Where Is the Empirical Support for the Effectiveness of Cognitive Behavior Therapy for Adults With Intellectual Disability

Comments on an article by J. Graser et al. (see record 2022-44063-001). The authors provide a commentary on Graser et al. regarding meta-analysis evaluating the effectiveness of cognitive behavior therapy (CBT) to treat anxiety, depression, and anger in adults with intellectual disability (ID). Depression and anxiety are suitable targets being two of the most common psychiatric symptoms reported by people with and without ID. To understand the inclusion of anger as a treatment target, it may be helpful to know that aggression is often identified as the reason for referral to psychiatric services for people with ID and that irritability has been considered a general sign of emotional distress as well as a symptom of depression in children and in adults with ID. The Graser et al. review and meta-analysis makes an important contribution to the understanding of the effectiveness of CBT for adults with ID. In evaluating the effectiveness of CBT to treat depression, anger, and anxiety, the authors retained eight RCTs, seven CTs, and took the unusual decision to also include uncontrolled trails (uCT), provided the uCTs reported quantitative pre- and post-intervention outcome measures. Graser et al. argued that the inclusion of uCT provided variance in methodological rigor across studies and allowed them to compare effect sizes across types and degrees of study control. The commenting authors applaud Graser et al. for evaluating methodological quality and risk of bias in each study as well as for including the uncontrolled clinical trials. (PsycInfo Database Record (c) 2022 APA, all rights reserved)