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Background: People with learning disabilities experience bereavement in the same emotionally overwhelming way as the general population. The Dual‐Process Model of grief is characterised by the oscillation between Loss‐Orientation and Restoration‐Orientation. These processes involve experiencing and accepting the emotional pain of grief (Loss‐Orientation) and adapting to a new world without the deceased person (Restoration‐Orientation). Methods: A single case study sought to explore how Cognitive Behavioural Therapy (CBT) and Compassion Focused Therapy (CFT) principles can be used to support people with a learning disability to navigate the grieving process, as understood by the Dual‐Process Model. Findings: This case study describes CBT formulation and assessment, and implementation of CBT and CFT strategies in a man with Williams syndrome, demonstrating improvements in mood, and a greater ability to turn towards suffering and experience both Loss‐ and Restoration‐Oriented processing. Conclusion: CBT and CFT may be useful and appropriate modalities for clinicians to consider when supporting people with a learning disability to navigate loss, as understood through the Dual Process Model. Accessible summary: This case study explores the complex nature of grief and bereavement for a man with learning disabilities during the COVID‐19 pandemic.This case study reports on helping a man with learning disabilities better understand his experience of loss, and how his fears and low mood about losing other important people are kept going.The therapeutic work, in this case study uses Cognitive Behavioural Therapy and Compassion Focused Therapy strategies to help a man with learning disabilities navigate his experience of loss, turn towards suffering, and challenge unhelpful thoughts.The paper explores and reflects on how therapy might helpfully be adapted to meet the individual needs of a man with learning disabilities.This case study thinks about the barriers to doing effective psychological therapy with a man with learning disabilities given the impact of the Covid‐19 pandemic on important third‐sector groups. [ABSTRACT FROM AUTHOR]

Accessible Summary Pupils with autism are often physically handled in schools without teachers realising that this can be distressing for them., Many teachers do not know about the United Nations Convention on the Rights of Persons with Disabilities., Teachers need support with developing their understanding of how pupils experience being handled., It is important that the rights of disabled pupils are recognised and protected., Summary 'Positive handling' has become a popular intervention within education and other services in England in the management of behaviours that challenge. This paper uses a vignette of an observation of the handling of children with autism as a starting point for consideration of whether this practice can ever really be experienced as positive or whether it is often little more than a mechanism of control that disregards the rights of disabled children and young people. All schools are mandated under the United Nations Convention on the Rights of Persons with Disabilities to protect the rights of disabled pupils, but, to date, there has been very little engagement by teachers with this agenda. This paper identifies some of the rights of pupils that are negated through current practice and evaluates what support Prouty's principles of pre-therapy from the field of counselling might offer teachers with developing a rights based agenda. [ABSTRACT FROM AUTHOR]

Accessible summary:: “Learning disability” replaced the outdated term, “mentally handicapped” in the UK over 20 years ago. Recently, some services and professionals have been using the term “intellectual disability” instead. In America, “intellectual disability” has been chosen to replace the old term, “mental retardation.” There has been lots of explanation why this has happened. In the UK, there has not been much explanation. It is important to know what terms mean and why they are being used because their use affects the lives of people with learning disabilities. This article looks at what different people in the UK think about term “intellectual disability.” Abstract: Background: The term “intellectual disability” is increasingly used to refer to people with learning disabilities in British learning disability policy, practice and research. This change is undoubtedly a reflection of the changing international context. The inclusion of the term “intellectual disability” has been particularly pronounced in countries such as the USA. By contrast, this change has been relatively silent in England. Methods: In light of this, the paper explores the discussions of 12 focus groups conducted with professional and lay groups working in or influencing learning disability research and practice in England. Each focus group was asked the following two questions: Have you heard of the term “intellectual disability” and how do you feel about the term “intellectual disability?.” Discussion and Conclusion: Thematic analysis of the discussions identified four dominant themes: dislike and disbelief; ambiguity; tautology; and fear. It is concluded that more explanation is required in order for researchers and practitioners in England to understand this semantic change. [ABSTRACT FROM AUTHOR]

