Combining clinical interventions for carers of people with intellectual disabilities: a systematic review of combined interventions for carers of people with developmental disabilities, and a realist evaluation of a combined acceptance and commitment therapy and positive behaviour support intervention for carers of children with intellectual disabilities
Turco De Pretis-Cagnodo, Matteo
BACKGROUND: A systematic review was conducted to examine whether combined Applied behaviour analysis (ABA) and Mindfulness-based interventions (MBIs) are effective in increasing the psychological wellbeing and quality of life of carers of people with intellectual and developmental disabilities, and to determine whether combined interventions achieve more positive results than interventions delivered alone. METHODS: Using the Ovid search software, systematic searches of Ovid MEDLINE, APA PsychInfo, and Embase were conducted in November 2020. The review included studies that combined ABA and MBIs in interventions with both paid and unpaid carers, working and living in any setting, and caring for people of any ages. RESULTS: Thirteen studies involving 322 paid care staff and 195 parents of people with intellectual and developmental disabilities were included. Seven studies examined staff caring for adults, while the remaining six studies focussed on parents caring for their children (under 18 years old). Studies varied considerably in terms of design, sample size, diagnosis, and methodological quality. Within the context of these limitations, results tentatively suggest that combined ABA and MBI interventions are effective in decreasing carer stress and challenging behaviour, and that they can be more cost-effective than ABA interventions delivered alone. CONCLUSION: While there is emerging evidence that combined ABA and MBI interventions are beneficial to carer wellbeing, it is not possible to draw firm conclusions on the basis of the existing literature. Future studies should aim at evaluating the effectiveness of combined interventions further using high quality randomized controlled trials.
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