Adapting a DBT informed programme for people with intellectual disabilities: Reflections

Within our community learning disability service, many patients with emotion regulation difficulties were re-referred soon after discharge. We introduced our adapted Dialectical Behaviour Therapy (DBT) informed programme in 2017, as DBT has a strong evidence base to treat patterns of emotional dysregulation (Linehan, 2013). We can showcase the effectiveness of our adapted programme by its high demand, excellent attendance and low rate of re-referrals, however, gathering more in-depth evidence proved more difficult. This article reflects on how we moved from adapted psychometrics to diary cards to observing skill application to collaboration with our patients as way to measure outcomes. Easy to read summary ■ People with intellectual disabilities (PWID) can find it difficult to manage their emotions, cope during times of distress and have good relationships. ■ We adapted a therapy called Dialectical Behaviour Therapy (DBT) to help achieve these. We used simple language, lots of visuals and fun activities to do this. ■ PWID accessing our programme attended a group and one-to-one session every week for nine months. ■ We wanted to show others how much our adapted programme helped PWID develop skills to cope and feel better. ■ After trying lots of different ways to do this, our facilitators noticed and recorded when skills were used. Experiences of attending our adapted programme were also shared via video.