RESEARCH & COMMENTARY

Research
gaps.

What we looked for, and didn’t find.

Every “Not yet known” note across the site, gathered in one place for students and researchers.

Read in 60 seconds

What this is: the gaps in the evidence that each page names.

Who it’s for: students and researchers looking for a project.

How to read it: a gap means our targeted search didn’t find something, not that it can’t exist.

One thing to take away: disability is still under-researched in psychotherapy.

Four kinds of gapGaps by approachIf you’re researching one

The short version

Across the site, pages end with a “Not yet known” note: things our searches didn’t find. This page gathers them in one place, grouped by approach. Disability is still under-researched in psychotherapy, so many of these gaps could become student projects, dissertations or research proposals. These are the results of targeted searches, not systematic reviews, so a gap listed here means we didn’t find something, not that it doesn’t exist.

Four kinds of gap

Our framework

“No research with disabled people” can mean quite different things. The newer pages separate four:

Studies designed around disability

Research built specifically with or for disabled people.

Studies reporting disability

Research that records how many participants were disabled.

Results reported by disability

Research that compares outcomes for disabled and non-disabled participants.

Tests of specific adaptations

Research evaluating a particular access adaptation or modification.

A targeted search failing to find one of these doesn’t prove disabled people were absent from the research. Older pages use simpler wording and are being brought into line.

Gaps by approach and section

131 distinct gaps, last rebuilt in October 2026. Each is listed once per section, with the pages that note it. Select a heading to open it.

