The effects of cognitive stimulation therapyfor individuals with a learning disability: a mixed methods study

Student thesis: Doctoral Thesis


Background: Cognitive Stimulation Therapy (CST) is an evidenced-based manualised group
intervention for the management of dementia in the general older adult population. Research
suggests CST significantly impacts upon individuals’ cognitive functioning and quality of
life. Since its conceptualisation, CST has been adapted to include maintenance CST,
individual CST, and culturally-adapted CST. Despite these adaptations, CST has not been
adapted to the needs, or evidenced for the use in the treatment, of individuals with a learning
disability, who are a population at an increased risk of developing dementia. This study
aimed to examine the feasibility and effects of CST for individuals with a learning disability
and dementia, and whether outcomes were comparable to the general older adult population.
Method: This study utilised a mixed methods design, incorporating an experimental case
series and a qualitative multi-perspectival IPA methodology. Four individuals with a learning
disability completed measures of cognitive and adaptive functioning, quality of life, and
mental health pre, post and 6-8 weeks following attendance at a pilot CST group, which was
adapted to the needs of individuals with a learning disability. Three individuals with a
learning disability, six caregivers, and two group facilitators took part in a semi-structured
interview discussing their views and experiences of the CST group.
Results: There was no statistically significant change in cognitive functioning at the grouplevel.
Despite this, individuals evidenced changes in cognition functioning from pre-CST to
post-CST on the subscales examining language, orientation, and memory. Quality of life was
positively impacted, with self-reported improvements in areas of relationships and activities.
The four superordinate themes extracted from the data: “Connecting”, “Meaning”,
“Changing”, and “Ending” supported the quantitative findings. In addition, these provided an
understanding of some key considerations when adapting CST for this population, including
the experience of group cohesion, the role of personally meaningful activities, and the loss
experienced at the end of the group.
Conclusions: The results obtained in this study provide preliminary evidence regarding the
feasibility and effects of CST for individuals with a learning disability. Despite the results
being consistent with the wider evidence-base, future studies with more methodologically
robust designs are required before any firm conclusions can be drawn. Importantly,
individuals with a learning disability reflected that CST provided them with an opportunity to
experience connection, value, and a sense of ownership within their care and treatment. The
implications for clinical practice are outlined alongside the areas for future research.
Date of Award2019
Original languageEnglish
Awarding Institution
  • Teesside University
SupervisorAsh Summers (Supervisor) & Paul Sharpe (Supervisor)

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