BEAMS-ID

A randomised controlled trial to evaluate the effectiveness and cost-effectiveness of a therapy to treat anxiety disorders in adults with moderate to severe intellectual disabilities.

BEAMS-ID Trial: multicentre two-arm parallel randomised controlled trial comparing a behavioural intervention for anxiety disorders and treatment-as-usual to treatment-as-usual with adults with moderate to severe intellectual disabilities.

Adults with moderate to severe intellectual disabilities often cannot communicate using words. They need support with personal care, many require constant support from carers. People with moderate to severe intellectual disabilities are more likely to have anxiety disorders, but are often excluded from mental health research and have limited access to therapy. In a recent research study, we adapted and tried out an anxiety therapy with adults with moderate to severe intellectual disabilities. This therapy is called Behavioural Interventions to Treat Anxiety in Adults with Moderate to Severe Intellectual Disabilities (BEAMS-ID) and is made up of 8-15 weekly sessions. During sessions, the person and their carer learn: (1) about anxiety and how it affects people (‘psychoeducation’), (2) ways to relax and feel calmer, (3) and how to face fears slowly and safely (‘graded exposure’). We want to work out if BEAMS-ID, when used alongside usual support (called “routine care”), is better at reducing anxiety than just routine care alone. We also want to find out whether BEAMS-ID is good value for money.

We will sign up 184 adults with moderate to severe intellectual disabilities who have an anxiety disorder. Their carers (paid and unpaid carers including family) will also take part. Everyone will be randomly put into one of two groups: Group 1 will receive BEAMS-ID and routine care, Group 2 will receive routine care only.

We will ask carers questions before putting people into the two groups, and then again 26-weeks, and 52-weeks later. These questions will be about the person’s anxiety, other problems, quality of life, and the carer’s wellbeing. We will also look at how much BEAMS-ID costs and compare the costs and benefits of BEAMS-ID and routine care. To better understand how people feel about BEAMS-ID, we will talk to 20 carers and 20 clinicians. We will also use a Talking Mat® with 20 adults with intellectual disabilities, this is a tool that helps people with communication difficulties share their thoughts and feelings.

We developed BEAMS-ID together with carers and clinicians, and we included feedback from people with moderate to severe intellectual disabilities who tried the therapy. We developed the research plan and BEAMS-ID therapy with the National Autistic Society and the Challenging Behaviour Foundation. We will also set up two groups to support the research, a Carer Advisory Group, and a Lived Experience Advisory Panel of adults with moderate to severe intellectual disabilities who have anxiety and received BEAMS-ID therapy.

We will share the results in different ways so that they are easy to understand and reach a wide range of people.