Facing your fears together
Peer-mentored cognitive behavioral therapy for adolescents with mild intellectual disability and anxiety disorder
As a clinician and scientist, I have spent my entire career working on bridging the gap between science and practice for adolescents with mild intellectual disability. This group of 163.000 adolescents in the Netherlands have an IQ lower than 85 and significant limitations in adaptive functioning (APA, 2013; Greenspan, 2017) and are at-risk for comorbid mental health problems. Approximately 30 to 50% of adolescents with mild intellectual disability have comorbid psychiatric problems and these are often underdiagnosed (Einfeld et al., 2011). Especially behavior and anxiety problems are highly prevalent (Buckley et al., 2020). Effective treatment for anxiety disorders in mild intellectual disability is currently non-existent. The most effective treatment for anxiety problem, cognitive behavioral therapy (CBT) is much less effective in individuals with mild intellectual disability (Hronis et al., 2019; Unwin et al., 2016).
Developmental neuroscience and behavioral studies point to peer-influence as a potentially powerful adolescence-specific port-of-entry for therapy enhancement, as adolescents are highly sensitive to peer feedback (Do et al., 2020; Foulkes & Blakemore, 2016; Knoll et al., 2015). This effect is even stronger in adolescents with mild intellectual disability. A way to operationalize this social learning in the psychotherapy setting is through peer-mentored intervention.
The main objective of this project is therefore to develop and test a peer-mentored CBT manual for adolescents with mild intellectual disability and anxiety problems. I will work together with clients, parents and therapists to develop a feasible and effective new therapy model. The peer-mentored CBT will also be tested in this project to assess client experience, client and parent satisfaction and whether the treatment is successful in reducing anxiety problems. The project is a close collaboration between GGZ Delfland and Leiden University and has been funded by ZonMw.