Abstract
PurposeThe purpose of this paper is to explore significant events in psychotherapy with clients with intellectual disabilities (IDs).Design/methodology/approachFour therapy dyads, each consisting of one client and one therapist, were recruited. Following the brief structured recall procedure (Elliott and Shapiro, 1988), semi-structured interviews focused on helpful events in psychotherapy, using video of particular sessions as a stimulus to help prompt recall of that session.FindingsUsing interpretative phenomenological analysis, five super-ordinate themes were identified: “The Uniqueness of the Therapeutic Relationship”; “Using adaptations to Express Emotions”; “Client Behaviour/Therapist Behaviour”; “Hope and Paternalism”; and “Meaning-Making”. The results provide additional evidence that significant therapy events occur for clients with IDs. Furthermore, the research enabled insights to be gained about the process of therapy for this client group and for exploration of therapeutic factors that may be involved in facilitating a significant therapy event.Research limitations/implicationsThis study highlights the need for therapists to work in such a way as to facilitate significant events in therapy. Whilst this study was a necessary first step, owing to the non-existence of research in this area, the sample size and qualitative design may limit any wider generalisation of the findings.Originality/valueSignificant events have not previously been explored in psychotherapy with clients with IDs. This research could therefore make an important contribution to our understanding of the process of psychotherapy for this client group.
Highlights
IntroductionDevelopment of psychotherapy for people with intellectual disabilities
Introduction vaDevelopment of psychotherapy for people with intellectual disabilitiesPeople with a disability face a number of challenges, such as the physical or organic aspects of disability, attitudes from society, and self-stigmatisation (Becket & Taylor, 2016).the Learning Disabilities Mortality Review Annual Report (Norah Fry Centre for Disability Studies, 2018), identified the persistence of health inequalities for people with intellectual disabilities (IDs), highlighting the need for further action in order to meet the health needs of this client group
Client Participants seemed to be alluding to the therapeutic relationship in their narrative by exploring what it was like to talk to their therapist
Summary
Development of psychotherapy for people with intellectual disabilities. The Learning Disabilities Mortality Review Annual Report (Norah Fry Centre for Disability Studies, 2018), identified the persistence of health inequalities for people with intellectual disabilities (IDs), highlighting the need for further action in order to meet the health needs of this client group. IDs can recognise and experience emotions in a similar way to the non-ID population (Bermejo, et al, 2014); this suggests that this client group has the ability to gain insight and develop self-awareness, factors that contribute to therapeutic change (Lacewing, 2014). Since the publication of the psychotherapy and learning disability report (Royal College of Psychiatrists Council, 2004), the evidence base has steadily grown, and substantial case study evidence exists for a number of psychotherapeutic approaches.
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