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The treatment of auto-erotic asphyxiation in a man with severe intellectual disabilities: the effectiveness of a behavioural and educational erogramme
- Authors:
- THOMPSON A.R., BEAIL N.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(1), 2002, pp.36-47.
- Publisher:
- Wiley
The treatment of individuals with severe intellectual disabilities who engage in self-injurious sexual practices and are incapable of giving consent poses a significant challenge to health care services. Treatment options can be highly personal and intrusive, and potentially pose a risk of litigation. However, there is also a risk of being prosecuted for negligence if necessary treatment is not pursued. This paper discusses the treatment of an individual engaged in such a behaviour - auto-erotic asphyxiation. It describes how the legal aspects of the design and implementation of the treatment approach were handled. The treatment of individuals with severe intellectual disabilities who engage in self-injurious sexual practices and are incapable of giving consent poses a significant challenge to health care services. Treatment options can be highly personal and intrusive, and potentially pose a risk of litigation. However, there is also a risk of being prosecuted for negligence if necessary treatment is not pursued. This paper discusses the treatment of an individual engaged in such a behaviour - auto-erotic asphyxiation. It describes how the legal aspects of the design and implementation of the treatment approach were handled. The treatment of individuals with severe intellectual disabilities who engage in self-injurious sexual practices and are incapable of giving consent poses a significant challenge to health care services. Treatment options can be highly personal and intrusive, and potentially pose a risk of litigation. However, there is also a risk of being prosecuted for negligence if necessary treatment is not pursued. This paper discusses the treatment of an individual engaged in such a behaviour - auto-erotic asphyxiation. It describes how the legal aspects of the design and implementation of the treatment approach were handled. The treatment of individuals with severe intellectual disabilities who engage in self-injurious sexual practices and are incapable of giving consent poses a significant challenge to health care services. Treatment options can be highly personal and intrusive, and potentially pose a risk of litigation. However, there is also a risk of being prosecuted for negligence if necessary treatment is not pursued. This paper discusses the treatment of an individual engaged in such a behaviour - auto-erotic asphyxiation. It describes how the legal aspects of the design and implementation of the treatment approach were handled. The treatment approach involved a behavioural and psycho-educational programme. A single case study methodology was utilized in order to assess the effectiveness of the intervention. The intervention led to the learning of new adaptive behaviour. Auto-erotic asphyxiation ceased and the individual's masturbatory behaviour changed sufficiently to reduce the threat of mortality. Qualitatively, a significant reduction in the level of stress experienced by the individual's family was reported. It is concluded that behavioural and educational techniques may be effective in the management of such cases. Further research replicating such techniques with similar cases is required prior to the efficacy of this treatment becoming established.
Descriptive analysis of self-injurious behaviour and self-restraint
- Authors:
- FORMAN Debbie, HALL Scott
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(1), 2002, pp.1-7.
- Publisher:
- Wiley
Self-restraint often appears to be associated with self-injurious behaviour (SIB), and has been described as an attempt to prevent or escape from SIB. Research into the determinants of self-restraint is limited, and the present single case study assesses the environmental determinants of self-restraint and SIB, as well as describing the relationship between the two behaviours. Using observations in the natural environment were conducted for 16.5h and data were collected on SIB, self-restraint and environmental events. Sequential analysis showed that SIB and self-restraint were unrelated to environmental events and that the behaviours co-varied inversely. Self-injurious behaviour occurred at higher than chance levels immediately following self-restraint and also at high levels immediately prior to self-restraint. Whilst these results would appear to support the hypothesis that self-restraint was negatively reinforced by escape from SIB, the data cannot be explained solely by this theory. The implications of these findings for the behavioural theory of SIB and the conceptualisation of self-restraint are discussed.
Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS—LD)
- Authors:
- ASHOK Roy, et al
- Journal article citation:
- British Journal of Psychiatry, 180, January 2002, pp.61-66.
