Psychological therapies can be helpful for adults with IDD and co-occurring mental health problems. There is some evidence that cognitive-behavioural therapy (CBT) can be effective for treating depression, anxiety and difficulty regulating emotions in this population (Koslowski et al., 2016; Unwin et al., 2016; Weston et al., 2016). Behaviour activation (an important CBT skill), as well as guided self-help for depression can also be effective (Jahoda et al., 2017).
Mindfulness-based interventions have some emerging support for people with IDD (Chapman et al., 2013) and people with ASD (Cachia et al., 2016). Emerging evidence also suggests that virtual reality can be a useful way to expose adults with ASD to situations that are stressful and to help them develop new coping strategies (Maskey et al., 2018).
Modifications to therapy may include more visuals and repetition of concepts, and including caregivers in the session or at the start and end of sessions to help maintain therapeutic gains outside the session.
Creating emergency care plans
People with IDD are more likely to visit the emergency department in psychiatric crisis and to visit repeatedly, so it is important that their care plan and information be available. For patients who make repeat visits, you can work with the hospital to create a care plan. This may include booking a follow-up appointment with you to debrief and plan for next time. It can be helpful when creating the plan to involve all of the relevant people in the patient’s circle of care. The primary care section of the Surrey Place website provides tools for preventing and managing crisis, and the Mental Health in Autism website provides a sample safety plan for autistic adults.
Supporting family caregivers
When a person with IDD has a psychiatric disorder, it affects the entire family. You can assess caregiver distress using the Brief Family Distress Scale, which is a one-item tool that measures how well the family is coping. Services for people with IDD are often lacking or insufficient, particularly in adulthood, so it is important to link people to supports, plan for the future and talk about potential crises. Families can benefit from information and support, and also from psychological therapies that promote their mental health and help them to cope. The resources section below lists reading material you can recommend to support family members.