The practice of individual psychodynamic psychotherapy with people who have intellectual disabilities

Abstract

Problem: Individual psychodynamic psychotherapy has become more widely available to people who have intellectual disabilities in recent years and a literature on its use has developed. However, there does not appear to be a clear exposition of the process and practice of this treatment approach when used with this population. Method: Case studies and technical papers relating to the process and practice of individual psychodynamic psychotherapy with people with intellectual disabilities published between 1981 and 2010 were examined to ascertain how the model was being used. Practice was delineated into the nature of the therapeutic frame and the action of therapists within sessions. Outcome: The nature of the therapeutic frame was discussed with reference to the available literature, noting the need for flexibility around settings and session duration whilst maintaining the consistency of the frame required, ensuring provision of a secure base. The action of therapists was considered in three stages: information gathering, formulation/ recontextualisation and communication of interpretations. Discussion: Common practice was identified whilst acknowledging the paucity of descriptive practice in the literature, particularly with regard to the formulation of material into interpretations. Areas for development are identified to develop a literature to assist with developing practice and training.

Keywords:

• psychodynamic psychotherapy
• intellectual disability
• psychoanalysis
• formulation
• psychotherapy practice
• psychotherapy