The feasibility and acceptability of a therapist measure of assimilation of problematic experiences for clients with Intellectual Disability

The aim of this thesis is to develop a measure for therapists of clients with Intellectual Disability (ID) to assess change in psychotherapy. This thesis consists of two sections; a systematic literature review and an exploratory
research study. Using systematic review methodology, thirteen studies were identified that investigated the effectiveness of psychoanalytic and psychodynamic psychotherapy with clients with ID. The studies were assessed for quality using a widely used quality rating tool and a narrative synthesis was used to describe the results. The studies were of generally poor quality;
however, research has advanced from using single case studies and more robust designs are gradually being implemented, such as controlled methodologies. Continuing this trend in the implementation of more robust designs and the development of outcome measures standardised for clients
with ID should be a focus of future research.

The research report explored the feasibility and applicability of a measure of change in psychotherapy in routine practice with clients who have ID. The Therapist Assimilation Measure (TAM) has been designed for use with
the general population and is based on the Assimilation of Problematic Experiences Scale (APES). Twelve therapists adapted the TAM and piloted its use in their practice, additionally providing feedback on their experiences with
using the measure. The feedback was used in combination with item analysis and frequency distribution to further modify and shorten the TAM. The reliability
of the final 24-item measure, the TAM-ID, was tested and good internal consistency (α = .58 to .92) and high inter-rater reliability (ICC = .84 to .90) was found. The assimilation model was found to be an acceptable framework to use with clients with ID.