The evidence-base for exposure therapy in people with learning disabilities experiencing specific phobias is sparse. This case study describes the assessment, formulation and treatment of spider phobia in a woman with learning disabilities using an exposure-based intervention augmented with mindfulness practice and bereavement work. To evaluate…

Institutions, and their problems, have traditionally dominated learning disability histories. We know far more about what happened in areas where councils established and/or enthusiastically used local institutions than other places. Local authorities less committed to institutional care must have relied more on family and other carers. This may…

People with learning disabilities are sometimes prescribed psychotropic medication to help manage their challenging behaviour. This case study describes how a multicomponent behavioural intervention in conjunction with the systematic withdrawal of sodium valproate was strongly correlated with reduced aggression. No symptoms of bipolar disorder or…

This is a report of a service improvement pilot project undertaken at an inpatient autism service for adults with intellectual disabilities and severe challenging behaviours. Within the service, a key facet of the care pathway was the use of a biopsychosocial case formulation. Formulation meetings were led by psychology and involved a full…

People with learning disabilities have higher levels of health needs compared with the general population (Nocon, 2006, Background evidence for the DRC's formal investigation into health inequalities experienced by people with learning disabilities or mental health problems. London and Manchester, Disability Rights Commission). Research has shown…

The following article introduces the Solihull Approach, a structured framework for intervention work with families (Douglas, "Solihull resource pack; the first five years." Cambridge: Jill Rogers Associates, 2001) and aims to demonstrate the usefulness of this approach in working with school-age children with complex neurodevelopmental…

Adults with intellectual impairments have a high prevalence of stammering. Characteristic speech and associated behaviours are also different in quality and more variable between individuals than those of the typical adult population. This paper describes a speech and language therapy group with two adults with intellectual impairments and…

This paper describes the process of couple therapy with a client who has a mild learning disability and cerebral palsy, and her partner, who also has cerebral palsy (all information has been anonymised and pseudonyms are used throughout). Informed consent was gained from both individuals for the purposes of writing about their case. Therapy…

Many people with intellectual disabilities are still not being listened to by the services providing them with care and support, and when they become upset and frustrated, they are all too readily regarded as being mentally ill. To help people with intellectual disabilities describe and make sense of their experiences and feelings in a…

Self-efficacy has been reported to play a significant role in stress levels of parents facing challenging behaviours of their children with learning disabilities. The role of self-efficacy has also been found to affect the stress levels of professional caregivers in such situations. To understand the implications of staff self-efficacy in…

There appears to be some degree of hesitation and lack of confidence among professionals in conducting capacity assessments. This document explains a two-phase process developed and implemented by a multi-disciplinary group of professionals during a pilot project. The first phase in the decision making process is to determine to what extent the…

Estimates suggest that up to one quarter of people who have a severe learning disability engage in self injurious behaviour (SIB). SIB poses serious risks, both to the person's physical health and their quality of life. Behavioural approaches have made a contribution to supporting people who engage in SIB, although the last review of these…

The paper examines aspects of the implementation of "Valuing People" by focusing upon four case studies of people, which are representative of a greater number of referrals to an organisation providing support for people with learning disabilities. It shows that despite many positive aspects of the policy, it sometimes fails the most vulnerable,…

This case study demonstrates the effectiveness of a classroom based learning programme in the acquisition of road safety skills. The participant, a child with severe learning disabilities, was taught road safety behaviours in the classroom with the aid of photograph cards. When he had mastered these skills in the classroom, he returned to the…

Assessment for a diagnosis of dementia is hard enough under the best possible conditions. There are possible alternative or concomitant diagnoses, such as depression, to consider. However, when the possible dementia concerns a gentleman with severe learning disabilities and with a severe communication disorder then this assessment becomes even…