Accessible Summary: Some clients in learning disability services have problems in their relationships with people. Some clients with learning disability have broken the law and live in hospital. For clients in hospital, treatment can be learning about managing behaviour, feelings and relationships.  This treatment is given by different professionals. This treatment is important to help stop these clients getting into trouble with the police again. An important part of treatment is to help clients understand their experiences in relationships. This case study is about Oliver, and how psychologists and an art therapist worked together to help him.​ Abstract: Background: Clients with attachment issues are over‐represented in learning disability services. Forensic inpatient services are no exception. Treatment pathways comprise multidisciplinary interventions, and skills‐based treatments are considered vital to recovery and maintenance of prosocial and adaptive behaviour and reduction in risk. An important aspect of treatment is the psychological intervention to enable clients to understand their early experiences and the way this may have impacted on later relationships and behaviour. Without exploring the difficult early lives that many clients in forensic inpatient services have experienced, skills‐based treatments and attempts to facilitate discharge may not be effective. Materials and methods: This case study presents the theoretical background of attachment, autism, learning disability and sexual offending that informed the collaborative multidisciplinary psychological treatment offered to one man with learning disabilities and autism in a secure forensic setting. Results: The introduction of Art Psychotherapy enabled the client to explore his history and the potential internal barriers to his therapeutic progress. Issues of safety and belonging, previously unexplored with this man, were uncovered and these themes were incorporated into his risk formulation and treatment plan. Conclusions: The paper reflects on the specific contribution of Art Psychotherapy in specialist services, and the importance of the collaborative relationship between the Art Psychotherapist and the ward Multi‐Disciplinary Team. [ABSTRACT FROM AUTHOR]

Accessible summary Some men with learning disabilities have a sexual fetish which may present a support challenge for staff or carers., Sexual fetish in people with learning disabilities is often ignored, seen as pathological or associated with risk., It is possible to support sexual fetish in person-centred ways which respect individual rights and informed choice., Summary This paper reports on a psycho-educational intervention associated with the sexual fetish of a man with mild learning disability and autism which centred on his use of nappies and baby paraphernalia. It outlines the nature and expression of his sexual fetish and the risks perceived to be associated with it and describes the approach developed to support him, including the aims which underpinned the work and the methods and processes employed. It was found that a person-centred psycho-educational approach from a rights based perspective achieved important changes in his life and self-esteem and helped challenge assumptions about his sexual risk. The paper also reflects on the organisational location of this work and identifies the applied learning for supporting the sexual fetish of people with learning disabilities, of value for informing sex education and sexuality support for people with learning disabilities more widely. [ABSTRACT FROM AUTHOR]

Accessible summary People with learning disabilities need to visit the doctor like everyone else, but this is sometimes difficult., This paper is about a boy who needed to have a blood test., It took seven appointments and 15 weeks to take a blood sample., This paper talks about ways that medical services could get better and change to help people with learning disabilities visit the doctor., Summary People with learning disabilities have higher levels of health needs compared with the general population ( Nocon, 2006, Background evidence for the DRC's formal investigation into health inequalities experienced by people with learning disabilities or mental health problems. London and Manchester, Disability Rights Commission). Research has shown that these individuals receive less effective health care ( Michael, 2008, Tizard Learn Disabil Rev, 13: 28) and has explored the challenges and barriers in accessing health services ( Jackson Brown & Guvenir, 2009, Br J Learn Disabil, 37: 110). This case study describes the experience of a child with a severe learning disability and his family accessing mainstream health care for a simple medical procedure. Implications for how healthcare services can be organised to meet the needs of learning disabled people are discussed, addressing issues such as physical environment of surgeries and hospitals, communication between staff teams, staff skills and lack of preparedness. [ABSTRACT FROM AUTHOR]

