Group psychotherapy with mentally retarded adults: issues related to design, implementation, and evaluation

Although the mental health needs of mentally retarded persons are becoming increasingly acknowledged by service providers, psychotherapy is still neglected as a treatment modality. This paper provides a framework for considering issues related to the design, implementation, and evaluation of group psychotherapeutic endeavors to benefit dually diagnosed clients. A social systems approach to psychopathology is described to illustrate how a variety of potentially treatable aspects of dysfunctioning can be identified and selected as treatment goals for group psychotherapy with mentally retarded individuals. Treatment models are presented to assist in the pragmatic blending of behavioral and psychodynamic interventions that are relevant for conducting group psychotherapy with this population. Administrators and clinicians are provided with a prototype of how to establish and maintain cost-effective linkages between mental health and mental retardation agencies, so that dually diagnosed clients are not excluded from receiving services they need. Finally, process and outcome evaluation strategies are considered which might provide an empirical basis for documenting the effectiveness of group psychotherapy as a viable, nondrug approach to treating psychopathology in mentally retarded individuals.