Adapting Individual Psychotherapy for Adults with Intellectual Disabilities: A Comparative Review of the Cognitive–Behavioural and Psychodynamic Literature

Abstract

Background Historically, adults with intellectual disabilities have had little access to individual psychotherapy. Over the last 20 years an increasing body of literature has described psychotherapy with this client group and reported methods for adapting traditional psychotherapeutic techniques. Method The current review identified the frequency of adaptations suggested by Hurley et al. (1998) [Journal of Developmental and Physical Disabilities, vol. 10, pp. 365–386] within cognitive behavioural and psychodynamic studies with adults with intellectual disabilities. Twenty‐five studies were reviewed, 10 cognitive–behavioural and 15 psychodynamic. Results A total of 94 adaptations were identified. Within cognitive behavioural therapy (CBT) studies, flexibility in method was the most frequently considered adaptation whilst transference and countertransference issues were most frequently considered within psychodynamic studies. Across the two approaches, disability and rehabilitation issues were given the least consideration. Conclusions Implications for practitioners and services are highlighted along with recommendations for future research.

Using computers to teach people with intellectual disabilities to perform some of the tasks used within cognitive behavioural therapy: A randomised experiment

“…The findings of both Bruce et al (2010) and Vereenooghe et al (2015) are encouraging and potentially offer a new approach to prepare people with IDs prior to accessing CBT, in addition to adaptations to the content and delivery of CBT itself (Whitehouse, Tudway, Look, & Stenfert-Kroese, 2006). Building on this, the current study developed and evaluated a computerised training programme to help people with IDs learn some of the component skills of CBT: i.e.…”

Intellectual disability and computers in therapy: Views of service users and clinical psychologists

“…For people with ID, these adjustments include more frequent and shorter therapy sessions, simpler language and therapeutic methods, more therapist directivity, and greater interactivity, for example through the use of games (Hurley, Tomasulo, & Pfadt, 1998;Whitehouse, Tudway, Look, & Stenfert-Kroese, 2006). The impact of these adjustments remains unclear, as the availability of systematically analysed data regarding potential changes in the uptake of these services by people with ID is limited (Taylor & Knapp, 2013).…”

Ethical Challenges in the Treatment of Individuals With Intellectual Disabilities

“…Furthermore, clinicians should take into account the client's cognitive and verbal abilities in planning such feedback sessions to ensure the client has an opportunity to understand the implications of the assessments (Bernet & Dulcan, 1999;Whitehouse, Tudway, Look, & Kroese, 2006). Again, consistent with recommendations for acquiring consent, gathering information, and similar practices, periodic comprehension checks can be valuable indicators of the clients' level of understanding.…”

“…The general principles behind treating individuals with ID and comorbid mental illness are not distinct from treating clients ETHICAL CHALLENGES IN TREATING ID whose cognitive functioning falls in the average range (Bernet & Dulcan, 1999;Whitehouse et al, 2006). Indeed, a number of conventional psychotherapeutic techniques have been shown to be effective in treating a wide array of psychiatric disorders in patients with ID (Willner, 2005; but see also Sturmey, 2005Sturmey, , 2006.…”