Search results for ‘Subject term:"learning disabilities"’ Sort:
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Identification and description of adults with mental handicaps showing physically aggressive behaviours
- Author:
- REED Julie
- Journal article citation:
- Mental Handicap Research, 3(2), 1990, pp.126-136.
- Publisher:
- BIMH Publications
Proposes that, for the purposes of planning for future service provision and resource allocation, the identification of people whose physical aggression is likely to present challenges to those with whom they live and work should also consider the influence of additional factors, such as predictability, emotional arousal, and topographic differences. These may be important variables in staff perceptions and management of physically aggressive behaviour.
Overcoming difficult behaviour: a guide and sourcebook for helping people with severe mental handicaps
- Author:
- PRESLAND John L
- Publisher:
- British Institute of Mental Handicap
- Publication year:
- 1989
- Pagination:
- 342p., tables, bibliog.
- Place of publication:
- Kidderminster
Defining and measuring problems; identifying existing influences; planning and implementing a treatment programme. Covers a wide range of specific problems.
The structured assessment of violence risk in adults with intellectual disability: a systematic review
- Authors:
- HOUNSOME J., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(1), 2018, pp.e1-e17.
- Publisher:
- Wiley
Background: While structured professional judgement approaches to assessing and managing the risk of violence have been extensively examined in mental health/forensic settings, the application of the findings to people with an intellectual disability is less extensively researched and reviewed. This review aimed to assess whether risk assessment tools have adequate predictive validity for violence in adults with an intellectual disability. Methods: Standard systematic review methodology was used to identify and synthesise appropriate studies.Results:A total of 14 studies were identified as meeting the inclusion criteria. These studies assessed the predictive validity of 18 different risk assessment tools, mainly in forensic settings. All studies concluded that the tools assessed were successful in predicting violence. Studies were generally of a high quality. Conclusions: There is good quality evidence that risk assessment tools are valid for people with intellectual disability who offend but further research is required to validate tools for use with people with intellectual disability who offend. (Edited publisher abstract)
The assessment and treatment of a man with mild learning disability, violent behaviour and chronic low self-esteem: a case study
- Authors:
- BISHOP Amanda J., HENRY Jayne C.
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 2(1), March 2008, pp.38-44.
- Publisher:
- Emerald
The following case study describes the assessment, formulation and treatment of a man with mild learning disabilities and a history of violent behaviour. Following several years of offence-related work, identification of chronic low self-esteem provided an alternative approach to addressing the risk of violence by treatment based on the cognitive model of low self-esteem. Global self-esteem and fear of negative evaluation were assessed at baseline, middle and end of treatment and at one-month follow-up. Although scores improved over the course of 23 sessions and were maintained at one-month follow-up, the change was minimal and unlikely to be clinically significant. However, the client reported benefits from therapy and there were observable positive behaviour changes. Discharge was facilitated from secure services to supported living in the community. The results from this case study show that, with adaption, cognitive behavioural therapy for low self-esteem may successfully be applied to people with mild learning disabilities. Therapy to address issues underlying offending behaviour is often required in addition to offending behaviour programmes in order to reduce the risk of re-offending.
Clinical and actuarial prediction of physical violence in a forensic intellectual disability hospital: a longitudinal study
- Authors:
- McMILLAN Dean, HASTINGS Richard P., COLDWELL Jon
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(4), December 2004, pp.255-265.
- Publisher:
- Wiley
There is a high rate of physical violence in populations with intellectual disabilities, and this has been linked to problems for the victim, the assailant, members of staff and services. Despite the clinical significance of this behaviour, few studies have assessed methods of predicting its occurrence. The present study examined clinical and actuarial methods of predicting violence in a forensic intellectual disability hospital. The sample for the study consisted of people resident in the hospital during a 1-year period (n = 124). Clinical prediction used a risk rating made by members of the person's clinical team, whereas actuarial prediction used the number of violent incidents in the 6-months before the date of the clinical risk assessment. Computerized hospital records of violence in the 6 months after the assessment were used to examine the predictive accuracy of the two methods. The clinical method produced an area under the curve of 0.74 (95% CI: 0.650.83) in a receiveroperating characteristic curve analysis. The value for the actuarial method was 0.77 (95% CI: 0.690.86). Both methods performed at levels significantly above chance, but no one method was found to be superior to the other. These findings suggest that it is possible to predict who is at risk of violence in forensic populations with intellectual disabilities. Here, the authors discuss the clinical implications of these findings and the clinical application of risk prediction within clinical services.
Natural therapeutic holding
- Author:
- STIRLING Christopher
- Journal article citation:
- Nursing Times, 20.1.99, 1999, pp.55-57.
- Publisher:
- Nursing Times
Considers an alternative to control and restraint in the management of violence for people with learning disabilities.
The use of natural therapeutic holding as a non-aversive physical intervention in the management of violence
- Author:
- STIRLING Christopher
- Journal article citation:
- British Journal of Learning Disabilities, 26(3), 1998, pp.105-109.
- Publisher:
- Wiley
Whilst it is currently recognised and acknowledged that the use of physical interventions in the management of aggression and violence is appropriate in some circumstances, the aims, values and application of such approaches have come under closer scrutiny in recent years. It is now accepted that any physical intervention must be non-aversive in application and be considered as part of an overall programme which emphasises the development of positive alternative behaviours other than violence. Developments in risk management have placed agreed onus on professionals to develop specific intervention programmes which not only consider the risks presented by the client, but also consider the risk associated with the interventions used. This article discusses National Therapeutic Holding which, the author argues, addresses these issues and provides not only some answers to the professional, legal and ethical debates, but also equips carers with a set of interactive and responsive skills which can be used therapeutically.
Prevention and detection of abuse
- Author:
- SEATON Marie
- Journal article citation:
- Elders the Journal of Care and Practice, 4(4), December 1995, pp.5-27.
Over recent years, abuse of vulnerable people such as elderly with dementia, those with a learning disability or mental health problem has received increased publicity. This article outlines guidelines prepared by the charity United Response to guide and assist all staff, who may need to know how to act when abuse is alleged and also to assist staff in identifying signs that abuse may be occurring or that a situation exists which might lead to abuse. Covers the need for staff training, definitions of abuse and necessary procedures.
The dynamic risk assessment and management system: an assessment of immediate risk of violence for individuals with offending and challenging behaviour
- Authors:
- LINDSAY William R., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(4), December 2004, pp.267-274.
- Publisher:
- Wiley
Research on dynamic risk assessment has developed over the last 10 years and a number of variables have emerged as being possible predictors of future sexual and violent offences. These variables include hostile attitude/anger and compliance with routine. In 2002, Thornton developed a framework for dynamic risk assessment which also includes distorted and dysfunctional attitudes, socio-affective functioning, self-management and, for sex offenders, sexual interests. In 2000, Hanson & Harris provided empirical support for the predictive power of a number of dynamic factors which they split into stable and acute variables. In their research they found poor social supports, antisocial lifestyle, and poor self-management strategies to be important in addition to co-operation with supervision and hostile attitude. The present report describes the development of the Dynamic Risk Assessment and Management System (DRAMS) an assessment for dynamic/proximal risk factors in people with intellectual disabilities. In a field trial, the DRAMS was administered by staff unfamiliar with the formal requirements of the assessment. They were familiar with other ward-based assessments. Ten subjects were assessed for reliability purposes (total of 45 assessments) and five subjects were assessed consistently over a 3-month period. Eighteen aggressive incidents were recorded in these five subjects and the relationship between DRAMS assessments and the incidents was calculated. Assessments were recorded on the day of the incident, the day before the incident and on a control day, which was at least 7 days before or after an incident. Four items achieved high reliability mood, psychotic symptoms, self-regulation, compliance with routine in addition to total score. Two items achieved intermediate reliability antisocial behaviour and problems with thinking/attitudes, and three items were not applicable to this client group in that none of the participants was ever rated on them substance abuse, renewal of emotional relationships and victim access. One item had poor reliability therapeutic alliance. There were significant differences between the DRAMS assessment on the control day and assessments both on the day prior to the incident and the day of the incident for three of the six subscales and total score. Initial results would suggest that the DRAMS is a reliable instrument apart from the therapeutic alliance category. Initial signs suggest that it may be predictive of aggressive incidents in residential settings. Several developments to other settings and the client groups are discussed.
Risk assessment in people with learning disabilities
- Author:
- SELLARS Carol
- Publisher:
- British Psychological Society/Blackwell
- Publication year:
- 2002
- Pagination:
- 168p.,bibliog.
- Place of publication:
- Oxford
This book provides an explanation of the concept of risk, and a discussion of the key areas where risks need to be assessed in the lives of people with learning disabilities. It describes an approach to assessing risks and emphasizes the need to see risk assessment as an ongoing process in which all interested parties can consider the potential risks in any situation.