Counseling and Psychotherapy

  • Edward J. Nuffield
Part of the Applied Clinical Psychology book series (NSSB)


A psychodynamic approach to the treatment of behavior disorders in the mentally retarded population has had to justify itself over several decades. The history of this topic is replete with claims and counterclaims. Some authors (e. g., Clark, 1933), considering mental retardation as an example of the regression to the fetal stage, view clients as potentially capable of responding to psychoanalytic therapy. Others (e. g., Rogers, 1942) consider counseling only effective for individuals of average or superior intelligence. These are extreme views, however, and over the past few years a consensus appears to be emerging. The essence of this viewpoint is that, although psychodynamic principles can be applied successfully to an individual with virtually any IQ, the applicability of a traditional psychotherapeutic approach is limited by a number of factors. These factors include not only the severity of the mental retardation but also the nature and quality of the severe behavior disorder that the individual may be exhibiting. The second point leads to the necessity of understanding not only psychodynamic factors but also neurophysiological, neurochemical, and sociocultural vectors that underlie the behavior disorder of the mentally retarded individual. A comprehensive diagnostic formulation of the individual under consideration is, therefore, predicated. The comprehensive management of the severely disordered mentally retarded individual will require a composite of approaches by individuals from many disciplines, all working together as a team. Counselors or psychotherapists working within the framework of psychodynamic principles will need to understand the theoretical bases of their co-workers and integrate their approaches with those of others in order to avoid dissonance among the team members and confusion in the structuring of a comprehensive treatment plan.


