Developing a therapeutic relationship with a blind client with a severe intellectual disability and persistent...

Area of Science:

• Developmental Psychology
• Clinical Psychology
• Behavioral Therapy

Background:

• Individuals with severe intellectual disabilities and Down syndrome often exhibit persistent challenging behaviors.
• Attachment-based approaches are increasingly recognized for their potential in addressing behavioral and emotional dysregulation.

Purpose of the Study:

• To investigate the efficacy of attachment-based behavior modification in a 17-year-old male with Down syndrome and severe challenging behaviors.
• To examine the development of the therapeutic attachment relationship during the intervention.

Main Methods:

• A single-case study design alternating attachment therapy with control sessions.
• Assessment of challenging behavior using residential observation lists.
• Video analysis of attachment behaviors and physiological measures of affect regulation (pre-ejection period and respiratory sinus arrhythmia).

Main Results:

• Significant reduction in the frequency and intensity of challenging behaviors.
• Increased appropriate replacement behaviors and reduced physiological arousal (PEP) during attachment-based treatment.
• Enhanced active and sustained attachment behaviors, particularly proximity seeking, towards the attachment therapist.

Conclusions:

• Attachment-based psychotherapy is effective in eliciting attachment behaviors in adolescents with severe intellectual disabilities and dysregulation.
• The therapeutic attachment relationship serves as a crucial platform for facilitating positive behavior change.