The Use of Psychotherapy in Supporting People with Intellectual Disabilities Who Have Experienced Bereavement

Abstract

This study aimed to build an understanding of the internal and external factors that affect the bereavement process in people with intellectual disabilities (PWID). This was achieved by drawing on my previously published works, by analysing the research of others and by applying a critical clinical reflection to examples from my practice as a dramatherapist with PWID, through the use of vignettes. The study is uniquely concerned with what can be learned by exploring the significance of the attachment relationship, the complexity of dependency and the effect of living with the primary trauma of disability on bereavement and grieving. A comprehensive analysis of the existing research revealed that there is little understanding of the normal bereavement process in PWID and that there is a high incidence of complicated grief. The critical reflection on practice enabled me to enlarge upon the emergent theory of complex grief and to identify important components. By applying the lens of attachment theory a greater awareness of how grief can become complicated has been reached that can inform the design of more responsive services for PWID. This study has highlighted that there are both internal and external reasons which may explain some of the emerging evidence that points to an abnormally high incidence of complicated grief in PWID (Brickel and Munir 2008 and Dodd and Guerin 2009), A new model of psychodynamic disability psychotherapy has emerged from this study, which proposes to include the supportive network as a component of the therapeutic treatment for PWID. The model and findings from this study can be used to inform the development of appropriate bereavement support for PWID. The findings can be further used in order to promote more supportive and effective practice from Health and Social Care Professionals towards families when a baby with intellectual disabilities is born.