Vulnerability and protection talk: Systemic therapy process with people with intellectual disability

Abstract

Background Vulnerability and protection are key concepts within the literature relating to systemic therapy for people with an intellectual disability ((ID)). This paper explores the processes by which these concepts were discussed in systemic therapy sessions. Method Four videotapes of systemic therapy sessions were evaluated using a qualitative design, incorporating thematic and conversation analysis. The videotapes were drawn from systemic therapy sessions with 3 families with an adult with ID. Results Vulnerability and protection themes were identified within the content of therapeutic conversations, including protection from the disability and its consequences; protection from peers, siblings, and the world at large; and protection from emotionally sensitive topics. Protective strategies were also used by all system members through the process of therapy. Key strategies were topic switch and reversals. Conclusions Protection is a key issue. Clinical practice could be enhanced if therapists reflect on the strategies they employ in addressing protection effectively.