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Frequency of use and characteristics of people with intellectual disabilities subject to physical interventions
- Authors:
- McGILL Peter, MURPHY Glynis, KELLY-PIKE Amanda
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.152-158.
- Publisher:
- Wiley
This study sought to clarify the frequency and circumstances of physical intervention (PI) use and gather data on the characteristics of individuals subject to PI. Data on individuals subject to PI were gathered by postal questionnaire completed by service providers from three samples: people who (i) had attended a PI conference and/or purchased a PI policy document; (ii) operated in a specific geographical area of England and (iii) operated specialist assessment and treatment settings for children/adults with intellectual disabilities throughout the UK. Frequent PI use was reported. Restraint was most commonly reported – monthly or more frequently with most individuals. Overall, those receiving PI were more likely to be young, male, not legally restricted and identified as having an autistic spectrum disorder than those who did not receive PI. The relatively frequent use of PI is consistent with routine rather than last resort use. Such use carries risk of physical and psychological damage. Service providers should systematically reduce the frequency of use of PI.
Keep Safe: the development of a manualised group CBT intervention for adolescents with ID who display harmful sexual behaviours
- Authors:
- MALOVIC Aida, ROSSITER Rowena, MURPHY Glynis
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 9(1), 2018, pp.49-58.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to focus on the development of Keep Safe, a manualised group intervention for adolescents with intellectual disabilities (ID) who display harmful sexual behaviour (HSB) as the initial phase of a feasibility study. National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. Aims included taking account of adolescents’ and families’ needs, motivations and practical commitments, integrating best- practice and being accessible and appropriate across different types of services. Design/methodology/approach: Keep Safe development progressed from the practitioner/researcher collaborative young sex offender treatment services collaborative-ID through a project team, Keep Safe development group, comprising a range of practitioners with a variety of clinical expertise across services and an Advisory Group of people with ID. An expert-consensus methodology based on the Delphi method was used. The iterative process for the manual draws on the slim practice-based evidence from UK, New Zealand, North America and Australia. Findings: Keep Safe comprises six modules distributed through 36 term-time young people’s sessions, alongside 16 concurrent parental/ carer sessions (some joint). The main focus of Keep Safe is to enhance well-being and reduce harm. Four initial sites volunteered as feasibility leads, and two more were added as recruitment was more difficult than foreseen. Originality/value: National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. This study is innovative and valuable given the recognition that research and practice is significantly lacking in this area.
The chronicity of self-injurious behaviour: a long-term follow-up of a total population study
- Authors:
- TAYLOR Lorne, OLIVER Chris, MURPHY Glynis
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 24(2), March 2011, pp.105-117.
- Publisher:
- Wiley
Self-injury is common for people with intellectual disabilities, and is associated with various risk identifiers, such as degree of disability, sensory impairments, and autism. This study investigated the quality of life and changes in behaviour for a cohort of 49 people with intellectual disabilities and self-injurious behaviour (SIB) who were all part of a previous total population study conducted in the south of England. Findings revealed that 84% of the sample continued to self-injure nearly 20 years on, with no significant mean changes in severity. More people were receiving psychological treatment; more were also receiving anti-convulsant and anti-psychotic medications, though polypharmacy had reduced. The number of people accessing full-time day activities had decreased, with 44% of people only accessing structured daily activities for 2.5 days per week or less. The authors concluded that this study added to the growing evidence of extreme chronicity for SIB and the relative lack of impact of treatment for people in whom SIB was well-established. In ending, they highlight the importance of early intervention to help eliminate SIB.
Challenging behavior: a barrier to inclusion?
- Author:
- MURPHY Glynis
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 6(2), June 2009, pp.89-90.
- Publisher:
- Wiley
Arguably, the most important outcome measure for services to people with intellectual disabilities is quality of life. Quality of life has been defined in numerous ways and may consist of many aspects, including physical, material, and emotional well-being, as well as interpersonal relationships, personal development, self-determination, social inclusion, and civic rights. However, the most important aspect is social inclusion. People with intellectual disabilities who show challenging behaviour, however, often make other people uncomfortable so that social inclusion is more difficult, and evidence suggests that both children and adults with intellectual disabilities and challenging behaviour (and their families) have poorer quality of life and more restrictions in their lives than others with intellectual disabilities. Examination of the psychosocial aspects of quality of life indicates that modern services are still not good at providing people with challenging behaviour with opportunities for making relationships, employment, and social inclusion. We need to improve our ability to target these areas of quality of life, particularly social inclusion for people with challenging behaviour.
