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date: 12 July 2020

Abstract and Keywords

Many individuals with developmental and intellectual disabilities (ID) who are dually-diagnosed with mental health problems experience emotional, cognitive, and behavioural regulation difficulties. The comprehensive, multi-modal approach offered by Dialectical Behaviour Therapy (DBT) addresses the complex intra- and inter-personal challenges that create and maintain patterns of dysregulation and challenging behaviours. This chapter presents information to help DBT therapists understand factors relevant to applying DBT with individuals with dual-diagnosis and emotion regulation skills deficits. Although standard aspects of DBT are critical, adjustments to improve access for individuals with ID are necessary. Therapists treating this population must be competent in standard DBT and in managing factors associated with cognitive load to modify interventions in ways that remain fundamentally DBT. This chapter addresses accommodations that alter delivery mechanisms, not changing core processes, and introduces the Skills System, an adapted curriculum with which the DBT therapist can help individuals with ID improve intrinsic emotion regulation capacities.

Keywords: Intellectual disabilities, developmental disabilities, dual-diagnosis, emotion regulation, challenging behaviours, Skills System

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