Psychiatric Bulletin (2004) 28: 230. doi: 10.1192/pb.28.6.230
© 2004 The Royal College of Psychiatrists
Psychiatric Bulletin (2004) 28: 230
© 2004 The Royal College of Psychiatrists
Psychotherapy and learning disability
Council Report CR116, March 2004, Royal College of Psychiatrists,
£7.50, 72 pp.
The report is available for purchase from the College Book Sales Office
and can be downloaded from the website:
www.rcpsych.ac.uk
- Can psychotherapy really be useful for people with learning
disabilities?
- Where is it actually happening?
- Which professionals are doing it?
- What types of therapy are useful?
- What training do therapists have?
- What training do they need?
- What is different about psychotherapy and people with learning
disabilities?
- Can people with all levels of disability benefit?
- Which service should be providing this? Who needs to know about it?
- 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.
