A Preliminary Evaluation of Adapted Cognitive Behavior Therapy for Anxiety in Adolescents with Mild Intellectual Disability in Indonesia
DOI:
https://doi.org/10.25217/0020269745500Keywords:
cognitive behavior therapy, anxiety, intellectual disabilityAbstract
Individuals with mild intellectual disability (MID) experience elevated rates of anxiety that adversely affect emotional well-being and social participation. Although Cognitive Behavioral Therapy (CBT) is well-established for anxiety in the general population, evidence for its use with individuals with MID remains limited. This case series explored the feasibility and preliminary clinical outcomes of an adapted CBT intervention for anxiety in adolescents with MID. Four adolescents (aged 14 years) with clinically significant anxiety received seven sessions of CBT adapted through simplified language, visual supports, repetition, role-play, and caregiver involvement. Anxiety was assessed at pre-intervention, post-intervention, and follow-up using the Glasgow Anxiety Scale for People with an Intellectual Disability (GAS-ID). Individual change was evaluated using the Reliable Change Index (RCI). Qualitative data from participant worksheets and supporter interviews were analyzed thematically. All participants demonstrated reliable reductions in anxiety symptoms that were maintained at follow-up. Qualitative findings suggested improvements in emotional awareness, social participation, and coping skills. These findings indicate that adapted CBT may be feasible and potentially beneficial for adolescents with MID, warranting further evaluation in controlled studies.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Ardi, Z., Eseadi, C., Yuniarti, E., Yendi, F. M., & Murni, A. W. (2023). Efficacy of cognitive behavioral therapy with local wisdom and web-based counseling on generalized anxiety disorders and functional gastrointestinal disorders in adolescent college girls: Protocol for a randomized controlled trial. JMIR Research Protocols, 12(1), e50316. https://doi.org/10.2196/50316
Arjadi, R. (2018). Feasibility study of cognitive behavioral therapy as an intervention for mild cognitive impairment in elderly Indonesians. In Proceedings of the 1st International Conference on Intervention and Applied Psychology (ICIAP 2017).
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.
Charlesworth, G., & Reichelt, F. K. (2004). CBT formulations: A practical guide for clinicians. Routledge.
Cooper, S., McLean, G., Guthrie, B., McConnachie, A., Mercer, S., Sullivan, F., & Morrison, J. (2015). Multiple physical and mental health comorbidity in adults with intellectual disabilities: Population-based cross-sectional analysis. BMC Family Practice, 16, 110. https://doi.org/10.1186/s12875-015-0329-3
Dagnan, D., & Jahoda, A. (2006). Cognitive-behavioural intervention for people with intellectual disability and anxiety disorders. Journal of Applied Research in Intellectual Disabilities, 19(2), 91–97. https://doi.org/10.1111/j.1468-3148.2005.00260.x
Emerson, E., & Hatton, C. (2007). Mental health of children and adolescents with intellectual disabilities in Britain. The British Journal of Psychiatry, 191(6), 493–499. https://doi.org/10.1192/bjp.bp.107.038729
Hassiotis, A., Serfaty, M., Azam, K., Strydom, A., Martin, S., Parkes, C., King, M., & Blizard, R. (2011). Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): A pilot randomised controlled trial. Trials, 12, 95. https://doi.org/10.1186/1745-6215-12-95
Hronis, A., Roberts, L., & Kneebone, I. I. (2017). A review of cognitive impairments in children with intellectual disabilities: Implications for cognitive behavior therapy. British Journal of Clinical Psychology, 56, 189–207. https://doi.org/10.1111/bjc.12124
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. https://doi.org/10.1037/0022-006X.59.1.12
Mindham, J., & Espie, C. A. (2003). Glasgow Anxiety Scale for People with an Intellectual Disability (GAS-ID): Development and psychometric properties. Journal of Intellectual Disability Research, 47, 22–30. https://doi.org/10.1046/j.1365-2788.2003.00458.x
Muñiz, J., Elosua, P., Hambleton, R. K., & International Test Commission. (2013). International Test Commission guidelines for test translation and adaptation: Second edition. Psicothema, 25(2), 151–157. https://doi.org/10.7334/psicothema2013.24
National Institute for Health and Care Excellence. (2016). Mental health problems in people with learning disabilities: Prevention, assessment and management (NG54). https://www.nice.org.uk/guidance/ng54
Raven, J., Raven, J. C., & Court, J. H. (2000). Manual for Raven’s Progressive Matrices and Vocabulary Scales. Oxford Psychologists Press.
Roid, G. H. (2003). Stanford-Binet Intelligence Scales (5th ed.). Riverside Publishing.
Sari, I. P., & Assyari, M. (2019). Family counseling program for children with mild intellectual disability through cognitive-behaviour therapy (CBT) approach and conjoint. In The 9th International Conference on Special Education in Southeast Asia Region (ICSAR) 2019 (p. 455).
Siste, K., Hanafi, E., Murtani, B. J., Baigent, M., Riley, B. J., Sessions, J., & Kusuma, K. S. (2024). Internet-based cognitive behavioral therapy for individuals with gambling disorder in Indonesia: Protocol for a pilot and feasibility study. F1000Research, 13, 689. https://doi.org/10.12688/f1000research.139321.1
Stallard, P. (2005). Think good–feel good: A cognitive behaviour therapy workbook for children and young people. Wiley.
Vereenooghe, L., & Langdon, P. E. (2013). Psychological therapies for people with intellectual disabilities: A systematic review and meta-analysis. Research in Developmental Disabilities, 34(11), 4085–4102. https://doi.org/10.1016/j.ridd.2013.08.030
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