angerCognitive behavioural therapy (CBT) may be effective in improving anger control in people with learning disabilities, according to a new study.

Many people with learning disabilities can find it hard to control their anger which often leads to aggression and serious consequences such as being excluded from mainstream services. But a team of researchers from Swansea University has found that CBT could be effective in controlling anger.

The researchers set out to evaluate the effectiveness of group-based CBT on 179 people with learning disabilities all of whom had been identified as having problems with anger control.

Half of the service users received CBT sessions every week for 12 weeks. The sessions were delivered in the participants’ usual day services by care workers who had been trained to act as lay therapists. The rest of the service users did not receive therapy until after the end of the study, and acted as a control group.

Before the study began, all participants completed self-assessments to measure how they would respond to hypothetical or real situations that were potentially anger-provoking. They were reassessed after 16 weeks and again after 10 months, with keyworkers and home carers also asked to assess each participant’s ability to cope with anger-provoking situations.

The researchers found that service users receiving therapy did not report a significant reduction in their anger responses to hypothetical triggers but they did report a decrease in their anger response to real triggers, and their keyworkers reported that their anger had decreased significantly compared with the controls, at both the 16 week and 10 month follow-ups.

Both service users who received therapy and their keyworkers reported that they were better at using anger coping skills. The service users’ keyworkers and home carers also reported lower levels of challenging behaviour in those who had received therapy.

Study lead Professor Paul Willner said: “CBT is the treatment of choice for common mental health problems, and widening access to CBT is seen as a major policy priority. However, the delivery of CBT to people with intellectual disabilities is underdeveloped, and there is limited evidence of its effectiveness for this client group.

"Our study clearly shows that group-based CBT was effective in improving anger control by people with intellectual disabilities. The CBT intervention also decreased challenging behaviour, as rated by both keyworkers and home carers."

Reference: Willner P, Rose J, Jahoda A, Kroese BS, Felce D, Cohen D, MacMahon P, Stimpson A, Rose N, Gillespie D, Shead J, Lammie C, Woodgate C, Townson J, Nuttall J and Hood K (2013) Group-based cognitive-behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomised controlled trial. British Journal of Psychiatry. 

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