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Background and purpose
This systematic literature review evaluates the effectiveness of adapted mindfulness-based therapies on improving the emotion regulation of adults who have an intellectual disability and who are incarcerated. This population is at increased risk for contact with the criminal justice system. They face worse outcomes than the general population at every stage, from arrest to incarceration to recidivism. Individuals who have an intellectual disability are likely to have deficits in emotion regulation. In particular, people who have low verbal and executive functioning may be unable to engage in the cognitive processes required to regulate emotions. They are therefore more likely to engage in maladaptive self-soothing behaviors, including self-harm and interpersonal violence. Many people who have an intellectual disability have difficulty accessing verbal- and cognitive- based treatments. Recent research on mindfulness highlights its potential to improve emotional and executive functioning without complex cognitive restructuring.
Methods
This paper examines five interventions that incorporate mindfulness to identify effective adaptations for this particular population. The authors and years of reviewed studies are:
Chilvers, J., Thomas, C., Stanbury, A. (2011)
Morrissey, C., Ingamells, B. (2011)
Oxnam, P., & Gardner, E. (2011)
Sakdalan, J.A., Shaw, J., & Collier, V. (2010).
Singh, N.N., Lancioni, G.E., Winton, A.S.W., Singh, A.N., Adkins, A.D., & Singh, J. (2008).
Results
Each treatment included skill development, mostly in group format. A majority of programs were based, at least loosely, on Dialectical Behavior Therapy mindfulness skills and format. The interventions were specifically created for people who have an intellectual disability. They were designed to be uniquely interactive and engaging, and material was made accessible through the frequent use of visual aides and experiential learning.
The studies used a range of measures, including incident report in each case. Outcomes in every study indicated a decrease in incidents for participants. Further evidence suggested that adapted mindfulness-based treatments can decrease an individual’s risk - and security - level and reduce distress symptoms. Mindfulness-based programs, with a skills training approach that have been specifically adapted to address those with an intellectual disability, can improve behavior within a correctional setting.
Conclusions and implications
This topic requires further study. There is a need to integrate concepts from Special Education into the design and implementation of mindfulness skills curricula for individuals who have an intellectual disability and deficits in emotion regulation. Interventions must be creatively adapted so that information is accessible and relevant. It may be necessary to explicitly teach fundamental emotion concepts and vocabulary.