Does training improve understanding of core concepts in cognitive behaviour therapy by people with intellectual disabilities? A randomized experiment


Correspondence should be addressed to Professor Shirley Reynolds, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7QH, UK (e-mail:


Background. People with intellectual disabilities (ID) experience similar or even higher rates of mental health problems than the general population and there is a need to develop appropriate treatments. Cognitive behaviour therapy (CBT) is effective for a wide range of disorders in the general population. However, there is some evidence that people with ID may lack the cognitive skills needed to take part in CBT.

Aims. To test if people with ID can learn skills required for CBT, specifically the ability to distinguish between thoughts, feelings, and behaviours and to link thoughts and feelings (cognitive mediation).

Method. A randomized independent groups design was used to examine the effect of training in CBT on two tasks measuring CBT skills. Thirty-four adults with ID were randomly allocated to the experimental condition (N=18) or to the control condition (N=16). CBT skills were assessed blind at baseline and after the intervention.

Results. The training led to significant improvements in participants' ability to link thoughts and feelings, and this skill was generalized to new material. There was no effect of training on participants' ability to distinguish amongst thoughts, feelings, and behaviours. People with ID can, therefore, learn some skills required for CBT. This implies that preparatory training for CBT might be useful for people with ID. The results might be applicable to other groups who find aspects of CBT difficult.