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Article
Publication date: 4 July 2016

Erica E. McInnis

The purpose of this paper is to report the evidence base for the practice of individual psychodynamic psychotherapy with adults with intellectual disabilities (IDs).

Abstract

Purpose

The purpose of this paper is to report the evidence base for the practice of individual psychodynamic psychotherapy with adults with intellectual disabilities (IDs).

Design/methodology/approach

Literature review.

Findings

In total, 14 papers were reviewed. From these, one existing review and seven individual papers provided enough evidence to support effectiveness of individual psychodynamic psychotherapy for people with IDs.

Research limitations/implications

This research indicates individual psychodynamic psychotherapy to be of benefit. Indeed, all studies reviewed supported individual psychodynamic psychotherapy, but methodological shortcomings weakened the confidence placed in findings for some studies. Limitations of this review include methodological shortcomings of studies reviewed, a small number of existing studies and reliance on case studies.

Practical implications

Therapists and commissioners of services should routinely make individual psychodynamic psychotherapy available as part of a spectrum of therapies available to people with IDs who experience emotional and behavioural problems. This is because it is needed for some clients and they benefit.

Social implications

Individual psychodynamic psychotherapy for people with IDs adds to the range of therapies available to alleviate emotional distress and enhance well-being. These are necessary to provide a foundation for meaningful contribution to society, particularly for those who have experienced psychological trauma (Frankish, 2016).

Originality/value

This review includes more relevant studies than previous reviews and adds to a limited number of reviews in this area.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 4
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 1 July 2001

Graham Barnes

Addresses the problem of psychotherapy coming to understand itself formally as a conversation in which healing of distortions and breakdowns in communication occurs. The…

Abstract

Addresses the problem of psychotherapy coming to understand itself formally as a conversation in which healing of distortions and breakdowns in communication occurs. The paper proposes making concepts the basis for the psychotherapy conversation by linking psychotherapy to second‐order cybernetics and utilizing Pask’s conversation theory. The first part describes cybernetics as the context for the study of the distortions and breakdowns in communication. The second part discusses conversation theory as a formal description of the procedures of psychotherapy, as a way to converse in psychotherapy, as a way to talk about psychotherapy and as a way to change the conversation of psychotherapy. The final part discusses four distinctive characteristics of the evolving conversation of psychotherapy where psychotherapy composes itself as a conversation. These characteristics are what psychotherapy is (its definition), what it is about (its object), how it proceeds (its methods), and what it is for (its value).

Details

Kybernetes, vol. 30 no. 5/6
Type: Research Article
ISSN: 0368-492X

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Article
Publication date: 10 December 2009

David O'Driscoll

Individual psychodynamic psychotherapy for people with learning disabilities has been more available since the 1980s, with numerous case studies and reports of…

Abstract

Individual psychodynamic psychotherapy for people with learning disabilities has been more available since the 1980s, with numerous case studies and reports of effectiveness, yet little is know about the history of psychodynamic psychotherapy. This paper is a historical account of the international development of psychodynamic psychotherapy for people with learning disabilities. It discusses some of the clinicians' case reports, views and conclusions. It is important that, as therapists, we continue to learn and develop. This is a story of ‘opportunities lost’. Although a number of therapists were well‐placed to develop psychotherapy as a valuable treatment option, it did not happen. The paper discusses the reasons, ranging from widespread therapeutic pessimism to inability in the therapist to process the ‘disability transference’. It outlines the various British contributions before and since the ground‐breaking and well‐known work of Valerie Sinason, whose 1992 book is still the most influential contribution. Psychodynamic psychotherapy has developed more of a tradition than other therapy approaches in this field, but there is still only sparse literature on and recognition of this work.

Details

Advances in Mental Health and Learning Disabilities, vol. 3 no. 4
Type: Research Article
ISSN: 1753-0180

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Article
Publication date: 7 March 2016

Erica Elaine McInnis

The purpose of this paper is to report effectiveness of disability psychotherapy with a male adult with a mild intellectual disability presenting with complex emotional…

Abstract

Purpose

The purpose of this paper is to report effectiveness of disability psychotherapy with a male adult with a mild intellectual disability presenting with complex emotional and behavioural problems.

Design/methodology/approach

An individual case study was used with repeated analytic, quantitative and qualitative measures. This reported progress from individual weekly disability psychotherapy of psychodynamic orientation within an emotional disability framework.

