Group Work

  • Andrew Jahoda
  • Biza Stenfert Kroese
  • Carol Pert


CBT group work has been shown to be beneficial for people with intellectual disabilities, and feedback from clients suggests that the non-specific effects of group intervention are particularly valued. We therefore consider the influence of other psychological approaches such as systemic, interpersonal, person-centred and psychodynamic therapies as complementing our CBT interventions. When offering CBT group therapy, attention must be paid to preparation and practical issues such as how to advertise and recruit, how to choose and prepare the venue, and how to assess the clients’ psychological needs and goals. Making the group accessible, comfortable and safe and encouraging a positive group identity are important aspects to consider and can improve attendance and reduce dropout. Having support staff or family members accompany the clients and take an active part in the group can have both advantages and disadvantages and needs to be carefully planned. How best to enforce group rules and how to end the group in a way that maximises the chances that progress is maintained in the long term must also be considered at an early stage.


  1. Bender, M., & Tombs, D. (1992). How should we measure the effect of groupwork with adults with learning difficulties? I. Outcome variables. Clinical Psychology Forum, 43, 2–6.Google Scholar
  2. Bisson, J. L., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013) Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. The Cochrane Library, Issue 12. Art. No.: CD003388. DOI: 10.1002/14651858.CD003388.pub4.
  3. Briere, J., & Scott, C. (2015). Complex trauma in adolescents and adults: Effects and treatment. Psychiatric Clinics of North America, 38(3), 515–527.CrossRefPubMedGoogle Scholar
  4. British Psychological Society, Royal College of Psychiatrists and Royal College of Speech and Language Therapists. (2007). Challenging behaviour: A unified approach. Leicester: British Psychological Society.$
  5. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.Google Scholar
  6. Gillies, D., Taylor, F., Gray, C., O’Brien, L., & D’Abrew, N. (2015). Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents. Evidence Based Child Health, 8, 1004–1016.CrossRefGoogle Scholar
  7. Halgin, R. P. (1985). Teaching integration of psychotherapy models to beginning therapists. Psychotherapy: Theory, Research, Practice, Training, 22(3), 555–563.CrossRefGoogle Scholar
  8. Holen, S., Waaktaar, T., Lervag, A., & Ystgaard, M. (2012). The effectiveness of a universal school-based programme on coping and mental health: A randomised, controlled study of Zippy’s friends. Educational Psychology, 32(5), 657–677.CrossRefGoogle Scholar
  9. Holmes, G. (2010). Psychology in the real world – Community-based groupwork. Ross-on-Wye: PCCS Books.Google Scholar
  10. Marsh, L. C. (1953). Group treatment of the psychoses.
  11. McLeod, J. (2011). Qualitative research in counselling and psychotherapy (2nd ed.). London: Sage.Google Scholar
  12. MacMahon, P., Stenfert Kroese, B., Jahoda, A., Stimpson, A., Rose, N., Rose, J., Townson, J., Hood, K., & Willner, P. (2015). ‘It’s made all of us bond since that course…’ – A qualitative study of service users’ experiences of a CBT anger management group intervention. Journal of Intellectual Disability Research, 59(4), 342–352.Google Scholar
  13. Mevissen, L., & de Jongh, A. (2010). PTSD and its treatment in people with intellectual disabilities: A review of the literature. Clinical Psychology Review, 30, 308–316.CrossRefPubMedGoogle Scholar
  14. Mishara, B., & Bale, C. (2004). An international programme to develop the coping skills of six and seven year old children. In S. Saxena & P. Garrison (Eds.), Mental health promotion from countries: A joint publication of the world federation for mental health and the world health organisation. WHO Library Cataloguing-in-Publication Data.Google Scholar
  15. Novaco, R. W. (2003). The Novaco anger scale and provocation inventory (NAS-PI). Los Angeles: Western Psychological Services.Google Scholar
  16. Pert, C., Jahoda, A., Stenfert Kroese, B., Trower, P., Dagnan, D., & Selkirk, M. (2013). Cognitive behavioural therapy from the perspective of clients with mild intellectual disabilities: A qualitative investigation of process issues. Journal of Intellectual Disability Research, 57(4), 359–369.CrossRefPubMedGoogle Scholar
