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Journal article

Enhancing the emotion recognition skills of individuals with learning disabilities: a review of the literature

Authors:
WOOD Pamela Margaret, KROESE Biza Stenfert
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 20(6), November 2007, pp.576-579.
Publisher:
Wiley-Blackwell

It has been repeatedly demonstrated that individuals with intellectual disabilities experience significant difficulties in recognizing facial expressions of emotion. The aim of this review was to address whether such skills can be enhanced amongst individuals with intellectual disabilities. The PsychInfo database on Dialog DataStar (1972–2006) was searched for all published journal articles investigating whether emotion recognition skills can be enhanced amongst individuals with intellectual disabilities. Four relevant articles were identified. Training in emotion recognition skills resulted in improvements in all four studies, with one study maintaining improvements at 8-month follow-up. The four published studies identified that emotion recognition skills can be enhanced and maintained over time. Despite claims in the literature that training in emotion recognition skills will enhance the social skills of individuals with intellectual disabilities, none of the studies considered the impact of training upon everyday functioning, leaving the ultimate efficacy of such training open to question.

Journal article

Service users' views of physical restraint procedures in secure settings for people with learning disabilities

Authors:
JONES Peter, KROESE Biza Stenfert
Journal article citation:
British Journal of Learning Disabilities, 35(1), March 2007, pp.50-54.
Publisher:
Wiley-Blackwell

The appropriateness and justification of physical restraint procedures in secure learning disability settings is an emotive issue. This paper examines the views of 10 service users from secure residential facilities who are restrained frequently. Using a semi-structured interview schedule, Service users were interviewed about their restraint experiences. They reported that restraint can lead to potentially abusive situations and that staff should try other approaches before restraining someone. They were divided on whether it calmed them down and whether staff enjoyed performing restraint. Other comments included that restraint may or may not serve a purposeful goal and that there is a definite need for staff training for those involved in performing restraint.

Journal article

The use of psychotropic medication for people with learning disabilities

Authors:
KROESE Biza Stenfert, HOLMES Guy
Journal article citation:
Tizard Learning Disability Review, 10(4), October 2005, pp.19-22.
Publisher:
Emerald

The authors comment on articles written by Heslop et al and Lim in Learning Disability Review 10(4) and also highlight on aspects of their own earlier review of the use of psychotropic drugs for people with learning disabilities.

Journal article

Employment opportunities for people with mental handicaps

Authors:
KROESE Biza Stenfert, et al
Journal article citation:
Mental Handicap, 18(4), December 1990, pp.143-145.
Publisher:
British Institute of Mental Handicap

Reports on a small scale survey of people in employment by the REAL Work Group which indicated that people with mental handicaps can be successfully placed in the open job market.

Journal article

Mental health services for adults with intellectual disabilities – what do service users and staff think of them?

Authors:
KROESE Biza Stenfert, et al
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 26(1), 2013, pp.3-13.
Publisher:
Wiley-Blackwell

Mental health services for services users with intellectual disabilities remain deficient both in terms of quality and access. The aim of this qualitative study was to investigate service users', support staff and community team members' views of the services currently provided to adults with intellectual disabilities and mental health problems and what they consider to be desirable qualities for staff to possess. Two different methodologies were used to collect data. First, 2 focus groups were conducted with service users who have intellectual disabilities and mental health problems and 2 focus groups were conducted with a variety of staff with recent experience of intellectual disabilities services. Second, individual interviews were conducted with 12 staff members employed in residential and community intellectual disabilities services.  The data were analysed using interpretive phenomenological analysis. The identified themes were: being interested, communication, competence-promoting support, past/present/future links, prevention, reviews and liaison, working with carers, looking after staff, staff training/supervision and interface between services. A number of suggestions for improving services are identified and discussed in the context of current service policies and procedures.

Journal article

Psychological factors associated with obtaining employment

Authors:
HENSEL Elizabeth, KROESE Biza Stenfert, ROSE John
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 20(2), March 2007, pp.175-181.
Publisher:
Wiley-Blackwell

Less than 10% of people with intellectual disabilities are employed. The aim of the present study was to investigate what psychological factors might predict employment outcome for people with intellectual disability who had received a placement in a supported employment service. Sixty people were interviewed whilst they were in the supported employment preparation agency and where possible 3 and 9 months after leaving. The structured interview included a number of psychological measures. Those who subsequently gained employment were compared with those who did not. Those who gained employment were significantly more motivated by status aspiration, and judged themselves significantly less happy than those who did not gain employment, at the first interview. It is possible that people who are more dissatisfied with their life might be more motivated to change their circumstances. Supported employment agencies might consider using a measure of motivation as an entry criterion or as a way of identifying who needs help with developing motivation.

