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Service users' views of physical restraint procedures in secure settings for people with learning disabilities
- Authors:
- JONES Peter, KROESE Biza Stenfert
- Journal article citation:
- British Journal of Learning Disabilities, 35(1), March 2007, pp.50-54.
- Publisher:
- Wiley
The appropriateness and justification of physical restraint procedures in secure learning disability settings is an emotive issue. This paper examines the views of 10 service users from secure residential facilities who are restrained frequently. Using a semi-structured interview schedule, Service users were interviewed about their restraint experiences. They reported that restraint can lead to potentially abusive situations and that staff should try other approaches before restraining someone. They were divided on whether it calmed them down and whether staff enjoyed performing restraint. Other comments included that restraint may or may not serve a purposeful goal and that there is a definite need for staff training for those involved in performing restraint.
Mental health services for adults with intellectual disabilities – what do service users and staff think of them?
- Authors:
- KROESE Biza Stenfert, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 26(1), 2013, pp.3-13.
- Publisher:
- Wiley
Mental health services for services users with intellectual disabilities remain deficient both in terms of quality and access. The aim of this qualitative study was to investigate service users', support staff and community team members' views of the services currently provided to adults with intellectual disabilities and mental health problems and what they consider to be desirable qualities for staff to possess. Two different methodologies were used to collect data. First, 2 focus groups were conducted with service users who have intellectual disabilities and mental health problems and 2 focus groups were conducted with a variety of staff with recent experience of intellectual disabilities services. Second, individual interviews were conducted with 12 staff members employed in residential and community intellectual disabilities services. The data were analysed using interpretive phenomenological analysis. The identified themes were: being interested, communication, competence-promoting support, past/present/future links, prevention, reviews and liaison, working with carers, looking after staff, staff training/supervision and interface between services. A number of suggestions for improving services are identified and discussed in the context of current service policies and procedures.
Psychological factors associated with obtaining employment
- Authors:
- HENSEL Elizabeth, KROESE Biza Stenfert, ROSE John
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(2), March 2007, pp.175-181.
- Publisher:
- Wiley
Less than 10% of people with intellectual disabilities are employed. The aim of the present study was to investigate what psychological factors might predict employment outcome for people with intellectual disability who had received a placement in a supported employment service. Sixty people were interviewed whilst they were in the supported employment preparation agency and where possible 3 and 9 months after leaving. The structured interview included a number of psychological measures. Those who subsequently gained employment were compared with those who did not. Those who gained employment were significantly more motivated by status aspiration, and judged themselves significantly less happy than those who did not gain employment, at the first interview. It is possible that people who are more dissatisfied with their life might be more motivated to change their circumstances. Supported employment agencies might consider using a measure of motivation as an entry criterion or as a way of identifying who needs help with developing motivation.
How do fathers with id experience their children being removed from their care through the English court system?
- Authors:
- PYTLOWANA Agnieszka, KROESE Biza Stenfert
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 18(4), 2021, pp.313-323.
- Publisher:
- Wiley
Background: Fathers with ID are likely to face many disadvantages when compared with non-ID parents, such as social and financial challenges and emotional trauma, including trauma due to having their children removed from their care. Services are required to support fathers with ID and tailor their practices to be accessible to this group of parents. Despite recommendations, many services continue to struggle to provide this. Aims: There are very few studies exploring the experiences of fathers with ID whose children have been removed by English courts. The aim of this study was to provide insights into the experiences of these fathers in order to inform practice guidelines on how fathers with ID can be best supported. Methods: Interpretative phenomenological analysis (IPA) was used to analyze interviews with five fathers. Results: IPA produced the following themes: The Court as Lion's Den, Fighting for my Role as a Father, and The Personal Cost of it All. Conclusions: The findings highlight that fathers with ID find the experience of their children being taken into care overwhelmingly painful. The processes by which these decisions are made are seen as unfair. Recommendations for practice improvement are offered. (Edited publisher abstract)
Trauma-focussed cognitive-behaviour therapy for people with mild intellectual disabilities: outcomes of a pilot study
- Authors:
- KROESE Biza Stenfert, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 10(5), 2016, pp.299-310.
- Publisher:
- Emerald
Purpose: Trauma-focussed cognitive-behaviour therapy (TF-CBT) is the most effective treatment for post-traumatic stress disorder (PTSD). Individuals who present with complex PTSD are among the most complex and challenging patients seen by intellectual disability psychology and psychiatry services. The purpose of this paper is to study TF-CBT intervention for people with intellectual disabilities and complex PTSD. Design/methodology/approach: Three groups of adults with intellectual disabilities (ID) presenting with complex PTSD (n=3, n=5 and n=4) were treated using a 12-week manualised intervention adapted from a procedure routinely used in adult mental health services. Participants completed the Impact of Event Scale as adapted for people with intellectual disabilities (IES-ID) before and after the intervention, and interviews conducted to ascertain their experiences of the group were analysed using interpretative phenomenological analysis (IPA). Findings: The ten participants who completed the intervention showed a 27 per cent decrease in median Impact of Event Scale Intellectual Disabilities scores, equivalent to a medium effect size (d=0.50). Five themes were identified from the interviews: being listened to; it is nice to know you are not the only one; being in a group can be stressful; the importance of feeling safe; achieving and maintaining change. Participants also provided constructive feedback to promote improvements to the manual. Research limitations/implications: A feasibility study followed by methodologically robust clinical trials is now needed to establish the effectiveness of the intervention and its utility in clinical practice. Practical implications: This small study has confirmed the potential of TF-CBT as an intervention for extremely vulnerable individuals with ID who present with complex PTSD. Social implications: The findings indicate that a group intervention is both feasible for and acceptable to adults with ID. Originality/value: To date, no study has investigated the effectiveness and feasibility of a TF-CBT group intervention for adults with mild ID. (Publisher abstract)
Making sense of varying standards of care: the experiences of staff working in residential care environments for adults with learning disabilities
- Authors:
- HUTCHINSON Andrew, KROESE Biza Stenfert
- Journal article citation:
- British Journal of Learning Disabilities, 44(3), 2016, p.182–193.