  17. Razza, N. J., & Tomasulo, D. J. (2005). Healing trauma: The power of group treatment for people with intellectual disabilities. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  18. Rose, J., Loftus, M., Flint, B., & Carey, L. (2005). Factors associated with the efficacy of a group intervention for anger in people with intellectual disabilities. British Journal of Clinical Psychology, 44(3), 305–317.CrossRefPubMedGoogle Scholar
  19. Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretive phenomenological analysis: Theory, method and research. London: Sage.Google Scholar
  20. Stenfert Kroese, B., & Thomas, G. (2006). Treating chronic nightmares of sexual assault survivors with an intellectual disability – Two descriptive case studies. Journal of Applied Research in Intellectual Disabilities, 19, 73–80.Google Scholar
  21. Stenfert Kroese, B., Gillott, A., & Atkinson, V. (1998). Consumers with intellectual disabilities as service evaluators. Journal of Applied Research in Intellectual Disabilities, 11(2), 116–128.CrossRefGoogle Scholar
  22. Stenfert Kroese, B., Willott, S., Taylor, F., Smith, P., Graham, R., Rutter, T., Stott, A., & Willner, P. (2016). Trauma-focussed cognitive-behaviour therapy for people with mild intellectual disabilities: Outcomes of a pilot study. Advances in Mental Health and Intellectual Disabilities, 10(5), 299–310.CrossRefGoogle Scholar
  23. The Complex Trauma Taskforce. (2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults.¼ISTSS_Complex_PTSD_Treatment_Guidelines&Template¼%2FCM%2FContentDisplay.cfm&ContentID¼5185. Accessed 7 Nov 2016.
  24. Unwin, G., & Stenfert Kroese, B. (2015). An independent evaluation of Zippy’s friends for children and young people with special educational needs (Final report for the Judith Trust).
  25. Vereenhooge, L., & Langdon, P. E. (2013). Psychological therapies for people with intellectual disabilities: A systematic review and meta-analysis. Research in Developmental Disabilities, 34, 4085–4102.CrossRefGoogle Scholar
  26. Vos, T., Haby, M. M., Magnus, A., et al. (2005). Assessing cost-effectiveness in mental health; helping policy-makers prioritize and plan health services. Australian and New Zealand Journal of Psychiatry, 39, 701–712.CrossRefPubMedGoogle Scholar
  27. Whitfield, G. (2010). Group cognitive-behavioural therapy for anxiety and depression. Advances in Psychiatric Treatment, 16(3), 219–227.CrossRefGoogle Scholar
  28. Whittington, A., & Grey, N. (2014). How to become a more effective CBT therapist -mastering metacompetence in clinical practice. Oxford: Wiley Blackwell.Google Scholar
  29. Willner, P. (2004). Brief cognitive therapy of nightmares and post-traumatic ruminations in a man with a learning disability. The British Journal of Clinical Psychology, 11, 222–232.Google Scholar
  30. Willner, P. (2015). The neurobiology of aggression: Implications for the pharmacotherapy of aggressive challenging behaviour by people with intellectual disabilities. Journal of Intellectual Disability Research, 59(1), 82–92.CrossRefPubMedGoogle Scholar
  31. Willner, P., & Lindsay, W. R. (2016). Cognitive behaviour therapy. In N. Singh (Ed.), Clinical handbook of evidence-based practices for individuals with intellectual disabilities. Cham: Springer.Google Scholar
  32. Willner, P., Rose, J., Jahoda, A., Stenfert Kroese, B., Felce, D., Cohen, D., MacMahon, P., Stimpson, A., Rose, N., Gillespie, D., Shead, J., Lammie, C., Woodgate, C., Townson, J., Nuttall, J., & Hood, K. (2013). Group-based cognitive-behavioural anger management for people with mild to moderate intellectual disabilities: Cluster randomised controlled trial. The British Journal of Psychiatry, 203(4), 288–296.CrossRefPubMedGoogle Scholar
  33. Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.Google Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  • Andrew Jahoda
    • 1
  • Biza Stenfert Kroese
    • 2
  • Carol Pert
    • 3
  1. 1.Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
  2. 2.School of PsychologyUniversity of BirminghamBirminghamUK
  3. 3.Learning Disabilities ServiceNHS Greater Glasgow and ClydeGlasgowUK

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