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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)
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)
Staff's attitudes and working conditions in community-based group homes of people with mental handicaps
- Authors:
- KROESE Biza Stenfert, FLEMING Ian
- Journal article citation:
- Mental Handicap Research, 5(1), 1992, pp.82-91.
- Publisher:
- BIMH Publications
Survey based on a questionnaire showed considerable job satisfaction particularly in the areas of teaching clients and outings with clients, as well as some stress.
Gender issues for people with intellectual disabilities and mental health problems: asking what service users and staff think
- Author:
- KROESE Biza Stenfert
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(4), 2013, pp.181-190.
- Publisher:
- Emerald
The current qualitative study aims to investigate service users’, support staff's and community team members’ views of gender differences in cause and presentation of mental health problems, whether current services respond differently to men and women with mental health problems and areas in which services can become more gender sensitive. Two focus groups were conducted with service users with intellectual disabilities and mental health problems in addition to two focus groups with a variety of staff. Subsequently, individual interviews were conducted with both male and female staff members employed in residential and community intellectual disability services. The number of participants totalled 54 (16 service users and 38 staff). Thematic analysis was adopted in order to identify dominant themes in the discourse of these stakeholder groups. The analysis produced a number of themes which include: compliance versus challenge; vulnerability; expression of emotion; gender equality; same sex support; caring qualities; and boundaries. A number of suggestions for improving services are discussed in the context of the current findings. (Publisher abstract)