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Management of aggression care plans in a forensic intellectual disability service: a ten-year progress update
- Authors:
- KITCHEN David, THOMAS Cathy, CHESTER Verity
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(2), 2014, pp.88-96.
- Publisher:
- Emerald
Purpose: Standardised approaches to the management of aggression and violence are critical for all stakeholders of intellectual disability services. The purpose of this paper is to describe the Management of Aggression Care Plan (MoACP). The care plan aims to reduce levels of restrictive interventions, to ensure any interventions relative to aggression and violence are the least restrictive possible, and to promote adaptive behaviours and support life enriching opportunities, in a manner which is personalised to the unique profiles of every patient. Design/methodology/approach: The MoACP was first described by Thomas et al. (2005). This paper describes the rationale, theoretical basis, structure and benefits of the care plan, and provides details of revisions made to the plan in response to evidence-based practice recommendations. Findings: The value of implementing a structured approach to the care planning of management of aggression and violence, in reducing the frequency and impact of restrictive practices, and promoting life enriching opportunities is described. Practical implications: The paper describes a number of practical features of the care plan which most support its continued effectiveness, including patient involvement, individual patient focused training, and audit. Originality/value: Although many services undertake localised approaches to the care planning of management of violence and aggression in forensic intellectual disability services, few have been described in the published literature. (Publisher abstract)
The prevention of offending behaviour by people with intellectual disabilities: a case for specialist childhood and adolescent early intervention
- Authors:
- CHESTER Verity, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 13(5), 2019, pp.216-227.
- Publisher:
- Emerald
Purpose: Elucidating where antisocial or violent behaviour arises within the life course of individuals with intellectual disability (ID) could improve outcomes within this population, through informing services and interventions which prevent behaviours reaching a forensic threshold. The paper aims to discuss this issue. Design/methodology/approach: The Historical Clinical Risk Management-20, Version 3 assessments of a cohort of 84 inpatients within a forensic ID service were analysed for this study, with a particular emphasis on items concerned with the age at which antisocial or violence first emerged. Findings: For most participants, violent or antisocial behaviour was first observed in childhood or adolescence. The study also highlighted a smaller subgroup, whose problems with violence or antisocial behaviour were first observed in adulthood. Originality/value: The study findings suggest that targeted services in childhood and adolescence may have a role in reducing the offending behaviour and forensic involvement of people with ID. This has implications for the service models provided for children and adolescents with ID with challenging or offending behaviour. (Edited publisher abstract)
An audit of a smoking cessation programme for people with an intellectual disability resident in a forensic unit
- Authors:
- CHESTER Verity, GREEN Fatima N., ALEXANDER Regi T.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(1), January 2011, pp.33-41.
- Publisher:
- Emerald
This article first briefly reviews the literature on smoking and smoking cessation programmes for people with intellectual disability. A smoking cessation programme in place in a forensic in-patient service for people with intellectual disabilities in the East of England is then described together with the findings of an audit to establish the prevalence and significant associations of smoking in this group and the effect of the intervention. The intervention focused on health education and nicotine replacement therapies. The audit included 79 patients, 48 of whom were smokers on admission. Fifteen subjects gave up smoking while resident in the service. Those who did not give up significantly reduced the number of cigarettes they smoked per day. Female smokers appeared less likely to give up than men. Length of stay and treatment with antipsychotic medication were not significantly linked to smoking behaviour. There was a significant relationship between the level of security in which a patient was resident and smoking. Patients treated on medium secure wards were significantly more likely to be smokers than those in lower levels of security. The authors conclude that this simple smoking cessation programme appeared to be effective in cutting down smoking rates and tobacco consumption in this population. They comment that the findings need to be viewed with caution as the audit was limited by the lack of a control group and conducted in a single service.