Journal article

Trauma-focussed cognitive-behaviour therapy for people with mild intellectual disabilities: outcomes of a pilot study

Authors:
KROESE Biza Stenfert, et al
Journal article citation:
Advances in Mental Health and Intellectual Disabilities, 10(5), 2016, pp.299-310.
Publisher:
Emerald

Purpose: Trauma-focussed cognitive-behaviour therapy (TF-CBT) is the most effective treatment for post-traumatic stress disorder (PTSD). Individuals who present with complex PTSD are among the most complex and challenging patients seen by intellectual disability psychology and psychiatry services. The purpose of this paper is to study TF-CBT intervention for people with intellectual disabilities and complex PTSD. Design/methodology/approach: Three groups of adults with intellectual disabilities (ID) presenting with complex PTSD (n=3, n=5 and n=4) were treated using a 12-week manualised intervention adapted from a procedure routinely used in adult mental health services. Participants completed the Impact of Event Scale as adapted for people with intellectual disabilities (IES-ID) before and after the intervention, and interviews conducted to ascertain their experiences of the group were analysed using interpretative phenomenological analysis (IPA). Findings: The ten participants who completed the intervention showed a 27 per cent decrease in median Impact of Event Scale Intellectual Disabilities scores, equivalent to a medium effect size (d=0.50). Five themes were identified from the interviews: being listened to; it is nice to know you are not the only one; being in a group can be stressful; the importance of feeling safe; achieving and maintaining change. Participants also provided constructive feedback to promote improvements to the manual. Research limitations/implications: A feasibility study followed by methodologically robust clinical trials is now needed to establish the effectiveness of the intervention and its utility in clinical practice. Practical implications: This small study has confirmed the potential of TF-CBT as an intervention for extremely vulnerable individuals with ID who present with complex PTSD. Social implications: The findings indicate that a group intervention is both feasible for and acceptable to adults with ID. Originality/value: To date, no study has investigated the effectiveness and feasibility of a TF-CBT group intervention for adults with mild ID. (Publisher abstract)

Journal article

Making sense of varying standards of care: the experiences of staff working in residential care environments for adults with learning disabilities

Authors:
HUTCHINSON Andrew, KROESE Biza Stenfert
Journal article citation:
British Journal of Learning Disabilities, 44(3), 2016, p.182–193.
Publisher:
Wiley-Blackwell

Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have been made to understand variations in care standards, there remains a need for more research in this area. Additionally, little attention has been paid to understanding support staff experiences of working in residential services and to developing a more theoretical understanding of the role they fulfil. Using interpretive phenomenological analysis (IPA), this study aimed to examine front-line staff members' experiences of working in residential care for people with learning disabilities. Six experienced front-line care workers (four female, two male) took part in semi-structured interviews. Data were analysed according to the principles of IPA, and three superordinate themes were identified as being central to participants' experiences of their work roles: Degree of Positive Relationship Reciprocity; Value Congruence and Intrinsic Motivation; and Experiences of Environmental and Organisational Constraints. Results are discussed in relation to the existing literature on care standards and the factors associated with abusive or neglectful practices, and in terms of their contribution to theory and applied practice. (Publisher abstract)

Journal article

How do women with an intellectual disability experience the support of a Doula during their pregnancy, childbirth and after the birth of their child?

Authors:
McGARRY Alison, KROESE Biza Stenfert, COX Rachel
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 29(1), 2016, pp.21-33.
Publisher:
Wiley-Blackwell

Background: The aim of this study was to gain insight into the experiences of parents with an intellectual disability who received support from Doulas during pregnancy, birth and following the birth of their child. In addition, the experiences of the Doulas who provided the support were investigated. Materials and Methods: Four women with an intellectual disability who received Doula support were interviewed before and after the birth of their child. Three Doulas were interviewed after the birth about their experiences of supporting women with an intellectual disability. Results: Interview transcripts were analysed using Interpretive Phenomenological Analysis (IPA). Themes were identified from each interview, before an overall analysis of themes from each support phase was undertaken. Conclusions: Pre-natally, the Doula was considered helpful and a reliable source of information about pregnancy. Each mother perceived Doula support as a means of keeping her child in her care. Post-natally, mothers described a trusting relationship with their Doula, who enabled them to make informed choices. Doulas described how they adapted their work to meet the needs of parents with intellectual disability. Being involved in Child Protection procedures was perceived as stressful and challenging. (Edited publisher abstract)

Journal article

A review of literature exploring the possible causes of abuse and neglect in adult residential care

Authors:
HUTCHISON Andrew, KROESE Biza Stenfert
Journal article citation:
Journal of Adult Protection, 17(4), 2015, pp.216-233.
Publisher:
Emerald

Purpose: The purpose of this paper is to present a systematic review of empirical research, which explores possible causal and risk factors linked to abuse or neglect in residential care facilities. Design/methodology/approach: Electronic database searches were conducted to identify and synthesise studies reporting on empirical research aimed at exploring causal and/or risk factors associated with abuse or neglect in adult residential care services. Sample characteristics, design characteristics and outcome data were extracted from each paper. This information was then collated and summarised. Each study was evaluated using Sale and Brazil’s (2004), cross-paradigm framework of trustworthiness and rigour. Findings: In all, 17 papers, reporting on 15 separate research studies, met the inclusion criteria for this review. Results revealed that research in this area has utilised a diverse range of methodological approaches to explore abuse and/or neglect within the context of residential services for older adults and adults with learning disabilities. Possible causal and risk factors identified were separated into those that operated at a cultural or organisational/environmental level and those that operated at an individual or interpersonal level. Originality/value: While there are limitations associated with presenting a review of such a diverse group of studies, this paper presents a valuable synthesis of the empirically derived causal and risk factors linked to the abuse and neglect of adults in care. Additionally, readers are able to obtain a comprehensive overview of the quality of empirical research in this area. Finally, a number of applied implications and future research directions are highlighted, which may contribute to the development of further research and ultimately to improvements in residential care standards and a reduction in future instances of abuse and neglect.

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