"Moving on" through the locked ward system for women with intellectual disabilities.

BACKGROUND: The move to community support for all people with intellectual disabilities is an aspiration with international significance. In this article, we draw on rich accounts from women with intellectual disabilities detained under the Mental Health Act (E&W) 1983 and staff at an National Health Service secure setting in England to explore how "moving on" is defined and perceived. METHODS: The study reports on an ethnographic study using the field-notes and the 26 semi-structured interviews with detained women and staff on three wards. RESULTS: We first explore staff conceptions of moving on, which include behavioural change and utilizing coping strategies. Then, we discuss the areas of analysis that women discussed: taking back responsibility, success in arranged relationships, acceptance of regime and resistance to progression. CONCLUSION: The concepts of moving on were not determined by the women but by the service. We recommend further research which explores women's own rehabilitation requirements.

Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study.

BACKGROUND: Music has the potential to be an effective and engaging therapeutic intervention in the treatment of mental illness. This research area remains underdeveloped. AIMS: This paper reports the feasibility of an innovative low-intensity CBT-based music (CBT-Music) group targeted to symptoms of depression and anxiety. METHOD: A total of 28 participants with symptoms of depression and anxiety who were attending community mental health services were recruited for the study and randomized into TAU (treatment as usual) plus low-intensity CBT-Music (treatment) or to TAU alone (control). The treatment group consisted of a 9-week music group that incorporated various components of CBT material into a musical context. Feasibility was the primary outcome. The secondary outcomes were a reduction in depression, anxiety (Hospital Anxiety and Depression Scale) and disability (WHO Disability Assessment Schedule 2.0) assessed at baseline and 10 weeks. RESULTS: Recruitment proved feasible, retention rates were high, and the participants reported a high level of acceptability. A randomized control study design was successfully implemented as there were no significant differences between treatment and control groups at baseline. Participants in the treatment group showed improvement in disability (p = 0.027). Despite a reduction in depression and anxiety scores, these differences were not statistically significant. CONCLUSIONS: A low-intensity CBT-based music group can be successfully administered to clients of community mental health services. There are indications of effectiveness in reducing disability, although there appears to be negligible effect on symptoms of anxiety and depression. This is the first report of a trial of a low-intensity CBT-based music group intervention.

Wadaiko performance enhances synchronized motion of mentally disabled persons.

People with mental disabilities tend to lack communication skills and have difficulty with interpersonal relationships. Interpersonal communication skills were examined in two people with Down Syndrome with regard to playing wadaiko (Japanese drum). Motion analysis compared single play and two-person play in which one participant was more skillful than the other. The effect of wadaiko play was quantified using two different methodologies: motion delay and hit-timing analysis and visual analog-scale (VAS) ratings before and after play. The motion analysis indicated that the study participants became mutually synchronized in playing wadaiko, and that a participant played more accurately when he played with a senior member. VAS ratings indicated that participants felt more positive after practicing wadaiko than before and self-confidence improved. Synchronized gestures of wadaiko performance may be an effective therapy for people with limited communication skills.

Physical activity and nutrition health promotion interventions: what is working for people with intellectual disabilities?

A scoping review of studies on physical activity and nutrition health promotion interventions for individuals with intellectual disabilities was conducted. Searches included MEDLINE, PsycINFO, and CINAHL databases from 1986 through July 2006. The final number included 11 articles comprising 12 studies. Generally, this review indicated some evidence for fitness and psychosocial benefits of community-based physical activity and exercise programs for adults with intellectual disabilities. When combined with a more comprehensive health behavior education program incorporating exercise and nutrition information, some evidence exists for reductions in weight.

Feeding therapy for children with food refusal.

Disabled children suffer not only from their primary disease, but also from other complications, including food refusal. The purpose of this study was to elucidate the relationship between these conditions and food refusal in disabled children. The effectiveness of feeding therapy in treating food refusal was also examined. The study subjects were 67 disabled children (35 boys and 32 girls; mean age at initial examination: 6.5 years, SD: 6.0 years) who attended the Nippon Dental University Hospital between April 2004 and August 2008. Of them, the 13 subjects who were diagnosed as those who refused food received feeding therapy combined with desensitization therapy for hypersensitivity. Approximately 20% of the subjects showed food refusal symptoms. Primary disease, respiratory impairment and gastroesophageal reflux were not causes of food refusal in this population. There was a significant relationship between food refusal and hypersensitivity (p = 0.021). After receiving feeding therapy, six of the seven subjects with hypersensitivity but without dysphagia at initial examination recovered from food refusal. Food refusal did not significantly correlate with tube feeding. Hypersensitivity and/or tube feeding may induce food refusal. For subjects with these conditions, feeding therapy combined with desensitization therapy is effective in achieving recovery from food refusal.

