Extrait

Background and study aims Many people with learning disabilities find it hard to control their anger. This often leads to aggression, which can have serious consequences, such as exclusion from mainstream services and the need for potentially more expensive emergency placements. Anger management teaches people to recognize what makes them angry and learn skills that they can use to cope better with those situations. Several small studies of anger management groups for people with learning disabilities have shown promising results. All of the published studies have reported that people who take part in an anger management group show less anger at the end than people who are waiting for treatment, and they stay less angry for several months afterwards. The aim of this study is to evaluate the effectiveness of an anger management intervention for people with mild to moderate learning disabilities. Who can participate? Adults aged 18 to 65 attending a service for people with mild to moderate learning disabilities, and identified by service staff as having problems in managing their anger. What does the study involve? Participants are randomly put into one of two conditions, according to which day service they attend. Half of them take part in staff-led anger management groups. The other half are supported as usual by staff while they wait for treatment (waiting-list group). Anger management is usually taught by Clinical Psychologists. In this study, the group therapy takes place in the services that the service users attend during the day, and the therapists are staff in those services. A Clinical Psychologist teaches the staff how to work with a treatment manual. The manual was written for use by therapists who have never done this before. It gives full details of how to run each session of a 12-week anger-management course. At the end of the 12 weeks, there is a six-month follow-up period. Then the staff who work with the waiting-list groups are taught how to use the manual, so that the waiting-list groups can also be offered anger management. We train the staff how to use the manual; then, when the groups are running, we check that the staff are running them properly and if they are running well; and at the end, we talk to staff about how they found it to run a group and if there has been any effect on the rest of their service. The main point of the study is that we assess how well people are doing before and after they take part in an anger management group, and six months later. We measure how angry and aggressive people get and how well they cope with difficult situations, both in the service and at home, how they feel about themselves, and what they thought of the group. We also find out if it costs less to support people after they have been part of an anger management group. We do all this by talking to the service users themselves, their key-workers in the service, and their home carers. What are the possible benefits and risks of participating? The potential benefit to participants is that participants will learn to express their anger more appropriately, with a decrease in aggression, so increasing their opportunities for social inclusion, and decreasing the risk of placement breakdown, exclusion from services, and involvement with the criminal justice system. We believe there to be no significant risks to participants or society. There is a hypothetical risk that a client's condition could be worsened by participation in the group, but the likelihood of this happening is extremely small. Where is the study run from? Abertawe Bro Morgannwg University NHS Trust (UK) When is the study starting and how long is it expected to run for? July 2009 to December 2011 Who is funding the study? Health Technology Assessment Programme (UK) Who is the main contact? Prof. Paul Willner

Critère d'inclusion

• Mild to moderate learning disabilities, anger management

Liens

• isrctn
• ictrp