Initial Testing of a Novel, Mental Imagery-Based Anxiety Intervention for People With Mild to Moderate Intellectual Disabilities Using a Single Case Experimental Design.
Olivia M Hewitt, Paul A Thompson, Craig Steel and 1 others
Five people with mild to moderate intellectual disabilities found a new mental imagery anxiety programme acceptable, and three of the five who completed it showed reliable anxiety reduction.
One therapist, one site, and mid-study changes make this too early to act on.
Key findings
1The intervention was well attended and completed: all five who finished attended all nine sessions (92.6% overall attendance), standardised measures were completed at every timepoint with no missing data, and no serious adverse events were reported.
2Three of the five who completed the intervention (PPT01, PPT04, PPT05) showed both reliable and clinically significant change on the Glasgow Anxiety Scale for ID at end of intervention; one showed no reliable change and one had missing data.
3Daily mood recordings showed a statistically significant change between baseline and intervention for only one participant (PPT01); the other four showed no clear effect, with variability attributed to external factors such as illness, trauma disclosure, and physical health conditions.
Still to come
How it was doneWhat they found
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What it does not show
Five people, one therapist, one NHS Trust — there is no way to tell whether the results would hold with a different therapist, in a different setting, or with a different mix of participants. The intervention was changed after the first three participants finished, so the five who completed it did not all receive the same treatment; any effect seen is a blend of two versions. No blinding was used, and the participants knew they were in a trial, which can inflate self-reported mood and anxiety scores. The follow-up was only 2 weeks, so there is no information about whether any gains lasted. Three of the five completers and two of the three supporters interviewed had received the refined (second) version of the intervention, so the qualitative data do not represent the original programme. The daily mood scale (1–5) may not be sensitive enough to detect the kind of change this intervention produces, and one participant hit a ceiling effect. Self-report measures, even in adapted form, may not capture the full picture for some people with intellectual disabilities.
Declared interests
Funded by the National Institute for Health and Care Research (NIHR300501). The authors declare no conflicts of interest.
The easy way to misread this
Do not read the three reliable changes on the anxiety scale as evidence this programme works. The primary aim was acceptability, not efficacy; the sample was five people seen by one therapist at one site; and the intervention was modified after the first three participants, so the five completers did not all receive the same treatment. This is a feasibility signal, not a treatment effect.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →