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Adapting compassion focused therapy for an adult with a learning disability: a case study
- Authors:
- COOPER Rosalind, FREARSON Julia
- Journal article citation:
- British Journal of Learning Disabilities, 45(2), 2017, pp.142-150.
- Publisher:
- Wiley
Background: Joe was referred to the Community Learning Disabilities Team (CLDT) for support around low mood and overeating. Initial formulation suggested compassion focused therapy (CFT) as an intervention. The evidence base for using CFT with people with learning disabilities is currently limited. Materials and Methods: Adaptations were made to the CFT framework, accounting for Joe's learning disability. A case study design was used to investigate the effectiveness of intervention. Joe attended 13 sessions of assessment, formulation and intervention. Client feedback was incorporated to assess suitability of the CFT approach and adaptations made. Results and Conclusions: Changes in scores on outcome measures were limited. However, findings from this exploratory study suggest that CFT can be meaningfully adapted for use within the field of learning disabilities. Implications for clinical practice and directions for future research are discussed. (Publisher abstract)
Patients with learning disabilities who lack capacity detained under the Mental Health Act in the UK: a case study
- Authors:
- SAWHNEY Indermeet, ZIA Asif, GATES Bob
- Journal article citation:
- British Journal of Learning Disabilities, 45(2), 2017, pp.138-141.
- Publisher:
- Wiley
Background: In the UK, the Mental Health Tribunal is a long-established safeguard for patients detained under the Mental Health Act. This gives such patients an effective appeal mechanism to ensure legal protection of their liberty. This act contains sections that allow for civil detention in the case of mental disorder. The right to apply to the tribunal against such detention is underpinned by the right to liberty under Article 5 of the European Convention of Human Rights (ECHR). Some patients with learning disabilities may lack capacity and the ability to challenge their detention. Method: This article presents a case study of a woman with Down's syndrome and severe learning disabilities. Whilst this woman was detained under the Mental Health Act, she could have applied for a review of her detention to the Mental Health Tribunal within 14 days. She did not do so because she lacked capacity to instruct solicitors. Subsequently, as a result of appeal, the case proceeded through English and European judicial review. Results: The European Court of Human Rights, in the case of MH v UK (2013), has ruled that the appeals procedure for patients without capacity detained under Section 2 of the Mental Health Act is not compatible with Article 5(4) of the European Convention of Human Rights. The European Court has ruled that special procedural safeguards are required to enable this cohort of patients to exercise their rights guaranteed by Article 5(4). Conclusions: Responsible clinicians [treating consultant psychiatrists] need to ensure that all patients detained under section 2 of the Mental Health Act have an assessment of their capacity to apply to the tribunal. There need to be systems in place to alert hospital managers when a patient lacks capacity to apply for a tribunal. Hospital managers should request the Secretary of State to apply for a tribunal in these instances. Knowledge of this ruling is relevant to informing the practice of other interdisciplinary healthcare professionals working with such patients. (Publisher abstract)
Rare instances of individuals with autism supporting or engaging in terrorism
- Authors:
- FACCINI Lino, ALLELY Clare Sarah
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 8(2), 2017,
- Publisher:
- Emerald
Purpose: The prevalence of individuals with an Autism Spectrum Disorder being associated with terroristic threats, lone wolf terrorism or affiliating with terroristic groups is rare. Design/methodology/approach: However, several cases are presented, where individuals with autism are involved in making a naïve, empty terroristic threat, or uttering serious serial terroristic threats. Other cases are also presented of individuals being at risk for an abduction or being used by a terrorist group, and finally committing an act of domestic lone wolf terrorism. Findings: Essential to the analysis was establishing a functional connection between autism-based deficits and the terroristic threats, terrorism, and when to not criminalize naïve, empty terroristic threats or acts. Originality/value: Currently, tools available to law enforcement and prosecutors exploit the vulnerabilities and liabilities which arise as a result of group interactions, a “preventive” approach to terrorism that is not applicable to the solitary, “lone wolf” terrorist (Barnes, 2012; Zierhoffer, 2014).There has been relatively little research (including case studies) examining individuals with ASD who engage in terrorism. For instance, when dealing with an individual with ASD who is charged with terrorism, it is crucial to consider how the diagnosis of autism may have presented as a contextual vulnerability, and to make sure that justice, rehabilitation and management, are informed by an understanding of the person’s diagnosis of ASD (Al-Attar, 2016). (Publisher abstract)
A family's battle to understand "challenging behaviour"
- Authors:
- JACK David, JACK Jill
- Journal article citation:
- Tizard Learning Disability Review, 22(2), 2017, pp.99-104.