Acceptance and Commitment Therapy (2)
Attachment, Care and Autonomy (16)
  • Studies of adults with physical disabilities suggest attachment patterns broadly similar to non-disabled adults, which fits this branch’s central distinction. We have not located studies that measure attachment in relation to how much personal care someone receives, or trials of attachment-informed therapy designed for disabled clients. Evidence on physical disability should not be assumed to apply unchanged to intellectual disability, autism or sensory disability. Noted on: Attachment, Care and Autonomy.
  • Studies of adults with physical disabilities have found attachment patterns broadly similar to those of non-disabled adults (see the attachment hub). We have not located studies that relate attachment to the amount of personal care received, or that compare therapy approaches for disabled people moving towards self-directed support. Noted on: Can I Need Help and Still Be Autonomous?.
  • We have not located research on secure-base support specifically in relationships where one partner provides substantial personal care, or on how disabled adults experience support during exploration. Noted on: Safe Haven and Secure Base.
  • We have not located research that measures how secure long-term dependence on personal care feels to disabled adults, or what most affects it. Noted on: Secure Dependence and Interdependence.
  • Self-report attachment measures have been used with adults with physical disabilities (Hwang, Johnston & Smith, 2007, Rehabilitation Psychology, 52, 184–195). We have not located validation studies checking whether items about depending on others work the same way for adults who receive substantial personal care. Noted on: Attachment Patterns Without Fixed Labels.
  • We have not located research on how disabled adults who rely on care experience help as conditional, or on how often such expectations reflect current rather than past conditions. Noted on: When Help Feels Conditional.
  • We have not located research on attachment-informed therapy with disabled clients, or on how often access needs are misread as attachment behaviour. Noted on: Attachment in the Therapy Room.
  • We have not located research on how disabled clients experience therapist breaks or imposed endings, or on practices that help. Noted on: Rupture, Repair, Breaks and Endings.
  • We have not located research on how childhood hospitalisation affects adult attachment in disabled people specifically, or on therapy approaches for this. Noted on: Medical Separation and Attachment.
  • We have not located research on attachment in autistic adults’ close relationships that uses measures designed with autistic people, or validation of the Adult Attachment Interview with autistic adults. Noted on: Neurodivergent Communication and Attachment.
  • We have not located systematic validation of attachment measures across physically disabled, deaf, or communication-impaired adults, or studies of how often attachment assessments are used in proceedings involving disabled parents. Noted on: Attachment Assessment and Disability.
  • We have not located research on attachment in children of physically disabled parents, or of deaf or blind parents, comparable to the study above. Noted on: Disabled Parenting and Attachment.
  • We have not located research on attachment and sexuality in disabled adults, or on how care roles within couples affect sexual intimacy. Noted on: Sexuality and Attachment.
  • We have not located research on how disabled people experience the loss of a long-term personal assistant, or on attachment in relationships with paid carers. Noted on: Intimate Care and Attachment.
  • We have not located published research on attachment-informed practice by disabled therapists, or on how clients’ attachment responses are shaped by a therapist’s disability. Noted on: Disabled Therapists and Attachment.
  • We have not located research on how disabled adults’ expectations about asking for help change once care becomes reliable, or on therapy approaches for this. Noted on: The Help Is Reliable: Why Does Asking Still Feel Dangerous?.
Body Psychotherapy Through a Disability Lens (11)
Cognitive Behavioural Therapy Through a Disability Lens (2)
Comparative Cases (6)
Comparing Approaches (1)
  • We have not located trials comparing different therapy approaches specifically for disabled clients, or studies showing which adaptations of each approach work best. Noted on: Comparing Approaches.
Compassion-Focused Therapy: Disability, Shame and Self-Criticism (11)
  • We have not located randomised trials of standalone CFT with people with physical or sensory impairments other than chronic pain and chronic illness, or research on how disabled people experience soothing practices or the threat-system model. Many studies don’t report participants’ disabilities. Noted on: Compassion-Focused Therapy: Disability, Shame and Self-Criticism.
  • We have not located research on CFT for internalised ableism, or on how disabled people’s inner critics relate to criticism they have received from others. Noted on: Whose Voice Is the Inner Critic?.
  • We have not located research on fears of compassion in disabled people specifically. Noted on: When Compassion Feels Unsafe.
  • We have not located research on how disabled people experience CFT’s three-system model. Noted on: Threat, Drive and Soothing.
  • We have not located research on how CFT addresses discrimination or disability-related injustice. Noted on: Compassion with Courage.
  • We have not located research on CFT practices for people with respiratory or neuromuscular conditions, or on compassionate imagery for people with aphantasia. Noted on: Soothing That Fits Your Body.
  • We have not located randomised trials of standalone CFT with people with physical, sensory or energy-limiting impairments other than chronic pain and chronic illness, or research on CFT and internalised ableism. Noted on: Evidence, Adaptations and Limits.
  • We have not located research on how disabled people imagine their compassionate self. Noted on: Developing a Compassionate Self.
  • We have not located research on the gap between knowing and feeling among disabled people specifically. Noted on: I Know It Isn’t My Fault. Why Do I Still Feel Bad?.
  • We have not located published CFT case studies with people with multiple sclerosis or other energy-limiting conditions. Noted on: What Happens in the Therapy Room?.
