Exploring how people with intellectual disabilities experience the therapeutic alliance: a ‘best fit’ framework analysis using Bordin's model

Background: There is an increasing interest in therapeutic alliance within talking therapy for people with intellectual disability. The applicability of frameworks such as Bordin's (1979) model of therapy alliance has not been considered.

Method: A review of qualitative literature on people with intellectual disability's experience of talking therapy identified 23 papers. A ‘best fit’ framework synthesis was used to explore the applicability of Bordin's model to the experiences of people with intellectual disability in therapy.

Results: The analysis supported Bordin's core themes of bond, task and goals. An additional theme was identified concerning the extension of the therapist's role to include active advocacy and support in the lives of people with intellectual disability outside of therapy.

Conclusion: This study identified the experience of people with intellectual disability in therapy as consistent with Bordin's model and suggests that further research specific to the model would be productive.