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- Author:
- PENWARDEN Adam
- Journal article citation:
- Learning Disability Today, April 2011, pp.20-21.
- Publisher:
- Pavilion
- Place of publication:
- Hove
A brief overview of the aims of SPOT, a support planning outcomes tool, being developed by Turning Point to measure outcomes in learning disability services is provided. The tool is designed to help staff ensure that a service user's needs, wishes and goals and progress can be documented and evidence from the beginning.
An open trial of psychodynamic psychotherapy for people with mild-moderate intellectual disabilities with waiting list and follow up control
- Authors:
- SKELLY Allan, McGEEHAN Caoimhe, USHER Robert
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(5-6), 2018, pp.153-162.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the outcome of psychodynamic psychotherapy for people with intellectual disabilities (ID), which has a limited but supportive evidence base. Design/methodology/approach: The study is a systematic open trial of flexible-length psychodynamic therapy offered in an urban community to 30 people with mild and moderate ID, presenting with significant emotional distress on the Psychological Therapies Outcome Scale for people with intellectual disabilities (PTOS-ID). Allocation to therapy was made according to an established stepped care approach according to need, and the mean number of sessions was 22.03 (range 7–47). Treatment fidelity was checked via notes review and cases excluded from analysis where there were other significant psychological interventions. Findings: On both self-report (PTOS-ID) and independent ratings (Health of the Nation Outcome Scales-Learning Disability (HoNOS-LD)) recipients of therapy: did not improve while waiting for therapy; improved significantly during therapy, with large pre–post effect sizes; and retained improvements at six-month follow-up. Research limitations/implications: While it is important to conduct further controlled trials, the findings provide support for previous studies. High rates of abuse and neglect were found in the sample, suggesting that more trauma-informed and relational approaches should be explored for this client group. Originality/value: No other study of this size has been completed which used dedicated standardised outcome measures, with this therapy type, with both waiting list and follow-up control and with account of model fidelity. (Publisher abstract)
Rapid risk assessment in acute hospital for patients with intellectual disabilities
- Authors:
- READ Stevie, JOHNSON Tristan
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(6), 2012, pp.321-322.
- Publisher:
- Emerald
People with intellectual disabilities have been shown to be at significantly higher risk, compared to the rest of the population, for adverse events happening to them in hospital. The authors share the outcomes from a patient safety project conducted in an acute hospital in England by the Trust's intellectual disabilities team. A project structure was used, supported by the Trust patient safety team through association with the National Institute for Innovation and Improvement: leading improvement in patient safety (LIPS) programme. The aim of the project was to bring together the current evidence, to understand the risk issues for this group and develop a robust risk assessment tool that could be embedded into the care processes in acute hospitals. A six month pilot concluded that a short assessment in a familiar format was more likely to be used by nurses. Risk assessment on its own did not deliver better and safer care. It must be accompanied by a series of clear, evidence based actions which used together ensure the patients' total safety and care needs are met. This tool is used throughout the Trust and in a number of other hospitals across the eastern region. Its use has contributed to reducing length of stay and improving health outcomes.
Managing sexually harmful behaviour in a residential special school
- Authors:
- PRITCHARD Duncan, et al
- Journal article citation:
- British Journal of Learning Disabilities, 40(4), December 2012, pp.302-309.
- Publisher:
- Wiley
Children and young people who present sexually harmful behaviour are marginalised and do not always participate in community activities. This is especially true for those with learning disabilities. This case study describes a multi-component intervention in Wales that successfully reduced the sexually harmful behaviour of a 16-year-old boy with a mild learning disability. The intervention was comprised of cognitive behaviour therapy, Social Stories™ and a behavioural programme that reinforced appropriate behaviour with social praise and access to preferred items and a range of community activities. Following the intervention, the study participant was able to join in a wide range of supervised community activities.
“Shared Pathway” national pilot project: the experience of a secure learning disability service
- Authors:
- ESAN Fola, et al
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 3(2), 2012, pp.98-110.
- Publisher:
- Emerald
The cost of secure care has been increasing over the past few years. Despite the increased spending on secure services, there continues to be difficulties relating to patient progression through the care pathway to safe integration in the community. The Shared Pathway project was developed by the North of England Specialist Commissioning Group, Yorkshire and Humber Office in partnership with service users, clinicians and commissioners. The aims of the Shared Pathway are to: reduce costs within secure services without reducing quality; meet individual need; and demonstrate efficiency. The purpose of this paper is to describe the experience of a secure learning disability service in participating in the national Shared Pathway pilot project in secure services. It explores some background drivers to the project as well as the experience of service users and staff. Recommendations on service-wide implementation of the Shared Pathway are made. The findings show that the implementation of the Shared Pathway will lead to considerable changes in practice. It may be useful in ensuring evidence based outcomes are routinely used by clinicians in secure services in collaboration with patients. It may also clarify to patients what their role is in engaging in treatment that helps them in moving through secure services.
Families and personalisation project: key learning outcomes summary for families, local authorities and support providers
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2012
- Pagination:
- 9p.
