-intensity intervention.

Introduction: Depression is three to four times more prevalent in autistic people and is related to reduced quality of life. There is a need for empirically supported psychological interventions for depression specifically adapted to meet the needs of autistic adults. ADEPT-2 aims to establish the clinical and cost-effectiveness of an adapted low-intensity psychological intervention (guided self-help) for depression in autistic adults.

The influence of therapy quality on outcomes from behavioural activation and guided self-help treatments for depression in adults with intellectual disabilities.

Objectives: We report the effect of quality of therapy delivery on outcomes in a randomized, controlled trial of behavioural activation (BA) and guided self-help (GSH) for depression in adults with intellectual disabilities.

Methods: A study specific measure of quality was used in a linear mixed effect model to determine the effects therapy and therapy quality on therapy outcome.

Results: There was a significant interaction between quality and treatment type, with lower quality therapy associated with better outcome for GSH but poorer outcome for BA, with little difference in outcomes at higher levels of therapy quality.

Including significant others in psychological therapy with people with intellectual disabilities: A national survey of the practice of UK psychologists.

Background: Talking therapy for people with intellectual disabilities is often specifically adapted. One adaptation is the involvement of significant others in therapy, however, there is no systematic description of the use of this adaptation in routine clinical practice.

Method: An online survey of UK psychologists regarding the inclusion of significant others in individual therapy with people with intellectual disabilities.

How do people with intellectual disabilities understand friendship? A systematic meta-synthesis.

Background: Previous systematic reviews of the relationships of people with intellectual disabilities have included consideration of intimate relationships. In this paper, we report a systematic review of papers describing friendship only.

Method: A systematic qualitative meta-synthesis of the research exploring experiences of friendship as reported by people with intellectual disabilities.

Adapting psychological interventions for people with severe and profound intellectual disabilities: A behavioural activation exemplar.

Background: People with severe to profound intellectual disabilities experience similar or higher levels of depression than those with more mild intellectual disabilities. Yet, there is an absence of evidence about how to adapt existing psychological therapies for this population.

Method: A behavioural activation intervention (BeatIt) for people with mild to moderate intellectual disabilities was adapted for people with severe to profound intellectual disabilities and depression.

Behavioural activation for depressive symptoms in adults with severe to profound intellectual disabilities: Modelling and initial feasibility study.

Background: Almost no research has been published reporting on evaluations of the effectiveness of psychological interventions for people with severe to profound intellectual disabilities and depression. This paper describes the development and initial feasibility testing of an adapted Behavioural Activation therapy (BeatIt2) for this population.

Method: Phase 1 of the study examined participant recruitment and willingness to be randomised in the context of a planned Randomised Controlled Trial (RCT).

Effectiveness of primary care psychological therapy services for treating depression and anxiety in autistic adults in England: a retrospective, matched, observational cohort study of national health-care records.

Background: Autistic adults report a higher prevalence of anxiety and depression than adults without identified autism but have poorer access to appropriate mental health care. Evidence-based psychological therapies are recommended in treatment guidelines for autistic adults, but no study has investigated their effectiveness in large samples representative of the autistic population accessing routine care. This study aimed to examine therapy outcomes for autistic adults in a primary care service.

Facilitating transformative endings: Therapists' experience of ending therapy with people with intellectual disabilities-An interpretative phenomenological analysis.

Background: Endings in therapy are discussed widely in mainstream literature, however, there is only a small amount of research that considers endings in therapy for people with intellectual disabilities.

Methods: Eight therapists were interviewed about their experience of ending therapy with people with intellectual disabilities. Interviews were analysed using Interpretative Phenomenological Analysis (IPA).

An investigation into the factor structure of the Health of the Nation Outcome Scales for People with Learning Disabilities.

Background: The Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) is one of the most used outcome measures in learning disability services in the United Kingdom. There is relatively little known of the psychometric properties of the scales.

Method: A data set of HoNOS-LD scales from 571 people with learning disabilities was randomly split into two halves.

Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self-help therapies.

Background: No previous studies have reported predictors and moderators of outcome of psychological therapies for depression experienced by adults with intellectual disabilities (IDs). We investigated baseline variables as outcome predictors and moderators based on a randomised controlled trial where behavioural activation was compared with guided self-help.

Methods: This study was an exploratory secondary data analysis of data collected during a randomised clinical trial.

The experiences of therapists providing psychological treatment for adults with depression and intellectual disabilities as part of a randomised controlled trial.

Background: Health professionals were trained to deliver adapted psychological interventions for depression to people with learning disabilities and depression alongside a supporter. Exploring the delivery of psychological interventions can help increase access to therapy.

Method: Twenty-seven participants took part in six focus groups, and the data were subject to a Framework Analysis.

Development and psychometric properties of a team formulation measure in intellectual disabilities services.

Background: This article describes the development and use of the Formulation Understanding Measure to evaluate team formulation with staff supporting people with intellectual disabilities.

Method: A quantitative design with an opportunistic sample was used to evaluate the psychometric properties of the Formulation Understanding Measure (FUM) including pre- and post-administration at case formulation workshops. The measure was developed based upon experience of delivering case formulation workshops and was administered alongside case formulation workshops with 347 staff team members.

