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The Learning Disabilities Elf

Psychotherapy for adults with learning disabilities requires a more rigorous evidence base

John Northfield

We posted last year about a review of the literature on the effectiveness of psychotherapy with people with learning disabilities which suggested that there was evidence that it could be moderately effective. However, the authors urged some caution as the studies they reviews did not include any randomised controlled trials.

This current review summarises the research published since 2008. The author points out that very few empirical studies have been published despite what he calls “a strong perception that such approaches are not only necessary but also of great value.”

He suggests that the review points to

  • Tentative findings concerning the relationship between intellectual level and suitability for treatment, primarily with cognitive behavioural therapy.
  • Therapies based on mindfulness emerging as important new developments.
  • Psychodynamic approaches continuing to rely on opinion over evidence to support their use.

The author concludes, not unlike the conclusions of last year’s review, that further rigorous research on processes and outcomes are needed.

Fact or faith?: on the evidence for psychotherapy for adults with intellectual disability and mental health needs, Flynn A. in Current Opinion in Psychiatry, 25, 5, 342–347

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Written by

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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  • Victoria Jones

    Victoria Jones

    13 years ago
    This article declares itself to be 'as much one of opinions as of facts' and should certainly be read in this light. It seems to suggest that systemic therapies are 'common modifications to standard psychotherapeutic methods' when they in fact have their own epistemology going back to the work of Bateson and Haley and cybernetics post WW2. It rightly reinforces the need for more evidence in psychotherapy generally. However, it also implies that people with learning disabilities require an evidence base of their own regarding the benefits of psychotherapy thus potentially imposing more rigorous standards of evidence on a minority population in a field that needs to do more research anyway. Is this evidence based practice, evidence based exclusion, or merely a matter of opinion?
    • 1 reply
    • John Northfield
      John Northfield 13 years ago
      Hi Victoria, Thanks for your comment. You raise some interesting points, although I was not clear I fully understood what you meant by the phrase evidence based exclusion? I am not sure I read the article as requiring higher standard of evidence for psychotherapeutic interventions for people with learning disabilities. It seems to me that building an evidence base for the efficacy of any intervention needs to take into account relevant factors associated with the target population, so the assertion that there have been ‘tentative findings concerning the relationship between intellectual level and suitability for treatment, primarily with cognitive behavioural therapy’ seemed to me to also be about the positive targeting of what works rather than a platform for exlcusion.