Contando e encantando histórias de vida em um centro de atenção psicossocial / Telling and enchanting lifestories in a psychosocial care center / Contando y encantando historias de vida en un centro de atención psicosocial

A Reforma Psiquiátrica tem provocado inúmeras mudanças na atenção ao portador de sofrimento mental, ampliando as formas de intervenção junto a essa população. Este trabalho teve por objetivo relatar a experiência de criação de um grupo de contação de histórias em um Centro de Atenção Psicossocial (CAPS). Nesse grupo, por meio da apropriação de contos milenares, histórias do cotidiano e experiências de vida dos próprios participantes, é criado um espaço no qual cada um pode se aproximar de suas emoções, fantasias, pensamentos e medos de maneira metafórica e lúdica, potencializando possibilidades de compreensão do funcionamento psíquico. O grupo ocorre semanalmente, com 20 usuários de ambos os sexos, com duração de uma hora e vinte minutos. Nesse espaço de escuta, acolhimento, lembranças e ressignificação de sentidos, os participantes podem experimentar a si mesmos em outras possibilidades do existir, escrevendo também mais um capítulo da história de vida do próprio grupo.(AU)

The Psychiatric Reform has caused numerous changes in care to patients with mental disorder, widening the forms and scope of treatments. This study aimed to present an experience report of the creation of a storytelling group at a Psychosocial Care Center (CAPS). In this group, through the world of ancient tales and participants' own daily stories and life experiences, patients can approach their emotions, fantasies, thoughts and fears in a metaphoric and ludic way, thus improving their chances of gaining a better understanding of their own psychic performance. The group has 20 participants of both genders, and meets weekly for one hour and twenty minutes. In this environment of listening, embracement, memories and review of meanings, participants are able to experience themselves in other possibilities of being. At the same time they write another chapter of the life story of the group itself.(AU)

La Reforma Psiquiátrica ha provocado diversos cambios en la atención al portador de sufrimiento mental, ampliando las formas de intervención junto a esta población. Este trabajo tuvo como objetivo relatar la experiencia de creación de un grupo de contadores de historias en un Centro de Atención Psicosocial (CAPS). En este grupo, a través de la apropiación de cuentos milenarios, historias cotidianas y experiencias de vida de los propios participantes, se crea un espacio en el cual ellos pueden aproximarse a sus emociones, fantasías, pensamientos y miedos de una forma metafórica y lúdica, potencializando posibilidades de comprensión del funcionamiento psíquico. El grupo funciona semanalmente, con 20 usuarios de ambos sexos, con duración de una hora y veinte minutos. En ese espacio de escucha, acogida, recuerdos y resignificación de sentidos, los participantes pueden probar a sí mismos en otras posibilidades del existir, escribiendo también más un capítulo de la historia de vida del propio grupo.(AU)

Contando e encantando histórias de vida em um centro de atenção psicossocial / Contando y encantando historias de vida en un centro de atención psicosocial / Telling and enchanting lifestories in a psychosocial care center

A Reforma Psiquiátrica tem provocado inúmeras mudanças na atenção ao portador de sofrimento mental, ampliando as formas de intervenção junto a essa população. Este trabalho teve por objetivo relatar a experiência de criação de um grupo de contação de histórias em um Centro de Atenção Psicossocial (CAPS). Nesse grupo, por meio da apropriação de contos milenares, histórias do cotidiano e experiências de vida dos próprios participantes, é criado um espaço no qual cada um pode se aproximar de suas emoções, fantasias, pensamentos e medos de maneira metafórica e lúdica, potencializando possibilidades de compreensão do funcionamento psíquico. O grupo ocorre semanalmente, com 20 usuários de ambos os sexos, com duração de uma hora e vinte minutos. Nesse espaço de escuta, acolhimento, lembranças e ressignificação de sentidos, os participantes podem experimentar a si mesmos em outras possibilidades do existir, escrevendo também mais um capítulo da história de vida do próprio grupo.

