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Thinking on your feet: understanding the immediate responses of staff to adults who challenge intellectual disability services
- Authors:
- RAVOUX Peggy, BAKER Peter, BROWN Hilary
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(3), May 2012, pp.189-202.
- Publisher:
- Wiley
Previous research suggests that there is a significant gap between the conceptualisation of good practice in challenging behaviour management strategies and current practice in intellectual disability services in the UK. This study investigated staff members’ perspectives of managing clients with challenging behaviours. Semi-structured interviews were conducted with eleven staff (ranging from managers to support workers) in two residential services in the independent sector. Both provided 24 hour support to four individuals. One service used a specific training package referred to as Non-Abusive Psychological and Physical interventions, the other used a positive behaviour support framework to inform their behavioural management policy. Service documents on challenging behaviour management were also examined. Analysis of the responses focussed on staff members’ immediate responses to clients’ difficult behaviours and their decision-making processes. The immediate responses of staff were the result of complex appraisals shaped by their service context involving the core processes of making the right choice and prioritising the best interests of all involved. The authors conclude that staff members’ responses can be understood as a dynamic and retroactive process, where their past and current challenging behaviour management influence their responses to clients in the future.
Commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review”
- Author:
- BROWN Hilary
- Journal article citation:
- Tizard Learning Disability Review, 19(1), 2014, pp.25-28.
- Publisher:
- Emerald
Purpose: This paper is a commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review” by Chris James and James Stacey. The purpose of this paper is to illustrate the thesis that standardised ways of evaluating health care interventions may have the inadvertent effect of undermining the case that people with intellectual disabilities should be offered the same opportunities to address their emotional and mental health difficulties as other citizens. Design/methodology/approach: The commentary argues that while the evidence base focuses on the outcomes of orthodox one-to-one interventions, sometimes broader “contextual reformulation” and systemic interventions are called for. However, family- or service-based interventions tend not to feature in studies. Findings: The commentary illustrates these issues by discussing two case studies, which demonstrate how relational issues tend to be unhelpfully focused on the person with intellectual disabilities to the detriment of family members or direct care staff, who may be struggling to make sense of the person's behaviour or distress. Originality/value: The commentary supports the argument put forward in the longer paper and also argues for mental health services to be offered on a non-discriminatory basis to people with intellectual disabilities and to their family members. But it also suggests that one of the additional impacts of service level psychotherapeutic interventions is to re-establish respect for the work of direct care staff whose work is often presented as if it is little more than domestic drudgery when in fact it involves negotiating and responding to people and their issues with great sensitivity and balance. (Publisher abstract)
A practical guide to working with people with learning disabilities: a handbook for care assistants and support workers
- Editors:
- BROWN Hilary, BENSON Sue
- Publisher:
- Hawker/Care Concern
- Publication year:
- 1992
- Pagination:
- 176p.,list of orgs.
- Place of publication:
- London
Practical text that includes chapters on: how services have changed; the caring relationship; individual planning; effective communication; sight and hearing; challenging behaviour; sharing the tasks of daily living; teaching new skills; day services; employment; leisure and recreation; meeting the needs of black people; mealtimes and personal care; sexuality; movement and lifting; health and medical care; rights, advocacy and support; how the home is managed; emergencies; and career planning.
A practical guide to working with people with learning disabilities: a handbook for care assistants and support workers
- Editors:
- BROWN Hilary, BENSON Sue
- Publisher:
- Hawker/Care Concern
- Publication year:
- 1995
- Pagination:
- 176p.
- Place of publication:
- London
Practical text for people working with people with learning difficulties. Looks at all aspects of the work, including: how services have changed; coming into care; the caring relationship; individual planning; effective communication; sight and hearing; challenging behaviour; teaching new skills; day care; finding and keeping a job; leisure and recreation; meeting the needs of black people; mealtimes and personal care; sexuality; health care; medical matters; rights, advocacy and support; how the home is managed; managing an emergency; and career planning.