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Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on effectiveness in single-case experiments
- Authors:
- HEYVAERT Mieke, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 27(6), 2014, pp.493-510.
- Publisher:
- Wiley
Background: This article, the first in a two-part series, focuses on the effectiveness of restraint interventions (RIs) for reducing challenging behaviour (CB) among persons with intellectual disabilities. The second article focuses on experiences with RIs for CB among people with intellectual disabilities. Methods: A mixed-methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This first article reports on the meta-analysis of 59 single-case experiments on effectiveness of RIs for CB among people with intellectual disabilities. Results and Conclusions: The RIs reported on in the single-case experiments were on average highly effective in reducing CB for people with intellectual disabilities, and this reduction in CB was statistically significant. However, the effects vary significantly over the included participants, and the published data and reported outcomes are rather unrepresentative of the everyday use of RIs among persons with intellectual disabilities. (Edited publisher abstract)
BILD Code of practice for minimising the use of restrictive physical interventions: planning, developing and delivering training
- Author:
- BRITISH INSTITUTE OF LEARNING DISABILITIES
- Publisher:
- BILD
- Publication year:
- 2014
- Pagination:
- 66
- Place of publication:
- Birmingham
- Edition:
- 4th ed.
A Code of Practice which provides a framework for training and purchasing organisations to help them shape the content of their training on minimising the use of restrictive practices. Relevant for those working with both adults and children across a range of different settings, including education and health and social care. It provides an update the 2010 edition to reflect a shift in emphasis to positive behaviour support and to take account of new guidance in England, 'Positive and Proactive Care: Reducing the need for restrictive interventions, which aims to minimise the use of restrictive practices and reducing the use of restrictive physical interventions. The Code includes individual sections for organisations purchasing training; organisations delivering training; and individual trainers. Areas covered include: implementing best interests; risk assessment and health and safety; course curriculum development; review of the effectiveness and quality of training; and monitoring the performance of participants. (Edited publisher abstract)
Restraint and seclusion: the perspective of service users and staff members
- Authors:
- MERINEAU-COTE Julie, MORIN Diane
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 27(5), 2014, pp.447-457.
- Publisher:
- Wiley
Background: The current study examined how restrictive measures are perceived by persons with intellectual disabilities and staff. Materials and Methods: Interviews were conducted with eight persons with intellectual disabilities who experienced a restrictive measure and their care providers. They were queried on their understanding of the restrictive measure, its impact on the relationship, their emotions and alternative interventions. Results: Restrictive measures were experienced negatively by persons with intellectual disabilities and their care providers. Service users reported feeling sad and angry, whereas staff mentioned feeling anxious. Moreover, persons with intellectual disabilities appeared to understand the goal of restrictive measures (e.g. ensuring their own and others' safety) and identified alternative interventions (e.g. speaking with a staff member or taking a walk). Conclusion: Debriefing sessions with service users and staff may help minimize negative consequences. (Edited publisher abstract)
The use of seclusion: good practice guide
- Author:
- MENTAL WELFARE COMMISSION FOR SCOTLAND
- Publisher:
- Mental Welfare Commission for Scotland
- Publication year:
- 2014
- Pagination:
- 21
- Place of publication:
- Edinburgh
The Mental Welfare Commission first published guidance on the use of seclusion in 2007, focusing on restrictions placed on people in a hospital setting and the authorisation, regulation and monitoring required to safeguard the rights of the individual. As assessments and treatment are increasingly provided by community services, similar restrictions are now being applied in a variety of community settings. This reviewed guidance reflects these changes and attempt to address the implications of current practice. The use of seclusion can place severe restrictions on an individual’s freedom of movement and lead to untoward physical and psychological consequences for the person. Seclusion should only be considered where there is a clear and identified risk that the person who is to be secluded presents a significant degree of danger to other people; and that the situation cannot be managed more safely or appropriately by any other means. It should only take place in the context of a clear care plan, with a concern for the safety of the individual and ensuring that the restriction is not perceived as a punishment. (Edited publisher abstract)
A human rights perspective on reducing restrictive practices in intellectual disability and autism
- Editor:
- KARIM Sam
- Publisher:
- BILD
- Publication year:
- 2014
- Place of publication:
- Birmingham
This book explores the importance of human rights legislation and ethical decision making on reducing the use of restrictive practices when supporting people with an intellectual disability and people with autism. It provides examples of how legislation, case law and guidance have been used in the countries of England, Wales, Australia and North America to uphold people’s rights and challenge abusive practices. Chapters include: legal reflections on the human rights of restraint reduction; the importance of safeguarding rights and the role of legislation: the Australian perspective; ethical principles and good practice in reducing restrictive practices; replacing restraint: good practices in North American human service programmes for persons with intellectual disabilities and autism; and good practices in Australia in the use of restraint reduction practices for people with intellectual disabilities and autism. (Edited publisher abstract)
Learning disabilities census report: further analysis: England, 30 September 2013
- Author:
- HEALTH AND SOCIAL CARE INFORMATION CENTRE
- Publisher:
- Health and Social Care Information Centre
- Publication year:
- 2014
- Pagination:
- 41
- Place of publication:
- Leeds
This report presents further findings from the 2013 Learning Disability Census, following an initial report published in December 2013. The Census provides a snapshot of inpatients with learning disabilities, autistic spectrum disorder and/or challenging behaviour, and the services they receive. The survey was one of the initiatives commissioned in response to the abuse at Winterbourne View Hospital. This report contains information relating to patient experience of care including: drug administration; incidents, restraint and seclusion; ward accommodation, uses of the Mental Health Act (1983), and information on the commissioning and provision of learning disability services including costs and care planning. The census data was collected on 30 September 2013. Responses from 104 provider organisations were received on behalf of 3,250 service users. (Edited publisher abstract)