There have been many barriers preventing people with intellectual disabilities (ID) from accessing psychodynamic treatments. Therapists, notably Freud in the early 1900s and later Carl Rogers in the 1960s, believed that people with ID were unsuitable for psychodynamic therapies, as they did not have the intelligence seen as a prerequisite for this mode of treatment. There were also assumptions that people with ID were immune to emotional distress or did not understand emotional pain and suffering, and so were not affected by it. Until relatively recently, treatments have tended to be social (e.g. institutionalization), behavioural, or pharmacological, despite the growing trend towards more talking treatments in the non-ID population.
What is psychodynamic psychotherapy?
The term psychotherapy includes any type of talking therapy. The Department of Health's review of strategic policy on National Health Service psychotherapy services in 1996, advised that every mental health professional should be able to offer supportive and psycho-educational therapy as part of a combined package of care. This should include engaging the person sufficiently so that they return for follow up, asking exploratory questions if they don't understand, and listening to their difficulties.
Essentially, any type of treatment that involves talking to the person – either individually or in a group, as part of a care network or family – can be approached psychodynamically.