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‘Change can only be a good thing:’ staff views on the introduction of a harm minimisation policy in a Forensic Learning Disability service
- Authors:
- FISH Rebecca, WOODWARD Sarah, DUPEROUZEL Helen
- Journal article citation:
- British Journal of Learning Disabilities, 40(1), March 2012, pp.37-45.
- Publisher:
- Wiley
Harm minimisation with people who self-injure involves providing advice to the client on how to injure themselves safely using clean instruments and how to care for wounds. NICE guidelines now recommend the discussion of harm minimisation with clients who repeated self-injure. This study aimed to investigate staff views on using harm minimisation with people with a learning disability who self-harm. An online survey was designed, and all staff at a secure unit for people with learning disabilities were invited to take part. The survey used multiple-choice questions as well as providing room for open comments. There were 71 completed surveys, 52 of which were from staff in ward-based positions. A total of 85% of the staff were in favour of the introduction of a harm minimisation policy. They felt that this policy could benefit some but not all of the clients, and that staff and clients should be able to choose whether to be involved in using harm minimisation. Common requests for inclusion were: clear, individualised guidelines that include roles and responsibilities; staff and client support systems; client education and staff training; and advice about duty of care issues. The article concludes that services should consider implementing a harm minimisation policy on an individual basis.
`It's OK for people to feel angry': the exemplary management of imminent aggression
- Author:
- DUPEROUZEL Helen
- Journal article citation:
- Journal of Intellectual Disabilities, 12(4), December 2008, pp.295-307.
- Publisher:
- Sage
- Place of publication:
- London
Ward managers working in a medium secure learning disability service were asked to identify members of staff who they believed to be superior in the management of violent and aggressive individuals. A grounded theory approach was used to interview staff about their management of imminent aggression. The participants explained their strategies in terms of the following eight themes, which were common to all interviews: safety and de-escalation, attribution and control, relationships, understanding and empowerment, anticipating reactions, creating a facade, communication, and humour. The participants described the importance of building up trusting relationships with clients when trying to understand the reasons for the client's behaviour. They also explained how they offer a `get-out clause' to the client, a way for the client to decide to calm down without losing face. The participants also reported that creating the appearance of being in control can help, as does the use of humour to aid communication.
Why couldn’t I stop her? Self injury: the views of staff and clients in a medium secure unit
- Authors:
- DUPEROUZEL Helen, FISH Rebecca
- Journal article citation:
- British Journal of Learning Disabilities, 36(1), March 2008, pp.59-65.
- Publisher:
- Wiley
This paper is the synthesis of two pre-existing studies. It details the experiences of nine people with mild/moderate learning disabilities who self injure, and those who work with them. At the time of this study the participants were living and working in a medium secure unit at Calderstones NHS Trust in Lancashire. A phenomenological approach was used, and during in-depth interviews, the participants gave rich descriptions of their experiences of self injury. The descriptions that emerged from the interviews detailed four main themes: understanding, communication, control and blame.