created at: 2012-10-31The first time I accompanied a client who had Intellectual and Developmental Disabilities (I/DD) to a counseling session I was 18 years old, working as a direct care staff. In our 15-minute session, the majority of questions were directed to me. As we exited that office I wondered: why weren’t the therapist’s questions directed towards the person receiving treatment? Why was the session so short? Did the client feel respected and listened to during the session?

A shift has taken place in the world of mental health for clients with I/DD. Treatment manuals and workbooks for clients with I/DD are published in greater frequency and I receive emails on a weekly basis about webinars regarding mental health services for clients with I/DD. Despite this, there continues to be a very small number of clinicians who provide individual therapy to clients with I/DD.

When a client with I/DD or their parent reaches out to me, we discuss the reasons for seeking treatment and the client’s methods of communication and information processing. For example: How does your son or daughter communicate – how does he or she verbally and non-verbally convey when an experience arises that causes discomfort, happiness, confusion, etc.? How does he or she best process information? What level of involvement by family, friends, and/or staff has been most effective in comprehensively meeting the needs of the client? I then consider how conversation and materials can be modified based on individual needs and abilities: whether it may be helpful to include pictorial representations, allow for writing or typing on assistance devices, and include technology such as audio-recorders to capture key points to be reviewed at home.

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