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Ethical approaches to physical interventions: volume II: changing the agenda
- Editors:
- ALLEN David, (ed.)
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2009
- Pagination:
- 224p., bibliog.
- Place of publication:
- Kidderminster
The editor brings together a collection of papers from leading academics and practitioners which together provide an overview of key developments and best practice with regard physical interventions. They analyse current policies and practices, examine physical intervention and abusive practices and discuss future needs. The material is divided into three overarching themes. The first looks at training in physical intervention, including a review of the current evidence, the British Institute of Learning Disabilities (BILD) physical intervention training accreditation scheme, the need for an effective assessment tool for intervention and the provision of training to parents. The second theme considers some of the current controversies including, the use of mechanical restraint in relation to self-injury, emergency medication for the management of challenging behaviour, the use of seclusion and time out and a discussion of fatalities that have occurred in restraint within UK adult care services. The final theme considers the paradigm shift required to move from a focus on physical intervention, that reflects a reactive approach to challenging behaviour, towards a more proactive, preventative approach. It considers how teaching new skills to service users can be critical in preventative intervention and looks at the issues and practices around restraint reduction.
Predictors of restrictive research strategy use in people with challenging behaviour
- Authors:
- ALLEN David, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.159-168.
- Publisher:
- Wiley
Intrusive reactive strategies (physical restraint, emergency medication and seclusion) are frequently used procedures in the management of challenging behaviour. The present study identifies predictors for reactive strategy use in an attempt to more clearly delineate at risk service users. Eight hundred and thirty-nine agencies and service settings in a large area of South Wales were screened to identify children and adults with challenging behaviour against a number of defined operational criteria. Full data were available for 901 participants. Univariate and multivariate statistics were employed to identify predictors for reactive strategy use. The individuals most at risk of the use of reactive strategies were those who were subject to formal detention under the Mental Health Act (restraint and sedation), had more severe challenging behaviour (seclusion), showed destructive behaviour (restraint and seclusion) were placed out of area (seclusion) and had behavioural plans in place for specific topographies (restraint and sedation).