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A preliminary model of forensic practitioner resilience within a learning disabilities service
- Authors:
- HARVEY Joel, QUINN Brian
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 3(3), 2012, pp.158-169.
- Publisher:
- Emerald
This study set out to develop a conceptual model of working within a forensic learning disability service. It starts from the perspective of staff and aims to articulate what staff need in order to manage the complex challenges of their work effectively and to meet the needs of service users. Semi-structured interviews were conducted with a purposive sample of 10 staff working as part of the multi-disciplinary team in order to obtain a broad range of professional background and experience. Staff included a psychiatrist, occupational therapist, speech and language therapist, 3 forensic nurses and a unit manager. Staff identified a number of complexities in their role including: the presentation of the client group; risk assessment and management; multi-agency working; and the emotional complexity of the work. A preliminary model of resilience was developed which set out factors that would help staff manage these complexities and work towards meeting the needs of service users. The model includes individual, proximal and wider systemic factors. It is argued that building relationships and establishing trust with service users, staff, and wider agencies is the bedrock of forensic practitioner resilience. Moreover, an integrative model of multi-disciplinary team working helps facilitate trust between staff.
Capacity to choose and refuse? A case study
- Authors:
- GUTHRIE Susan, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(6), 2012, pp.293-300.
- Publisher:
- Emerald
This case study reflects on the risk assessment, treatment, and care issues for a man in his late thirties with a learning disability, mental illness and a degenerative neurological condition who was under Section by the Mental Health Act. It focuses on the distinctive roles and perspectives of the members of the multidisciplinary team supporting him. The management of risk for this man was particularly complex due to his self-harming and impulsivity. The article focuses on issues around referral to speech and language assessment for dysphagia and management advice. Each specialist clinician (nurse, speech and language therapist, psychiatrist) reflects on their role as a member of a team. The perspective of the man himself is represented, although he was unable to give a consistent descriptive self report. For people with mental illness and intellectual disability the capacity to understand and retain information about their condition may be limited and variable. The authors discuss the multiple ethical issues in attempting to preserve a modified autonomy and in decision making around best interests. They look at the particular challenges encountered when supporting someone with dysphagia if the person is unable to understand and refuses to comply with guidelines outlining restrictions to mealtime choices.