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Managing chronic pain in people with learning disabilities: a case study
- Authors:
- LEWIS Sarah, BELL Dorothy, GILLANDERS David
- Journal article citation:
- British Journal of Learning Disabilities, 35(2), June 2007, pp.93-98.
- Publisher:
- Wiley
Chronic pain is a prevalent, under-diagnosed problem in the learning disability population. This is in part due to communication problems, unrecognized pain behaviours and the effects of medication. As a consequence, chronic pain often goes untreated and causes ongoing distress. This paper initially describes the main research that has been carried out into learning disabilities and chronic pain management and then goes on to detail the case of a 32-year-old woman with mild-moderate learning disabilities who has been suffering from chronic pain for 16 months. A multi-modal and multidisciplinary assessment was carried out to explore the physical and psychological underpinnings of her pain and its impact on her quality of life. A cognitive-behavioural pain management intervention was developed by adapting a manual for non-learning disabled adults to meet the physical, social and cognitive needs of the client. Sessions were carried out once a week for 4 months and improvements were reported in the level of pain intensity, levels of anxiety and depression and the range of activities she took part in.
‘Sad, just sad’: a woman with a learning disability experiencing bereavement
- Authors:
- CAMPBELL Alison, BELL Dorothy
- Journal article citation:
- British Journal of Learning Disabilities, 39(1), March 2011, pp.11-16.
- Publisher:
- Wiley
Death and the resulting grief process is a challenging subject. For those with learning disabilities, it is especially difficult and often leads to an increased risk of behavioural and emotional issues. This article describes the psychological assessment and treatment of Hannah, a 48 year-old woman with a mild learning disability, who was experiencing difficulties with the recent bereavement of her mother. During eight sessions over a three month period, and by involving all of the significant people in Hannah’s life, an understanding of her specific difficulties in coming to terms with the loss of her mother began to emerge. This led to the assessment information and psychological theory being combined into a comprehensive formulation, such as a reduction in social activities resulting in more time alone, and working with a total of fourteen care staff. This case study highlights the benefits of normalising the grief reaction and acknowledges the difficulties that may arise when those with learning disabilities try to find ways to express their grief.