Systemic family therapy using the reflecting team: the experiences of adults with learning disabilities

Abstract

Accessible summary Sometimes people with learning disabilities and their families get upset and want to talk about their problems. They might see a therapist who talks to them and their family together. This is sometimes called family therapy. The therapist might use a team of other therapists to give the family other ideas. This is called the reflecting team. We wanted to know what it was like for the person with learning disabilities when this happened. We showed five adults with learning disabilities a DVD of the reflecting team in their family therapy and asked what it was like for them. They told us interesting things about what was helpful and what was not helpful in their therapy. This will help us give a better service to adults with learning disabilities who have family therapy. Summary This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis (IPA) was appropriate to gather participants' views using semi‐structured interviews. The interviews used DVD‐assisted recall of the reflecting team. Various validation strategies were employed, including respondent feedback and a focus group with the therapists. Insights were gained in the areas of ‘therapists’ focus on strengths and difficulties’, ‘differences in metacognition’, ‘finding a voice in therapy’, ‘frustration with the outcome of therapy’ and ‘managing an unusual experience’. The research has indicated some important factors to consider in the successful inclusion of adults with learning disabilities in systemic family therapy.

Is it possible to use interpretative phenomenological analysis in research with people who have intellectual disabilities?

“…Some of the papers explicitly stated that carers were present in some of the interviews to support the person with an intellectual disability ROSE Et al. (Anslow, 2013;Roscoe et al, 2016;Rushbrooke et al, 2014). Anslow (2013) acknowledged that methodologically this was supportive in allowing people to take part in the research who might have otherwise struggled to do so.…”

“…of the papers investigated the experiences of parents with intellectual disabilities(Baum & Burns, 2007;Gould & Dodd, 2014;Shewan et al, 2014;Wilson et al, 2013). Seven of the studies explored the experience of receiving psychological therapy(Anslow, 2013;Lewis et al, 2016;MacDonald et al, 2003;MacMahon et al, 2015;Merriman & Beail, 2009;Roscoe et al, 2016;. Three studies looked at the experiences of people with…”

Therapeutic support for young people with learning difficulties: what enables effective practice?

“…Some participants reported that communication difficulties impacted on therapeutic work (Ramsden et al, 2016). Specifically, Anslow’s (2014) participants reported a sense of powerlessness in finding an effective way of communicating, with one recalling not understanding the “long words’ (p. 42) used by the therapist in their initial session. Participants in Boyden et al’s (2013) study valued creative and interactive tools such as books, pictures, Play‐Doh and drawings to support communication, with one participant sharing that they preferred to talk and draw.…”

“…Practical activities in therapy were mentioned with one participant sharing ‘some of the things we haven’t really done, we’ve just talked about–they haven’t really been improved’ (Anslow, 2014, p. 242); others referred to the practical work completed with the psychologist (Lewis et al, 2016). One participant shared how the use of imagery and metaphors helped with understanding feelings (Boyden et al, 2013).…”

Erwachsene mit Intelligenzminderung und psychischer Störung respektive problematischem Verhalten: Systemrelevante Strategien zur Reduktion aggressiver Eskalationen

“…Systemische Beiträge zur Unterstützung von Erwachsenen mit IM liegen nur vereinzelt vor [13], meist für einen bestimm-ten Ausschnitt der Versorgung von Betroffenen, z. B. die psychotherapeutische Einzelbehandlung [14], die familientherapeutische Arbeit [15], den Heimkontext [16], die Supervision professioneller Teams [17] oder die Arbeit mit dem Gesamt-Helfernetzwerk [18]. Für Kinder und Jugendliche mit IM und psychischen Störungen liegt ein detailliertes, systemisch ausgerichtetes Konzept für die psychiatrische Arbeit vor [4].…”