Findings

Disability psychotherapy led to a reduction in emotional and behavioural problems, reduction in emotional disability and facilitated protective psychological growth. In total, 88 sessions resulted in cessation of problem behaviours when other approaches did not. Given this therapy is likely to be reserved for the most complex and severe of cases, this study suggests more sessions of psychotherapy are needed than inferred from previous studies of effectiveness (Beail et al., 2007). This is to promote a sense of self which facilitates psychological well-being.

Research limitations/implications

Limitations of a single case study include generalisability, controlling other factors in real life settings and subjectivity from inclusion of analytical measures. Further studies and follow-up would determine longevity of benefits. Nevertheless disability psychotherapy can be effective and should be available in a culturally appropriate service to meet the diverse needs of people with intellectual disabilities.

Originality/value

This case study adds to the limited body of evidence on effectiveness of psychotherapy for people with intellectual disabilities. It is novel to report formal outcomes from an emotional disability model (Frankish, 2013a) and the use of analytic and attachment outcome measures.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

Content available
Article
Publication date: 22 February 2011

Mirela Vlastelica

In the course of group analytic psychotherapy, where we discovered the power of the therapeutic effects, there occurred the need of group analytic psychotherapy

Abstract

In the course of group analytic psychotherapy, where we discovered the power of the therapeutic effects, there occurred the need of group analytic psychotherapy researches. Psychotherapeutic work in general, and group psychotherapy in particular, are hard to measure and put into some objective frames. Researches, i. e. measuring of changes in psychotherapy is a complex task, and there are large disagreements. For a long time, the empirical-descriptive method was the only way of research in the field of group psychotherapy. Problems of researches in group psychotherapy in general, and particularly in group analytic psychotherapy can be reviewed as methodology problems at first, especially due to unrepeatability of the therapeutic process.

The basic polemics about measuring of changes in psychotherapy is based on the question whether a change is to be measured by means of open measuring of behaviour or whether it should be evaluated more finely by monitoring inner psychological dimensions. Following the therapy results up, besides providing additional information on the patient's improvement, strengthens the psychotherapist's self-respect, as well as his respectability and credibility as a scientist.

Details

Mental Illness, vol. 3 no. 1
Type: Research Article
ISSN: 2036-7465

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Article
Publication date: 1 September 2006

Stefan Priebe and Donna Wright

There has been a recent initiative in England to establish a wider provision of psychotherapy. Studying the models of psychological treatment and experiences in other…

Abstract

There has been a recent initiative in England to establish a wider provision of psychotherapy. Studying the models of psychological treatment and experiences in other countries may enable policy makers in England to learn lessons and avoid pitfalls. This paper assesses and compares the provision of psychotherapy for adults in a selected number of European and non‐European countries. A structured list of psychotherapy features was used to collect information from each country on the number of psychotherapists, professional qualifications, the settings and models of psychotherapy, the referral procedures, funding arrangements, quality management and outcome assessments. These data were then compared in a non‐systematic way. Comparison of levels of provision was the most difficult to establish, but the findings suggest that psychotherapy that is broadly free at the point of entry is more widely available in other EU countries than in England. They also show that the plans currently being discussed for a psychotherapy service in England differ from those provided in most of the other countries in this study. The differences include the lack of statutory accreditation rules and lower qualification thresholds for psychotherapists, the concept of treatment centres, the low number of sessions, and the regular assessment of outcome data. Therefore, based on this comparison, the necessity of these features, their priority and possible alternatives may need to be considered.

Details

Journal of Public Mental Health, vol. 5 no. 3
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 2 April 2020

Julian Himmerich

Psychodynamic psychotherapy is increasingly adapted and used with individuals with intellectual disability (ID) and mental health difficulties. However, the evidence base…

Abstract

Purpose

Psychodynamic psychotherapy is increasingly adapted and used with individuals with intellectual disability (ID) and mental health difficulties. However, the evidence base is still small and largely based on case studies and small trials whose participants mainly have mild to moderate ID. This paper aims to review and critique the literature in regards to the adaptations; and the effectiveness of psychodynamic psychotherapy for those with severe and profound ID.

Design/methodology/approach

A systematic literature search of PsycINFO, Social Policy and Practice, Medline, Cumulative Index to nursing and allied health literature and applied social sciences index and abstracts was conducted. Six studies met inclusion criteria and underwent a quality evaluation and critical review.

