The British Journal of Psychiatry (2000) 177: 566
© 2000 The Royal College of Psychiatrists
Psychotherapy and developmental disability
K. P. Courtenay
Department of Psychiatry of Disability, St George's Hospital Medical
School, Jenner Wing, Cranmer Terrace, London SW17 ORE
EDITED BY MATTHEW HOTOPF
I welcome Holmes' (2000)
editorial outlining the application of psychotherapies in psychiatry and
across the sub-specialities. He advocates the inclusion of the broad range of
psychotherapeutic treatments in all psychiatric practice and the development
of a research and evidence base for the work. It is of concern, however, that
in spite of his reference to learning disability as a psychiatric speciality
in his introduction, he has effectively excluded people with learning
disability by failing to include those with a developmental disability in his
list of those benefiting from psychotherapeutic techniques.
On account of the neglect of developmental disability by psychotherapy, the
Institute for Disability and Psychotherapy has been founded in order to
provide, train in and research effective treatments for people with
developmental disability and thus include them in health care. Each method of
therapy cited in the editorial from analytic to family therapy is relevant and
applicable to the patient group in my practice. Common themes in the
experience of their lives are abuse and rejection
(Sinason, 1992). The
behavioural and psychological manifestations and the effects on personality of
these problems in a person with developmental disability have the potential to
give invaluable insights into the development of personality and the treatment
of personality disorders in the population without developmental
disability.
I hope that practitioners of the psychotherapies will have the courage to
embrace all that working with people with developmental disability has to
offer and to include rather than further compound the exclusion of people from
the provision of effective care and treatment.
REFERENCES
Holmes, J. (2000) Fitting the biopsychosocial
jigsaw together. British Journal of Psychiatry,
177, 93-94.[Free Full Text]
Sinason, V. (1992) Mental Handicap
and the Human Condition. London: Free Association
Books.