- Publisher:
- Cambridge University Press
Frequent impaired social functioning, problems with communication and associated physical conditions meant that a bespoke instrument was needed for people with learning disabilities. This article describes the development of the Health of the Nation Outcomes Scales for People with Learning Disabilities (HoNOS—LD).
Positive approaches to understanding and managing risk: a workbook to support the mandatory units of the Certificates in Working with People who have Learning Disabilities
- Author:
- BRADLEY Alice
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2002
- Pagination:
- 75p.
- Place of publication:
- Plymouth
Includes legal obligations and rights on the part of carers to take risks in managing challenging behaviour and other problems. The book outlines policies and procedures for service providers, ethical and legal issues around physical intervention, and positive management techniques.
Dilemmas in the community risk management of sexually offensive behaviour
- Authors:
- ROBERTSON John, CLEFF Jennifer
- Journal article citation:
- British Journal of Learning Disabilities, 30(4), December 2002, pp.171-175.
- Publisher:
- Wiley
A small group of experienced community workers providing risk management for men with learning disabilities who sexually offend was studied. Attribution statements participants made about their risk appraisals were anaylsed. Results highlight the effort participants made to obtain sufficient information. They focused on factors external to the service-user for minimizing the importance of such risks. Services that fail to develop specialist risk assessment skills may compromise risk management by community staff.
Towards the creative management of risk: perceptions practices and policies
- Authors:
- ALASZEWSKI Andy, ALASZEWSKI Helen
- Journal article citation:
- British Journal of Learning Disabilities, 30(2), June 2002, pp.56-62.
- Publisher:
- Wiley
This present article examines the importance of risk when supporting individuals with learning disabilities. Risk is an important issue in the provision of support. Service users saw risk primarily in terms of hazards. Carers were concerned about hazards and harm, but recognised the need for risk-taking. Professionals emphasized the importance of reasonable risk-taking. Agencies also recognised the importance of risk management, and most had or were developing risk policies. However, most of these policies are based on a restricted approach to risk which emphasizes hazard assessment, and health and safety issues.
Balancing act
- Author:
- HENDY Steven
- Journal article citation:
- Community Care, 23.5.02, 2002, pp.40-41.
- Publisher:
- Reed Business Information
Service providers should support people with learning difficulties to develop meaningful interpersonal relationships, but robust and sensitive procedures are essential in order to balance rights with risks.
Re-assessing the social worker's role as an appropriate adult
- Author:
- WHITE Ciaran
- Journal article citation:
- Journal of Social Welfare and Family Law, 24(1), 2002, pp.55-65.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The role of the appropriate adult is a small but significant element of the criminal justice system, designed to offer some degree of protection to particular categories of vulnerable person suspects; namely juveniles and mentally disordered persons in police detention. The role is quite often performed by social workers, though it is not exclusive to them. However, authorities have given little detailed thought as to how the duties of the appropriate adult are to be complied with and it appears that very often social workers are not trained in performing the role. This article suggests that we re-appraise our expectations of those asked to fill the role of the appropriate adult, offering them more detailed guidance on specific issues. It also explores how organized training could help social workers to discharge the role in a manner commensurate with its spirit.
An unreliable witness
- Author:
- -
- Journal article citation:
- Community Care, 14.3.02, 2002, pp.44-45.
- Publisher:
- Reed Business Information
A multi-disciplinary panel discusses the rape of a woman with learning difficulties by a day care worker. The police decided not to proceed with the prosecution as the victim was considered an unreliable witness.
Risk assessment in people with learning disabilities
- Author:
- SELLARS Carol
- Publisher:
- British Psychological Society/Blackwell
- Publication year:
- 2002
- Pagination:
- 168p.,bibliog.
- Place of publication:
- Oxford
This book provides an explanation of the concept of risk, and a discussion of the key areas where risks need to be assessed in the lives of people with learning disabilities. It describes an approach to assessing risks and emphasizes the need to see risk assessment as an ongoing process in which all interested parties can consider the potential risks in any situation.