Introduction

1. A literature review of Cognitive Behavioural Therapy and anxiety in Learning Disabilities- staff training SabihaAzmi- Lead Clinical Psychologist: BCHC NHS Trust IoannaTsimopoulou- Mres Student- University of Birmingham GemmaUnwin- Research Fellow- University of Birmingham FLD Conference -27th March 2014. Llandudno- Wales

2. Introduction People with LD suffer from mental health problems more often than the general population and anxiety is between the most common disorders (Cooper et al., 2007; Reid et al. 2011; Richards et al. 2001; Smiley 2005). CBT is being used by therapists for its treatment, but there is little evidence on how effective these interventions are (Willner 2005). 1. Examine the effectiveness of CBT interventions that are delivered by therapists or staff for people with LD and anxiety. • Staff training is crucial, as it increases their ability to recognize mental health problems that coexist with LD and improves their emotional intelligence (Costello et al.2007; Quigley et al. 2001; Zijlmans et al. 2011). 2.Determine which are the most effective techniques of training staff that works with people with LD and anxiety.

3. Methodology We searched the following databases: Embase, MEDLINE and PsycINFO Terms related to: LD, CBT, anxiety, staff and staff training.

4. 90 records identified through database searching. 76 records after duplicates removed. 76 titles and abstracts screened 61 records excluded 15 full texts assessed for eligibility 10 records excluded 5 studies included Plus 2 more studies from cross-referencing 7 studies included Results A. Effectiveness of CBT for adults with LD and anxiety • No staff-administered CBT intervention for anxiety. • The majority of the studies have important methodological limitations and flaws • Small number of participants • No control group • Short-term or no follow-up assessment • No masking process or fidelity assessment

5. Results A1. LD and anxiety Quantitative VS Qualitative CBT is not effective CBT is effective More and of higher quality research is needed!

6. Results A2. LD and a mixed clinical picture with anxiety and depression or anger • Qualitative • CBT seems to be effective • service users • staff • Quantitative VS • Mixed results • The RCT shows no significant decrease in anxiety Generally, there is a difference between the quantitative and the qualitative studies.

7. 120 records identified through database searching. 87 records after duplicates removed. 87 titles and abstracts screened 74 records excluded 13 full texts assessed for eligibility 13 records excluded 0 studies included Results B. Most effective methods of training staff that works with people with LD and anxiety • A meta-analysis from van Oorsouw et al. (2009) • 55 studies in a period of 20 years

8. In service format Coaching - on - the - job format Pack age of training techniques , Verbal feedback – corrective, neutral and praise with Avoid instructions verbal feedback Results B1. Most effective methods of training staff that works with people with LD Goals Format Techniques

9. Conclusions and recommendations for future research • Not much persuading quantitative evidence for the effectiveness of CBT interventions in reducing anxiety in people with LD. • RCTs • Sensitivity of the existing evaluation tools • No staff-administered CBT intervention for anxiety. • Development of CBT programmes delivered by staff • No study for effective techniques in training staff that works with people with LD and anxiety • Identify the most effective methods and techniques • Training staff in CBT techniques • Dodd et al. (2013) • Brown & Marshall (2006)

10. Contact: Dr. SabihaAzmi Sabiha.Azmi@bhamcommunity.nhs.uk Thank you!

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