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Physically handicapped individuals in psychotherapy: some empirical data.

This paper analyzed empirical data obtained from charts of eight clients with physical handicaps undergoing psychotherapy in an outpatient state mental health facility in West Texas. Research variables germane to psychotherapeutic issues encountered by these clients were explored. Content analysis of the charts revealed the following salient issues in therapy: anger, dependence vs. independence, anxiety, sexual needs, body image, self-deprecation, and difficulties in interpersonal relationships. Therapeutic interventions found to be beneficial included cognitive therapies with an assertiveness component, interpersonal skills training, and growth-promoting therapies. Focus of therapy dealt with ego strengthening and utilization of competencies, boundary issues, interactional patterns, anger, and anxiety. These preliminary data suggest fruitful explorations of other variables pertinent to coping with physical disabilities, for example, age, gender, and ethnic differences, type of disability, social support, and early family intervention. Implications for practice, theory, and research are identified. The community mental health nurse can augment practice with greater understanding of these at-risk individuals.