Perceived barriers and facilitators to positive therapeutic change for people with intellectual disabilities: client, carer and clinical psychologist perspectives

Studies have highlighted successful outcomes of psychological therapies for people with intellectual disabilities. However, processes underlying these outcomes are uncertain. Thematic analysis was used to explore the perceptions of three clinical psychologists, six clients and six carers of barriers and facilitators to therapeutic change for people with intellectual disabilities. Six themes were identified relating to: what the client brings as an individual and with regard to their wider system; therapy factors, including the therapeutic relationship and adaptations; psychologists acting as a ‘mental health GP’ to coordinate care; systemic dependency; and the concept of the revolving door in intellectual disability services. The influence of barriers and facilitators to change is complex, with facilitators overcoming barriers and yet simultaneously creating more barriers. Given their potential impact on the psychologists’ roles and access to therapy for people with intellectual disabilities, findings suggest these factors should be formulated as part of the therapeutic process

Out of control : A teacher's account

This is a post-peer-review, pre-copyedit version of an article published in Psychoanalysis, Culture and Society. The definitive publisher-authenticated version; Ramvi, E. (2012) Out of control: A teacher's account. Psychoanalysis, Culture & Society, 15(4), pp. 328-345, is available online at: DOI : 10.1057/pcs.2009.7This paper draws on data collected from my recent exploration of how teachers become competent in the area of relationships. In an interview, a student teacher, Kristin, voiced the challenges she faced: 'I think it is easy enough to get the knowledge the student needs. The problem is, in a way, when people are involved'. This paper presents an encounter between Kristin and a student after Kristin had started to work as a teacher. It shows the difficulty of being professional when 'people are involved', that is, when emotions are at work