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Psychology for people with learning disabilities
- Authors:
- SOUTH BIRMINGHAM PRIMARY CARE TRUST (Producer), OGI Laura (producer)
- Publisher:
- South Birmingham Primary Care Trust
- Publication year:
- 2010
- Pagination:
- (34 mins.), DVD
- Place of publication:
- Birmingham
Consisting of a DVD and booklet, this project pack explains the various psychological services which are available to people with learning disabilities. It is written as a working handbook for both family and professional carers. The resource outlines what clinical psychologists do, how they work and who they may of benefit to. It provides a useful distinction between the various psychologists a person may come into contact with when accessing services. The bulk of the booklet is dedicated to a series of two-page descriptions of common clinical approaches which may be employed when working with a person with learning disabilities: psychodynamic psychotherapy, positive behavioural support, cognitive analytic therapy, cognitive behavioural therapy and family therapy. The DVD attempts to orientate users to what is likely to happen when they see a psychologist. It mirrors the booklet in structure and outlines the main psychological approaches offered to people with learning disabilities by Birmingham PCT. In addition there is a chapter titled “Service User Forum” in which members of a service user advocacy groups ask questions relating to the practicalities of seeing a psychologist.
An exploratory study of the defence mechanisms used in psychotherapy by adults who have intellectual disabilities
- Authors:
- NEWMAN D. W, BEAIL N.
- Journal article citation:
- Journal of Intellectual Disability Research, 54(7), July 2010, pp.579-583.
- Publisher:
- Wiley
An important concept in psychodynamic theory and practice is that of defence mechanisms; mental operations that remove components of uncomfortable affects from conscious awareness. The identification of defences is a primary task for the therapist who then uses them in the formulation of their interventions. Work with adults who have intellectual disabilities (IDs) suggests that they use primitive defences. This hypothesis is tested in a case series analysis of the defences used in therapy by adults who have IDs. Transcripts of psychotherapy sessions with eight adults with mild IDs (two men, six women, age range 20-40, IQ 45-65) were evaluated using the defence mechanism rating scale (DMRS). Contrary to expectation the participants use a wide range of defences from primitive to mature. There was evidence suggesting the development of a defensive style, but little evidence to show change in defensive structure across the first eight sessions of treatment. This exploratory study suggests that adults who have IDs use a range of defences in psychotherapy and have particular defensive styles. Further work with more participants and a longer time frame is recommended. The findings also indicate that the DMRS may need development work to make it a more sensitive and valid measure of the full range of defences used by people with IDs.
Reaching out: a proactive process to include young people with learning disabilities in counselling in secondary schools in the UK
- Author:
- PATTISON Sue
- Journal article citation:
- British Journal of Guidance and Counselling, 38(3), August 2010, pp.301-311.
- Publisher:
- Taylor and Francis
This paper outlines a proactive process to include young people with learning disabilities in mainstream counselling in secondary schools in the UK based on the findings of a consequential mixed methods research study. Data collected from a quantitative and qualitative survey of 396 participants, and qualitative semi-structured interviews with 15 counsellors and psychotherapists, were used to build a model for inclusive counselling practice in secondary schools. Results showed the main inclusive theoretical approaches to counselling young people with learning disabilities were identified as integrative, humanistic/person-centred or psychodynamic. Six categories of increasing inclusivity were: raising awareness of the service; specialist training; an integrated partnership approach; expert supervision; advocacy; and active promotion of services. The author applies those findings and the model to the school counselling context. The findings provide useful insights into counsellors' views and perspectives on inclusive counselling and a proactive way forward for facilitating greater access to counselling in schools for young people who have learning disabilities.
‘I want to be listened to’: systemic psychotherapy with a man with intellectual disabilities and his paid supporters
- Authors:
- HAYDON-LAURELUT Mark, NUNKOOSING Karl
- Journal article citation:
- Journal of Family Therapy, 32(1), February 2010, pp.73-86.
- Publisher:
- Wiley
This paper contends that the systemic approach can be useful in working with adults with intellectual disabilities and their relational network, including paid care services. A practice example using a systemic approach with a man with intellectual disabilities and his paid supporters showed a movement from an internal description of the problem as existing in the man with intellectual disabilities to a focus on coordinating the relationship between the man and his paid supporters. More specifically, in this example the man with intellectual disabilities stated that he wished to be listened to. This led to the residential service manager accounting for her service’s support and to service change which focused more on the care relationship and to improved practices of listening. This article concludes by saying that, although this is not a new process, it would seem to be of noteworthy utility in the context of working with those who live and work in services for people with intellectual disabilities and who may not have had access to this kind of conversation in the past.
"Nothing about us without us": combining professional knowledge with service user experience in training about mental health and learning disabilities
- Authors:
- HENEAGE Celia, MORRIS Di, DHANJAL Kuljinder
- Journal article citation:
- Mental Health and Learning Disabilities Research and Practice, 7(2), Autumn 2010, pp.120-129.
