Table 1 Therapy adaptations
Therapeutic strategies | Adaptations for intellectual disability and COVID-19 |
|---|---|
Engagement and rapport | Regular and predictable appointments, scheduled in advance Pictorial, easy-read therapy contract co-created with client and family Person-centred approaches e.g., repetition, use of language, shared agenda setting, gay affirmative therapy, etc All materials posted to the client and family in between sessions |
Creating a shared case formulation | Maintenance cycles tentatively sketched, posted to client, then updated together in session Shared images and gestures used to co-create the formulation |
Commencing self-monitoring | Remote mindfulness techniques in session, and practiced as homework Regular referral to the formulation, encouraging the client to recognise her current feelings and urges |
Identification of high-risk situations | All instances of comfort eating and their antecedent events recorded, then discussed in session Basic behavioural experiments |
Prevention of over-eating | Emotions underlying antecedent events targeted e.g., social strategies to prevent loneliness |
Developing mood regulation skills | Client’s list of personal coping strategies to prevent comfort eating prominently displayed Encouragement of creative expression of emotions e.g., drawing |
Enlisting help from others | Permission for family and MDT input sought from client |
Relapse prevention | Continued practice of mood regulation skills Ongoing family support Formulation and intervention summary shared with family, Community Learning Disability Team, and day centre staff |