- Publisher:
- Emerald
Purpose: This is about the authors’ son James’ life. The purpose of this paper is to share a story of misfortune and a battle to find answers in which the greatest enemy was ignorance. Such experiences are not uncommon. It is the authors hope that sharing this will make some small contribution to bringing about change. Design/methodology/approach: The authors discuss the experiences of care placements, and the battle to understand "challenging behaviour". Findings: Reflecting upon James’ experiences of the care system, it is clear that the system is fragmented and operates in silos that do not work together. Decision makers were all too often individuals not qualified to assess James’ needs and therefore implement appropriate solutions. The outcome was repeated failure which resulted in the view that he was a lost cause. Originality/value: Such cruelty as James has experienced should be recognised and banished forever. (Publisher abstract)
Inclusion of persons with disabilities in mainstream employment: is it really all about the money? A case study of four large companies in Norway and Sweden
- Authors:
- KUZNETSOVA Yuliya, YALCIN Betul
- Journal article citation:
- Disability and Society, 32(2), 2017, pp.233-253.
- Publisher:
- Taylor and Francis
This study investigates how large companies respond to public policy measures to ensure the inclusion of persons with disabilities in mainstream employment based on a case study of four companies in Norway and Sweden. The qualitative interviews, which were conducted with company managers, government representatives in Norway, and non-governmental organisations in Sweden, revealed three overarching themes: (1) ‘legitimacy’, (2) ‘financial interests’ and (3) ‘non-financial support’. The results indicate a more proactive response from the Swedish companies, especially regarding persons with intellectual and learning difficulties. The Norwegian companies reveal a high commitment to their own employees. These findings cannot be explained solely using neo-institutional theory, which holds that organisations demonstrate ‘conformity with powerful institutional myths to strengthen support and secure survival'. The results indicate that inclusive targeted corporate policies and programmes, advisory support, and the agency and value choices of the management might matter more. (Publisher abstract)
Researching unheard voices: parents caring for their adult children who have learning disabilities
- Author:
- LAWRENCE Julie
- Journal article citation:
- Social Work and Social Sciences Review, 19(3), 2017, pp.81-97.
- Publisher:
- Whiting and Birch
The intention of this article is to convey the importance of research with ‘hard to reach’ populations and utilise the outcomes from a qualitative (Doctor of Philosophy) study completed in 2017. Important issues, which involved both social workers located within an adults’ multi-disciplinary team (MDT) and parents who supported their (adult) children with learning disabilities, are discussed throughout. The White Paper Valuing People (Department of Health, 2001) is briefly discussed in relation to the impetus towards supporting parents and informal carers. Furthermore, the notion of health and social care integration and its progress is also highlighted, with a focus upon how progress (or not) has had an effect upon parents supporting an (adult) child with learning disabilities. Creative methods of parental engagement are revealed, which highlight the complexities of supporting a son or a daughter with learning disabilities. Stanfield’s (2000) Four-level Framework has been utilised as the basis for data generation and the analysis of the findings. The ‘lived experiences’ of parents who received statutory services are presented as five individual case studies, which discuss their sons’ and daughters’ support arrangements. The Mental Capacity Act, 2005 has been referred to in this article as the underpinning legislation which brought about changes for the parents and the circumstances of their children. Consequently, the parents discussed their changing relationships with social workers as a result of using this legislation. All the parents (n=5) illustrated the significance of social workers’ support and how their input had made a positive difference to their lives. The findings from this research study were shared with social workers and allied health professionals located within the learning disabilities service. The purpose was to present ‘new knowledge’ about the lives of parents receiving multi-disciplinary services. (Edited publisher abstract)
People with intellectual disabilities at the end of their lives: the case for specialist care?
