Significant therapy events with clients with intellectual disabilities

DOIhttps://doi.org/10.1108/AMHID-07-2018-0033
Published date05 November 2018
Date05 November 2018
Pages173-183
AuthorSarah Wills,Lorna Robbins,Tony Ward,Gary Christopher
Subject MatterHealth & social care,Learning & intellectual disabilities
Significant therapy events with clients
with intellectual disabilities
Sarah Wills, Lorna Robbins, Tony Ward and Gary Christopher
Abstract
Purpose The purpose of this paper is to explore significant events in psychotherapy with clients with
intellectual disabilities (IDs).
Design/methodology/approach Four therapy dyads, each consisting of one client and one therapist,
were recruited. Following the brief structured recall procedure (Elliott and Shapiro, 1988), semi-structured
interviews focused on helpful events in psychotherapy, using video of particular sessions as a stimulus to help
prompt recall of that session.
Findings Using interpretative phenomenological analysis, five super-ordinate themes were identified:
The Uniqueness of the Therapeutic Relationship;Using adaptations to Express Emotions;Client
Behaviour/Therapist Behaviour;Hope and Paternalism; and Meaning-Making. The results provide
additional evidence that significant therapy events occur for clients with IDs. Furthermore, the research
enabled insights to be gained about the process of therapy for this client group and for exploration of
therapeutic factors that may be involved in facilitating a significant therapy event.
Research limitations/implications This study highlights the need for therapists to work in such a way
as to facilitate significant events in therapy. Whilst this study was a necessary first step, owing to the
non-existence of research in this area, the sample size and qualitative design may limit any wider
generalisation of the findings.
Originality/value Significant events have not previously been explored in psychotherapy with clients with
IDs. This research could therefore make an important contribution to our understanding of the process of
psychotherapy for this client group.
Keywords Mental health, Interpretative phenomenological analysis, Intellectual disabilities, Qualitative,
Psychological therapy, Significant therapy events
Paper type Research paper
Introduction
Development of psychotherapy for people with intellectual disabilities (IDs)
People with a disability face a number of challenges, such as the physical or organic aspects of
disability, attitudes from society and self-stigmatisation (Becket and Taylor, 2016).
Furthermore, the Learning Disabilities Mortality Review Annual Report (Norah Fry Centre for
Disability Studies, 2018) identified the persistence of health inequalities for people with IDs,
highlighting the need for further ac tion in order to meet t he health needs of th is client group.
Additionally, peo ple with IDs experienc ing mental health dif ficulties have histo rically been
excluded from psychotherapies due to their degree of intellectual impairment (Bender, 1993).
However, research has shown that individuals with IDs can recognise and experience
emotions in a simi lar way to the non-ID population (Bermejo et al., 2014); this indeed suggests
that this client group has the ability to gain insight and develop self-awareness, factors that
contribute to therapeutic change (Lacewing, 2014). Since the publication of the psychotherapy
and learning disability report (Royal College of Psychiatrists, 2004), the evidence base has
steadily grown, a nd substantial case study evide nce exists for a number of psychothe rapeutic
approaches. Throughout this paper, psychotherapy has been taken to refer to all
psychological approaches as follows.
Received 9 July 2018
Revised 19 September 2018
Accepted 21 September 2018
Sarah Wills is based at the
University of the West of
England, Bristol, UK.
Lorna Robbins is based at
Somerset Partnership NHS
Foundation Trust,
Bridgwater, UK.
Tony Ward is Associate
Professorand Gary Christopher
is Senior Lecturer, areboth at
the University of the Westof
England, Bristol,UK.
DOI 10.1108/AMHID-07-2018-0033 VOL. 12 NO. 5/6 2018, pp.173-183, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE173

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