Working with people with intellectual disabilities

This chapter looks at why, and how, a clinical psychologist might work with a person with intellectual disabilities. It provides a definition of what intellectual disability is and how it is assessed. The epidemiology and aetiology of intellectual disabilities will also be described. The chapter will explain that clinical psychologists do not see people because they have intellectual disabilities, but as a consequence of the additional challenges faced by people in this group. Having an intellectual disability may bring additional physical and life challenges that most people would find difficult to manage. However, having intellectual disabilities also means that your intellectual capacity is more limited, meaning that dealing with these issues can be even more difficult, leaving you vulnerable to experiencing a greater risk of psychological and behavioural problems. Clinical psychologists are well equipped to help individuals with intellectual disabilities in this situation and may work directly with them, their carers or with wider organisational care and support services. The chapter will describe the types of interventions used and their evidence base, and provide a case example of how such a problem may be assessed, formulated and an intervention developed. Historically, people with intellectual disabilities have been a group that have been excluded and stigmatised and it has been difficult for them collectively to challenge this position. Today, the picture is more positive, with people with intellectual disabilities having more opportunity to voice their concerns and exert their right to access appropriate services; however, as will be explored at the end of the chapter there remains a fine balance between the expression of individual choice and protection by others, which remains one of the most critical issues facing working in this area today.