The study examined the effects of transition employment support to two cohorts of young people who were in their last year in school or college in 2005/2006 and 2006/ 2007. This paper reports the views of carers, teachers and support workers of the impact this additional support made to the young people. Analysis of the data reveals a difference between the views of carers and those of professionals. The paper argues that these differences may reflect different understandings of the aim and purpose of transition support and which may make it difficult to achieve a smooth transition for all stakeholders when not taken into account. This may have implications for how to structure and deliver transition support, some of which are being outlined in the discussion. [ABSTRACT FROM AUTHOR]

Accessible summary: • Valuing People is a policy which aims to help people with learning disabilities become included in all parts of life. It needs money and resources to make it work. • It has worked well for some people but others have had some very bad experiences as a result of how the policy has worked. • This has led to these people not being included, and this is something that nobody intended to happen. • We make some suggestions of how things could be improved, so that the aims of Valuing People can be met. The paper examines aspects of the implementation of Valuing People by focusing upon four case studies of people, which are representative of a greater number of referrals to an organisation providing support for people with learning disabilities. It shows that despite many positive aspects of the policy, it sometimes fails the most vulnerable, resulting in greater levels of social exclusion for this group. The paper draws on Scull (1983) and Burton & Kagan’s (2006) documentary analysis of Valuing People ( Department of Health, 2001 ) to argue that the policy, in its implementation, is firmly located within the Government’s neo-liberal ideology. The conclusion is that whilst the policy is intended to be one which enhances social inclusion, its implementation has the unintended consequences of social exclusion, which could have been, and still can be, avoided. [ABSTRACT FROM AUTHOR]

Accessible summary • This paper is about how people get good support. This can happen when you have a direct payment, and you have your own personal assistant (PA). But you need to have a good PA, who knows how to communicate well. • Two people with learning disabilities worked in the research team on this project. The team made videos of people with learning disabilities working with their PAs. • It is important that the PA knows how to support you well. For instance, they should treat you with respect. This means that you can tell them what to do. They should talk to you like an adult, and listen to what you want. They should not rush you. • A good PA will remind you that you’ve got a choice. They will help you be in control of your choices, but they won’t force you to make a choice. • PAs sometimes have to give you advice. But that should be on your terms. It’s good to have a friendly relationship with your PA. It’s a bit like team work. • People with learning disabilities can help to train their own PAs. This project made a training pack, with a DVD. For people with learning disabilities to have control over their lives, the quality of their support staff matters. This paper reports on an inclusive research study, which used video analysis to study the communication skills of personal assistants (PAs) who worked with people with learning disabilities. The findings reveal some of the fine detail in the strategies these PAs used, to show respect, support choices, and give advice. They were able to step back, to listen and observe the person with learning disabilities, and to use good, open body language. They also gave people time, built up a close relationship based on shared interests and activities, and they talked with people in a friendly, adult way. It is difficult to support people to manage their lives, and team work is important. People with learning disabilities also have to play their role in the relationship. This research produced training materials that will help people with learning disabilities to train and support their own PAs. [ABSTRACT FROM AUTHOR]

Accessible summary • A lot of people worry about going to the dentist. • Sometimes people aren’t given a choice about the treatment they have at the dentist. • We worked with somebody to help them feel better about going to the dentist. • People can copy our work to help other people feel better going to the dentist. Dental anxiety is a common form of anxiety problem, and research suggests that more people with learning disabilities experience dental anxiety than in the general population. Very little work has been done to investigate effective non-medical approaches for supporting people with a learning disability and dental anxiety to access dental care. This has created a significant barrier to accessing treatment, and meant that individual’s are not offered a meaningful choice between treatment options. Using a case study, this paper demonstrates that a simple cognitive behavioural intervention can be effective in reducing dental anxiety, and offer a more meaningful choice of treatment options. This paper is limited in that no formal assessment measures were used, and was evaluated through client feedback. It is possible that this intervention could be applied by other practitioners to increase the accessibility of dental health services. [ABSTRACT FROM AUTHOR]

