Psychotherapy and learning disability

1. • Can psychotherapy really be useful for people with learning disabilities?

2. • Where is it actually happening?

3. • Which professionals are doing it?

4. • What types of therapy are useful?

5. • What training do therapists have?

6. • What training do they need?

7. • What is different about psychotherapy and people with learning disabilities?

8. • Can people with all levels of disability benefit?

9. • Which service should be providing this? Who needs to know about it?

10. • Is there any research?

These are just some of the questions answered in this new Council Report, many of them for the first time. The Joint Faculty Working Group, which produced it in liaison with many different interested professionals, took a broad view of their brief ‘to examine the present position of psychotherapy for people with learning disability and make recommendations for future training and service provision’. In doing so, they have produced a highly topical, innovative and informative report with content relevant to all disciplines who have any contact with people with learning disability.

The report begins with user views of their experience of group therapy, followed by some examples of psychotherapy in everyday practice. The small but growing literature and evidence base is then reviewed, and a recommendation made for more outcome research to be funded. A nationwide survey gives an insight into present practice and the barriers to accessing services for people with learning disabilities. This is followed by a comprehensive description of developments in services, therapeutic approaches and their application with this client group, and present opportunities for professional training and development for all disciplines.

This report demonstrates that there is neither inclusion nor equity for this needy client group in accessing psychotherapy services from which evidence shows they can benefit. Present strategy, in England in particular, appears to value ‘inclusion’ to the detriment of equity. If these values are to be equally respected, ordinary psychological services need to be willing, resourced and trained to meet the needs of those people with learning disability for whom they could provide. Learning disability services must be enabled to provide a mentally healthy emotional environment. Therapists must be trained to deliver specialist therapy to those with the special needs described. No single professional group or statutory or voluntary/independent agency can plan or deliver these services in isolation. Collaborative joint planning and implementation is required. Likewise, there are implications for the development of education and training which apply to many disciplines at different levels of specialism.

The report concludes with strong, specific recommendations for strategy, service planning and delivery and the education and training of all disciplines, both in specialist and generic services. It gives a welcome lead and direction where previously there was none.