Cognitive behavioural therapy and the impact of internalised societal discourses in people with intellectual disabilities: a case example.

Purpose – Whilst there is a growing evidence base for the use of cognitive behavioural therapies (CBT) for people with intellectual disabilities, there may be challenges to using an approach that locates problems within people rather than as being generated and maintained through social relations and social discourses. The purpose of this paper is to present a cautionary case that demonstrates some of the potential dilemmas and challenges that can be experienced in therapy when applying this way of working to a client with intellectual disabilities. Design/methodology/approach – The authors present a case example of work with Mark, a young man with intellectual disabilities who accessed services for support with his low mood and outline the challenges faced when using CBT in understanding his presenting problem. Findings – There is evidence from the case example that there is the potential for therapeutic techniques used in CBT to promote questions that invite, generate and reinforce feelings of incompetence and inability in people with intellectual disabilities. Originality/value – The use of narrative techniques is discussed as a means of avoiding locating the problem as being within clients with intellectual disabilities; the implications that this has for the use of CBT with this client group are considered. [ABSTRACT FROM AUTHOR]