Therapeutic relationships with individuals with learning disabilities: a qualitative study of the counselling psychologists' experience

Abstract

Accessible summary This research looked at what it is like to have a relationship with someone with a learning disability when doing psychological therapy. It is important we know what it is like to have this relationship, so we can be good at doing therapy and get good outcomes for people. The results say that the relationship is complicated but very important, and we need to know more about it. SummaryThe therapeutic relationship, between client and therapist, is seen as a fundamental aspect in the outcome of therapy in the nonlearning disabled population. Literature suggests that the issues that are important in psychological therapy with the nonlearning disabled population should not lose significance with individuals with learning disabilities. Despite this, there exists a poor empirical and theoretical understanding of the complexities of the therapeutic relationship, when the individual has a learning disability. As a discipline, Counselling Psychology has a particular interest and skill base in understanding the therapeutic relationship and is therefore in a position to offer a valuable contribution to understanding the therapeutic relationship when an individual has a learning disability. Through eight semi‐structured interviews, counselling psychologists currently working with individuals with learning disabilities were asked to share their experiences and understanding of the nature and role of the therapeutic relationship. A qualitative methodology guided by interpretative phenomenological analysis (IPA) enabled detailed exploration of the counselling psychologists' perspective. Themes emerged identifying the therapeutic relationship as fundamental yet difficult due to variables such as the client's experience in relationships, the need for multiple relationships, the experience of needing to facilitate reassurance and the necessary skills for therapeutic approaches. Themes also emerged relating to therapist's motivations, values and needs when working with this client group and tensions concerning individualisation and the setting culture. The themes are discussed in relation to the existing literature and implications for theory and practice are explored.