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After a varied and confused period from the days of Freud to the 1980s, psychotherapy for people with disabilities began to be recognised as having value. Several strands of development occurred at the same time and came together in the early 1980s. These strands will be discussed, the way they came together and what has happened since.

This paper charts the development and practice of disability psychotherapy for the author and for services.

A personal account relating events to the development of thinking and practice.

The author suggests that a paradigm shift has occurred over the 30 years to a position of “doing with” as opposed to “doing to”.

This has not previously been put forward as a way of understanding present day services.

This paper demonstrates that it is both possible and useful to measure the emotional developmental stage of people with intellectual disability.

A tool was designed, based on a stage theory of development and tested for reliability and validity.

The tool was found to be both reliable and valid.

This is new work with no predecessor.

This paper summarises the main areas of therapeutic developments in recent years in the field of learning disability. There has been a growing interest in alternative ways of helping learning‐disabled people live with themselves and the world in a socially acceptable way. Most such approaches are person‐centred, even if provided in a group setting. The range and types of therapies are illustrated and the advances in humanistic approaches highlighted. Cognitive, psychodynamic and creative therapies have been added to behaviour therapy, with good results, indicating the potential of learning‐disabled people to benefit from the same sorts of therapy as other people.

The purpose of this paper is to reflect on putting a paradigm shift into practice to become a disability psychotherapist (Frankish, 2013a).

A personal reflective account.

The author suggests seven conditions necessary or advisable for growth of disability psychotherapy (DP) within the workplace.

Strategies to help implementation of DP have not been published to date.