The Emotion Regulation Skills System for Youth & Adults with Cognitive Impairment

The Skills System at JRI provides training and consultation and engages in research aimed at improving access and quality of evidence-based treatment for vulnerable youth and adults with learning and behavioral health challenges.

Addressing Mental Health Care Disparities: Individuals with intellectual disabilities (ID) are among the most vulnerable and underserved survivors of trauma and victimization. They are three times more likely to experience trauma or be victimized than non-disabled populations. Under-reporting of abuse has historically been dramatically higher for cognitively impaired victims. Individuals with ID are more likely to struggle with co-occurring mental health diagnoses than non-disabled trauma victims. It is estimated that 50% of people with ID demonstrate challenging behaviors, including aggression, self-injury, and sexually reactivity. Our Center’s research has highlighted that trauma engenders physiological dysregulation impacting all levels of personal and social functioning. Individuals with co-occurring ID and mental health difficulties are among the survivor groups at greatest risk, and yet, this population routinely contends with numerous barriers impeding both access to services and successful recovery.

Innovative Solutions: Enhancing emotional, cognitive, and behavioral regulation skills is a core component of intervention for many behavioral health issues, and a primary element of treatment within many evidence-based models. At our Center, we have developed and/or empirically tested a number of cutting-edge, trauma-focused treatment models that heavily emphasize the building of self-regulatory capacity. These include our ARC, CBP, SMART and TCTSY models as well as numerous other externally developed models that we have intensively studied, including EMDR, Urban Improv, clinical neurofeedback and heart-rate variability retraining.

Because of the pervasive skills deficits that many individuals with significant cognitive challenges experience, interventions need to include enhanced supports to improve accessibility to treatment components. For example, effective treatments for this population need to organize concepts to facilitate recall and generalization, while minimizing cognitive-load demands.

The Emotion Regulation Skills System: The Skills System is an evidence-based, user-friendly DBT™-Informed Emotion Regulation skills curriculum that offers a tangible skill set, in teaching formats that can be tailored for all learning abilities. This model is specifically designed to be accessible to individuals diagnosed with mild/moderate intellectual disabilities, ASD, of other psychiatric conditions that impact learning capacities.

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The Skills System may be a useful intervention for agencies that experience challenges meeting the complex needs of youth or adults with cognitive or developmental impairments in their programs. The Skills System curriculum provide a series of specialized, trans-theoretical treatment tools that can easily integrated into more comprehensive treatment frameworks, such as ARC and DBT. As a “plug-in” to other models, the Skills System can offer clients, caregivers, and providers powerful yet fun skills that make abstract concepts more concrete. The Skills System is designed to provide necessary scaffolding to increase awareness in the present moment, make adaptive decisions and plans at all levels of emotion, and execute goal-directed actions. Therapists, family members and other adults in the client’s broader caregiving system functioning as in-vivo skills coaches can improve generalization of skills, enhancing opportunities for attunement and competency.

Skills System at JRI: Julie F. Brown, PhD, author of The Emotion Regulation Skills System for the Cognitively Challenged Client: A DBT™-Informed Approach (2016), adjunct faculty at the Trauma Center at JRI, and program director of the Skills System at JRI, provides training and consultation related to Skills System. A comprehensive Skills System train-the-trainer implementation empowers agencies to:

  • Run Skills System groups or provide individual skills training to teach clients the Skills System
  • Integrate the Skills System into DBT or other forms of individual therapy to enhance skills acquisition
  • Train/supervise support staff and/or collaterals (e.g. family members) to be in-vivo skills coaches to improve the generalization of skills
  • Create a sustainable, adherent Skills System program designed to improve intrinsic self-regulation capacities of the clients being served.

To learn more about the Skills System, CLICK HERE. Contact Julie at (508) 317-2115 and/or email Julie.