The influence of therapy quality on outcomes from behavioural activation and guided self‐help treatments for depression in adults with intellectual disabilities

Dagnan, David ORCID: https://orcid.org/0000-0002-5709-1586 , Thompson, Paul, Hastings, Richard, Hatton, Chris, Melville, Chris, Cooper, Sally‐Ann, McMeekin, Nicola, Fulton, Lauren, Jones, Rob, McConnachie, Alex and Jahoda, Andrew (2025) The influence of therapy quality on outcomes from behavioural activation and guided self‐help treatments for depression in adults with intellectual disabilities. British Journal of Clinical Psychology, 64 (2). pp. 139-147.

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Abstract

Objectives: We report the effect of quality of therapy delivery on outcomes in a randomized, controlled trial of behavioural activation (BA) and guided self‐help (GSH) for depression in adults with intellectual disabilities.

Methods: A study specific measure of quality was used in a linear mixed effect model to determine the effects therapy and therapy quality on therapy outcome.

Results: There was a significant interaction between quality and treatment type, with lower quality therapy associated with better outcome for GSH but poorer outcome for BA, with little difference in outcomes at higher levels of therapy quality.

Conclusions: Factors suggesting high quality in individualized BA may indicate problematic engagement for GSH. More research into processes in therapy for people with intellectual disabilities is required.

Practitioner points:
• There is little research on the effect of the quality of therapy delivery on therapy outcome for therapy with people with intellectual disabilities.
• Factors indicating therapy quality in therapy with people with intellectual disabilities may be different for therapies with different therapist and client demands.

Item Type:	Article
Journal / Publication Title:	British Journal of Clinical Psychology
Publisher:	Wiley / The British Psychological Society
ISSN:	2044-8260
Departments:	Institute of Health > Medical Sciences
Additional Information:	Professor Dave Dagnan, PhD, Visiting Professor in the Institute of Health at the University of Cumbria, Consultant Clinical Psychologist with Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust and Research Director for North Cumbria Integrated Care NHS Foundation Trust. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Depositing User:	Insight Administrator
SWORD Depositor:	Insight Administrator
Date Deposited:	03 Jun 2025 09:03
Last Modified:	26 Jun 2025 08:30
URI:	https://insight.cumbria.ac.uk/id/eprint/8844

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