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Do persons with intellectual disability and limited verbal capacities respond to trauma treatment?
- Authors:
- MEVISSEN Lisebeth, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 36(4), December 2011, pp.278-283.
- Publisher:
- Taylor and Francis
People with intellectual disability have been found to be more likely to experience traumatic events and negative life events. This study aimed to examine whether eye movement desensitisation and reprocessing (an eight-phase psychotherapeutic approach) would be an applicable and effective treatment method for clients with substantial limited verbal capacities. It focused on 2 clients with moderate intellectual disabilities, serious behavioural problems, and histories of negative life events. The article provides a description of the 2 clients and a summary of the results of their treatment. In both cases, post-traumatic stress disorder-like symptoms decreased and gains were maintained at follow-up. The authors conclude the study suggests that eye movement desensitisation and reprocessing is a potentially applicable psychotherapeutic treatment method for clients with intellectual disabilities, even if they have substantially limited verbal capacities. They note that the findings highlight the need for further research.
Substance misuse among offenders in a forensic intellectual disability service
- Authors:
- PLANT Amie, et al
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(3), 2011, pp.127-135.
- Publisher:
- Emerald
To date, there are few studies investigating the links between substance abuse and offending behaviour among those with intellectual disabilities. This study examined the prevalence of alcohol and substance misuse in patients within a forensic intellectual disability service in England and the effect of a Drug and Alcohol Awareness Course. Seventy four patients participated. Results revealed that about half of the patients had use or dependence with the problem being equal in men and women. Whilst alcohol and cannabis were the commonest drugs of abuse, cocaine, stimulants and opiates were abused by a small but significant number. Of the substance misusers, 35% had used the drug in the immediate lead up to their offence. A diagnosis of personality disorder and past history of convictions for violent offences was significantly more likely to be present in this group. The authors concluded that the prevalence of substance misuse makes it an important risk factor that could determine treatment outcomes. Disability units need substance abuse treatment programmes that can be formally evaluated. Implications for service planning are discussed.
A preliminary investigation of the utility of the "Behavior Support Plan Quality Evaluation Guide II" for use in Australia
- Authors:
- WEBBER Lynne S., et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 36(4), December 2011, pp.273-277.
- Publisher:
- Taylor and Francis
In Victoria, Australia, the Disability Act 2006 specifies that all people receiving a government-funded disability service and who are subject to a restrictive intervention (such as a chemical or mechanical restraint) must have a behaviour support plan. The quality of behaviour support plans can be an important influence on the quality of the support provided to people with disability who show challenging behaviours. The Behavior Support Plan Quality Evaluation Guide II has been used to assess behaviour support plans to support children in schools in the United States. This study examined its usefulness for assessing behaviour support plans designed for adults with an intellectual disability in community support services in Australia. The researchers surveyed experienced practitioners about the relevance of the evaluation guide components, and an audit was conducted of randomly selected behaviour support plans submitted as a statutory requirement. The findings showed evidence of acceptable validity and reliability, and evidence of the need for substantial improvement in the quality of behaviour support plans. The authors conclude that the findings support the utility of the Behavior Support Plan Quality Evaluation Guide II to inform and evaluate service planning in supporting adults with intellectual disability who show challenging behaviour.
A quality framework for personalised residential supports for adults with developmental disabilities
- Authors:
- COCKS E., BOADEN R.
- Journal article citation:
- Journal of Intellectual Disability Research, 55(8), August 2011, pp.720-731.
- Publisher:
- Wiley
The purpose of this study, the Personalised Residential Supports (PRS) Project, was to examine the nature, purposes and outcomes of residential supports that are developed around the needs and preferences of individual adults with developmental disabilities and their families. It considered the perspectives of all key stakeholders including service providers. PRS as conceived initially as having four key criteria in the support arrangements, a high degree of: individualisation; individual/family influence; informal relationships; and person-centredness. Four methods were used to develop a descriptive framework for PRS: a review of empirical and descriptive literature; 2-year case studies of six adults from Western Australia whose living arrangements met the initial PRS criteria; a focus group of adults with developmental disabilities; and a series of written surveys of 18 ‘experts’ including family members, service providers and policymakers. Qualitative analysis resulted in a PRS quality framework made up of nine themes containing 28 attributes. The nine themes were named as: Assumptions, Leadership, My Home, One Person at a Time, Planning, Control, Support, Thriving and Social Inclusion. The research is continuing to develop the framework so that it can be used in the evaluation of existing or planned residential support arrangements.
If the support's right, she's right: an evaluation of Partners for Inclusion
- Author:
- MACINTYRE Gillian
- Publisher:
- Scottish Consortium for Learning Disability
- Publication year:
- 2011
- Pagination:
- 58p., bibliog.
- Place of publication:
- Glasgow
Partners for Inclusion is a voluntary organisation that provides support for adults with learning disabilities and mental health problems. It has adopted a person-centred approach to supporting people with ‘high’ or ‘complex’ support needs in order to provide services based on individual needs, wants and desires. This report presents the findings of an evaluation aiming to measure the progress made in the 4 years since the service was last evaluated. Specifically, it aimed to address: whether people are living the life they choose; whether people are living in the place that makes sense for them now; in what ways people’s lives have changed since receiving a service from Partners for Inclusion; and the experiences of staff who work for Partners for Inclusion. The research included a total of 50 interviews with individuals who receive services, support staff, family members, friends, and other professionals. The findings show that, for some people, lives have changed in significant ways since receiving support from Partners for Inclusion. However, further work is needed in areas of social inclusion, such as participating in education and employment. In common with other person-centred organisations, the staff often experience lone working with a resultant reduction in collegial support. A number of recommendations are provided in the areas of: personalisation; creating opportunities; and organisational capacity.