How service-users with intellectual disabilities understand challenging behaviour and approaches to managing it.

Background: This study explored understandings that service-users with intellectual disabilities and challenging behaviour held around their behaviour, what shaped these understandings, and the relationship between how behaviours are managed and well-being.

Methods: Eight participants (three female, five male) partook in individual semi-structured qualitative interviews. Interviews were transcribed and analysed using interpretative phenomenological analysis.

Patients admitted to more research-active hospitals have more confidence in staff and are better informed about their condition and medication: Results from a retrospective cross-sectional study.

Rationale, Aims And Objectives: Clinical research activity in hospitals is associated with reduced mortality and improved overall care quality. In England, the latter is a compound score of several elements and both staff and inpatient feedback form part of the Care Quality Commission (CQC) ratings. The objective of this study was to determine if NHS Trusts' National Institute for Health Research (NIHR) study activity data correlates with specific outcomes from national NHS staff and patient surveys.

"Getting into it": People with intellectual disabilities' experiences and views of Behavioural Activation and Guided Self-Help for depression.

Background: No studies have explored the acceptability of Behavioural Activation and Guided Self-Help interventions for depression with people who have intellectual disabilities.

Method: Twenty-five participants were purposively sampled from participants taking part in a trial comparing Behavioural Activation with a Guided Self-Help intervention. A framework analysis was used to analyse interviews covering participants' expectations and views of therapy.

PHQ-9: One factor or two?

The PHQ-9 has been found to be reliable and valid, but with both a single and two-factor structure suggested in the literature. This measure has not yet been subject to psychometric investigation using Mokken scale analysis. Confirmatory Factor Analysis (CFA) and Mokken analysis were performed on retrospective data from an NHS Trust.

A review of the frequency and nature of adaptations to cognitive behavioural therapy for adults with Intellectual Disabilities.

Background: There is increasing evidence that cognitive behavioural therapy (CBT) can be effective for people with intellectual disabilities. The aim of this review was to report the nature and frequency of adaptations reported in studies of CBT for people with intellectual disabilities.

Method: This review updated and extended a previous review by (Whitehouse et al.

Behavioural activation versus guided self-help for depression in adults with learning disabilities: the BeatIt RCT.

Background: Depression is the most prevalent mental health problem among people with learning disabilities.

Objective: The trial investigated the clinical effectiveness and cost-effectiveness of behavioural activation for depression experienced by people with mild to moderate learning disabilities. The intervention was compared with a guided self-help intervention.

Supporting people with intellectual disabilities in psychological therapies for depression: A qualitative analysis of supporters' experiences.

Background: Clinicians recommend including carers or others in a supporting role in the therapy as an important adaptation of psychological therapies for people with intellectual disabilities. This nested qualitative study from a larger trial explored supporters' experiences of supporting people with intellectual disabilities receiving behavioural activation or guided self-help therapies for depression.

Method: Twenty-one purposively sampled supporters were interviewed.

A systematic review of cognitive behavioural therapy for anxiety in adults with intellectual disabilities.

Background: Anxiety disorders have high prevalence in people with intellectual disabilities. In populations without intellectual disabilities, cognitive behavioural therapy is a first line psychological therapy for these presentations. There is no existing review of the range of methods and outcomes from intervention studies in this area.

Exploring the emotion regulation strategies used by adults with intellectual disabilities.

Objectives: There is a growing body of evidence revealing emotion regulation difficulties are a common factor in the development and maintenance of mental health problems in the general population, however relatively little is known of the emotion regulation strategies used by people with intellectual disabilities.

Method: A qualitative approach was used to explore the emotion regulation strategies used by adults with a mild intellectual disability in interpersonal experiences. Semi-structured interviews were conducted with 11 participants with the transcripts analyzed using Thematic Analysis.

The relationship between the therapeutic alliance and clinical outcomes in cognitive behaviour therapy for adults with depression: A meta-analytic review.

Research consistently provides evidence for the relationship between the therapeutic alliance (TA) and outcome across various therapies and presenting problems. Depression is considered the leading cause of disability worldwide, and there is substantial evidence for the efficacy for Cognitive Behaviour Therapy (CBT) in its treatment. At present, there is lack of clarity specifically about the relationship between the TA and outcome in CBT for depression.

Comparison of behavioural activation with guided self-help for treatment of depression in adults with intellectual disabilities: a randomised controlled trial.

Background: Psychological therapies are first-line interventions for depression, but existing provision is not accessible for many adults with intellectual disabilities. We investigated the clinical and cost-effectiveness of a behavioural activation intervention (BeatIt) for people with intellectual disabilities and depression. BeatIt was compared with a guided self-help intervention (StepUp).

Training therapists to work with people with intellectual disability in Improving Access to Psychological Therapies (IAPT) services.

Background: Current policy in the England suggests that people with intellectual disabilities should, where possible, access mainstream mental health services; this should include access to mainstream therapy services. It is likely that mainstream therapists will need training and support to work with people with intellectual disabilities.

Method: Sixty-eight therapists working in an English Improving Access to Psychological Therapies (IAPT) service received one- or 2-day training on working with people with intellectual disabilities.