- Authors:
- FORRESTER-JONES Rachel, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 30(6), 2017, pp.1138-1150.
- Publisher:
- Wiley
Background: People with intellectual disabilities have a shorter life expectancy, but healthcare improvements mean that they are beginning to live longer, with associated health difficulties. This means that there is an urgent need to focus research on ageing as well as end-of-life care. This study aimed to explore a specialist intellectual disability service for older people who are dying and how it related to their quality of life and to costs associated with care provided. Method: Data were collected for nine residents and 15 staff members of the specialist service. A single case study design with mixed methods including observations, interviews, standardised questionnaires and costs analysis was utilised. Results: The study found positive results regarding overall quality of life, although individuals had limited social networks. Placement fees paid by local health trusts and social services departments were slightly higher than the estimated cost of care reflecting good financial management by a small voluntary sector organisation. Conclusion: Whilst the philosophical arguments around “specialist” care persist, this service fills a gap in intellectual disability care provision. (Edited publisher abstract)
Housing with care and support: a snapshot of the sector and its challenges and opportunities
- Author:
- SKILLS FOR CARE
- Publisher:
- Skills for Care
- Publication year:
- 2017
- Pagination:
- 36
- Place of publication:
- Leeds
Using five in-depth case studies of housing with care and support providers, this paper explores the strategic and operational issues they face, the influence these have on their workforce and what they saw as the future challenges ahead. The five case studies focused on extra care housing for older people and supported living for people with learning disabilities. The services were set up using different delivery models, some splitting the landlord function from the housing support function and some separating the housing from the care function, with some keeping all three together. Issues discussed include: the structure of the service and its effect on learning and development, workforce planning; recruitment and retention; progression and career development; and partnership, integration and changing expectations of commissioners and their influence on the workforce. Common themes identified across the sites included: challenges in recruitment and retention; lone working as a factor in poor staff retention; and an increasing number of people with high levels of need living in extra care housing, placing the model at risk. Common gaps in learning included mental health, substance dependence, anti-social behaviour, challenging behaviour and preventing loneliness. (Edited publisher abstract)
Spina Bifida and Hydrocephalus: Our Heritage – the role of heritage exhibitions in tackling social isolation
- Author:
- LUPSON Marc
- Journal article citation:
- Tizard Learning Disability Review, 22(3), 2017, pp.117-131.
- Publisher:
- Emerald
Purpose: Using the “Spina Bifida and Hydrocephalus: Our Heritage” exhibition as a case study, the purpose of this paper is to look at how heritage exhibitions can be used to address social isolation and also serve as a way to give an identity to a community with a disability. Design/methodology/approach: The paper reviews the process of creating the exhibition, some of its most significant elements and its impact. Findings: A heritage exhibition can be an effective way to address social isolation and inclusion. Originality/value: This was a unique exhibition with considerable impact on members of the Spina Bifida and Hydrocephalus community and with the potential to have a broader value in promoting change in attitudes towards disability. (Publisher abstract)
Top tips for developing Personal Health Budgets for children and young people with complex needs
- Author:
- THINK LOCAL ACT PERSONAL
- Publisher:
- Think Local Act Personal
- Publication year:
- 2017
- Pagination:
- 10
- Place of publication:
- London
These top tips provide essential ‘building blocks’ for the successful development of Personal Health Budgets for children and young people. They are based on work undertaken by the National Development Team for Inclusion (NDTi) for Think Local Act Personal and NHS England with Plymouth, Hampshire and Derbyshire. The tips cover the areas of: leadership; understanding Personal Health Budgets as whole system change; understanding and gaining commitment from key players, such as health and social care professionals; placing families at the centre of the process; clarity around support planning; linking into wider service systems; developing staff skills, and developing the third sector and community capacity. It includes two case studies which highlight the benefits of having advisors with lived experience of Personal Health Budgets. (Edited publisher abstract)