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An important new NHS study has found that a simple, home based video therapy could radically improve support for thousands of families of children with intellectual disabilities. Intellectual disability is a lifelong condition that involves difficulties with understanding, learning and achieving independence. It’s linked to many genetic syndromes (eg, Down syndrome, Fragile X) or other conditions (eg, foetal alcohol spectrum disorder), though in many cases we simply don’t know the cause. Families of these children currently wait years for specialist help.

The trial, led by the Tavistock and Portman NHS Foundation Trust (now part of North London Foundation Trust) and published in Pilot and Feasibility Studies, suggests that a brief, strengths focused therapy delivered remotely over Microsoft Teams is a practical, effective and family friendly way to bridge a major gap in mental health provision.

Across England, tens of thousands of families caring for children with intellectual disabilities remain stuck on lengthy waiting lists for specialist mental health services. Many face years without structured support.

This new research offers a striking alternative.

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A different kind of therapy

Unlike traditional talking therapies, Video interaction guidance (VIG) focuses not on problems but on what parents are already doing well.

A trained practitioner films a short everyday moment – playing, eating, chatting – and edits the footage to highlight positive, attuned interactions. Parents and practitioners then watch these clips together, identifying the strengths that often go unnoticed in the chaos of daily life.

For many exhausted families, that strengths based, confidence building approach is transformative.

The study involved 40 parents of children aged 6 to 12 with intellectual disabilities, recruited across five NHS Trusts in London, East Anglia and the Northwest. Families were randomly assigned either to receive VIG alongside their usual care or to continue with usual treatment alone.

Crucially, sessions were delivered entirely via Microsoft Teams, making VIG accessible to families who would struggle to attend in person appointments.

The trial’s purpose wasn’t to prove VIG’s effectiveness outright but to answer three fundamental questions needed before launching a large national study:

• Can enough families be recruited?
• Will parents stay in the study long enough?
• Will families complete the therapy?

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Encouraging results

The findings exceeded expectations in most areas:

• 75% of parents stayed in the study for over six months, comfortably meeting the target of 70%
• 70% completed at least three cycles of VIG (two fortnightly meetings), showing strong engagement
• Data collection rates were exceptionally high – up to 100% at six months
• No safety incidents were reported at any point

Recruitment was the only challenge, with a 36% success rate. But researchers believe this can be improved by widening eligibility and recruiting through non clinical routes such as special schools.

Interviews with parents and clinicians were among the most powerful aspects of the trial.

Parents described VIG as supportive, uplifting and unlike anything they had been offered before.

“I love it… I really enjoyed it,” said one parent.

Another reflected: “I learned… that I shouldn’t be so hard on myself.”

One added poignantly: “I feel like somebody cared for us… I feel like I am not alone.”

Clinicians also reported profound change:

“It feels enormously transformative in their day-to-day lives,” said one practitioner.

Another recalled showing a mother evidence of her strengths: “Without VIG I would never have been able to convince mum that she did have a lot of gifts… It was just such a beautiful thing to do with them.”

Remote delivery was seen as a major advantage: reducing travel, cutting costs and fitting neatly into families’ already demanding routines.

A survey of 66 specialist NHS mental health services revealed a striking absence of early support:

• Only 15% had used any form of video feedback intervention in the previous year.
•  Almost none offered it to families on waiting lists, despite this being a time of acute need.

VIG itself cost the NHS an average of £153 per session and £307 per cycle, similar to the costs of many existing interventions but with far greater flexibility and reach.

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Towards a national trial

The study has been endorsed by professionals and parent carers. 

Moving forward to a more definitive trial and the application to fund such a definitive trial is now in process.

Proposed next steps include:

• Extending the age range of eligible children
• Recruiting families through special schools and other community settings
• Allowing more time to complete VIG cycles
• Scaling up delivery across multiple NHS sites

For families, the message is clear: a supportive, strengths focused therapy delivered on their own terms is not only feasible but deeply valued.

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Totsika, V., Kennedy, E., Absoud, M. et al. ‘A feasibility randomised trial of remotely delivered Video Interaction Guidance for parents of children with intellectual disability referred to specialist mental health services’(2026) is available at: https://doi.org/10.1186/s40814-026-01800-2

Our patient and public involvement partner the Challenging Behaviour Foundation where there is a video with one of our parent advisors explaining the findings.

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The study was funded by the National Institute for Health Research (NIHR Research for Patient Benefit programme). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.