- Publisher:
- South West Yorkshire Mental Health NHS Trust and University of Huddersfield
Recent policy documents have proposed that people with learning disabilities should be more fully included in generic mental health care provision. Such services now include the government’s ‘Improving Access to Psychological Therapies’ (IAPT) initiative which focuses particularly on the provision of support to people suffering from anxiety and depression. This article reports on a training session delivered to IAPT practitioners based at a university in the south of England by a service user with learning disabilities who had accessed mental health services (one of the authors), together with a clinical psychologist and an honorary assistant psychologist. The practitioners were involved in the provision of time-limited psychological intervention, based on Cognitive Behaviour Therapy (CBT) principles. Four key questions were considered: what is learning disability; what emotional difficulties might they experience in particular; how can CBT be adapted to meet their needs; what information is available about people with learning disabilities and employment? Among the 32 practitioners who attended the training day, 56% had worked with them in a professional context. The practitioners completed pre and post evaluation forms in which they were asked to rate their knowledge about and confidence in working with people with learning disabilities. Following the training participants rated themselves as having significantly greater knowledge and confidence. Many of the qualitative reasons given for these changes mentioned the contribution of the service user. Observations from the facilitators are also presented. It is concluded that joint training needs to be developed and its impact further researched.
Psychotherapy for people with learning disabilities: creating possibilities and opportunities. A review of the literature
- Author:
- TAYLOR Jon
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 1(3), October 2010, pp.15-25.
- Publisher:
- Emerald
People with learning disabilities have traditionally been denied access to a range of psychological therapies. Similarly, offenders with learning disabilities, particularly in prison settings, have largely been unable to access treatment strategies that are provided for offenders who do not have such disabilities. As a consequence these individuals are denied the opportunity to address their criminogenic needs or attend to their psychological welfare. This paper provides a brief exploration of the reasons and evidence for such practice, alongside the evidence that people with learning disabilities can successfully engage in psychotherapy. It is concluded that there is no evidence that would support the exclusion of people with disabilities from treatment options. Psychotherapeutic approaches with a strong evidence base for the general population can be routinely modified to increase their accessibility for people with learning disabilities.
A meta-analysis of intervention effects on challenging behaviour among persons with intellectual disabilities
- Authors:
- HEYVAERT M., MAES B., ONGHENA P.
- Journal article citation:
- Journal of Intellectual Disability Research, 54(7), July 2010, pp.634-649.
- Publisher:
- Wiley
This meta analysis reviewed the distinct biological, psychotherapeutic and contextual interventions used to treat challenging behaviour among persons with ID and analysed the intervention effects and moderating variables. A literature search was conducted using the databases ERIC, PsycINFO, Web of Science and Medline. A random-effects meta-analysis was carried out, supplemented with sensitivity, subgroup, meta-regression and publication bias analyses. Eighty articles were identified, of which 30 contained sufficient data to enable statistical meta-analysis. Eighteen described a biological, 13 a psychotherapeutic and nine a contextual intervention, either applied alone or combined. The overall standardised mean difference was 0.671. As shown by sensitivity analysis, this summary effect size was robust. Assessed through subgroup and meta-regression analysis, all tested moderators showed no statistically significant association with the treatment effects. After applying several analysis techniques the authors concluded that their meta-analysis did not suffer excessively from publication bias effects. It is concluded that several biological, psychotherapeutic and contextual interventions effectively reduce challenging behaviours among persons with ID.
The challenge of the randomised control trial to psychotherapy research with people who have learning disabilities
- Author:
- BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 4(1), March 2010, pp.37-41.
- Publisher:
- Emerald
This article examines key features of randomised controlled trials along with potential challenges that emerge when applied to evaluations of psychotherapeutic interventions with people who have learning disabilities. The randomised control trial is regarded as the gold standard among the methods used in treatment outcome studies, whatever the treatment. Many regard this approach as giving the clearest indication of the efficacy of treatment. This method imposes the highest level of control over other factors that may influence outcome so that the true effects of the treatment can be tested.
Therapeutic progressions of client and therapist throughout a course of psychodynamic therapy with a man with mild learning disabilities and anger problems
- Author:
- ALIM Nadja
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 4(1), March 2010, pp.42-49.
- Publisher:
- Emerald
Anger problems, coupled with challenging behaviour in people with learning disabilities is an area of growing concern both clinically and economically within the NHS. Although there is a long history of psychodynamic therapy with people with learning disabilities and anger problems, there is little evidence that suggests that this approach is effective. This paper outlines a case study exploring 18 psychodynamic therapy sessions with a 34 year old adult male with mild learning disabilities and anger problems. It investigated therapy outcomes and progress along a nine-stage Malan model, as well as analysing therapeutic interactions leading to therapy progression. The case study patient’s progression along Malan stages was explored by a thematic analysis matching therapy sessions to the Malan model. The investigation of therapeutic interactions was achieved by discourse analysis of those therapy sessions indicative of Malan-Stage progression. In conclusion, the author suggests that people with learning disabilities and anger problems may benefit from short-term psychodynamic therapy interventions.
Implications of the literature on equine-assisted activities for use as a complementary intervention in social work practice with children and adolescents
- Authors:
- SMITH-OSBOURNE Alexa, SELBY Alison
- Journal article citation:
- Child and Adolescent Social Work Journal, 27(4), August 2010, pp.283-290.
- Publisher:
- Springer
This article reviews the literature investigating psychosocial benefits of equine-assisted activities (EAA) for children and adolescents with physical, mental, and family challenges. It further analyses implications for clinical social work practice in the use of EAA as complementary or adjunct interventions with these populations, thus addressing a gap in the literature on population-specific outcomes of EAA. As a contribution to methodology in future research, the conceptual analysis suggests that concurrent examination of complementary interventions across categories of special needs could add to the knowledge base concerning these children’s psychosocial status. Cross-domain investigations could also assess the contribution of each challenge to the status of children with multiple conditions.