Treating and assessing learning disabled clients

Clinical inference when assessing learning disabled clients

Charles R. Davenport, Psy.D.

 

 

 

 

 

 

 

 

 

 

It is extremely important that therapists be aware of the biases affecting their thinking and judgment. In a clinical setting therapists frequently draw conclusions biased on heuristics derived from initial impressions of their clients. These impressions can range from assumptions of intellectual competence to social aptitude. However, these conclusions, frequently, do not accurately represent reality. If the clinician incorporates statistical reasoning with their impressions they are far more accurate in representing the clients actual traits.  Frequently, Learning Disabled (LD) clients are referred to therapists after having being labeled LD. In many of these cases the LD client is at a disadvantage being that the therapist may have preconceived notions as to the traits of LD individuals. Where in actuality these traits vary greatly from one LD individual to another.

Unfortunately, the initial conceptualization the therapist constructs is difficult to change in the face of opposing information or collected data. This may be a result of pride, the anchoring, or labeling phenomenon. If the therapist reads a new LD clients file without having prior knowledge regarding the variability within this diverse population they may form several false pretenses biased on stereotypical knowledge.

Another dynamic, which may distort the therapists' interpretation of a LD client, is the influence of the confirmatory bias. The therapist who believes their LD client is intellectually deficient or less capable than other individuals may look for and be more open to observations that confirm these beliefs. Which, again, is a disservice to the client.

The therapist, being in a position of extreme power, has a responsibility to be aware of these elements of impression formation. They should also be in tune with their emotional responses to clients and assess the origin of these thoughts and emotions. It is helpful for therapists who are working with a new sector of the population to consult with an expert in the particular area in order to minimize inaccurate conceptualizations of their clients.

Therapists tend to overlook alternatives to their initial assessment of a client. In the case of the LD client, there are several characteristics which are shared with and frequently misdiagnosed as Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADDHD). These behaviors are elevated distractibility and in some cases hyperactive behavior. Therapists should be mindful of possibly delaying and/or making less automatic judgments when assessing these clients regardless of past diagnoses. When suspecting an ADD or ADDHD diagnosis it may be beneficial for the therapist to consider alternate diagnoses such as LD if evidence supports such a diagnosis.

Closely tied with delaying diagnosis and considering alternative diagnosis is the therapists' ability accept the possibility of personal fallibility. Frequently, the therapist perceives himself or herself, and wants to be perceived as, an expert. Therefore, therapists tend to rule-out personal fallibility in all aspects of the therapeutic process. We know this is not an adaptive trait such therapists surely would not recommend this behavior to their clients. Yet, they are frequently unaware of this aspect which distorts their judgment.

In other words, the therapist should be aware of the origins of their thoughts, behaviors, and preconceived notions. They should be mindful of the unconscious heuristics and elements of ego support, acting on, and possibly distorting their judgment and assessment. This seems especially relevant when working with a population such as LD clients who have a host of social and clinical stereotypes. These stereotypes frequently depict their abilities and traits inaccurately and tend to conglomerate unique individuals inaccurately.  

Posted by:

Charles R. Davenport, Psy.D.

Licensed Psychologist

Charles R. Davenport, Psy.D., LLC.

Offices: Sarasota, FL and Venice, FL

Phone: (941) 321-1971

 

www.drcharlesdavenport.com