Accessible Summary In the UK, more people with learning disabilities have the chance to have more choice and control over their lives., One big issue for many people with learning disabilities is that they should have control over their own money., There can be quite a lot of problems for people with learning disabilities around managing money. Staff do not always know how best to help. Banks and building societies are not always helpful or accessible., Giving people more choice or control over their money does not always mean that things will be better for people with learning disabilities., People with learning difficulties need better kinds of support to have choice and control over their money., Summary In the UK, policy on adult social care places an emphasis on maximising choice and control for service users, including people with learning disabilities. The shift from the provision of organised services for groups of people to offering individual and personal budgets and pots of money for people to buy their own services has major implications for the way in which people with learning disabilities are offered the opportunity to be much more 'hands-on' with managing their own financial affairs. Some of the financial implications of personalisation are arguably quite complex, and it is not clear how well people with learning disabilities are being supported with this. This paper highlights some key and emerging issues on the topic of money and personalisation and draws on interviews with a range of staff in learning disability services and highlights their views, hopes and concerns about the best ways to support people with money matters. The response of mainstream financial institutions to the needs of people with learning disabilities and the political and economic context in which the personalisation agenda is developing are also discussed. [ABSTRACT FROM AUTHOR]

Accessible summary Systemic practice is about working with all the people who are important in someone's life. Important people, such as friends and family, are seen as the 'system' around a person. This way of working does not see the problem as belonging to one person, but as belonging to the whole system., Psychodynamic psychotherapy is about trying to understand what's happened in someone's past and how this might be affecting their life today. People sometimes find themselves getting into the same difficulties in relationships again and again. This way of working tries to understand why the person has become 'stuck' in this way. The therapist will think about the client's feelings and wishes about their life and their relationships. They will also think about the relationship that grows between therapist and client. Talking about the relationship between therapist and client can help people to understand problems that they have in other relationships., This case study shows how psychological theory can help the therapist to decide what to do in therapy and how best to work with the client/s in understanding the problem., Summary This paper describes the process of couple therapy with a client who has a mild learning disability and cerebral palsy, and her partner, who also has cerebral palsy (all information has been anonymised and pseudonyms are used throughout). Informed consent was gained from both individuals for the purposes of writing about their case. Therapy spanned twelve sessions and was informed by systemic and psychodynamic ways of thinking. Formulations are discussed, and psychological theory is linked to what happened in the therapy room. The current study takes a reflective stance and discusses the process of therapy, which includes successes as well as pitfalls. Pertinent issues for people with learning disabilities are discussed in terms of power dynamics, the impact of physical disability, capacity to consent to therapy and the effects of abuse. [ABSTRACT FROM AUTHOR]

Accessible summary • This study is about the life stories of six older people with Down’s syndrome who spent some part of their childhoods in institutionalised settings. • They have interesting and moving stories to tell about their lives. They talked about their childhood and current lives, their likes and dislikes, their strengths and difficulties and their hopes and dreams. They also spoke about the important people in their lives. • The participants did not talk about themselves as being ‘old’, ‘disabled’ or as having ‘Down’s syndrome’. They talked about themselves in other ways, such as being ‘normal’, being a ‘man’ or a ‘beautiful lady’. • The researcher learnt about herself whilst doing this study. She learned about the value of taking time to listen to people and she reflected on her own life story. This paper is a narrative analysis of the accounts of six older people with Down’s syndrome who spent part of their childhood in institutional environments. The study aimed to find out how the participants talked about themselves. Different types of narrative analysis were used, including those of Murray ( Qualitative psychology: a practical guide to research methods, London, UK, Sage, 2003), Gergen & Gergen ( Hist Social Psychol, Hillsdale, NJ, Erlbaum, 1984) and Labov & Waletsky ( Essays on the verbal and visual arts, Seattle, University of Washington Press, 1967). All of the participants spoke about their childhood, current and future lives. Most participants were able to reflect upon their strengths, limitations and hopes. The analysis highlighted the commonalities across the accounts: loss, abuse, health, significant others, transition, resilience and identity. Significantly, none of the participants identified themselves as having ‘Down’s syndrome’ or a ‘learning disability,’ nor did they identify with being ‘older’. Instead, individuals identified themselves in relation to gender and social roles. The accounts varied in terms of their form, structure, coherence and reflexive capacity. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]