Anxiety Treatment for Adolescents with Mild Intellectual Disability: A stakeholder-engaged overview of effective therapy components

Objectives The main objective of this thesis was to identify effective treatment components regarding anxiety therapy for adolescents with mild to borderline intellectual disability (MBID), in order to gain new and potentially fundamental insights for developing clinically effective interventions for this population. The research question was: ‘What works in anxiety treatment for adolescents with MBID?’ Methods A mixed methods design was used, consisting of both quantitative and qualitative analyses, with a stakeholder-engaged approach. In total, 32 stakeholders participated, including adolescents with MBID (N = 9), parents (N = 8), and therapists (N = 15). In the quantitative part, a Chi-square test was conducted to examine whether stakeholder groups were representative of the populations they intended to reflect, and to test whether they differed in the therapeutic aspects they emphasised. The qualitative part explored stakeholders’ perspectives on effective components of anxiety...Show moreObjectives The main objective of this thesis was to identify effective treatment components regarding anxiety therapy for adolescents with mild to borderline intellectual disability (MBID), in order to gain new and potentially fundamental insights for developing clinically effective interventions for this population. The research question was: ‘What works in anxiety treatment for adolescents with MBID?’ Methods A mixed methods design was used, consisting of both quantitative and qualitative analyses, with a stakeholder-engaged approach. In total, 32 stakeholders participated, including adolescents with MBID (N = 9), parents (N = 8), and therapists (N = 15). In the quantitative part, a Chi-square test was conducted to examine whether stakeholder groups were representative of the populations they intended to reflect, and to test whether they differed in the therapeutic aspects they emphasised. The qualitative part explored stakeholders’ perspectives on effective components of anxiety treatment through focus group and individual interviews. Open coding and thematic analysis were used to analyse the transcripts. Results Quantitative results showed a statistically significant association between stakeholder group and response topic, χ²(4, N = 230) = 9.90, p = .042, with a small effect size (Cramer’s V = .15). This supports the hypothesis that stakeholder groups emphasised different therapeutic aspects. Qualitative findings were largely consistent with current clinical guidelines for anxiety treatment in adolescents with MBID. Adolescents valued therapists who understand them and take them seriously, and autonomy in healthcare decision making. Parents emphasised the importance of being involved in therapy and their need for guidance. Therapists highlighted that standard anxiety protocols can be used for this group when adapted to individual needs. Conclusions and Implications Adolescents with MBID, parents and therapists each have a unique view on what is important in anxiety treatment for adolescents with MBID. The importance of a trusting therapeutic relationship and parental involvement were reaffirmed. Clinical practice should include more psychoeducational support for parents. Guidelines revisions could consider including physically active breaks, parental involvement during exposure exercises, and examples of positive reinforcement. Future research is recommended to examine whether personal characteristics may outweigh mental age in determining the most suitable type of therapy.Show less

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Anxiety Treatment for Adolescents with Mild Intellectual Disability: A stakeholder-engaged overview of effective therapy components