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Adapted Therapy in ID — MRCPsych Paper B MCQ

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EasyIntellectual DisabilityAdapted Therapy in IDMRCPsych Paper B

A 35-year-old man with mild intellectual disability is referred for psychological treatment of recurrent anger. He has good verbal skills and is motivated to engage. Which approach to adapting the intervention best accords with NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Tailor communication, pace, structure, supports and carer involvement to his assessed needs

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · E = shown as D · C = shown as E

B is correct. NICE NG54 recommends that adaptations are informed by assessment and tailored to the person's preferences, level of understanding, strengths, communication needs and other impairments. The therapist should agree the intervention's structure, duration, pace and flexibility with the person and consider visual methods and support from carers or care workers, particularly for applying skills between sessions. Good verbal ability does not remove the need to assess reasonable adaptations, so A is incorrect. Cognitive-behavioural anger-management interventions may be used in intellectual disability, making C incorrect. Medication is not a prerequisite for psychological treatment, excluding D. NICE NG11 allows anger-management therapy to be delivered individually or in groups, so E is also incorrect.

Reference: National Institute for Health and Care Excellence. Mental health problems in people with learning disabilities: prevention, assessment and management (NG54), recommendations 1.8.1–1.8.4. 2016. https://www.nice.org.uk/guidance/NG54/chapter/Recommendations