Mental Retardation Group Therapy Music Therapy Group Guidance Dance Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ackerman, N. W., & Menninger, C. F. (1936). Treatment techniques for mental retardation in a school for personality disorders in children. American Journal of Orthopsychiatry, 6, 294–312.CrossRefGoogle Scholar
  2. Albini, J. L., & Dinitz, S. (1965). Psychotherapy with disturbed and defective children: An evaluation of changes in behavior and attitudes. American Journal of Mental Deficiency, 69, 560.PubMedGoogle Scholar
  3. Axline, V. (1949). Mental deficiency—Symptom or disease. Journal of Consulting Psychology, 13, 313–327.PubMedCrossRefGoogle Scholar
  4. Axline, V. (1957). Play therapy. Boston: Houghton Mifflin.Google Scholar
  5. Balthazar, E. E., & Stevens, H. A. (1975). The emotionally disturbed, mentally retarded: A historical and contemporary perspective. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  6. Bergin, A. E., & Lambert, M. J. (1978). The evaluation of therapeutic outcomes. In S. L. Barfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (pp. 139–180). New York: Wiley.Google Scholar
  7. Bialer, I. (1967). Psychotherapy and other adjustment techniques with the mentally retarded. In A. A. Baumeister (Eds.), Mental retardation, appraisal, education and rehabilitation (pp. 138–180). Chicago: Aldine.Google Scholar
  8. Birnbaum, M. K. (1974). Peer-pair psychotherapy: A new approach to withdrawn children. Journal of Clinical Child Psychology, 2, 13–20.Google Scholar
  9. Cantalapiedra, M. A., De Weerdt, C., & Frederick, F. (1977). Le role psychotherapique de l’educateur dans un externat póur jeunés enfánts. Revue de Neuropsychiatrie Infantile, 25, 787–811.Google Scholar
  10. Capobianco, R. J., & Cole, D. A. (1960). Social behavior of mentally retarded children. American Journal of Mental Deficiency, 64, 638–651.PubMedGoogle Scholar
  11. Cassity, M. D. (1977). Nontraditional guitar techniques for the educable and trainable mentally retarded residents in music therapy activities. Journal of Music Therapy, 14, 39–42.Google Scholar
  12. Chidester, L. (1934). Therapeutic results with mentally retarded children. American Journal of Orthopsychiatry, 4, 464–472.CrossRefGoogle Scholar
  13. Chidester, L., & Menninger, K. A. (1936). The application of psychoanalytic methods to the study of mental retardation. American Journal of Orthopsychiatry, 6, 616–625.CrossRefGoogle Scholar
  14. Clark, L. P. (1933). The nature and treatment of amentia. London: Bailliere, Tindall and Cox.Google Scholar
  15. Close, H. T. (1966). Psychotherapy. Voices, 2, 124.Google Scholar
  16. Cotzin, M. (1948). Group therapy with mentally defective problem boys. American Journal of Mental Deficiency, 53, 268–283.PubMedGoogle Scholar
  17. Cowen, E. L. (1955). Psychotherapy and play techniques with the exceptional child. In W. H. Cruikshank (Ed.), Psychology of exceptional children and youth (1st ed., pp. 343–375). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  18. Craft, M. (1965). Ten studies into psychopathic personality. Bristol: John Wright and Sons.Google Scholar
  19. Crenshaw, D. A. (1976). Teaching adaptive interpersonal behavior: Group techniques in residential treatment. Child Care Quarterly, 5, 211–220.CrossRefGoogle Scholar
  20. Davidson, C. D. (1975). Psychotherapy with mentally handicapped children in a day school. Psychotherapy: Theory, Research and Practice, 12, 13–21.CrossRefGoogle Scholar
  21. Davis, K. R., & Shapiro, L. J. (1979). Exploring group process as a means of reaching the mentally retarded. Social Casework, 60, 330–337.Google Scholar
  22. Deblassie, R. R., & Lebsock, M. S. (1979). Counselling with handicapped children. Elementary School Guidance and Counselling, 13, 199–206.Google Scholar
  23. Dolly, J. P., & Page, D. P. (1981). Reality therapy with institutionalized emotionally disturbed mentally retarded adolescents. Journal for Special Educators, 17, 225–232.Google Scholar
  24. English, H. G., & English, A. C. (1958). A comprehensive dictionary of psychological and psychoanalytic terms. New York: Longmans, Green and Co.Google Scholar
  25. Espenak, L. (1981). Dance therapy, therapy and application. Springfield, IL: Charles C Thomas.Google Scholar
  26. Fine, R. H., & Dawson, J. C. (1965). A therapy program for the mildly retarded adolescent. American Journal of Mental Deficiency, 69, 23–30.Google Scholar
  27. Fisher, L., & Wolfson, I. (1953). Group therapy of mental defectives. American Journal of Mental Deficiency, 57, 463–476.PubMedGoogle Scholar
  28. Freeman, M. (1936). Drawing as a psychotherapeutic intermedium. American Journal of Mental Deficiency, 41, 182–187.Google Scholar
  29. Fuller, J. S. (1977). Duotherapy: A potential treatment of choice for latency children. Journal of the American Academy of Child Psychology, 16, 469–477.CrossRefGoogle Scholar
  30. Ginott, H. G. (1976). Therapeutic intervention in child treatment. In C. Schaeffer (Ed.), Therapeutic use of child’s play (pp. 279–290). New York: Jason Aronson.Google Scholar
  31. Gorlow, L., Butler, A., Einig, K. G., & Smith, J. A. (1963). An appraisal of self-attitudes and behavior following group psychotherapy with retarded young adults. American Journal of Mental Deficiency, 67, 893–898.PubMedGoogle Scholar
  32. Hayes, M. (1977). The responsiveness of mentally retarded children to psychotherapy. Smith College Studies in Social Work, 47, 112–153.CrossRefGoogle Scholar
