Psychotherapy, learning disabilities and trauma: new perspectives

Hollins, Sheila; Sinason, Valerie

doi:10.1192/bjp.176.1.32

Cited by 131 publications

(104 citation statements)

References 10 publications

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“…There are indications that besides the cognitive impairments there are other factors making people with ID more vulnerable, including early institutionalization and hospital admissions due to comorbid medical impairments (Tomasulo et al, 2007). Further, it has been argued that understanding oneself as disabled can be traumatizing in itself (Hollins et al, 2000;Levitas, 2001). Thus, the findings of this study support the importance of the potential predisposition of people with ID to development of trauma-related symptoms, due to previous trauma exposure or other vulnerabilities.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there are indications that early separation from parents through early institutionalization or hospital admissions, fewer previous experiences in managing negative life events, and a limited capacity for gathering social support may make people with ID more vulnerable for the development of PTSD (Tomasulo & Razza, 2007). Moreover, it has been suggested that starting to understand oneself as disabled is potentially traumatizing in itself, thereby being another factor that might contribute to an elevated risk of developing PTSD (Hollins & Sinason, 2000;Levitas, 2001). …”

Section: Introductionmentioning

confidence: 99%

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PTSD and its treatment in people with intellectual disabilities

Mevissen

Jongh

2010

Clinical Psychology Review

164

160

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

PTSD and its treatment in people with intellectual disabilities

Mevissen

Jongh

2010

Clinical Psychology Review

164

160

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“…Psychotherapeutic issues Hollins & Sinason (2000) suggested a number of psychic organising principles, which have to be dealt with in psychotherapy for people with learning disabilities:…”

Section: Psychoanalysis For People With Learning Disabilitiesmentioning

confidence: 99%

“…The existence of disability at birth impacts on the relationship of the individual with their family and community (Hollins & Sinason 2000). There is an increase in emotional disturbance in proportion to the severity of the learning disability (Szivos & Griffiths, 1990).…”

Section: Psychoanalysis For People With Learning Disabilitiesmentioning

confidence: 99%

Cognitive Analytic Therapy in People with Learning Disability: An investigation into the common reciprocal roles found within this client group

Psaila

Crowley²

2005

MHLDRP

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Developments over the last twenty years have shown that, contrary to previous opinion, people with learning disabilities can benefit from psychotherapy (Sinason 1992; Kroese, Dagnan & Loumidia, 1997. Cognitive Analytic Therapy (CAT) has been adapted for use with a learning disability population (Ryle 2002). CAT collaboratively examines the Reciprocal Roles (RRs) a client plays in relationships. These are impacted by clients' experiences of the world. The aim of this research is to identify which RRs may become apparent in working with people with learning disabilities. The therapy notes of participants (n=16) who had undergone CAT were examined and analysed using content analysis. Twenty-two different RRs were found. Four common Reciprocal Roles and two common idealised Reciprocal Roles were identified. Other observations about the data are presented. The limitations and clinical implications of the study are discussed.

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“…neglect, abuse, exploitation and isolation. 10 In addition parents and families of people with learning disabilities often experience ongoing emotional responses, akin to a bereavement, in trying to accept the loss of the 'perfect child' who has not arrived or has been taken away through illness or accident." These bereavement-type symptoms can be re-kindled at times when previously held expectations for the disabled person are not realised.…”

Section: Psychological Difficultiesmentioning

confidence: 99%

Psychotherapy and learning disability

Dodd¹,

McGinnity²

2003

Ir. j. psychol. med.

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In Ireland today it is considered that approximately 6.7% of the population have learning disabilities.' According to the National Intellectual Disability Database Report, 2 26,760 people are registered as being in receipt of, or in need of, a learning disability service (prevalence rate of 7.38/1000 total population). Many of these people have coexisting physical disabilities and psychiatric disorder, both of which increase in prevalence in proportion to the severity of the learning disability. Actual estimates of co-morbidity of learning disability and psychiatric illness have ranged across studies from 10% to 39%, 3 but all are significantly higher than the general population and the prevalence of behaviour disorders (which often reflect psychiatric disorder in this group) has been found to be even higher at 60.4%. 4 The World Health Organisation, 5 in its definition of learning disability, points to the importance of holistic approaches to understanding individual needs; however there is still a tendency to attribute much emotional distress experienced by an individual to the disability rather than to particular emotional needs or psychiatric disorder.Over the last 20 years many changes have taken place in the development of care and services for people with learning disabilities. The philosophies of normalisation 6 and inclusion have brought about a change in focus for these services, with more emphasis on individual characteristics and needs than disabilities, so that even people with severe problems are seen as having a right to be supported in community settings.Increasingly, people with mild and moderate learning disabilities now find themselves working and living within the community, where they benefit from the advantages of choice in many aspects of life but also have to endure the many stresses and disadvantages, including difficulties with access to mainstream services. It is within this changing context that the whole issue of psychotherapy provision for people with learning disabilities is beginning to be addressed. Psychological difficultiesThe development of a child with learning disabilities will be Therapeutic difficultiesTraditionally, people with learning disabilities were excluded from the 'talking therapies'.' 3 In the first instance, many emotional and mental health problems were not recognised as such, and when they were, low IQ was commonly used as an exclusion criterion for suitability for therapy. In practice, there are significant problems in adapting psychotherapeutic approaches to working with this patient group. These include a high frequency of sensory disabilities, communication problems, dependence on others to access therapy, and related to this, consent to engage. However, regarding the dynamic based treatments, an acknowledgement of the importance of the therapeutic relationship between therapist and patient has allowed a rethink of the capacity of people with learning disabilities to participate and benefit.' 4 ' 5 Similarly the cognitive based therapies require some adap...

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Psychotherapy, learning disabilities and trauma: new perspectives

Abstract: Practitioners are encouraged to extend their therapeutic repertoire, and to report measurable outcomes.

Cited by 131 publications

References 10 publications

PTSD and its treatment in people with intellectual disabilities

PTSD and its treatment in people with intellectual disabilities

Cognitive Analytic Therapy in People with Learning Disability: An investigation into the common reciprocal roles found within this client group

Psychotherapy and learning disability

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