And Another Thing… Adapting Therapy for Particular Cognitive Impairments
In this chapter we consider how common cognitive impairments including problems relating to memory, attention, communication and cognitive rigidity might impact on therapy for clients with an intellectual disability.
The therapist must take full responsibility to improve accessibility, rather than expect the client to fit in with an imposed therapy structure. As the precise nature of difficulties will vary greatly from person to person, rather than suggesting standard adaptations, we discuss a range of adjustments from which the therapist can choose, depending on the extent of each client’s problems and the particular profile of impairments. Some difficulties relating to cognitive impairments affect the process of therapy whilst others impact on the intervention plan. Throughout the chapter we emphasise the importance of paying close attention to issues of engagement and rapport, which can easily arise when cognitive impairments are not accommodated skilfully by the therapist. Alongside some broad examples discussed in this chapter, to allow closer examination of how therapy may unfold, we also present a case study where we follow one client from assessment to formulation and intervention.
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