- Place of publication:
- Bath
The Better Lives programme was set up in response to concern about how families of people with learning disabilities were, or more commonly were not, becoming involved in and benefiting from the personalisation process. Specifically, the aim was to understand how to engage, inform and support families to achieve real personal outcomes beyond just a personal budget. The programme involved working with groups of families in 3 locations (Suffolk, Calderdale and Wolverhampton) over a period of 18 months. Despite each of the local authorities having people or departments responsible for engaging with and informing families, very few families who took part in the programme had previously been aware of the personalisation agenda and those few knew very little. The programme involved a variety of methods which included information sharing, planning, engaging with statutory services, and delivering real outcomes for the participating families. This document summarises the suggested learning outcomes from the programme for: working with families; local authorities; and support providers.
CREATE: summary of outcomes and benefits of an innovative therapeutic conservation programme
- Authors:
- SOUTHERN Hazel, et al
- Journal article citation:
- Journal of Care Services Management, 3(2), January 2009, pp.176-188.
- Publisher:
- Taylor and Francis
This paper describes the process by which Castlebeck - which provides specialist services with learning disabilities - began to look at ways of incorporating corporate social responsibility into the business in a meaningful way. The aim of the project CREATE was to provided the opportunity to create a new form of active community-based therapy for patients/residents, and improve staff satisfaction and engagement. Outcomes measures demonstrate a number of significant positive findings: a) statistically significant improvements in service users' self-esteem, social networks, physical health and skill development; b) staff involved have had reduced levels of sickness, increased levels of job satisfaction, increased skill development and improved attitudes; c) the local community has benefited from increased site visitor numbers, more positive community attitudes towards learning disabilities and increased biodiversity environmentally; d) positive awareness of Castlebeck has been increased locally and with key stakeholders.
The Ealing Intensive Therapeutic and Short Breaks Service: an update five years on
- Authors:
- DILKS-HOPPER Heather, et al
- Journal article citation:
- Tizard Learning Disability Review, 24(2), 2019, pp.56-63.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present an update on the Ealing Intensive Therapeutic and Short Breaks Service (ITSBS). Design/methodology/approach: The challenges the service has faced are reviewed, including the service’s response to those challenges. Also provided is a more detailed analysis of the outcomes of the service. Findings: The ITSBS continues to succeed in supporting young people with intellectual disabilities and challenging behaviour to stay at home with their families. Originality/value: Despite considerable challenges and adaptations to the model, the ITSBS is still achieving successful outcomes for vulnerable young people and is considered nationally to be a best-practice model. Few prior articles have provided an account of how innovative service models are maintained and evolve over time. (Edited publisher abstract)
Case study illustrations of a psychological treatment pathway in a secure intellectual disability service
- Authors:
- HICKMAN Gareth, THRIFT Su, TAYLOR Chenelle
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 9(2), 2018, pp.102-114.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to describe in detail the treatment pathway utilised in a male medium and low secure intellectual disability (ID) service. Over the preceding five years, service users have followed the outlined treatment pathway. The current paper offers case study material to illustrate the care pathway. Design/methodology/approach: The treatment pathway is described and two case examples are provided, illustrating participation in the pathway. Evaluative data are provided on length of hospitalisation, direction of pathway at discharge and risk reduction as assessed by the HCR-20, SVR-20 and HONOS Secure measures. Findings: The case examples provided document the assessment and treatment of two male offenders with ID, outlining their treatment pathways, subsequent reductions in assessed risk and their successful community discharge. Originality/value: A comprehensive treatment pathway is outlined together with the theoretical rationale, with illustrative case examples. (Edited publisher abstract)
Getting unstuck along the clinical pathway: an integrated multi-agency approach
- Authors:
- RICHARDS Luci, UCHENDU Nwamaka, O'HARA Jean
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(3), 2014, pp.192-196.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to highlight how the management of an adult with intellectual disabilities and complex medical conditions by a multi-disciplinary and multi-agency team approach across a clinical pathway (primary, secondary and tertiary care, health, social and third sector agencies) can be used to improve the person's physical and mental health outcome. Design/methodology/approach: Literature review and case report in which the paper describes the presentation of the patient with multiple complex physical health conditions, mild intellectual disability and challenging behaviour and description of the management process and the observed outcome. Findings: The patient required input from the multi-disciplinary community intellectual disabilities team and multi-agency team including social services and community support team, admission to a specialist intellectual disabilities ward to optimise her management. She improved relatively well and was discharged to the community. On discharge she continued to receive ongoing psychiatric, psychological and community psychiatric nurse input and maintains the sustained improvement in her mental health. She no longer displays risky or challenging behaviour, her mood has improved and there is no self-harm ideation. She remains anxious at times, however, her symptoms are much improved and do not affect her daily functioning. Originality/value: This case highlights the profound and enduring psychiatric and behavioural sequelae following brain malignancy and treatment and how essential a multi-disciplinary and multi-agency approach is in the successful management of complex issues. Her symptoms appeared relatively treatment resistant until she had a specialist inpatient admission. This case study also demonstrates the strengths and advantages of having specialist care pathway for such complex presentations, allowing for integrated community, secondary and tertiary care, and for the care system to work together in a coordinated and managed way. (Publisher abstract)