  33. Heinrichs, D. W., & Carpenter, W. T. (1981). The efficacy of individual psychotherapy: A perspective and review emphasizing controlled outcome studies. In S. Arieti (Ed.), American handbook of psychiatry (pp. 586–613). New York: Basic Books.Google Scholar
  34. Hinsie, L. E., & Campbell, R. J. (1970). Psychiatric dictionary (4th ed.). New York and London: Oxford University Press.Google Scholar
  35. Humes, C. W., Actamczyk, J. S., & Myco, R. W. (1969). A school study of group counselling with educable retarded adolescents. American Journal of Mental Deficiency, 74, 191–195.PubMedGoogle Scholar
  36. Hynes, J., & Young, J. (1976). Adolescent group for mentally retarded persons. Education and Training for the Mentally Retarded, 11, 226–231.Google Scholar
  37. Jakab, I. (1970). Psychotherapy of the mentally retarded child. In N. Bernstein (Ed.), Diminished people (pp. 223–261). Boston: Little, Brown.Google Scholar
  38. Johnson, E. (1953). The clinical use of Raven’s progressive matrices to appraise potential for progress in play therapy: A study of institutionalized and educationally retarded children. American Journal of Orthopsychiatry, 23, 391–398.PubMedCrossRefGoogle Scholar
  39. Kadis, O. L. (1951, May). The use of fingerpainting in psychotherapy with mentally retarded children. Paper presented at the 75th Annual Meeting of the American Association in Mental Deficiency, New York.Google Scholar
  40. Kanner, L. (1964). A history of the care and study of the feebleminded. Springfield, IL: Charles C Thomas.Google Scholar
  41. Kazdin, A. E., & Matson, J. L. (1981). Social validation in mental retardation. Applied Research in Mental Retardation, 2, 39–54.PubMedCrossRefGoogle Scholar
  42. Klein, M. (1932). The psychoanalysis of children. London: Hogarth Press.Google Scholar
  43. Knapczyk, D. R., & Yoppi, J. D. (1975). Development of cooperative and competitive play resources in developmentally disabled children. American Journal of Mental Deficiency, 80, 245–255.PubMedGoogle Scholar
  44. Kunkle-Miller, C. (1978). Art therapy with mentally retarded adults. Art Psychotherapy, 5, 123–133.CrossRefGoogle Scholar
  45. Lavalli, A., & Levine, M. (1954). Social and guidance needs of mentally handicapped adolescents as revealed through sociodrama. American Journal of Mental Deficiency, 58, 544–552.PubMedGoogle Scholar
  46. Lee, D. Y. (1977). Evaluation of a group counselling program designed to enhance social adjustment of mentally retarded adults. Journal of Counselling Psychology, 24, 318–323.CrossRefGoogle Scholar
  47. Leland, H., & Smith, D. (1965). Unstructured material in play therapy for emotionally disturbed, brain damaged mentally retarded children. American Journal of Mental Deficiency, 66, 621–627.Google Scholar
  48. Meltzhoff, J., & Kornreich, M. (1970). Research in psychotherapy. New York: Atherton Press.Google Scholar
  49. Michal-Smith, H., Gottsegen, M., & Gottsegen, G. (1955). A group therapy technique for mental retardates. International Journal of Group Psychotherapy, 5, 84–90.Google Scholar
  50. Moore, C. L. (1981). Activity group failure: Verbal group therapy success in a special education program. International Journal of Group Psychotherapy, 31, 223–231.PubMedGoogle Scholar
  51. Morrison, T. L., & Newcomer, B. L. (1975). Effects of directive vs. nondirective play therapy with institutionalized mentally retarded children. American Journal of Mental Deficiency, 79, 666–669.PubMedGoogle Scholar
  52. Moustakas, C. (1953). Children in play therapy. New York: McGraw-Hill.Google Scholar
  53. Mundy, L. (1957). Therapy with physically and mentally handicapped children in a mental deficiency hospital. Journal of Clinical Psychology, 13, 3–9.PubMedCrossRefGoogle Scholar
  54. Newcomer, R. B., & Morrison, T. L. (1974). Play therapy with institutionalized mentally retarded children. American Journal of Mental Deficiency, 78, 727–733.PubMedGoogle Scholar
  55. Norman, M. I. (1977). A counseling program for TMR students. School Counselor, 24, 274–277.Google Scholar
  56. Nuffield, E. J. (1983). Psychotherapy for the retarded. In J. L. Matson & J. A. Mulick (Eds.), Handbook of mental retardation (pp. 351–368). New York: Pergamon Press.Google Scholar
  57. Ringelheim, D., & Polatsek, I. (1957). Group therapy with a male defective group (a preliminary study). American Journal of Mental Deficiency, 62, 157–162.Google Scholar
  58. Rogers, C. R. (1942). Counseling and psychotherapy. Boston: Houghton Mifflin.Google Scholar
  59. Rogers, C. R. (1951). Client-centered therapy. Boston: Houghton Mifflin.Google Scholar
  60. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin.Google Scholar
  61. Roth, E. A., & Barrett, R. P. (1980). Parallels in art and play therapy with a disturbed retarded boy. The Arts in Psychotherapy, 7, 19–26.CrossRefGoogle Scholar
  62. Schachter, F. F., Myer, L. R., & Loomis, E. A. (1962). Childhood schizophrenia and mental retardation: Differential diagnosis after one year of psychotherapy. American Journal of Orthopsychiatry, 32, 584–594.PubMedCrossRefGoogle Scholar
  63. Schwartz, C. (1979). The application of psychoanalytic theory to the treatment of the mentally retarded child. Psychoanalytic Review, 66, 133–141.PubMedGoogle Scholar