  • We have not located research on how disabled clients experience therapist warmth as patronising, or on CFT with people with aphasia. Noted on: Compassion, Pity and Respect.
Dependency, Interdependence and Care (1)
  • We have not located studies testing how therapists distinguish practical dependence from attachment difficulties with disabled clients. Sources checked October 2026, using targeted searches. Noted on: Dependency, Interdependence and Care.
Fatigue or Avoidance? (1)
  • We have not located studies testing how well therapists distinguish fatigue from avoidance with disabled clients, or which approaches to that distinction work best. Noted on: Fatigue or Avoidance?.
For Referrers and Services (2)
  • Our targeted searches did not find research on how referral wording affects therapy for disabled people. Noted on: Before You Refer.
  • Our targeted searches did not find studies of how missed-appointment policies affect disabled clients of therapy services. Noted on: Making a Therapy Service Accessible.
Jungian Psychotherapy (2)
Language and Disability (1)
  • We have not located research on how therapists’ choice of disability language affects disabled clients’ experience of therapy or the therapeutic relationship. Noted on: Language and Disability.
Narrative Therapy, Disability and Identity (14)
  • There is published practice and case-study work on narrative therapy with people with intellectual disabilities and communication limitations (above). We have not located controlled outcome studies of White and Epston’s narrative therapy with disabled adults, or studies comparing ways of adapting it for people who use AAC or have memory differences. Noted on: Narrative Therapy, Disability and Identity.
  • We have not located research on narrative therapy for disabled adults’ sense of being a burden, or comparing it with other approaches. Noted on: Who Wrote the Burden Story?.
  • We have not located research on how disabled clients experience externalising conversations about their disability. Noted on: Externalising Without Erasing.
  • We have not located research on how unique outcomes are identified in narrative therapy with disabled clients. Noted on: Unique Outcomes and the Overcoming Trap.
  • We have not located research on how Frank’s narrative types appear in therapy with disabled people, as distinct from people with illness. Noted on: Restitution, Chaos and Quest.
  • We have not located research evaluating narrative therapy with people who use AAC, or comparing adaptations for people with memory differences. Noted on: Narrative Without Spoken Narrative.
  • We have not located research on re-membering conversations with disabled clients. Noted on: Re-membering and Disability Community.
  • We have not located research on definitional ceremonies or therapeutic documents with disabled clients, or on the use of accessible formats in narrative therapy. Noted on: Outsider Witnesses and Accessible Documents.
  • We have not located research on how professional descriptions in disabled people’s records shape their self-descriptions. Noted on: Who Decided What Counts as Normal?.
  • We have not located research on the pressure disabled people feel to prove competence, as explored in therapy. Noted on: The Proving Demand.
  • We have not located research on double listening with disabled clients. Noted on: Anger, Grief and What Matters.
  • We have not located research following narrative therapy with disabled clients across sessions. Noted on: Narrative Therapy in the Room.
  • We have not located controlled outcome studies of White and Epston’s narrative therapy with disabled adults, or studies of which adaptations matter most. Noted on: Evidence, Accessibility and Limits.
  • We have not located research on re-authoring conversations with disabled clients specifically. Noted on: Re-authoring Without Inventing a Better Version of Yourself.
Object Relations and Disability (1)
  • Our targeted searches did not find outcome studies of object relations therapy designed around disability; most disability-relevant writing is theoretical or case-based. Noted on: Object Relations and Disability.
Pluralistic Psychotherapy: Through a Disability Lens (12)
  • Our targeted searches did not find studies of pluralistic therapy designed around disability, or reporting results by disability. Noted on: Pluralistic Psychotherapy: Through a Disability Lens, Evidence, Adaptations and Limits.
  • Our targeted searches did not find studies of pluralistic goal-setting designed around disability, or reporting results by disability. That doesn’t mean disabled people were absent from the research. Noted on: Goals, Tasks and Methods.
  • Our targeted searches did not find studies of metatherapeutic communication designed around disability, or reporting results by disability. Noted on: Talking About How Therapy Is Working.
  • Our searches did not find research on therapy preferences among disabled clients specifically. Noted on: Preferences and Choice.
  • Our targeted searches did not find studies designed around disability, or reporting results by disability, on when or how pluralistic therapists change direction. Noted on: When to Change Direction.
  • Our targeted searches did not find published case studies of pluralistic therapy focused on disabled clients. Noted on: Pluralism in the Room.
  • Our targeted searches did not find studies of access arrangements in pluralistic therapy specifically. Noted on: Access Is Part of the Therapy.
  • Our targeted searches did not find studies of goal conflict between disabled clients, families and referrers in pluralistic therapy. Noted on: Whose Goal Is It?.
  • Our targeted searches did not find studies of collaborative formulation in pluralistic therapy designed around disability. Noted on: Understanding the Difficulty Together.
  • Our targeted searches did not find studies, designed around disability, of how disabled people use cultural resources alongside pluralistic therapy. Noted on: What Helps Outside Therapy?.
  • Our targeted searches did not find studies designed around disability on how disabled clients give feedback in therapy. Noted on: Feedback Without Having to Please.
  • Our targeted searches did not find studies of ruptures and repair designed around disability, or reporting results by disability. Noted on: When We Disagree or Get It Wrong.