La Reforma Psiquiátrica ha provocado diversos cambios en la atención al portador de sufrimiento mental, ampliando las formas de intervención junto a esta población. Este trabajo tuvo como objetivo relatar la experiencia de creación de un grupo de contadores de historias en un Centro de Atención Psicosocial (CAPS). En este grupo, a través de la apropiación de cuentos milenarios, historias cotidianas y experiencias de vida de los propios participantes, se crea un espacio en el cual ellos pueden aproximarse a sus emociones, fantasías, pensamientos y miedos de una forma metafórica y lúdica, potencializando posibilidades de comprensión del funcionamiento psíquico. El grupo funciona semanalmente, con 20 usuarios de ambos sexos, con duración de una hora y veinte minutos. En ese espacio de escucha, acogida, recuerdos y resignificación de sentidos, los participantes pueden probar a sí mismos en otras posibilidades del existir, escribiendo también más un capítulo de la historia de vida del propio grupo.

The Psychiatric Reform has caused numerous changes in care to patients with mental disorder, widening the forms and scope of treatments. This study aimed to present an experience report of the creation of a storytelling group at a Psychosocial Care Center (CAPS). In this group, through the world of ancient tales and participants' own daily stories and life experiences, patients can approach their emotions, fantasies, thoughts and fears in a metaphoric and ludic way, thus improving their chances of gaining a better understanding of their own psychic performance. The group has 20 participants of both genders, and meets weekly for one hour and twenty minutes. In this environment of listening, embracement, memories and review of meanings, participants are able to experience themselves in other possibilities of being. At the same time they write another chapter of the life story of the group itself.

Creating change: using the arts to help stop the stigma of mental illness and foster social integration.

Stigma is a social justice problem that plagues persons with psychiatric disabilities, their families, and society. It fuels the fear underlying discrimination; undermines consumer self-efficacy; and blocks rehabilitation, recovery, and social integration. The author hopes to create a passion for change and suggest a way that everyone can help stop stigma. This approach is simple: to nurture the artistic talent many clients possess and connect them with public venues for their artworks. On display, too, will be the "ability" in "disability." This will reduce stigma while building self-efficacy and empowerment. Anecdotal evidence supports this hypothesis. However, research is needed; a design for a study to test this hypothesis is described. Significantly, an antistigmal arts intervention can be conducted by any aware practitioner; one does not need to be an art therapist or have any background in art, only a desire to make a difference and resources on which to draw.

Clinical and benefit--cost outcomes of teaching a mindfulness-based procedure to adult offenders with intellectual disabilities.

The effects of a mindfulness-based procedure, called Meditation on the Soles of the Feet, were evaluated as a cognitive-behavioral intervention for physical aggression in 6 offenders with mild intellectual disabilities. They were taught a simple meditation technique that required them to shift their attention and awareness from the precursors of aggression to the soles of their feet, a neutral point on their body. Results showed that physical and verbal aggression decreased substantially, no Stat medication or physical restraint was required, and there were no staff or peer injuries. Benefit-cost analysis of lost days of work and cost of medical and rehabilitation because of injury caused by these individuals in both the 12 months prior to and following mindfulness-based training showed a 95.7% reduction in costs. This study suggests that this procedure may be a clinically effective and cost-effective method of enabling adult offenders with intellectual disabilities to control their aggression.

Cancer information needs of people with intellectual disability: a review of the literature.

The lifespan of people with an intellectual disability has increased significantly in recent years; however, this has resulted in a rising incidence of age-related illnesses including cancer. The World Health Organisation has expressed concern as evidence suggests prevalence rates for cancer are increasing for this group. The needs of people with a cancer diagnosis and an intellectual disability are beginning to be highlighted; however, there appears to be a substantial dearth of services including appropriate cancer information. This presents alarming obstacles and barriers to high-quality cancer care impacting on treatment, management and overall survival rates for this client group. Furthermore, a number of policy and research reports directed at the health needs of people with an intellectual disability have continually highlighted the need for accessible information and effective communication. Having access to cancer information should be considered a crucial part of providing optimum holistic care for this client group. Cancer professionals should assess the unique information needs of people with an intellectual disability as mainstream information does not meet their requirements. Furthermore, health professionals working in intellectual disability settings must also address their knowledge and information deficits in this regard. This paper presents a review of the literature with a specific focus on the cancer information needs of people with an intellectual disability.

