Cognitive behavioural anger management intervention for people with intellectual disabilities: costs of intervention and impact on health and social care resource use

Research output: Contribution to journalArticlepeer-review


  • D. Felce
  • D. Cohen
  • P. Willner
  • N. Rose
  • J. Shead
  • A. Jahoda
  • P. Macmahon
  • C. Lammie
  • A. Stimpson
  • C. Woodgate
  • D. Gillespie
  • J. Townson
  • J. Nuttall
  • K. Hood

Colleges, School and Institutes

External organisations

  • University of Wales Swansea
  • University of Glasgow
  • Cardiff University
  • Health Economics and Policy Research Unit Faculty of Health Sport and Science University of South Wales Pontypridd UK
  • Dementia and Psychological Services Learning Disabilities Specialist Health Service The Ridge Hill Centre Black Country Foundation Partnership Trust Stourbridge UK
  • Directorate of Learning Disability Services Abertawe Bro Morgannwg University Health Board Bridgend UK


BACKGROUND: Anger and aggression among adults with intellectual disability (ID) are associated with a range of adverse consequences for their well-being and that of their family or staff carers. The aims were to evaluate the effectiveness of an anger management intervention for adults with mild to moderate ID and to evaluate the costs of the intervention and its impact on health and social care resource use. This paper is concerned with the latter aim.

METHODS: A cluster-randomised controlled trial was conducted involving day services for adults with ID in Scotland, England and Wales. Incremental costs of delivering the intervention and its impact on subsequent total health and social care package costs were calculated. Full data comparing costs between baseline and follow-up 10 months later were collected for 67 participants in the intervention arm and 62 participants in the control arm. Cost differences between the groups at follow-up, adjusted for baseline levels, were calculated using non-parametric bootstrapping controlling for clustering.

RESULTS: The mean hourly excess cost of intervention over treatment as usual was £12.34. A mean adjusted cost difference of £22.46 per person per week in favour of the intervention group was found but this was not statistically significant.

CONCLUSIONS: The baseline-adjusted cost difference at follow-up would result in a fairly immediate compensation for the excess costs of intervention, provided the difference is not a statistical artefact. Further research is needed to clarify the extent to which it might represent a real saving in service support costs.

Bibliographic note

© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.


Original languageEnglish
Pages (from-to)68-81
Number of pages14
JournalJournal of Intellectual Disability Research
Issue number1
Early online date9 Jan 2014
Publication statusPublished - Jan 2015


  • Adult, Anger, Cognitive Therapy, England, Female, Follow-Up Studies, Health Services, Humans, Intellectual Disability, Male, Middle Aged, Scotland, Wales