Individuals with intellectual disabilities experiences of the therapeutic relationship

Published date18 April 2023
Date18 April 2023
Subject MatterHealth & social care,Learning & intellectual disabilities
AuthorSarah Parker,Tony Ward,Amelia Baldwin
Individuals with intellectual disabilities
experiences of the therapeutic relationship
Sarah Parker, Tony Ward and Amelia Baldwin
Purpose This research aimedto explore individuals with intellectual disabilities(ID) experiences of the
Design/methodology/approach Six individuals with ID were recruitedwho were currently having 1:1
therapy.Semi-structured interviews focusedon their experiences of the therapeutic relationship.
Findings Using interpretative phenomenological analysis, six personal experiential themes were
identified.These were labelled as a person-centredexperience, the importance of adaptions,‘‘I feel like I
know you’’, a secure base is offered,change does occur and an overlap of subjective experience. The
results indicate that participants’ accounts of their experiences indicated that the relationship was
important to them. This research also demonstrated that the benefits and value of involving individuals
with ID in qualitativeresearch.
Originality/value To the best of the authors’ knowledge,exploring the therapeutic relationshipfrom the
perspective of individuals with ID has not been previously explored in the literature. This research
highlights considerations for therapists working with this population to help them facilitate positive
Keywords Mental health, Intellectual disabilities, Therapeutic relationship, Therapy,
Interpretative phenomenological analysis, Qualitative
Paper type Research paper
Mental health in individuals with intellectual disabilities
The treatment of people with intellectual disabilities (ID) with mental health and emotional
difficulties has been criticised. There is a lack of appropriate servicesand limited availability
to the ones that do exist (Capri, 2014). Individuals with ID have historically not been
considered suitable for psychotherapy because they do not have the emotional capacity or
ability to form attachments required by such interventions. Therefore, working relationally
was not considered to be successful (Greenhill, 2011). This thinking has been challenged
and is now considered outdated (Bender, 1993;Goad, 2022), but interventions are still
dominated by the behavioural approach (Unwin et al., 2016). This is problematic because
they are not considered sufficient to help with individuals with IDs mental health problems
(King, 2005). Despite this, there is clearly a need to support individuals with ID because
mental health problems are overrepresented in this group compared to the general
population (Whittle et al.,2018).
Over the past decade, more peoplewith ID have accessed psychotherapeutic interventions
and initial research suggests outcomes are positive and that psychotherapy should be
considered a treatment for individuals with ID (Willner, 2005;Taylor, 2010;NICE, 2016).
NICE guidelines (2016) highlight the potential need to adapt approaches based on
individual needs and consider additional support. A report by Beail (2017) further supports
this and aims to provide professionals with information to support them with this. It also
highlights despite the increase of research in the last decade, it is still not enough. Other
Sarah Parker is based at
the University of the West of
England, Bristol, UK.
Tony Ward is based at the
Department of Health and
Social Sciences, University
of the West of England,
Bristol, UK. Amelia Baldwin
is based at the University of
the West of England,
Bristol, UK.
Received 23 September 2022
Revised 6 March 2023
Accepted 14 March 2023
A thank you to the support
recieved from my supervisors,
Tony Ward and Amelia
Baldwin. Also, the psychology
team within the ID team,
especially Dr Samantha Green.
PAGE 84 jADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES jVOL. 17 NO. 2 2023, pp. 84-94, ©EmeraldPublishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-09-2022-0036

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