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• Preface
• References
• Contents
• 1: Introduction
• Why Did We Write This Book?
• What Position Are We Coming from?
• How Did We Write This Book?
• What Is in This Book?
• What Next?
• References
• 2: History and Theory
• CBT: An Evolving Therapy?
• The Evidence
• Deficits and Distortions
• Making Therapy Meaningful: Asking the  Right Questions
• Therapy in Context
• A Theoretical Framework: The Social Self
• Therapeutic Sessions: An Interpersonal Process
• Conclusions
• References
• 3: Current Context
• Service Responses to People with Intellectual Disabilities and Mental Health Problems
• Why Such High Prevalence of Mental Health Problems?
• Access to CBT for People with Intellectual Disabilities
• CBT Demand Characteristics
• How Can We Make CBT Accessible for People with Intellectual Disabilities?
• Recent Research Findings on Clients’ Cognitive Capacity
• Other Factors: Meeting Halfway?
• References
• 4: Assessment and Setting the Scene for Cognitive Behaviour Therapy
• Making a Start
• Before We Start: Where to Meet?
• Hearing the Client’s Story and Creating a Safe Place
• Setting the Scene
• Finding the Right Pace
• Is CBT Suitable?
• Using Storyboards to Explore Social Cognition and Emotional Understanding
• Standardised Assessments
• Self-Monitoring and Diaries
• Common Stumbling Blocks
• Helpful Building Blocks: What You Can Do
• Problems Due to Cognitive Characteristics
• Increasing Compliance
• Choosing the Best Fit for Your Client
• Choosing Rating Scales: How Much and How Often
• Self-Perceptions
• References
• 5: The First Stage of Therapy
• Before Moving Forward: Taking Stock About the Model to Be Used
• Adapting CBT to the Needs of an ID Client
• Socialising into the Model
• Tapping into Clients’ Thoughts and Underlying Schema or Views of Self
• The Way You Think
• Understanding Distress
• The Role of Emotion
• A Shared Formulation
• References
• 6: Therapeutic Change
• A Continuing Need for Structure
• Behavioural Change
• Establishing a Therapeutic Dialogue
• Working with Thoughts and Feelings (Bottom Up and Top Down)
• Top-Down Approaches and Behavioural Experiments
• The Way You Think
• Perceptions of Self and Working with Stigma
• Real Changes
• Dealing with Setbacks
• Finishing Therapy
• Working with Different Presentations and Challenges
• References
• 7: And Another Thing… Adapting Therapy for Particular Cognitive Impairments
• Working with Memory Problems
• Problems of Attention and Distractibility
• Communication Difficulties
• Problems of Cognitive Rigidity
• Presenting Problem
• Clinical Interview and Background Information
• Self-Monitoring
• Social Understanding
• Identifying Helpful and Unhelpful Thoughts
• Aspects of Alan’s Presentation that Obstructed Therapy
• Draft Formulation
• Feeding Back an Accessible Formulation
• Intervention. A Concrete Plan
• Making the Thinking Feeling Link: One Thing Leads to Another
• Guidance Towards Reappraisal
• How True on a Scale of 0–10?
• Balanced Thinking
• But How Does This Work in Real Life?
• Getting Stuck on Thoughts
• Gaps in Therapy
• Progress Made
• Real Changes Too
• Conclusions
• References
• 8: Group Work
• Why Consider Group Work for People with ID?
• What Do Clients Think About Groups?
• Some Considerations
• Preparation
• Group Identity
• Making the Group Accessible and Safe
• Support Staff
• Enforcement of Group Rules
• Cognitive Strategies
• Peer Support
• Endings and Then?
• References
• 9: Mindfulness and Third Wave Therapies
• Mindfulness in Health Settings
• Mindfulness and People with Intellectual Disabilities: What’s the Evidence?
• So What Is Mindfulness?
• Mindfulness: A Different Process
• Mind and Body
• Mindfulness: A Different Relationship with Your Problems
• Mindfulness: A Different Relationship with Your Thoughts
• A Different Relationship with Yourself: Using Compassion
• Ways of Adapting Mindfulness
• Keep It Real: Making Sense of Abstract Concepts
• Making Mindfulness Relevant
• Make It Easy: Engaging People with Intellectual Disabilities in Mindfulness
• The Problem of the Wandering Mind
• Keep It Short and Repeat Often
• Working with Compassion
• Adapting Mindfulness to Suit Different Physical Needs
• Practising at Home
• Mindfulness Isn’t for Everyone
• Conclusions
• References
• 10: Working with Others
• Family Members
• Support Staff
• Health and Social Services Professionals
• Specialist Services
• References
• 11: Making a Real Difference
• Why Train Therapists
• A Framework for Specialist Training
• Materials and Supervision
• Increasing Access and the Mainstreaming Debate
• Manuals: Mapping a Way Ahead
• Broadening Access to CBT
• Conclusion
• References
• 12: Final Thoughts
• References
• Index