The providing information to refer to in Samaras

The
Equality Act (2010) obligates service providers to make ‘reasonable
adjustments’ to ensure equal access to services. Reasonable
adjustments can be defined as the requirement of public sector
organisations to adapt their provision or approach to facilitate
equal access to services for people with learning disabilities
(Public Health England, 2017). Some therapists acknowledge that they
need to be prepared to make appropriate reasonable adjustments for
people with learning disabilities in order to compensate for the
deficits in cognitive functioning (Jahoda et al., 2017).

As
Samara has not had input from the multi-disciplinary team, she may
lack some of the prerequisite skills for CBT. Researchers argue that
pre-therapy structured training can lead to significant improvement
in people with learning disabilities ability to link thoughts and
feelings (Bruce et al., 2010). Therefore, Samara may benefit from
preparatory training to gain an understanding of the concept of CBT
(Bruce et al., 2010). Also, as CBT treatment effects are argued to be
short-lived, another reasonable adjustment for Samara may include
booster sessions to sustain the positive impact of treatment (Unwin
et al., 2016). Moreover, considering some people with learning
disabilities have communication difficulties, provision of
information in an accessible format tailored to the individual may be
more meaningful (Mander, 2016). It appears that Samara prefers easy
read and pictorials, thus the learning disabilities nurse could
consider supporting and involving Samara by providing information to
refer to in Samaras preferred format.

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Ultimately,
research showing the positive impact of CBT in preventing and
treating depression is well established (van Zoonen et al. 2014;
Cuijpers et al.,2013), however, studies outline the concern regarding
short-term effects of CBT for people with learning disabilities.
Therefore, for Samara to experience long-term effects of CBT the
learning disabilities nurse can support Samara’s carers by training
and involving them through the intervention. This would support
sustaining the techniques learnt, transferring these skills to home
life, and supporting Samara with the homework component (Unwin et
al., 2016). Furthermore, putting in place reasonable adjustments is
essential as researchers outline the significant improvement in CBT
when reasonable adjustments such as pre-therapy, adapting the methods
and materials to make it accessible and booster sessions are put in
place (Jahoda et al., 2017; Bruce et al., 2010). Considering studies
show that CBT can have positive effects amongst people with mild to
moderate learning disabilities, CBT may be an appropriate therapeutic
intervention in supporting Samara with her mental health (Darbyshire
and Kroese, 2012).

A
nursing assessment is a critical part of the nurse’s role in order to
gather information to identify the patient’s needs and establish
future interventions (Dougherty et al., 2015). Incorporating Samara’s
views and opinions in the nursing assessment, regardless of capacity
demonstrate good practice, as this can be seen as being
person-centred (McCormack and McCance, 2016). Additionally,
communicating interest in Samara’s dreams and wishes shows adherence
to the person-centred approach as well as aiding the development of a
rapport, which assists the therapeutic relationship (Lay and Kirk,
2012). It can be argued that good practice was shown, however, there
are many significant components of care lacking from the nursing
assessment which are fundamental for Samara’s care. For example risk
assessments, integration of the multi-disciplinary team, a health
action plan, a hospital passport, urinalysis, blood test and a health
check, all are significant aspects of care required for people with
learning disabilities.