  64. Schweisheimer, W., & Walberg, H. J. (1976). A peer counseling experiment: High school students as small-group leaders. Journal of Counselling Psychology, 23, 398–401.CrossRefGoogle Scholar
  65. Selan, B. H. (1979). Psychotherapy with the mentally retarded. Social Work, 24, 263.Google Scholar
  66. Sherwood, S. (1980). Play psychotherapy with socially maladaptive mentally retarded children using same age and younger age peers as therapists. Unpublished doctoral dissertation, Ohio State University, Columbus.Google Scholar
  67. Shoben, E. J. (1953). Some observations on psychotherapy and the learning process. In O. H. Mowrer (Ed.), Psychotherapy: Theory and research (p. 125). New York: Ronald Press.Google Scholar
  68. Shuman-Carpenter, B. (1977). The effects of two methods of therapy on the body language of emotionally disturbed, retarded female adolescents (Doctoral dissertation, University of Michigan). Dissertation Abstracts International, 38.Google Scholar
  69. Slavson, S. R., & Schiffer, M. (1975). Group therapies for children: A textbook. New York: International Universities Press.Google Scholar
  70. Smith, E., McKinnon, R., & Kessler, J. W. (1976). Psychotherapy with mentally retarded children. Psychoanalytic Study of Children, 31, 493–514.Google Scholar
  71. Snyder, R., & Sechrest, L. (1959). An experimental study of directive group therapy with defective delinquents. American Journal of Mental Deficiency, 64, 117–123.PubMedGoogle Scholar
  72. Snyder, W. V. (1947). The present status of psychotherapeutic counselling. Psychological Bulletin, 44, 297–386.PubMedCrossRefGoogle Scholar
  73. Stacey, C. L., De Martino, M. F., & Sarason, S. B. (1957). Couseling and psychotherapy with the mentally retarded. Glencoe, IL: Free Press.Google Scholar
  74. Sternlicht, M. (1964). Establishing an initial relationship in group psychotherapy with delinquent retarded male adolescents. American Journal of Mental Deficiency, 69, 39–41.PubMedGoogle Scholar
  75. Sternlicht, M. (1966). Treatment approaches to delinquent retardates. International Journal of Group Psychotherapy, 16, 91–93.PubMedGoogle Scholar
  76. Strain, P. S. (1975). Increasing social play of severely retarded preschoolers with socio-dramatic activities. Mental Retardation, 13, 7–9.PubMedGoogle Scholar
  77. Subotnik, L., & Callahan, R. J. (1959). A pilot study in short-term play therapy with institutionalized educable mentally retarded boys. American Journal of Mental Deficiency, 63, 730–735.PubMedGoogle Scholar
  78. Szymanski, L. S. (1980). Individual psychotherapy with retarded persons. In L. S. Szymanski & P. E. Tanguay (Eds.), Emotional disorders of mentally retarded persons (pp. 131–147). Baltimore: University Park Press.Google Scholar
  79. Szymanski, L. S., & Rosefsky, Q. B. (1980). Group psychotherapy with retarded persons. In L. S. Szymanski & P. E. Tanguay (Eds.), Emotional disorders of mentally retarded persons (pp. 173–194). Baltimore: University Park Press.Google Scholar
  80. Thorne, F. C. (1948). Counselling and psychotherapy with mental defectives. American Journal of Mental Deficiency, 52, 263–271.PubMedGoogle Scholar
  81. Thorne, F. C., & Dolan, K. M. (1953). The role of counselling in a placement program for mentally retarded females. Journal of Clinical Psychology, 9, 110–113.PubMedCrossRefGoogle Scholar
  82. Trotzer, J. P. (1977). The counselor and the group: Integrating theory, training and practice. Monterey, CA: Brooks/Cole.Google Scholar
  83. Truax, C. B., & Mitchel, K. M. (1971). Research on certain therapist interpersonal skills in relation to process and outcome. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 346–369). New York: Wiley.Google Scholar
  84. Vail, D. J. (1955). An unsuccessful experiment in group therapy. American Journal of Mental Deficiency, 60, 144–151.PubMedGoogle Scholar
  85. Walker, P. W. (1977). Premarital counselling for the developmentally disabled. Social Casework, 58, 475–479.Google Scholar
  86. Weiner, E. A., & Weiner, B. J. (1974). Differentiation of retarded and normal children through toy-play analysis. Multivariate Behavioral Research, 9, 245–252.CrossRefGoogle Scholar
  87. Weinstock, A. (1979). Group treatment of characterologically damaged, developmentally disabled adolescents in a residential treatment center. International Journal of Group Psychotherapy, 29, 369–381.PubMedGoogle Scholar
  88. Welch, V. O., & Sigman, M. (1980). Group psychotherapy with mildly retarded, emotionally disturbed adolescents. Journal of Clinical Child Psychology, 8, 209–212.CrossRefGoogle Scholar
  89. Wiest, G. (1955). Psychotherapy with the mentally retarded. American Journal of Mental Deficiency, 59, 640–644.PubMedGoogle Scholar
  90. Yalom, I. D. (1970). The theory and practice of group psychotherapy. New York: Basic Books.Google Scholar
  91. Yonge, K. A., & O’Connor, N. (1954). Measurable effects of group psychotherapy with defective delinquents. Journal of Mental Science, 100, 944–952.PubMedGoogle Scholar
  92. Zapf, R. F. (1976, September). Group therapy with retarded adults: A reality therapy approach. Dissertation Abstracts International, 37(3A), 1418.Google Scholar

Copyright information

© Springer Science+Business Media New York 1986

Authors and Affiliations

  • Edward J. Nuffield
    • 1
    • 2
  1. 1.Department of PsychiatryWestern Psychiatric Institute and ClinicPittsburghUSA
  2. 2.University of Pittsburgh School of MedicinePittsburghUSA

Personalised recommendations