Psychoanalytic psychotherapy is a new development in the treatment of people with learning disabilities and mental health problems, which traditionally has utilised behavioural management and limited counselling. The papers collected here have evolved from the work of the pioneering Learning Disabilities Service at the Tavistock Clinic, London, which consists of specialised professionals from the fields of psychology, psychiatry, child and adolescent psychotherapy, adult psychotherapy and social work. The service mainly offers individual psychotherapy but it also provides group work, parent work, family therapy and consultative work with professionals where necessary. This volume demonstrates the vast range of work undertaken by members of the service, covering treatment for children, adolescents and adults from the fields detailed above. It also contains an in-depth look at aspects of life in residential settings and at audit and research. Several central concepts reoccur: the theory of early trauma; the theory of "secondary handicap", a term coined by Valerie Sinason to describe the particular use a person makes of their handicap; and the sheer painfulness of having a learning disability to all concerned and the magnitude of defensive manoeuvres used by people to evade this reality.
A major and worthwhile aim of the editors is to encourage an interest in training in psychotherapy with this patient group, an overlooked but rewarding field. This book will appeal to many for a variety of reasons. It is pertinent for those from any field who are already engaged in work with people with learning difficulties and will also be of interest not only to general practitioners and students of psychotherapy, but also to non-specialists who are connected with the issues raised, such as carers, keyworkers, family members and friends.