Counselling

There is along tradition of the use of counselling with people with intellectual disabilities, especially with adults with mild and moderate intellectual disabilities. Prout & Novak-Drabik (2003) conducted a meta-analysis of counselling outcome studies with people with intellectual disabilities. They cast their net broadly and reviewed articles published between 1968 and 1998 from multiple databases, used a variety of synonyms and related terms for intellectual disabilities and counselling and an operational definition of counselling. They identified an initial pool of 103 articles, which was reduced to a final group of 92 studies because of removal of studies that did not meet the criteria for the meta-analysis. They rated the studies' outcomes using a five-point Likert scale, which ranged from 1 for minimal change to 5 for marked change. They also calculated effect sizes. The average rating was approximately 3 indicating 'significant change'. The average effect size was 1.01 (range 0.06 to 1.85) but was only based on nine studies using sufficient subjects and group designs. They found that behavioural treatments were associated with significantly larger ratings of effectiveness than other forms of counselling. Prout & Noval-Drabik (2003, p. 87) concluded that 'psychotherapy with individuals who have mental retardation yields a moderate amount of change and is moderately effective or beneficial.'

This conclusion can be challenged. The authors include a list of the 92 papers included in their meta-analysis of counselling. A quick review of these references shows that the studies in the meta-analysis included the following counselling techniques: anger management, assertiveness training, social skills training, exposure treatment for obsessive compulsive disorder, desensitisation, relaxation training, cognitive therapy, group cognitive behaviour therapy, shaping, reinforcement of non-depressed behaviours and implosion. Hence, the possibility that the apparent effectiveness of counselling was due largely to the inclusion of traditional behaviour therapy cannot be excluded. At this time we must conclude that there are very limited data to support the use of counselling with people with intellectual disabilities.

Getting to Know Anxiety

Getting to Know Anxiety

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