Development and evaluation of a staff training program on palliative care for persons with intellectual and developmental disabilities
- Authors:
- HAHN Joan E., CADOGAN Mary P.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(1), March 2011, pp.42-52.
- Publisher:
- Wiley
Among the barriers and disparities that people with intellectual and developmental disabilities face at the end of life are limited educational opportunities and a lack of targeted training materials on palliative care for staff who provide their day-to-day care. This article reports on a project undertaken to develop, implement and evaluate a palliative care curriculum and educational programme to meet the particular learning needs of staff providing services and supports for individuals with intellectual and developmental disabilities living in long-term care settings. The programme was designed for staff providing palliative care in 5 developmental centres and 2 community facilities in California. The article describes the curriculum development, implementation, and evaluation to determine satisfaction with and effectiveness of the training programme at the end of the training course and at a 2 year follow-up. The authors report that participants' ratings of their levels of preparation and confidence to provide palliative care improved from pre-training to post-training, and that post-training practice changes in palliative care occurred. They conclude that the need for the development of a set of training materials for staff specific to palliative care for people with lifelong disabilities was confirmed in the study.
Collaborative psychosocial case formulation development workshops: a case study with direct care staff
- Author:
- INGHAM Barry
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(2), March 2011, pp.9-15.
- Publisher:
- Emerald
Psychosocial approaches are recommended as a way of supporting people with intellectual disabilities who display significant challenging behaviour or experience severe mental health difficulties. This paper outlines and examines a workshop approach with direct care staff supporting people with intellectual disabilities who display significant psychosocial difficulties. The workshops use a psychosocial framework in order to facilitate development of a case formulation by care staff and lead to changes in staff perception and management of the difficulties displayed by the individual. This study provides a pilot evaluation of these novel collaborative psychosocial formulation development workshops. A series of workshops were designed and delivered to 7 staff members supporting an individual who had been referred to specialist intellectual disabilities health services. The workshops were completed and a formulation was collaboratively developed and produced. Following the workshops, there were decreases in problematic behaviours displayed by the individual and in the staff team's perception of the severity of these behaviours. The staff team felt that the workshops had had a beneficial impact on their practice. The paper concludes that the workshops are feasible, positively received and associated with changes in the psychosocial difficulties displayed by individuals with intellectual disabilities.
Evaluation of treatment outcomes from a medium secure unit for people with intellectual disability
- Authors:
- ALEXANDER Regi T., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(1), January 2011, pp.22-32.
- Publisher:
- Emerald
Short-term treatment outcomes were evaluated in 138 individuals (109 male) admitted over a six-year period to a 64-bedded medium secure inpatient service for offenders with mild intellectual disabilities. The aim was to audit successful treatment outcome, defined by a move to a lower level of therapeutic security, and to establish the length of hospital stay and the socio-demographic, clinical and forensic variables associated with it. Seventy seven discharged and 61 current in-patients, were included. The median length of stay for the discharged group was 2.8 years, with 75% staying for less than 5 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. Of the 61 inpatients, 36 were considered ‘difficult to discharge long stay’ patients. However, a third of this group had moved to low secure rehabilitation settings within the service. The ‘difficult to discharge’ group had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not found to be predictive of length of stay. The author concludes that clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay. There is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables.
Psychometric comparison of the functional assessment instruments QABF, FACT and FAST for self-injurious, stereotypic and aggressive/destructive behaviour
- Authors:
- ZAJA Rebecca H., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 24(1), January 2011, pp.18-28.
- Publisher:
- Wiley
This study examined and compared the psychometric properties of three functional assessment rating scales. The scales were: The Questions about Behavioural Function (QABF); the Functional Assessment for Multiple Causality (FACT); and the Functional Analysis Screening Tool (FAST). The scales were compared for three target behaviour types: self-injurious behaviour (SIB); stereotypic behaviour; and aggressive/destructive behaviour. Each scale was administered twice by two raters to 130 adults with intellectual disability. Findings indicated that the reliability of the FACT and the QABF for estimates across all three behaviours was acceptable to good. The FAST had generally poorer reliability scores. In examination of the differences and similarities between the three instruments, it appeared that reliability and validity on the FAST were hindered by limited response format and restricted range of subscales.
Shared Care Scotland inspiring breaks programme
- Author:
- SHARED CARE SCOTLAND
- Publisher:
- Shared Care Scotland
- Publication year:
- 2011
- Pagination:
- 15p.
- Place of publication:
- Dunfermline
Shared Care Scotland embarked on a Scotland-wide programme of local Inspiring Breaks workshops to help individuals with support needs and unpaid carers to be more actively involved in shaping the short break and respite care services they receive. One goal of the workshops was to provide service users and carers with the information, skills and confidence they need to work with health and social care to determine the short break support they want. The workshops were delivered with the involvement of Peer Facilitators who were themselves living with a long term condition, or caring for someone with one. Nineteen workshops were delivered to a total of 240 people between October 2010 and June 2011, including one workshop specifically for carers of people with mental health problems and one for young carers. This report describes the process of delivering the Inspiring Breaks programme, learning from the programme, feedback from both participants and peer-facilitators, and ideas for the future. The feedback from participants and peer-facilitators demonstrates that the workshops were on the whole a valuable experience for those involved. Involving local authorities in the programme has encouraged them to think more broadly about how they can open up more flexible short break opportunities. Future plans, building on the findings of these workshops, are discussed.