Physical interventions with people with intellectual disabilities: staff training and policy frameworks
- Authors:
- MURPHY Glynis, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 16(2), June 2003, pp.115-125.
- Publisher:
- Wiley
Physical intervention or restraint with people who have intellectual disabilities is sometimes necessary, even though it is known to present dangers to both staff and service users (some service users have died as a result of restraint). This study aims to investigate the extent to which staff in intellectual disability services were trained in the use of physical interventions or restraint. Their views of a recent policy framework on physical interventions were also sought. There were three groups of participants: (i) group 1 included staff who had attended conferences on the Policy Framework (the conference sample); (ii) group 2 included staff from two geographical areas (the geographical sample); (iii) group 3 included staff in specialist assessment and treatment services (the SpAT sample). All participants were sent a questionnaire asking them about their training in (and use of) physical intervention methods and their opinions on the policy document. There were at least 12 different types of training recorded, including a number of varieties of Control and Restraint (C&R). By no means did all the senior staff did have training in physical intervention methods. The degree of training varied with the sample and the type of training varied with the employing organization. Most participants in group 1 were very positive about the BILD & NAS Policy Framework but few staff in groups 2 and 3 had read the document. About two-thirds of the participants said their services had (or were developing) a written policy on physical interventions. There remained a clear need for further training in physical interventions and evidence on which the effectiveness of different methods of physical interventions could be judged.
Physical interventions for people with intellectual disabilities: initial survey of training and evaluation of a policy framework
- Authors:
- MURPHY Glynis, KELLY-PIKE Amanda, McGILL Peter
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 14(4), 2001, pp.401-411.
- Publisher:
- Wiley
This article concerns an initial study of training in physical interventions amongst a group of senior staff and their views on a recent policy framework on physical interventions developed by the British Institute of Learning Disabilities (BILD) and National Autistic Society (NAS). All participants were sent a questionnaire asking them about their training in, and use of, physical intervention methods, and their opinions on the policy document. The participants came from a variety of services and were relatively well qualified and senior because of the way the sample was derived. Most participants were very positive about the BILD and NAS policy framework, and about two-thirds of the participants said that their services had, or were developing, a written policy on physical interventions. This group of staff, many of whom were trained in physical interventions, rated the BILD and NAS policy framework as very helpful. There remained a clear need for guidance with respect to the advantages and disadvantages of the many available methods, and an evidence base on which to judge the effectiveness of different methods of physical interventions.
Self-injurious behaviour: what do we know and where are we going
- Author:
- MURPHY Glynis
- Journal article citation:
- Tizard Learning Disability Review, 4(1), January 1999, pp.5-12.
- Publisher:
- Emerald
Self-injurious behaviour can become an intransigent difficulty, reduce people's quality of life and lead to hospital admissions or other restrictive outcomes. Over the last 15 years there have been some important developments in the treatment of severe self-injury, but the evidence is that these are making little impact on most people's lives. The reasons why this might be are discussed, and it is proposed that it is time for a radical new approach to interventions for self-injurious behaviour.
Understanding and responding to challenging behaviour: from theory to practice
- Authors:
- McGILL Peter, CLARE Isabel, MURPHY Glynis
- Journal article citation:
- Tizard Learning Disability Review, 1(1), January 1996, pp.9-17.
- Publisher:
- Emerald
While the concept of 'challenging behaviour' is socially defined, it often involves persistent behaviour with serious physical and social consequences for the person and others. Challenging behaviour is relatively common amongst people with learning disabilities and often dealt with poorly. Models for understanding such behaviour have developed over time and can now provide a relatively sophisticated account. Such models are of immense use in understanding the behaviour of individuals and have clear implications for the development of individualised interventions. They also have implications for the design and organisation of services which will more competently support people with challenging behaviour and, as far as possible, prevent its emergence in those at risk.