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The dose-effect relationship in psychodynamic psychotherapy with people with intellectual disabilities
- Authors:
- BEAIL Nigel, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.448-454.
- Publisher:
- Wiley
Although there is an established body of evidence attesting to the dose–effect relationship in psychotherapy with non-disabled adults, the issue as to whether such a relationship exists for persons with intellectual disabilities has not been previously examined. Dose–effect essentially concerns the amount of psychotherapy required to produce positive results. The current study used a naturalistic design to examine and compare the outcomes of three groups of participants with co-morbid psychological problems undergoing treatments of differing lengths (i.e. ‘doses’) with psychodynamic psychotherapy. Three measures of psychopathology were completed at assessment and at subsequent eight-session intervals until the conclusion of treatment. Each patient received a 3-month follow-up appointment, at which time the measures were again completed. Three treatment duration groups were subsequently constructed and compared via anova: eight sessions (n = 8), 16 sessions (n = 5) and 24 plus sessions (n = 7). Results were supportive of a dose–effect relationship, in that outcomes were generally equivalent regardless of treatment duration. It is concluded that most change appears to occur in the first eight sessions of treatment, with subsequent outcomes trailing off over time. The clinical implications of the study are discussed in the context of the methodological limitations identified.
Psychoanalytical psychotherapy
- Author:
- SINASON Valerie
- Journal article citation:
- Mencap News, 45, June 1994, p.16.
Describes how psychotherapy can help people with learning disabilities who are emotionally disturbed.
From denial to acceptance of sexually offending behaviour: a psychodynamic approach
- Author:
- BEAIL Nigel
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(5), 2013, pp.293-299.
- Publisher:
- Emerald
Purpose: Offenders who have intellectual disabilities like any one else may deny their offence. This paper reports a case study of a man who admitted his offence and them accepted probation with a condition of treatment. However, when he attended treatment he denied the offence. Thus do those providing treatment send them back into the criminal justice system or work with them try and help them accept what they have done and provide appropriate treatment to help them reduce future risk of offending. Design/methodology/approach: In this case study the assimilation model was used to understand the process of change and monitor change through exploratory psychotherapy. The psychotherapeutic model was psychodymnamic. Findings: The client demonstrated gains through the stages of the model toward acceptance of his problematic behaviour and continued to work on this through further psychotherapy. Originality/value: The assimilation model offers a useful approach to monitor change in psychotherapy; but especially when the client does not accept the problem the rest of the world feels they have. (Publisher abstract)
The therapeutic process with children with learning disorders
- Author:
- PALOMBO Joseph
- Journal article citation:
- Psychoanalytic Social Work, 8(3/4), 2001, pp.143-168.
- Publisher:
- Taylor and Francis
Clinicians who work with children and adolescents with learning disorders must be aware of the relationships between the learning disorder and the psychopathology the children present. This article offers a conceptual framework, abused on psychoanalytic self psychology, to understand the modifications that are necessary in the treatment of this population. The author suggests that, in contrast to other approaches, it is not possible to conceptualise the treatment of these children as having a beginning, a middle, and an end. Rather, the therapeutic process is open-ended and conceived as occurring during a series of moments. The moments may be categorised as concordant, complementary, or disjunctive. During concordant moments a holding environment is created: during complementary moments the transference and countertransference is addressed; and during disjunctive moments the ruptures that inevitably occur during treatment are dealt with.
Psychological interventions in self-injurious behaviour
- Authors:
- HALLIDAY Sabrina, MACKRELL Kelvin
- Journal article citation:
- British Journal of Psychiatry, 172, May 1998, pp.395-400.
- Publisher:
- Cambridge University Press
Psychological approaches to working with people with learning disabilities who self-injure have developed over the past 30 years. In this article the major literature is reviewed and an ecological framework is described which emphasises the importance of environmental, interpersonal and intrapersonal dynamics to understanding the multi-factorial nature of self-injury. Case examples are given. Concludes that persistence of self-injurious behaviour once established, requires an interdisciplinary approach which addresses comprehensively the variety of factors which have contributed to the development and maintenance of self-injury.
Group psychotherapy with learning disabled adults
- Authors:
- JONES Alison M., BONNAR Sally
- Journal article citation:
- British Journal of Learning Disabilities, 24(2), 1996, pp.65-69.
- Publisher:
- Wiley
An account is offered of group psychotherapy with five mildly learning disabled adults with emotional and maturational difficulties. Group content, dynamic process and problems, and evaluation are examined. Psychodynamic group psychotherapy with this client group is a treatment option not often undertaken but it is appropriate and potentially beneficial to this group of people. The task of the therapist is not easy and supervision and support are essential.
Intellectual disability and mental health: is psychology prepared?
- Authors:
- RAZZA Nancy J., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(6), 2014, pp.381-389.
- Publisher:
- Emerald
Purpose: The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach: The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings: The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications: This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programmes. (Edited publisher abstract)
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.
Psychological intervention for people with learning disabilities who have experienced bereavement: a case study illustration
- Authors:
- SUMMERS S. J., WIITS P.
- Journal article citation:
- British Journal of Learning Disabilities, 31(1), 2003, pp.37-41.
- Publisher:
- Wiley
The evidence base for interventions for people with learning disabilities who have experienced a bereavement is sparse. This article reviews current theoretical understandings of bereavement and loss and describes the assessment, formulation and psychological treatment of a woman with learning disabilities with close reference to these understandings. A psychological intervention is described, which utilizes both psycho-educational and psychodynamic approaches.
A group treatment for men with intellectual disabilities who sexually offend or abuse
- Authors:
- ROSE John, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(2), 2002, pp.138-150.
- Publisher:
- Wiley
Describes a group intervention for men with an intellectual disability who have sexually offended or abuse others. The group was in response to referrals to psychology department. The majority of these individuals had not subject to legal proceedings. Attitudes consistent with offending reduced after participation for most participants, however, these tended to revert to pre-group levels over time. Knowledge tended to increase after the group, however, problems with the questionnaire used made interpretation of the results difficult. No further incidents of sexual abuse have been recorded by any of the five group members who completed the group.