Strategic behaviour of institutional providers in mental handicapped care in the Netherlands.

PURPOSE: The purpose of this paper is to describe an inventory of the strategic responses of institutional providers of mental handicapped care to the strengthening of consumer choice through a personal care budget (PCB). DESIGN/METHODOLOGY/APPROACH: Semi structured interviews were conducted among 26 providers covering 52 per cent of the total market volume of about 100,000 clients annually. FINDINGS: A representative number of providers was included; on average a percentage below the national average of PCB users was found to be served. Of the 26 providers, 16 indicated adaption to their strategy in response to expected consumer empowerment The actual deployment of this response in the organisations seemed not to be very thorough or explicit. Surprisingly, as a growing part of PCB-clients choose alternative providers, no concerns were raised concerning the possible emergence of new service providers. ORIGINALITY/VALUE: Although the market share of PCB users is growing fast and existing providers do not seem to absorb this accordingly, a lack of market analysis and strategic behaviour of the traditional providers in response to this development was found. Based on this research growth of market shares of disruptive service providers can very well be anticipated.

Arte y capacidades diversas / No disponible

Cualquier medio artístico es una oportunidad para poder reivindicar el derecho a ser uno mismo. Mediante la manifestación artística, el artista proyecta su nivel de identidad y provoca en el espectador reacciones, ya sean positivas o negativas. La devolución de esas reacciones retroalimentan al artista haciendo que éste estimule su nivel de autoestima, favoreciendo la utilización de sus recursos internos, descubriéndose a sí mismo dentro de todas sus posibilidades. En las personas con discapacidad este proceso es igual, aun cuando se ve reforzado por disponer de un medio que le da la posibilidad de ser reconocidas, potenciando su valor como personas en el entorno social. En ASSIDO trabajamos la Danza Contemporánea y las Artes Plásticas con incursiones de ambas en la Música. En las actividades artesanas trabajamos desde los diseños de las personas con capacidades diversas y no desde los modelos de monitores o imitaciones. ASSIDO cuenta con una Compañía de Danza Vocacional llamada “Así Somos” integrada por 11 bailarines con síndrome de Down, que se encuentra inscrita dentro de los circuitos normalizados regionales y es compañía en residencia del Centro Cultural Municipal “Puertas de Castilla” de nuestra ciudad (Murcia). Dentro de la Danza se desarrollan talleres rehabilitadores y formativos atendiendo en la actualidad un total de 80 personas con edades entre los 5 y los 46 años. Contamos con Talleres Ocupacionales que trabajan con las Artes Pláticas y realizan dos Exposiciones anuales: “Vivir el Arte” y “ArteSano” y con Talleres de ArteTerapia para personas con mayor afectación en cuanto a niveles comunicativos y expresivos o trastornos mentales asociados. Hemos desarrollado cursos de formación hacia el empleo y la ocupación en relación a múltiples materias artísticas (AU)

No disponible

Inclusion of people with mental retardation and other developmental disabilities in communities of faith.

Our focus in this paper is on efforts to include persons with developmental disabilities in faith communities. We provide a review of the relevant literature on religious participation and faith communities for persons with disabilities and blend the limited data available on these topics with the perspectives of individuals whose efforts focus on these concerns. Topics explored are the implications of being part of the faith community in terms of its impact on quality of life, the barriers to inclusion in such communities, strategies for overcoming these barriers, and special considerations for adults with mental retardation or other developmental disabilities. Discussion of the implications for enhancing inclusion in faith communities is provided.

[Carry over: practical experience of persons with severe motor and intellectual disabilities].

Tomo clinic is a special clinic for the handicapped. We have supported a day care center and a group home for persons with severe motor and intellectual disabilities (SMID) for over ten years. It seems that physical well-being declines dramatically in persons with SMID over 20-years old. We need special cooperation with the general hospital not only for the treatment of adult diseases including esophageal cancer, but also to backup the social activities of our clinic, because we support daily lives of persons with SMID and their families who want to live together in their own communities for as long as possible. The author reported the daily medical care activities in the day care center and the group home.