Involving Carers in Therapy for Adults With Intellectual Disabilities: A Systematic Review of Client, Carer and Therapist Perspectives.

The quality of the included studies was generally low, with only three studies reflecting on researcher bias. Screening, extraction, and synthesis were conducted by a single author, introducing potential subjectivity. Most studies focused on skills-based therapies (like CBT or DBT) rather than exploratory or trauma-focused therapies, so findings may not apply to sensitive topics. The majority of participants were White British and studies were mostly from the UK, limiting generalisability to other cultures. People with severe intellectual disabilities were largely underrepresented, as most studies focused on mild-to-moderate ranges.

The authors declare no conflicts of interest. The work was funded by Health Education England.

Do not assume that carer involvement always improves outcomes or client comfort. The review found that for some clients, a carer's presence actively prevented them from discussing difficulties openly, and inconsistent carer attendance could disrupt the therapeutic process.