Many people with intellectual disability experience short attention span, gaps in memory and difficulties with memory processing. The degree to which this has an impact on communication in the counselling context depends on each individual and how well the counsellor can assess the individual’s communication ability and adapt their practice accordingly.
For example, sometimes a client might need to talk about a particular topic or an experience they have had, that initially seems unrelated to the counselling session. In this case it is both helpful and respectful to allow the person some time to talk about their topic before focussing on the counsellor’s plan for the session. Seemingly insignificant topics might turn out to be important, and counsellors need to assess whose needs they are meeting if they feel tempted to dismiss apparently irrelevant topics brought up by their client.
Anxiety before and within the counselling session is common. This can be caused by the understanding of many people that counselling is ‘talk-based’, coupled with their fear of failing in communication (Dagnan & Jahoda, 2006). Learning to understand the way that anxiety impacts on an individual’s memory, attention and concentration is extremely important.
More frequent, shorter sessions can be helpful, as well as being prepared to work slowly and with repetition. Adjusting the frequency of your speech might also be necessary, to assist the person’s level of comprehension and retention of what you say and the questions you ask.
The use of imagery and creating a visual record of counselling sessions is a useful technique for recording and remembering counselling sessions, and as a way to review and see development over time. However, some imagery may not work with some clients, and this needs to be explored sensitively with each client to avoid insult and/or embarrassment. For example, creating drawings to record the session might seem child-like or embarrassing to many adults with intellectual disability. Normalising the use of drawing and artwork in counselling with adults can help to break this association. For example, the counsellor might say, ‘I really like to use drawings to help me understand some things, do you mind if we do a drawing of what we’re talking about?’ (For further discussion about using artwork and creative techniques in therapy, see the sections: ‘Exploring feelings through art’, ‘Sand tray therapy’ and ‘Art work therapy’.)