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Trauma Support: a professional perspective

We asked Biza Stenfert Kroese (Senior Lecturer and Consultant Clinical Psychologist, University of Birmingham) and Cliff Hawkins (Consultant Clinical Psychologist, Black Country Partnership Foundation NHS Trust) for their insights into how to help people with learning disabilities cope with trauma…

People with learning disabilities are more likely than other people to be abused, due to being dependent on staff and having difficulties in recognising and reporting abuse. Between 70-90% of people with learning disabilities have experienced some form of abuse. 

People exposed to traumatic events (particularly when this involves abuse) often suffer Post-Traumatic Stress Disorder (PTSD) symptoms such as anxiety, flashbacks and recurring nightmares. They can also have difficulties with regulating their emotions, sustaining relationships and feeling close to others. They frequently suffer feelings of shame and guilt and may develop behaviours described as challenging. 

People with learning disabilities who experience psychological distress and behaviours described as challenging associated with PTSD are often prescribed drugs, even though there’s little evidence that drugs are effective. Drugs don’t address the underlying causes of PTSD, whereas ‘talking therapies’ do. Of the talking therapies, Trauma-Focused Cognitive Behaviour Therapy (TF-CBT) seems to be the most effective for PTSD in the general population. Standard TF-CBT procedures aren’t always suitable for people with learning disabilities, although increasingly we know how to adapt such procedures to make them more accessible.

TF-CBT aims to help people to improve their personal safety, self-care and ability to regulate their emotions. We offer people a 12-week programme that includes sessions on: staying safe; understanding the effects of trauma on our minds and bodies; understanding and managing emotions; relationships with others; coping with triggers/memories/flashbacks; thinking about the way we think. To make the sessions accessible to our clients we try to keep “talking at them” to a minimum and instead include lots of artwork, role play, quizzes, and mindfulness and relaxation exercises. Our clients have told us that although some difficult issues were discussed, they felt safe and supported, enjoyed the activities, and they particularly appreciated the contact with other group members.

So, if you know someone with a learning disability who you think may be experiencing PTSD, please contact your local NHS Community Team for Children or Adults with Learning Disabilities (CTLD) and ask for a Clinical Psychologist. If you don’t know your local CTLD, your GP or Social Worker will know. Also, you can ring the CBF’s Family Support Team for advice.

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