Psychodynamic Therapy (1)
  • Our targeted searches did not find outcome studies of psychodynamic therapy designed around disability, or reporting results by disability. Noted on: Psychodynamic Therapy.
Research & Commentary (3)
Resources for Disabled People (1)
  • We have not located research on whether self-advocacy scripts help disabled clients raise concerns in therapy, or which kinds of wording work best. Noted on: Self-Advocacy Script Library.
Resources for Therapists (6)
  • We have not located a systematic review of how commonly used psychotherapy outcome measures perform across different disabled populations. Evidence so far is condition-by-condition and measure-by-measure. Noted on: Assessment Bias and Diagnostic Overshadowing.
  • We have not located research on whether structured reflection tools like these change therapists’ practice with disabled clients. We would welcome feedback from therapists who use them. Get in touch. Noted on: Therapist Reflection Sheets.
  • We have not located research testing whether checklists like this change therapists’ practice with disabled clients. Noted on: Clinical Ableism Checklist.
  • We have not located research on how therapy goals for disabled clients are set, or whether autonomy-focused goals lead to better outcomes than independence-focused ones. Noted on: Reflecting on Independence.
  • We have not located research on how accessible intake and consent processes affect disabled people’s access to, or experience of, psychotherapy. Noted on: Accessible Intake and Consent.
  • We have not located research on how often private therapy practices make adjustments for disabled clients, or which adjustments make the most difference to them. Noted on: Reasonable Adjustments.
Rupture and Repair (1)
  • We have not located research on ruptures specifically involving disability, or on how often disabled clients withdraw rather than raise a problem. Noted on: Rupture and Repair.
Systemic and Family Therapy: Disability, Relationships and Care (17)
  • We have not located trials of specific systemic models (such as Milan or structural therapy) with disabled adults as clients. Trials of structured family interventions that include disabled people’s own outcomes do exist; see Evidence, Adaptations and Limits. Noted on: Systemic and Family Therapy: Disability, Relationships and Care.
  • We have not located research on how accessible circular questions are for people with learning disabilities, autistic people or AAC users. Noted on: Circular Questions and Curiosity.
  • We have not located research testing the Family Systems Illness model with families where disability is congenital or stable. Noted on: Disability and Family Life Over Time.
  • We have not located trials of specific systemic models (such as Milan, post-Milan or structural therapy) with disabled adults as clients, or outcome research on systemic work with families where a parent is disabled. Trials of structured family interventions that include disabled people’s own outcomes do exist (see above). Noted on: Evidence, Adaptations and Limits.
  • We have not located outcome research on systemic therapy for families where a parent is disabled. Noted on: Who Carries the Work of Care?.
  • We have not located research on how disabled adults experience being the identified patient in family therapy. Noted on: The Identified Patient.
  • We have not located research on how systemic therapists use the social graces with disabled clients. Noted on: Social Graces and Power.
  • We have not located published systemic case studies with adults with acquired brain injury living with a parent. Noted on: Systemic Therapy in the Room.
  • We have not located research on interaction patterns between disabled adults and family members who provide some of their care. Noted on: Patterns We Keep Getting Caught In.
  • We have not located research on triangles involving interpreters, communication supporters or personal assistants. Noted on: Triangles, Supporters and Speaking Through Someone Else.
  • We have not located research on how inadequate care services affect couple and family relationships, or on therapy that addresses this directly. Noted on: When the Family Is Carrying a Service Gap.
  • We have not located research applying differentiation or structural concepts specifically to adults who receive care from family members. Noted on: Care Without Losing Your Voice.
  • We have not located research on accessible versions of genograms or ecomaps for blind or visually impaired clients. Noted on: Genograms, Ecomaps and Relationship Maps.
  • We have not located research on adult siblings of disabled people in systemic therapy, or on disabled people’s own views of their siblings’ roles. Noted on: Siblings, Fairness and Invisible Responsibilities.
  • This page doesn’t review the research on couples where one partner is disabled. We have not located trials of couple therapy designed for this situation. Noted on: Partners, Care and Intimacy.
  • We have not located research on neurodiversity-affirming systemic family therapy, or on family therapy where parents are also autistic. Noted on: Autism, Communication and Mutual Understanding.
  • We have not located research on how multigenerational family stories about disability affect younger disabled family members. Noted on: Family Stories About Disability.
The Disabled Therapist (1)
  • Research on psychotherapists with invisible disabilities, and on how they manage disclosure and recognition, is still needed; the 2025 study above focused on visible disability. Noted on: Disabled Therapist Identity.
Training Institutions and Disability (1)
  • The 2025 study above recommends comparative research on how therapy training institutions include disability across different countries and cultures. Noted on: Training Institutions and Disability.
Trauma-Informed Therapy: Disability, Safety and Choice (17)

If you’re researching one of these

  • Check the original page for the context of the gap, and the sources it does cite.
  • Search again: new research may have appeared since the page was written.
  • Involve disabled people in designing the research, not only as participants.
  • If you find something we missed, or publish something that fills a gap, use the contact form to let us know.
Related reading: Sources and Bibliography · How This Site Uses Evidence · Research & Commentary