Tuesday, April 29, 2014

Treatment for clients with intellectual impairment

Often people think that those with intellectual impairment (II) or other disabilities do not need psychologists.  There are also people who think that all psychologists are the same.  This is like generalising to say that all vehicles are the same (e.g., no difference between a sedan, a 4x4, a van, a truck etc) and they are made for the same purpose. 

Alright, in my career, I have found the following myths to be common:

1.  People with II or other disabilities are not sexual beings.  This myth interestingly is commonly subscribed but is inaccurate.  In fact, a lot of people with II or other disabilities do have sexual drives and urges like others without II or other disabilities.  It probably shows in different ways.  For instance, they may lay close to each other or rub against each other fully clothed because they do not understand sex or variations of sex the way other people understand it.  Nevertheless, they are sexual beings.  They seek it but are probably not as good at concealing their tracks. 

2.  People with II or other disabilities are homosexuals.  Homosexuality is still taboo in conservative households (be it cultural or religious).  A lot of people with II have limited choices in relation to accommodation.  If they are dependent on government-funded support, it is likely that they are sharing a home with a few others with II or other disabilities of the same sex.  It is interesting to note that family members are terribly stressed to find their relatives having sex (in not the strictest sense of the word) with other cotenants.  [I find it interesting to note that I rarely see these family members when I want them to come in to discuss important aspects of care for their relatives because these family members are always too busy to travel.  However, they always have time to call me to let me know their displeasure of their relatives have "sex" with other same sex cotenants.]

3.  People with II cannot or do not learn.  This is false.  I remember having a discussion with parents of a young adult with II.  They were disappointed in him because they think that he would be unable to learn new simple things.  I made them aware that he was able to successfully push their buttons to avoid certain activities.  I also reminded them that he was able to provide a convincing account of his days while in their care.  I reminded that I was not trying to teach him something complicated and that we can use different techniques to teach him.  And yes, if you are wanting to know the outcome, we were successful in teaching a new set of routines with patience, dedication, ongoing repetitions and chaining (backward and forward) plus a lot of other behavioural strategies. 

You think that you are reading a list of 10 myths...  Sorry...  I can only think of the three major ones at this time of the night. 

Now, these myths are important to know because of the implications in the practical world.  Based on the third and final point, I want you to know that if you are looking for a psychologist to work with someone with II or disabilities, check that the psychologist has experience working with this population.  This is much like some psychologists specialise working with young people while others specialise working with adults or addictions etc.  Working with someone with II or disabilities require a different skill set.  Certainly, there may be some overlaps in skills relevant to working with the general population.  However, the therapy geared for this population is not based on lots of talking...  Ask what your psychologist plans to do with the client to bring about the changes.  If you do not get a clear answer when talking to this psychologist over the phone, call the next one. 

Hope this helps.