Working with adults with learning disabilities
Hang on - just what is a learning disability?
A good question! There is no universal definition, and your own research might lead to common answers. Let us look at a succinct definition from Mencap (2019) - "a reduced intellectual disability and difficulty with everyday activities - from household tasks to socialising to managing money - which affects someone throughout a lifetime".
Please remember this definition, as it will be referred to below!
According to data collated by the Office for National Statistics (2017) and Public Health England (2016), there are 1.4 million people in the UK living with a learning disability, with over 1.1 million of those individuals being adults 18 years and older.
Do these numbers seem higher than you might have thought? If so, this can draw on the importance of emotional difficulties that the learning disability population can experience during their lives.
Key aspects of working with adults with learning disabilities
When it comes to working with individuals with learning disabilities, there are two aspects that matter significantly and can affect a therapeutic assessment and subsequent intervention.
1. The balance between working with the adult and carer(s)
More often than not, working with adults with learning disabilities will mean that they may not be living on their own without any type of support. Remember the definition above? If one's intellectual ability is reduced and he or she has difficulties with daily activities (think cleaning, personal hygiene, and maintaining finances, among others) and accessing them independently, more help and guidance will be needed, whether it be from a parent or support worker.
Thus, when meeting with the adult, the client may just be best helped when discussing issues on his or her own, however also informing the carer as to the progress of sessions, as well as addressing any difficulties in relationships these adults may have with their carers, can be key in continuing progress.
This is because it may be a goal for adults with learning disabilities to maintain as much independence as possible from a carer. It may be important in order to feel more confident by maintaining as much independence in the first place! In sessions with adults with learning disabilities, often feeling like he or she cannot be independent (or that the carer needs to be around the adult most of the time) because a learning disability stops them from being so can be a central aspect to therapy, and affect the client's ability to function as confidently and independently as possible.
Therefore, it may be necessary for therapists to think about being inclusive of the carer at times during sessions, while maintaining the client's respect to autonomy and right to choose whether the carer can be involved during therapy sessions.
2. The availability of external support
Whether you are a therapist working on your own, or a multidisciplinary team as part of a group privately or in the public sector, it can be extremely important to know that adults with learning disabilities may not only rely on support from yourself! Working with others may include other professions as wide-ranging from psychiatrists, to nurses, to speech and language therapists, positive behaviour practitioners, a physiotherapist, and/or a dietician.
Not all adults with learning disabilities are working with the same set of professionals. But, to have access to different disciplines as adults with learning disabilities is incredibly vital as their needs may not just be emotional in nature. Sometimes, it may involve working with an adult who needs a medication review, with a dietician as he or she is unaware of unhealthy eating, or is having difficulty with housing and accessing the community, with a social worker needing to be brought into care.
Knowing which other professionals can help and simply knowing they can ask for help from other professionals with different expertise, in order to provide the best possible care, is extremely beneficial to the client.
Is the environment affecting the client? Does a client feel the medication being received is not providing any relief? Is a client feeling down because he or she is not being provided with enough time in the community?
These questions may have emotional impacts on clients, but knowing that a presenting issue with these adults is multi-faceted can be important in providing the help they need.
If you think the questions above are unique to adults with learning disabilities, it may be time to think again! The point here is that adults with learning disabilities - despite having a diagnosis that others do not and facing circumstances that others do not - have just as much as a reason to need help from a psychologist or from the community as someone else does.
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