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Factors affecting the provision of psychological therapy to people with learning disabilities in the NHS

Mason, Jonathan; (2002) Factors affecting the provision of psychological therapy to people with learning disabilities in the NHS. Doctoral thesis (D.Clin.Psy), UCL (University College London). Green open access

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Abstract

People with learning disabilities are known to be at increased risk of developing mental health problems. The reasons for this vulnerability are unclear, and a range of biological, sociocultural, cognitive, systemic and psychodynamic explanations have been forwarded. Further, although a significant amount of research has been focussed on psychological therapies for mental health problems, until recently little attention has been given to their application to people with learning disabilities. This, in combination with a number of other factors (such as a historical trend to suppose that people with learning disabilities struggle to make use of psychological therapy), means that this client group has relatively little access to therapy services. Five factors were proposed to affect the provision of psychological therapy to people with learning disabilities: service resources, the perceived effectiveness of psychological therapy with this client group, the perceived individual competence of clinicians in administering psychological therapy to this client group, the level of the client's disability and the diagnostic overshadowing bias. Psychologists and psychiatrists working in learning disability services throughout the UK were sent a questionnaire examining the 5 factors proposed above. 133 psychologists and 90 psychiatrists (32% response rate) returned completed questionnaires. Perceived individual competence was found to be the most consistent predictor of the provision of psychological therapy to people with learning disabilities. Service resources and effectiveness emerged as important in the case of systemic therapy and psychodynamic therapy, although only marginally so. Clinicians appeared to consider psychological therapy less appropriate, harder to do and less effective as the level of the client's disability increased. In addition, diagnostic overshadowing appeared to be influencing the way in which clinicians appraised the symptoms of mental health problems in people with learning disabilities. The significance of these findings is discussed in light of both recent clinical research and current developments in healthcare policy for people with learning disabilities.

Type: Thesis (Doctoral)
Qualification: D.Clin.Psy
Title: Factors affecting the provision of psychological therapy to people with learning disabilities in the NHS
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Psychology; Learning disabilities
URI: https://discovery.ucl.ac.uk/id/eprint/10099185
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