The authors of this paper set out to look at rates of sexual abuse and interpersonal trauma in people with learning disability. They hoped to explore the relationship between such trauma and psychological distress and to describe a psychotherapeutic intervention for such people.

The findings from a review of the literature suggested an inverse relationship between higher-than-average rates of trauma and interpersonal violence in the learning disability population. There was however also evidence of lower-than-average access to treatment and a lack of treatment model development for this population.

The authors set out three key areas in need of attention:

• the need to address the high rates of exposure to abuse
• the importance of taking into account developmental level when assessing the impact of potentially traumatic experiences
• the efficacy of the interactive-behavioural model of group psychotherapy for people with learning disabilities who have trauma-related distress

Based on a developing understanding of the phenomenology of traumatic exposure the authors go on to present a theoretical framework for a psychotherapeutic intervention which they suggest shows early signs of promise from the evidence base.

They conclude that there is a need for systematic efforts to reduce the rate of traumatic exposure to people with learning disabilities as they appear disproportionately exposed to this risk. They also conclude that an understanding of developmental level is critical in understanding how exposure to abuse can result in the development of psychological disorders.

They recommend a system to enable people with learning disabilities with trauma related disorders to have access to a targeted therapeutic approach.

Group psychotherapy for trauma-related disorders in people with intellectual disabilities, Razza N et al. in Advances in Mental Health and Intellectual Disabilities 5,5 40-45