I welcome Holmes' (Reference Holmes2000) 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 (Reference SinasonSinason, 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.