Therapies – Intellectual disability
Dr. Keogh has successfully worked with those who exhibit aggressive or sexually inappropriate behaviours.
Assessment and intervention- Autism and Psychopathy
At times individuals with Autism can present with what are called ‘atypical’ behaviours. Those who care for them may believe they are exhibiting psychopathy or callous unemotional traits if the individual is younger than 16 years.
Dr. Keogh can provide a thorough assessment of these traits and educate all concerned carers as to the outcome.
Psychopathy or callous unemotional traits (<16 years of age) is usually gauged by a persons lack of remorse and lack of empathy however the following consideration must be noted when the individual has autism; social communication deficits in those with autism somehow predispose them towards violent acts. The person may also have a high pain threshold combined with sensory issues related to touch, light and texture. The individual may have poor cognitive empathy predisposing to a lack of empathy for the pain and suffering of others. Executive dysfunction may also be a risk factor for aggressive behaviour through impaired control of impulsive behaviour or poor response selection. This would present as an inability to plan for the future, an inability to inhibit or delay responding, and inability to shift between activities flexibly. Any assessment of psychopathy needs to allow for these considerations.
When a forensic assessment is carried out on an individual with autism various factors are considered. The individual is assessed to measure the presence of cognitive empathy versus emotional empathy and screen for psychopathy. The ability to understand facial features is measured and a thorough cognitive assessment screening for dyspraxia, adhd etc. Mental health issues are addressed and a risk assessment is carried out to screen for risk of harm to the self and others. The individual is assessed thoroughly to assess for specific impairments relating to the diagnosis of autism.
Dr. Keogh gathers information from various sources who know the individual as well as by observing and talking to the individual. Such sources include parents, carers, teachers and any other professional involved with and concerned about the current behaviour of the individual concerned. This information is then applied to the relevant Hare Psychopathy Checklist.
A report is generated with recommendations for future interventions.
Positive behavioural support programmes
Positive Behavioural Support Programmes and attachment based therapeutic interventions are the treatment of choice for people displaying challenging behaviour, those with intellectual disabilities, and vulnerable others with a specific clinical need, such as Autistic Spectrum and ADHD etc. The function of the negative behaviour is analysed usually by conducting a functional behavioural assessment. This is usually considered to be a problem-solving process and the goal is to look beyond the actual behaviour itself. Then positive behaviours identified that are functionally equivalent for the person. These programmes seek to eliminate negative behaviour by not providing any reinforcement for these behaviours. However, natural consequences remain in place, and are explained to the person. The programme is developed together with the person’s family and/or care staff and implemented alongside attachment based therapeutic techniques .
Psycho-education is very beneficial in this process, i.e. grasping the world view of the individual, understanding attachment and the outcomes of an insecure attachment, understanding possible motives and misunderstandings in relating.
Various stage are involved in conducting a functional behavioural analysis, to identify both negatively viewed and positively viewed behaviours.;
– In concrete terms the specific behaviour is described and targeted
– Information about the specific behaviour is collected and the accuracy of the behaviour is measured.
– The behaviour is then categorised according to the reasoning behind it, is it pertaining to a certain skill or performance?
– The information is then analysed to formulate a reason and determine it’s function in the person’s life
– Interventions are then collaboratively devised
Reviews are systematically carried out to identify further areas of need and build confidence.
At times parents and teachers voice concerns about the behaviour of their child both at home and in school. Or adults can go undiagnosed. These concerns reflect fears regarding friendship formation, school work and general social, behavioural and emotional functioning. If there is a question regarding a possible ADHD diagnosis an assessment can be carried out by the appropriately qualified professional which can involve;
– Information gathering from caregiver/parent and teacher
– Observation of the child in various situations
– Psychometric testing involving the administration of cognitive/achievement testing of the child , and the completion of questionnaires by the teacher and parent
– Report feedback to the caregiver/parent
Early intervention is important in order to put in place the resources and programs which may be beneficial to the child and the family. However these assessments can be carried out at any age.
For those thinking of going to College/University and who have chosen to go down the DARE route, Dr. Keogh can write the necessary report.
Therapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client, patient, family, couple, or group. The problems addressed are psychological in nature and can vary in terms of their causes, influences, triggers, and potential resolutions. Accurate assessment of these and other variables depends on the practitioner’s capability and can change or evolve as the practitioner acquires experience, knowledge, and insight.
Our psychotherapists and psychologists are trained in a variety of therapeutic approaches, including Cognitive Behavioural Therapy (CBT), Psycho-dynamic, Existential and Humanistic, EMDR and Schema therapy.
Therapeutic sessions usually last for 50 minutes and are reviewed every six weeks. The therapist and client work collaboratively to meet the individual therapeutic needs of the client.
Dr. Keogh also offers therapies specifically created to work on the child/caregiver relationship. Given that children usually enjoy play and imaginative activities, there therapies are created to enhance the inner world of the child as well as being psycho-educative for the parent. The goal is always to build on the parent/child attachment relationship. Sessions last anywhere from 30 minutes to 90 minutes depending on the needs of the parent/child on the day. Usually the therapy is chosen after an initial assessment to determine the strengths and weaknesses in the child/parent relationship.