Clinical Practice in relation to people with Intellectual Disabilities

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

• Demonstrate an ability to think about the impact of the wider social context (i.e. the Social GRRAACCES), and specifically consider the experiences of being part of a marginalised and under invested community.
• Be able to demonstrate appropriate styles of communication with people with a wide range of cognitive ability, this includes teaching and training taking into account the needs of the individuals.
• Utilize knowledge of assessment processes, theoretical models and evidence based practice in relation to working with people with a range of cognitive abilities (i.e. intellectual disability, or some degree of cognitive impairment due to a range of factors – physical/mental health). This includes working with clients across a range of levels of intellectual functioning, significant levels of distress/challenging behaviour, working with carers and families and people with a range of communication difficulties
• Demonstrate an ability to work using consultation, work with service delivery models relevant services (i.e. intellectual disability, or service supporting individuals who require reasonable adjustments), develop leadership skills and working effectively within formal systems in a legislative context.
• Demonstrate an ability to evaluate different ways of working in relevant services (i.e. intellectual disability, or service supporting individuals who require reasonable adjustments), indirectly (through staff/carers), working in multi-disciplinary teams and show an ability to work using at least two evidence-based models of formal psychological therapy.

The intellectual disabilities spans semester one and two of the second year of training. The module starts with a two-week teaching block, and then, while trainees are on placement, teaching continues a day a week on a fortnightly basis. A further weeklong teaching block occurs in semester two.

The syllabus covers the following topics, which are outlined in Good Practice Guidelines: Training and

consolidation of clinical practice in relation to adults with intellectual disabilities (2021).

• The historical context of the lives and services for people with intellectual disabilities, including the historical constructions of ‘learning disability’ and other diagnostic labels.
• The current social and political context of the lives and services for people with intellectual disabilities.
• Relevant policies and guidance that applies to people with intellectual disabilities.
• Power differences between professionals and people with intellectual disabilities and how to address these in practice and research.
• The theory and critical appraisal of the applied practice of neuropsychological and adaptive functioning assessments.
• Critical awareness of the debates around ‘best practice’ in establishing eligibility for intellectual disability services.
• A biopsychosocial understanding of the mental health needs of adults with intellectual disabilities including the impact of different genetic disorders, as well as social context (e.g. marginalisation and the effects of stigma throughout a lifetime).
• A lifespan approach to understanding attachment and trauma informed care.
• The physical health needs of people with intellectual disabilities and an understanding of how health inequalities impact people with intellectual disabilities (e.g. understanding of programmes such as Stopping Over-Medication of People with a Learning Disability (STOMP) and the Learning Disabilities Mortality Review (LeDeR; www.bristol.ac.uk/sps/leder).
• How to adapt assessments and interventions across a range of therapeutic approaches to the needs of people with intellectual disabilities and their carers (family and/or paid carers).
• Assessment and intervention for behaviour that challenges services, including functional assessment and positive behaviour support (PBS).
• Teaching on pica and associated health risks, including mortality (specifically requested by the BPS in response to the inquest of the death of James Frankish in 2016 as a result of eating plant materials; see Shea et al., 2019a, 2019b).
• Autism spectrum disorders, including an understanding of different psychological theories, assessment and intervention.
• A range of methods suitable for evaluating a variety of psychological work with people with intellectual disabilities.
• Capacity and consent issues (including an understanding of the Mental Capacity Act (2005) and equivalent acts in devolved nations) and the implications for clinical practice and assessed work as part of the academic requirements of the programme.
• Supporting individuals with intellectual disabilities around relationships and sexuality (BPS, 2019c).
• Supporting parents who have intellectual disabilities.
• Dementia and people with intellectual disabilities, including best practice around assessment, diagnosis and intervention.
• Offending behaviour and forensic services for people with intellectual disabilities, with and without a diagnosis of ASD.
• The role of clinical psychology when working with people with profound and multiple intellectual disabilities and other co-morbid conditions, such as sensory impairments, physical impairments, and epilepsy.
• Providing consultation to mainstream services around supporting the inclusion of people with intellectual disabilities and making reasonable adjustments.

There aims to be a clear sense of progression in the syllabus supporting trainees to develop their skills in intellectual disability practice from early introductions to developing a knowledge of working with complex difficulties through evidence-based practice.

Teaching will include lectures, workshops, and practical exercises. This may involve a blended learning approach of in-person and online teaching. Throughout the module there is an emphasis on improving professional practice and this is achieved through using role plays, group work and case studies and examples. Service users and carers will also be involved in teaching when available.

Summative

This is how we’ll formally assess what you have learned in this module.

Referral

This is how we’ll assess you if you don’t meet the criteria to pass this module.