ABSTRACT
As we have seen earlier, notably in Chapter 3, the therapeutic relationship between a therapist and a client with intellectual disabilities is not a simple dyad. Working as part of the client’s network of support is a recognized feature of therapy with people with intellectual disabilities (see Sheppard, 2003) and should be acknowledged in this book too. However, working alongside other carers is not the only thing that expands and alters the therapy dyad. Sobsey’s (1994) ecological model (see Introduction) recognizes that individual relationships exist in an environmental and cultural context whereby each affects and is affected by, the other. Similarly, therapeutic work with traumatized, intellectually disabled people will be affected, dynamically, by the personal, social and cultural experience that the client with intellectual disabilities brings into the therapy room. These elements will also refract and resound in the organization that is providing the therapy service. In this analysis we are helped by an understanding of fractal processes, i.e. the way in which, as Hopper (2003) explains, in many realms of the universe, parts seem to manifest the same fundamental structures as their wholes. That is to say, the therapist works hard to provide a high-quality therapy experience, and the therapy service itself exists as part of a wider environment. In this wider context, therapy may, for example, be regarded as a waste of time and money because the client with intellectual disabilities is never going to ‘get better’. The negative view that whatever the emotional benefits, the cognitive deficits will remain, and so the therapy is pointless, may leak into the therapy process. In addition, the staff on whom we rely to bring the clients to therapy, and to support them sympathetically, may be poorly paid and relatively unsupported in their ancillary roles. As identified in Chapter 1, work with people with intellectual disabilities may not carry high status in a society that does not value
disabled citizens or view them as having a meaningful contribution to make. All these issues come with the client into the therapy room, along with their personal experiences of trauma and abuse.
