Intellectual disabilities and ACT: feasibility of a photography-based values intervention

There is limited evidence regarding clinical effectiveness of therapeutic interventions for people with intellectual disabilities (ID). Previous research has highlighted challenges regarding adaptation of Acceptance and Commitment Therapy (ACT) for people with ID. Central to ACT is a focus on living in congruence with individual core values. The concept of values is abstract and difficult for people with a limited verbal understanding to comprehend, and yet this approach holds much promise for people with ID. The paper aims to discuss these issues.

The current study outlines the adaptations undertaken to facilitate making the concept of values more accessible to people with ID. It also explores the feasibility of the adapted approach to the values component.

This trial has shown that it is possible to isolate a single component of ACT and adapt it for use with people with ID. The findings highlight the potential feasibility of a value-based approach for people with ID augmented through the use of participant-produced photography to enhance conceptual understanding of the values component of ACT.

Findings were reliant on self-report data, which may result in inaccurate reporting and may be influenced by social demands. Given the diverse and unique presentations of people with ID, the inclusion and exclusion criteria limits the extent to which the current findings may be generalised to people with ID more widely.

Participant-produced photography may be directly applied to clinical practice, with implied benefits of improving access to, and meaningful engagement with psychological therapies for people with ID. Development of (and ability to articulate) a readily available and easily accessible values system, during times of adversity, represents a key implication arising from the current trial.

The current study shows that people with intellectual disability can be helped to appreciate abstract concepts such as personal core values. It also shows the potential to work through the medium of personal photography to explore the feasibility of the adapted approach to the values component – potentially a logical preliminary step towards an ACT-ID evidence base. To the authors’ knowledge, this novel approach is the first of its kind in the ID literature.