A psychodynamic approach to emotional difficulties within a social framework*

Frankish, Pat

doi:10.1111/j.1365-2788.1992.tb00574.x

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…In comparison with the amount of literature on the use of CBT with adults with intellectual disabilities there is a larger body of literature that has considered the use of psychodynamic and psychoanalytical principles (e.g. Balbernie 1987;Howard et al 1989;Frankish 1992;Stokes & Sinason 1992;Symington 1992;O'Hara 1993;Gaedt 1995;Hassiotis 1999;Hollins & Sinason 2000;Linington 2002). Beail (1989aBeail ( ,b, 1995Beail ( , 1998Beail ( , 2001Beail ( , 2003 and has been one of the main contributers to the literature in this area and dates the application of psychoanalytical ideas to adults with intellectual disabilities back to the 1930s (although acknowledges that the first case report of individual therapy using this approach was not published until Symington 1981).…”

Section: Psychodynamic Psychotherapy For Adults With Intellectual Dismentioning

confidence: 99%

Adapting Individual Psychotherapy for Adults with Intellectual Disabilities: A Comparative Review of the Cognitive–Behavioural and Psychodynamic Literature

Whitehouse¹,

Tudway

Look

et al. 2006

Research Intellect Disabil

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Background Historically, adults with intellectual disabilities have had little access to individual psychotherapy. Over the last 20 years an increasing body of literature has described psychotherapy with this client group and reported methods for adapting traditional psychotherapeutic techniques. Method The current review identified the frequency of adaptations suggested by Hurley et al. (1998) [Journal of Developmental and Physical Disabilities, vol. 10, pp. 365–386] within cognitive behavioural and psychodynamic studies with adults with intellectual disabilities. Twenty‐five studies were reviewed, 10 cognitive–behavioural and 15 psychodynamic. Results A total of 94 adaptations were identified. Within cognitive behavioural therapy (CBT) studies, flexibility in method was the most frequently considered adaptation whilst transference and countertransference issues were most frequently considered within psychodynamic studies. Across the two approaches, disability and rehabilitation issues were given the least consideration. Conclusions Implications for practitioners and services are highlighted along with recommendations for future research.

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Section: Psychodynamic Psychotherapy For Adults With Intellectual Dismentioning

confidence: 99%

Adapting Individual Psychotherapy for Adults with Intellectual Disabilities: A Comparative Review of the Cognitive–Behavioural and Psychodynamic Literature

Whitehouse¹,

Tudway

Look

et al. 2006

Research Intellect Disabil

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“…Once the stage has been identified, it is possible to design an intervention that provides the necessary emotional environment in which progress can be made (Frankish, 1992). This involves naming a "significant other" at all times so that the individual being supported always knows who it is.…”

Section: Use In Practicementioning

confidence: 99%

“…Frankish (1989Frankish ( , 1992 described such an approach, building on the work of Valerie Sinason (2010). The Frankish model now includes tools for measuring the emotional developmental stage and for planning interventions.…”

mentioning

confidence: 98%

Measuring the emotional development of adults with ID

Frankish¹

2013

Advances in Mental Health and Intellectual Disabilities

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Purpose -This paper demonstrates that it is both possible and useful to measure the emotional developmental stage of people with intellectual disability. Design/methodology/approach -A tool was designed, based on a stage theory of development and tested for reliability and validity. Findings -The tool was found to be both reliable and valid. Originality/value -This is new work with no predecessor.Keywords Measurement, Emotional development Paper type Research paperAfter a long period of expecting behavioural approaches to solve all behavioural problems, there is now a growing recognition that feelings and emotional trauma may underpin behavioural disturbance (Royal College of Psychiatrist, 2004;Jahoda et al., 2001). There is, therefore, a need for an assessment of emotional development that can define and inform therapeutic interventions as well as measure change over time.Behavioural assessments tend to be based on frequency and severity of behaviours labelled as maladaptive for the individual, or the setting in which they live. The purpose of the assessment is to identify the behaviour, the antecedents and consequences, then design an intervention to eradicate or modify the behaviour. These behaviours can be very severe in nature, often involving harm to self or others. Behaviours that are frequent and not too severe, e.g. persistent touching, respond quite well to this sort of intervention. However, behaviours that are low frequency but high intensity are less amenable because there are fewer opportunities to intervene and the consequences of the behaviour could be severe. Individuals with the second pattern may find themselves escalating through services to secure provision because of the severity of what they do. However, usually without an appropriate intervention because of the difficulties of implementing a reinforcement or reward schedule. Some cognitive behavioural treatments are becoming more widely used with people with mild intellectual disability (ID) with some success (Nicoll et al., 2013). However, there is still a complex group for whom cognitive or behavioural approaches have limited usefulness. They frequently find themselves stuck in the secure system, usually because their behaviour is not understood. The emotional component would appear to be the missing link in understanding the meaning of the behaviours and possible intervention.High-frequency -low-intensity behaviours, i.e. those that cause irritation rather than fear, lend themselves better to behavioural interventions in segregated environments (Sturmey, 2008). The ability to engage in such an intervention depends on the skill of the staff group and the motivation of the service-user. It is notable that people who remain in residential services for long periods usually exhibit these types of behaviours. They are still prevented, by their behaviour, PAGE 272 j

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“…Boy: 7 years old, no physical problems; emotional stagerapprochement. Eighteen months previously, when psychological intervention began (Frankish, 1992) his emotional stage was differentiation. Behaviours included scratching, pinching, kicking and running away.…”

Section: Brief Description Of Childrenmentioning

confidence: 99%

A Summer School for Special Children, September 1991

Frankish¹,

Mountford²

1993

Journal of the British Institute of Mental Handicap (APEX)

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A summer school for seven children provided a therapeutic environment in which emotional needs could be addressed. This approach led to gains in development and reductions in severe behaviour disturbance. The scheme utilised finance from the health authority and the Mental Health Foundation, staff on short‐term contracts and a variety of help from existing resources. The combined effort ensured a crisis‐free summer and presented evidence of a way of working that is beneficial to some very disturbed children.

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A psychodynamic approach to emotional difficulties within a social framework*

Abstract: Emotional difficulties and their relationship to challenging behaviour are recognized and treated in a normal environment, providing a measurable reduction in maladaptive and anti‐social behaviour. The implications for community care are highlighted.

Cited by 9 publications

References 4 publications

Adapting Individual Psychotherapy for Adults with Intellectual Disabilities: A Comparative Review of the Cognitive–Behavioural and Psychodynamic Literature

Adapting Individual Psychotherapy for Adults with Intellectual Disabilities: A Comparative Review of the Cognitive–Behavioural and Psychodynamic Literature

Measuring the emotional development of adults with ID

A Summer School for Special Children, September 1991

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