Pilot project tests feasibility of reasonable adjustments in offering psycho-educational groups to adults with learning disabilities

A well constructed trial adding to growing evidence base for effectiveness of CBT for people with mild to moderate learning disabilities


In 2009, ‘The Improving Access to Psychological Therapies’ (IAPT) programme  produced ‘Positive Practice Guidance’ on support to people with learning disabilities which reiterated the need to ensure that mental health problems were identified as early as possible, but pointed out that  barriers still existed  in relation to providing psychological therapies to people with learning disabilities.

There has been little evidence of reasonable adjustments being made to remove some of these barriers since the publication of that report. The author of this paper set describes a pilot project which was established to evaluate an anxiety management group. The group was co-facilitated by Least Intervention First Time (LIFT) Psychology and the local community team for people with learning disabilities (CTPLD).


The project worked with five people who attended a nine-week anxiety management group. The course followed by the group had been adapted to be suitable for adults with learning disabilities from an existing course offered by the LIFT service. Before the group ran, each of the participants completed a skills and knowledge assessment as well as completing the Glasgow Anxiety Scale (GAS-ID), a 27 item self rating scale. These assessments were also completed after the group had ended and at follow-up to evaluate outcomes.

The researchers were keen to identify if the approach taken in the modified course showed that the LIFT had made reasonable adjustments in delivering an effective service for the people with learning disabilities undergoing the programme.


What they found was that none of the five people who underwent the course showed any  significant reduction in their anxiety levels. They did however show improvements in their skills and knowledge. Of the adjustments made to enable the group to run, some were seen as feasible if the group were offered long-term, but others were not.


The authors conclude that the pilot project showed that making reasonable adjustments to psycho-educational groups within Improving Access to Psychological Therapies services to better meet the needs of people with learning disabilities is possible, but call for additional work to build on their findings.

LIFT psychology primary care group for people with intellectual disabilities: can IAPT adapt?, Kirk J et al., in Advances in Mental Health and Intellectual Disabilities, 8,1, 51 – 62


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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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