Mixed practices including use of ideas from narrative therapy with a woman with diagnosis of an intellectual disability and personality disorder
| Pages | 187-195 |
| Date | 05 September 2017 |
| Published date | 05 September 2017 |
| DOI | https://doi.org/10.1108/AMHID-12-2016-0042 |
| Author | Mohamed Omer El-Tahir,Amanda Bayley |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Mixed practices including use of ideas
from narrative therapy with a woman with
diagnosis of an intellectual disability and
personality disorder
Mohamed Omer El-Tahir and Amanda Bayley
Abstract
Purpose –The purpose of this paper is to present outcomes of mixed practices including use of ideas from
narrative therapy (NT) in a case of mild intellectual disability (ID) and personality disorder. The formulation,
therapy adaptation and outcomes are presented.
Design/methodology/approach –The study is a single case report describing patient presentation,
assessments,psychologicalformulationand the mixed interventionsapproachesused, including ideasfrom NT.
Adaptations to meet the needs of patients with ID were described, and therapy outcome measured using
Health of the Nation Outcome scale and Psychiatric Assessment Schedule for Adults with Developmental
Disorders was presented.
Findings –The ideas used from NT suggest this is potentially a useful approach in practice for people with
intellectual disabilities and personality disorder. However, adaptation is needed for it to be used successfully
in practice as a therapeutic intervention.
Research limitations/implications –A single case study has its limitations, and further work on using ideas
from NT, its adaptation and use in this population will be needed.
Originality/value –There is no previous case of use of NT among patients with ID and personality disorder.
Keywords Mental health, Personality disorder, Learning disability, Intellectual disability, Narrative therapy,
Mixed practice
Paper type Case study
Introduction
Narrative therapy (NT) is a form of psychotherapy which uses ideas from social constructionist
principles. NT “views problems as separate from people and assumes people have many skills,
competencies, beliefs, values, commitments and abilities that will assist them to reduce the
influence of problems in their lives”(Morgan, 2000). The therapist works in collaboration with
individuals to understand the history and influence the problem has within people’s lives. Key to
NT is that “The person is never the problem […] the problem is the problem”(White and
Epston, 1990). By placing the problem outside of the individual, they can than evaluate their
relationship with the problem and look for times the problem is less influential or problematic
(unique outcomes). The therapist helps individuals identify their values and the skills and
competencies they possess, and use these to overcome the difficulties they face.
NT has been shown to be successful in a range of disorders including those who have
experienced multiple types of trauma (White, 2004) and working with women who have multiple
experiences of sexual abuse and or domestic violence (Draucker, 1998; Allen, 2011). It has been
used to work with individuals with high levels of suicidality (Stout, 2010) and personality
difficulties (White, 2004).
Received 7 December 2016
Revised 12 June 2017
10 July 2017
Accepted 14 August 2017
Mohamed Omer El-Tahir is a
Consultant Psychiatrist and an
Honorary Senior Clinical
Lecturer at the Llwyneryr Unit,
Abertawe Bro Morgannwg
University Health Board,
Swansea, UK.
Amanda Bayley is a Clinical
Psychologist at the Department
of Learning Disability, Abertawe
Bro Morgannwg University
Health Board, Swansea, UK.
DOI 10.1108/AMHID-12-2016-0042 VOL. 11 NO. 5/6 2017, pp.187-195, © Emerald Publishing Limited, ISSN 2044-1282
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ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
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