The assessment and treatment of a man with mild learning disability, violent behaviour and chronic low self‐esteem: a case study

Abstract

The following case study describes the assessment, formulation and treatment of a man with mild learning disabilities and a history of violent behaviour. Following several years of offence‐related work, identification of chronic low self‐esteem provided an alternative approach to addressing the risk of violence by treatment based on the cognitive model of low self‐esteem. Global self‐esteem and fear of negative evaluation were assessed at baseline, middle and end of treatment and at one‐month follow‐up. Although scores improved over the course of 23 sessions and were maintained at one‐month follow‐up, the change was minimal and unlikely to be clinically significant. However, the client reported benefits from therapy and there were observable positive behaviour changes. Discharge was facilitated from secure services to supported living in the community. The results from this case study show that, with adaptation, cognitive behavioural therapy for low self‐esteem may successfully be applied to people with mild learning disabilities. Therapy to address issues underlying offending behaviour is often required in addition to offending behaviour programmes in order to reduce risk of re‐offending.

Citation

Bishop, A. and Henry, J. (2008), "The assessment and treatment of a man with mild learning disability, violent behaviour and chronic low self‐esteem: a case study", Advances in Mental Health and Learning Disabilities, Vol. 2 No. 1, pp. 38-44. https://doi.org/10.1108/17530180200800006