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Unlocking Therapy to All Clients

Author: Tina Patterson 

Everyone deserves a chance to express their deepest concerns and darkest thoughts in order to tell the story of their life. For those who employ the services of a trained Marriage and Family Therapist (MFT), the opportunity to tell the story opens up a chance to retell their narrative and make changes in their story to live their life to the fullest (Stratton, 2016). People with intellectual disabilities deserve that same chance to retell their story to someone. Adults with intellectual disabilities are undeserved in the area of mental health care (Fletcher, 1993). The reported occurrence of mental health problems is approximately 2 to 3 times higher in people with intellectual disabilities compared to the general population (Borthwick-Duffy, 1994; Kerker, Owens, Zigler, & Horwitz, 2004). Most mental health care professionals are not typically trained in helping clients with an intellectual disability. This disparity in the client’s need for therapy and in the therapist’s training and comfort to provide appropriate therapy, creates a gap in services (Fidell,2000). MFTs can help unlock those narratives held captive inside and can assist their clients, to express their concerns and make necessary changes for a positive outcome. Regardless of whether a client has an intellectual disability, it should not be a deterrent to treatment. Everyone is entitled to pursuing their best life, and through the use of family systems therapy models, a marriage and family therapist can help their client to a successful outcome. 

Utilizing the client-therapist alliance and developing a true relationship, the client with intellectual disabilities can have a valuable and fulfilling experience in the therapeutic setting (Werges, 2007). The dedicated practice of unconditional positive regard for each client at their presenting level gives a therapist enough clinical presence with a client who has intellectual disabilities to lead to a positive outcome in most settings (Wilner, 2005). Clients should expect their therapist to employ a variety of appropriate models and interventions in order to provide an outcome that leads to an enhanced way of life (Prout & Strohmer, 1998). Regardless of diagnosis and presenting problem, an MFT can help the individual with life problems, relationship issues, and employment barriers (AAMFT, 2019). Everyone deserves a chance to be heard and everyone has a story to share.

In providing therapeutic services, a marriage and family therapist may employ, but are not limited to, the following models:

  • Cognitive Behavioral Therapy (CBT) has been shown to improve the lives of individuals with intellectual disabilities and assist in self- management skills (Taylor, Linday, & Willner, 2008).
  • Adlerian play therapy may allow clients to express themselves and communicate needs and connection in new ways with their families (Astramovich, Lyons, & Hamilton, 2015). Clients with intellectual disabilities can develop free expression and establish control over their environments through the use of  play therapy (Lorenz,2008).
  • Solution Focused Brief Therapy focuses on skills rather than deficits, and successes rather than not. It is structured and uses client competencies focusing not on problem areas, but on what the future goals might be (Roeden, Maaskant,& Curfs, 2014.
  • Narrative Therapy has been shown to assist individuals with intellectual disabilities in rewriting their own internal stories and lead them to ownership of their own lives and experiences (Wark, 2012).

Whatever model the MFT chooses, according to the needs of the client, the success of therapy rests in the relationship built between the client and therapist, and how they choose to proceed as a team to make progress toward successful outcomes. With training and experience, all therapists can feel comfortable serving all populations. You, or your family member with intellectual disabilities, may find therapeutic benefits from establishing a relationship with a therapist and unlocking a better future by seeking therapy at the Olson Marriage and Family Clinic.

American Association for Marriage and Family Therapy. Frequently asked questions about AAMFT. American Association for Marriage and Family Therapy. (n.d.). Retrieved January 16,2019 from https://www.aamft.org/membership/membership_faqs.aspx Astramovich, 

R.L., Lyons, C., & Hamilton, N.J. (2015). Play therapy for children with intellectual disabilities. Journal of Child and Adolescent Counseling, 1(1), 27-36. 

Borthwick-Duffy, S. A. (1994). Epidemiology and prevalence of psychopathology in people with mental retardation. Journal of Consulting and Clinical Psychology, 62(1), 17-27.

Fidell, B. (2000). Exploring the use of family therapy with adults with a learning disability. Journal of Family Therapy, 22, 308-323.

Fletcher, R. (1993). Mental illness‐mental retardation in the United States: policy and treatment challenges. Journal of Intellectual Disability, 37(1), 25-33.

Kerker, B. D., Owens, P. L., Zigler, E., & Horwitz, S. M. (2004) Mental health disorders among individuals with mental retardation: challenges to accurate prevalence estimates. Public Health Reports, 119(4), 409-417.

Lorenz, D. (2008) Can I play? Using play therapy for children and adolescents with disabilities. Paper presented at the American Counseling Association Conference, March, 2008, Honolulu, Hawaii.

Prout, H.T. & Strohmer, D.C. (1998) Issues in mental health counseling with persons with mental retardation. Journal of Mental Health Counseling, 20, 112-120.

Roeden,J.M., Maaskant, M.M., Bannink, F.P., and Curfs, L.M.G. (2011). Solution-focused brief therapy with people with mild intellectual disabilities: A case series. Journal of Policy and Practice in Intellectual Disabilities 8(4), 247-255. 

Roeden, J.M., Maaskant, M.A., & Curfs, L.M. (2014). Processes and effects of solution-focused brief therapy in people with intellectual disabilities: A controlled study. Journal of Intellectual Disability Resources, 58(4).

Stratton, P (2016). The Evidence Base of Family Therapy and Systemic Practice. Association for Family Therapy, UK.

Taylor, J.L., Linday, W.R., and Willner, P.(2008). CBT for people with intellectual disabilities: Emerging evidence, cognitive ability and IQ effects. UK Behavioral and Cognitive Psychology 36(6) 723-733.

Wark, S. (2012). Counseling support for people with intellectual disabilities: The use of narrative
therapy. Australian Journal of Rehabilitation Counseling, 18(1). 37-49.

Werges, D. (2007) The other dual diagnosis: Intellectual disability and mental illness. National Association for Developmental Disabilities Bulletin, 10(5).

Wilner, P. (2005). The effectiveness of psychotherapeutic interventions for people with learning disabilities: A critical overview. Journal of Intellectual Disability Research, 49(1), 73-85.

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