An AAIDD-Informed Framework for Cognitive Behavioral Case Formulation and Cognitive Behavior Therapy for Young People With Mild Intellectual Disabilities or Borderline Intellectual Functioning

Young people with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) form a heterogeneous group with a range of cognitive and adaptive (dis)abilities. MID-BIF youth show an increased vulnerability to developing mental health problems due to risk factors in various domains. Despite this increased risk, access to and use of mental health care is low and there is a dearth of evidence-based interventions suitable for use with MID-BIF youth. Cognitive behavioral therapy (CBT) is recommended as the first-line intervention for many psychiatric problems in young people. There is accumulating evidence to suggest that adapted CBT for use with ID adults and young people can lead to treatment success. However, there are few guidelines to help professionals take into account the combination of characteristics of the MID-BIF population. The American Association on Intellectual and Developmental Disabilities (AAIDD) provides a sound theoretical-conceptual framework which can be used to inform systematic decision-making about treatment planning and delivery of CBT for MID-BIF youth. This paper presents the AAIDD framework as a way in which characteristics of MID-BIF youth can be integrated into a cognitive behavioral case formulation. This AAIDD-informed case formulation elucidates the way in which features of MID-BIF contribute to the onset and maintenance of psychiatric problems. In addition, it provides insights into how treatment can be adapted to take into account delays and/or deficits in different areas of functioning. Awareness of the characteristics of the MID-BIF population enables the tailoring of CBT in order to enhance its applicability and optimize treatment effectiveness. Public Health Significance StatementThis article suggests that while CBT has the potential to be applied successfully with the vulnerable population of young people with MID-BIF, it requires tailoring to fit the specific needs of this group. We provide clinicians working with MID-BIF youth with a systematic approach to determining which adaptations to CBT are needed for optimal treatment, illustrated by a case example and a case formulation resource.