Treating people with learning disabilities after physical or sexual abuse (original) (raw)
Related papers
Hidden in Plain Sight: Treating Trauma in the Intellectually Disabled
Recently a colleague consulted with me about a young woman he had just evaluated in the hospital who had been traumatized by a sexual assault. He was stuck, unable to plan a course of action because the patient was quite challenged intellectually, and therefore the customary treatments seemed inappropriate. His literature search determined that although hundreds of books and articles have been written about the evaluation and treatment of psychological trauma, there was little guidance about intervention with traumatized patients who were intellectually limited. I suggested that he read this book. Razza and Tomasulo write that their goal is to "share our hard won lessons with other clinicians" (p. 3) regarding ways to understand and work with those who have intellectual disabilities in addition to psychological disorders, and more specifically those who have experienced psychological trauma through neglect and sexual assault. They make a strong case for providing therapy for this underserved population and then present a way to do it. Individuals with intellectual disabilities have regrettably been marginalized by society. They have been invisible even to mental health professionals, who often complete graduate training with no exposure to the nature of psychopathology in this population, and never see it in practice. Clinicians have not only been limited in their understanding of emotional disorders in the intellectually challenged, but assumed that such patients lack the necessary abilities to engage in the process of psychotherapy, and have therefore discouraged them from treatment. In recent years there has been an amplified interest in their mental health needs and treatments that might be tailored to meet them. Research has found that the prevalence of psychiatric disorders in intellectually disabled people is three to four times the rate found in the general population. Yet these disorders are often missed, having been masked by "diagnostic overshadowing," where professionals ascribe emotional symptoms to the mental retardation and assume they are behavioral manifestations of a cognitive defect rather than independent psychiatric disorders. Psychological problems might be overlooked as well because their symptom presentations can vary from the norm; for example, patients with mental retardation may be more agitated and disorganized than those without cognitive disabilities. Mentally disabled individuals may exhibit traumatic reactions to events that others may not see as traumatic, and low IQs make it harder for them to process these incidents. They also have low levels of social support and poorly developed social skills. Thus, they may relate badly, have difficulty explaining their symptoms, and have no one in their lives to assist them in doing so. rather than self-referred. The authors recommend that a group be made up of individuals with similar problems and intellectual abilities to promote comfort and the universality of their experiences. In addition, a member deviant from the group on such variables is at risk to drop out. Those who are paranoid or clearly antisocial are excluded, and individual contacts are recommended for them. This book provides excellent instruction concerning how the mentally handicapped patient may present less classical symptoms of psychological disorders. The authors discuss in detail the composition of IBT groups, and through specific clinical examples, including common mistakes and special problems in the initial interview, they offer group therapists who are naïve to this population sufficient information to establish their own IBT groups. Cases are carried from start to finish, with comments about progress and setbacks in the IBT groups, so the reader is left with an appreciation of how to organize and conduct these interventions. Well written and sensibly organized, this book should be required reading for anyone who works with the intellectually disabled or plans to. It also provides an interesting perspective for any reader who treats trauma patients, providing illumination for an area of suffering that has existed in the shadows for too long.
British Journal of Learning Disabilities, 2007
• People with learning disabilities are more likely to experience sexual things happening to them when they do not want them to. This is called sexual abuse. • A group was started to help women who have been sexually abused. The group met once a week and lasted for 20 weeks. • Women who were interested in attending this group were given information about it and asked on three separate occasions if they wanted to attend. • Seven women with learning disabilities took part in the group and their carers helped them travel to the group and then went into a separate carers group upstairs. After the groups had finished the carers helped the women get home again. • Some of the women found it very difficult to talk about the sexual abuse that had happened to them. At first they felt very upset and two women hurt themselves. Everybody felt angry about what had happened and it was good to hear they were not alone. • After several months the group helped the women feel less scared and depressed and helped the women's carers understand them better. • This research matters because it helped the women move on with their lives and will help others who want to start a survivors' of sexual abuse group.
Clinical effects of sexual abuse on people with learning disability
British Journal of Psychiatry, 2003
BackgroundThere are few publications concerning the psychological reactions of people with learning disabilities to sexual abuse. Most significantly, there are no controlled studies and few which demonstrate a systematic approach to documenting the sequelae of trauma.AimsTo critically review the published research in this field.MethodA literature search in peer-reviewed psychiatry, psychology nursing and social care journals for the years 1974 to 2001 was conducted and 25 studies were reviewed.ResultsSeveral studies suggest that, following sexual abuse, people with learning disabilities may experience a range of psychopathology similar to that experienced by adults and children in the general population. However, because of methodological limitations, these results are not conclusive.ConclusionsWhether people with learning disabilities experience reactions to sexual abuse similar to the general population has yet to be explored by systematic research.
2002
Declaration of interest None. Within the general population, experience of sexual trauma or abuse is associated with psychological disturbance (Briere, 1992; Kendall-Tackett et al, 1993; Friedrich, 1998). However, there are few publications concerning the psychological reactions of people with learning disabilities to sexual abuse. Most significantly, there are no controlled studies. Furthermore, the majority of studies are single case reports, and few demonstrate a systematic approach to documenting the sequelae of trauma in this group. This dearth in the literature is surprising, given that research in the general population suggests that individual responses to abuse may be less related to the actual characteristics of the event than to developmental variables that predispose the individual to being overwhelmed by the experience (Friedrich, 1998). In addition, we know that people with learning disabilities suffer from a similar or higher rate of mental health problems compared wi...
Journal of Adult Protection, 2012
Purpose -A schema for more clearly understanding the emotional and psychological abuse and neglect of people with intellectual disability was developed to support a narrative study with people with intellectual disability, families and other supporters about the lived experience of this maltreatment in disability accommodation services in Australia. This paper aims to describe the review of emotional and psychological abuse and neglect and the evolving new framework.
Disability & Society, 2009
Good research should be relevant and useful, it may even be enlightening or symbolic, but it can also be emancipatory. Qualitative research can be useful in challenging structures, policies and practices that disempower and marginalize segments of the population. However, could it be that the empowerment of the participant ends where the weakness of the researcher begins? In qualitative studies the researcher seems to have a number of favourite interviews. In a study on the relational and sexual experiences of 46 people with learning disabilities, 12 interviews were withdrawn from the general data on the basis of lack of relevance. It is important to reexamine why the voice of some people fell out of the in-depth analysis and whether this was justified. In this article some methodological opportunities and pitfalls to re-grant identity to these silenced narratives are considered and discussed.
British Journal of Learning Disabilities, 2019
• Sexual abuse is when someone does something sexual to someone else when they do not want them to. We wanted to find out how people get help after sexual abuse. • We learned that talking with a psychologist or with staff helps. It is best if these are people you trust. • It is also important that you know that the help will work. • How everyone involved in a person's support thinks about the abuse also plays a role in the kind of help a person gets.