- Publisher:
- Wiley
Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have been made to understand variations in care standards, there remains a need for more research in this area. Additionally, little attention has been paid to understanding support staff experiences of working in residential services and to developing a more theoretical understanding of the role they fulfil. Using interpretive phenomenological analysis (IPA), this study aimed to examine front-line staff members' experiences of working in residential care for people with learning disabilities. Six experienced front-line care workers (four female, two male) took part in semi-structured interviews. Data were analysed according to the principles of IPA, and three superordinate themes were identified as being central to participants' experiences of their work roles: Degree of Positive Relationship Reciprocity; Value Congruence and Intrinsic Motivation; and Experiences of Environmental and Organisational Constraints. Results are discussed in relation to the existing literature on care standards and the factors associated with abusive or neglectful practices, and in terms of their contribution to theory and applied practice. (Publisher abstract)
How do women with an intellectual disability experience the support of a Doula during their pregnancy, childbirth and after the birth of their child?
- Authors:
- McGARRY Alison, KROESE Biza Stenfert, COX Rachel
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(1), 2016, pp.21-33.
- Publisher:
- Wiley
Background: The aim of this study was to gain insight into the experiences of parents with an intellectual disability who received support from Doulas during pregnancy, birth and following the birth of their child. In addition, the experiences of the Doulas who provided the support were investigated. Materials and Methods: Four women with an intellectual disability who received Doula support were interviewed before and after the birth of their child. Three Doulas were interviewed after the birth about their experiences of supporting women with an intellectual disability. Results: Interview transcripts were analysed using Interpretive Phenomenological Analysis (IPA). Themes were identified from each interview, before an overall analysis of themes from each support phase was undertaken. Conclusions: Pre-natally, the Doula was considered helpful and a reliable source of information about pregnancy. Each mother perceived Doula support as a means of keeping her child in her care. Post-natally, mothers described a trusting relationship with their Doula, who enabled them to make informed choices. Doulas described how they adapted their work to meet the needs of parents with intellectual disability. Being involved in Child Protection procedures was perceived as stressful and challenging. (Edited publisher abstract)
Solicitors’ experiences of representing parents with intellectual disabilities in care proceedings: attitudes, influence and legal processes
- Authors:
- COX Rachel, KROESE Biza Stenfert, EVANS Roger
- Journal article citation:
- Disability and Society, 30(2), 2015, pp.284-298.
- Publisher:
- Taylor and Francis
This paper reports on an exploratory study of the role of solicitors acting for parents with intellectual disabilities (ID) in public law proceedings. The paper draws on in-depth interviews with 11 solicitors and a subsequent focus group in which the interview findings were presented and reflected on by six of the eleven participants. Two of the five themes that emerged will be discussed here. They are entitled ‘Attitudes and Influence’ and ‘Legal Processes’ and concern the attitudes and influence of those involved in assessing, supporting and representing parents with ID and the care proceedings processes encountered by parents with ID. (Publisher abstract)
Solicitor's experiences of representing parents with learning disabilities in care proceedings: altering practice and coping with stress
- Authors:
- COX Rachel, EVANS Roger, KROESE Biza Stenfert
- Journal article citation:
- Family Law, 44, July 2014, pp.1017-121.
- Publisher:
- Jordan
In the UK parents with learning disabilities are over represented in public law care proceedings and are at a much higher risk of having their children placed outside the birth family. This article outlines possible reasons for this and the impact on solicitors who represent parents with learning disabilities. (Edited publisher abstract)
Staff expectations and views of cognitive behaviour therapy (CBT) for adults with intellectual disabilities
- Authors:
- KROESE Biza Stenfert, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 27(2), 2014, pp.145-153.
- Publisher:
- Wiley
Background: The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated. Method: To explore their views and expectations of cognitive behaviour therapy (CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were recruited and interviewed before the CBT sessions commenced for their service users and nine took part in the second interview that took place after nine sessions. Results: Thematic Analysis of the interview transcripts indicates that staff members do not perceive CBT as a long-term solution for psychological problems have little knowledge of CBT and do not feel included in the process. Nevertheless, after nine sessions, most participants reported improved psychological well-being for their service users and expressed a wish for longer-term involvement of the therapist. Conclusions: The results suggest that for CBT to be effective in the longer term, the therapist is required to consider a wider systemic approach including staff training and supervision, staff and management consultancy and creating a delicate balance between confidentiality and sharing the psychological formulation with ‘significant others’ to ensure maintenance and generalisation of improved psychological well-being. (Publisher abstract)