Cooper, Rebecca; (2019) The long-term outcomes and feasibility of assessing a psychosocial intervention aimed at increasing the capacity of people with intellectual disabilities to manage and resist stigma. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Background: Intellectual disability stigma is widespread and has significant negative implications for individuals with intellectual disabilities. Stigma resistance is associated with positive outcomes across stigmatised groups of individuals, and is implicated as a target for interventions tackling stigma at the intrapersonal level. However, to date there have been no interventions that seek to directly manipulate stigma resistance in individuals with intellectual disabilities. Aims: The present study contributes to a multi-part feasibility and pilot study of a psychosocial intervention aimed at increasing the capacity of individuals with intellectual disabilities to manage and resist stigma. Specifically, it aimed to (1) examine the feasibility and acceptability of assessing longer-term outcomes of the intervention through (a) Qualitative interviews with group members, group facilitators and significant others four months from baseline and (b) standardised outcome measures completed by group members seven months from baseline; and (2) preliminarily assess the longer-term outcomes of the intervention. Method: The intervention consists of five manualised sessions delivered by facilitators of existing self-advocacy, social and educational groups for people with intellectual disabilities. Recruitment and retention rates were explored, and quantitative data assessing self-esteem, psychological distress, experienced discrimination and sense of social power were compared at baseline, intervention completion and follow-up. Qualitative interviews with group members, group facilitators and significant others were completed at follow-up and analysed using thematic analysis (Braun & Clarke, 2006). Results: Assessing the longer-term outcomes of the intervention through qualitative interviews with group members, facilitators and significant others four months from baseline and standardised outcome measures completed by group members seven months from baseline was both feasible and acceptable. No statistically significant changes in scores of self-esteem, psychological distress, experienced discrimination or sense of power were found between baseline and follow-up. However, increases in self-esteem and sense of power and decreases in psychological distress and experienced discrimination, all with small effect sizes, were found. Qualitative findings demonstrated long-term benefits of the intervention for group members, facilitators and significant others. Benefits to group members indicated increases in stigma resistance at the personal, peer and public levels. Conclusions: Preliminary findings of the long-term benefits of the intervention and feasibility and acceptability of the proposed methods of assessment of the outcomes indicate the appropriateness of a further controlled trial of the intervention. Recommendations for improving the feasibility and acceptability of assessing the longer-term outcomes of the intervention are made.

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