Findings

Six papers (all case studies) met inclusion criteria and underwent a quality evaluation and critical review. Some adaptations to therapy were reported, such as a more flexible therapeutic frame and increased use of the physical environment as a therapeutic tool. Due to significant methodological weaknesses of the included studies, it is yet unclear whether psychodynamic psychotherapy is an effective intervention for individuals with severe and profound ID.

Research limitations/implications

Only a small number of case studies met the inclusion criteria. Further research should use more robust outcome measures, larger samples and compare psychodynamic psychotherapy to alternative interventions.

Originality/value

This paper is the first to review the psychodynamic psychotherapy literature with regard to its effectiveness as a treatment specifically for individuals with severe and profound ID and mental health difficulties.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 14 no. 3
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 16 September 2011

H. Thompson Prout and Brooke K. Browning

The purpose of this paper is to provide an update on the effectiveness of psychotherapy with persons with intellectual disabilities.

Abstract

Purpose

The purpose of this paper is to provide an update on the effectiveness of psychotherapy with persons with intellectual disabilities.

Design/methodology/approach

This paper focused on summarizing the conclusions of other reviews published in the last ten years, including a recent review by the authors.

Findings

The paper concludes that there is evidence that psychotherapy with persons with intellectual disabilities is at least moderately effective. Further, there is evidence of effectiveness of psychotherapy for both child and adolescent, and adult populations. There is also evidence that a range of therapeutic interventions are effective and that a spectrum of problems can be addressed via psychotherapy.

Research limitations/implications

This area has received relatively little attention in the research literature and the area lacks a large base of methodologically sound and rigorous studies. There is a need for well‐designed studies, particularly randomized controlled trials (RCTs), and a need for better specification of treatments (e.g. manualized), better outcome measures, and clearer specification of diagnostic categories within the intellectual disability population.

Practical implications

This review provides continued support for the use of psychotherapy with persons with intellectual disabilities.

Originality/value

This review appears to represent the most current overview of research in this area.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 5 no. 5
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 16 July 2009

Charlotte Merriman and Nigel Beail

Long‐term psychodynamic psychotherapy is a costly service to provide, but many clinicians believe it is of benefit for people who have learning disabilities and…

Abstract

Long‐term psychodynamic psychotherapy is a costly service to provide, but many clinicians believe it is of benefit for people who have learning disabilities and psychological problems. There is also now some evidence for its effectiveness. However, the views of recipients is unknown. In this study, recipients of more than two years of psychodynamic psychotherapy were interviewed about their experiences and views. Themes emerged about the referral process, the experience and the outcome. Areas of strength were identified, as well as areas for improvement. The findings concur with previous findings on group therapy and help inform current and future provision of long‐term psychodynamic psychotherapy.

Details

Advances in Mental Health and Learning Disabilities, vol. 3 no. 2
Type: Research Article
ISSN: 1753-0180

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Article
Publication date: 12 March 2014

Michael Brune, Francisco José Eiroá-Orosa, Julia Fischer-Ortman and Christian Haasen

Psychotherapy with refugees in the western world is quite often complicated because many refugees live without a secure residency status. It is difficult to have a…

Abstract

Purpose

Psychotherapy with refugees in the western world is quite often complicated because many refugees live without a secure residency status. It is difficult to have a structured therapeutic perspective when doing psychotherapy with these patients because of their fears and daily problems. The purpose of this paper is to evaluate psychotherapy results for 190 traumatized refugees (40 per cent without a secure residency).

Design/methodology/approach

To measure the outcome of the psychotherapies the paper used HAM-D and CGI at baseline and at the end of the therapeutic process.

Findings

The study shows that, although refugees without a legal status had more depressive symptoms and lived with much higher psychosocial stress, psychotherapy was as effective as for traumatized refugees with a legal status.

Research limitations/implications

Heterogeneity, convenience sampling and retrospective completion of some of the baseline assessments.

Practical implications

Psychotherapeutic treatment of refugees has a clear positive effect on them and should be applied even in those without legal residence status in the host country.

Originality/value

This is the first study assessing the effectiveness of daily practice psychotherapy for refugees with and without a legal status in a comparative fashion.

Details

International Journal of Migration, Health and Social Care, vol. 10 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

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