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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
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.
Nottinghamshire Healthcare NHS Foundation Trust
Nottingham, United Kingdom
Impact of Events Scale for intellectual disabilities (IES-ID)
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.
Time frame: Completed weekly through baseline and intervention stages, approximately 16 weeks. Then at 6-week follow up (approximately week 22).
Lancaster and Northgate Trauma Scale for Intellectual Disabilities - Informant Version (LANTS-IV; Wigham et al., 2011)
47 scored on a six-point scale for frequency and three-point for severity.
Time frame: Completed weekly through baseline and intervention stages, approximately 16 weeks. Then at 6-week follow up (approximately week 22).
Clinical Outcome Routine Evaluation-Learning Disabilities (CORE-LD; Brooks et al., 2013)
14 scored on a three-point Likert scale measuring psychological distress across four domains: well-being, symptoms, functioning, and risk
Time frame: At baseline week 1 and at 6-week follow-up (approximately week 22).
Change interview (Elliott et al., 2001) with clients and carers
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.
Time frame: 6-weeks post-intervention. Sessions will be around 30-60 minutes.
Heart rate
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.
Time frame: Weekly during the intervention sessions, for approximately 12-weeks.
Post-session therapist reflections
Therapist reflections will be collected to gather information about their thoughts relating to the manual and therapy.
Time frame: Across the intervention phase, an average of a year
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