Intellectual Disability, Mild, Learning Disability, PTSD, Trauma, Psychological
Conditions
Brief summary
The goal of this naturalistic single case series design is to investigate if an adapted Narrative Exposure Therapy protocol can be effective, is feasible, and acceptable for adults with a mile learning disability. Participants will be complete three baseline sessions before taking part in Narrative Exposure Therapy using a manual that has been adapted for people with a learning disability. Trauma symptoms will be measured weekly using the Impact of Events scale adapted for intellectual disabilities. The person's carer will also complete an informant scale related to these symptoms (LANTS-IV). The client will also complete the CORE-LD at pre, and post therapy. Six weeks after the end of the intervention, the client and their carer will be invited to a feedback session to talk about how they found the intervention.
Interventions
NET is a psychological talking therapy that has been designed for people who have experienced multiple and prolonged traumatic experiences. It is typically 12-sessions, involving first a psychoeducation session, then laying a lifeline where stones are lain to represent traumatic events, and flowers positive life events. The following sessions the person is asked to talk through their life, going into detail on the traumatic memories that they have experienced.
Sponsors
University of Nottingham
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 and over * Meet the criteria for having a mild ID as assessed by a clinical psychologist within the team * English speaking * Have capacity to consent * The participant must be experiencing trauma related stress as assessed by themselves, the clinical psychologist and the research team * Be able to travel to one of the therapy sites * Carer participant must have ability to reflect and comment on the trauma related stress experienced by the client participant * Carer must also be 18 years old or older and be English speaking. * Carer must have known participant for 1 year or more.
Exclusion criteria
* They are substance dependent * They are currently receiving another trauma-focused intervention * Currently an inpatient * Carers excluded if they lack capacity to consent to take part in research
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact of Events Scale for intellectual disabilities (IES-ID) | Completed weekly through baseline and intervention stages, approximately 16 weeks. Then at 6-week follow up (approximately week 22). | The IES-ID (Hall et al., 2014) is a 22 item scale scored on a three-point Likert scale measuring trauma related symptoms. This is an adapted measure that has been validated for people with an intellectual disability. |
| Lancaster and Northgate Trauma Scale for Intellectual Disabilities - Informant Version (LANTS-IV; Wigham et al., 2011) | Completed weekly through baseline and intervention stages, approximately 16 weeks. Then at 6-week follow up (approximately week 22). | 47 scored on a six-point scale for frequency and three-point for severity. |
| Clinical Outcome Routine Evaluation-Learning Disabilities (CORE-LD; Brooks et al., 2013) | At baseline week 1 and at 6-week follow-up (approximately week 22). | 14 scored on a three-point Likert scale measuring psychological distress across four domains: well-being, symptoms, functioning, and risk |
| Change interview (Elliott et al., 2001) with clients and carers | 6-weeks post-intervention. Sessions will be around 30-60 minutes. | A feedback session will be held with the client and their carer around 6-weeks after the therapy has come to an end. This will ask for feedback on how they found the intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | Weekly during the intervention sessions, for approximately 12-weeks. | Heart rate will be taken using a fitness watch that can measure continuous heart rate. This will show whether any within and between session habituation has taken place. Subjective units of distress (Wolpe, 1969) will be used if clients do not wish to wear a heart rate device. |
| Post-session therapist reflections | Across the intervention phase, an average of a year | Therapist reflections will be collected to gather information about their thoughts relating to the manual and therapy. |
Countries
United Kingdom
Contacts
PRINCIPAL_INVESTIGATORThomas Schroder
University of Nottingham
Outcome results
None listed