City Research Online

Bereavement and Disability: Implications for the Therapeutic Encounter

Kliman, Elizabeth Angela (2009). Bereavement and Disability: Implications for the Therapeutic Encounter. (Unpublished Doctoral thesis, City University London)


This portfolio is presented in four parts: an overview, a research study, a client study and a critical literature review.

Overview: The first part introduces the portfolio and the overarching themes of bereavement and of disability. It introduces the researcher and the motivation behind this portfolio.

Research Study: This study explores the therapeutic relationship in bereavement counselling for clients with learning disabilities. Specifically, it addresses the impact upon the therapist of the work with the client as well as broader systemic issues. It examines the therapeutic relationship and suggests a six-stage model for effective bereavement counselling for individuals with learning disabilities.
Following a pilot study involving two participants, ten participants were interviewed using a semi-structured interview; seven of these were counsellors and three, counselling psychologists with varying levels of experience and theoretical orientations. Interviews were transcribed and analysed using grounded theory, according to the methodology of Glaser and Strauss (1967,1998). Questions were modified as new themes emerged from the data. A core category of Challenge emerged. This spanned a wide range of issues, all of which could be challenging for the client, therapist and others in the system and which interacted with and impacted on each other. Strategies for overcoming these challenges and achieving a feeling of success and ‘energy’ were explored. Interpretations of these findings are proposed and suggestions for future research are made

Critical Literature Review: This focuses on outcome research in order to examine the effectiveness of psychotherapeutic interventions for clients with learning disabilities who have been bereaved. It is argued that, although the outcome research, which is presented, indicates that bereavement counselling can be effective for this client group, there is a need for further rigorous exploration in order to provide an evidence base of the most effective interventions for clients with varying degrees of learning disabilities and experiences of bereavement.

Client Study: This study re-examines my work with a client with a physical disability. Sexuality has been viewed similarly in clients with physical and intellectual disabilities reflecting society’s double taboo against sexuality and disability. This parallels the rest of the portfolio which examines the double taboo experienced of both learning disabilities and bereavement. I reflect on the anxieties and difficulties this raised for me both professionally, as a trainee, and the challenges this work placed on my personal values, suggesting that disability leads to anxieties in therapists, particularly when combined with another challenge to our worldview.. I describe how I used a Cognitive Behavioural approach to work with a male client who presented with social anxiety and sexual difficulties. The client study describes how I worked with him to overcome the above obstacles to form a successful and effective therapeutic relationship.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
Doctoral Theses
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
[thumbnail of REDACTED - The whole thesis FINAL revised for publishing 10 CD.pdf]
Text - Accepted Version
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