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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.
Hurting no-one else’s body but your own: people with intellectual disability who self injure in a forensic service
- Authors:
- DUPEROUZEL Helen, FISH Rebecca
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 23(6), November 2010, pp.606-615.
- Publisher:
- Wiley
This paper presents findings from an investigation into the experiences of nine people with mild to moderate intellectual disability who self-injure. It looks beyond the clinical presentations in an attempt to capture the perceptions these people have of their care in a medium secure unit. A phenomenological approach was used, and during in-depth interviews, the participants gave descriptions of their experiences of self-injury. Through analysis of the interviews, findings revealed four main themes: coping strategies; staff and the organisational response – therapeutic communication; close observation; and looking to the future. As a coping strategy, self-injury was seen as an effective means of reducing distress; there were unique and common reasons for this distress. Common themes relating to the actions and reactions of health professionals and the organisational response were evident within all accounts. In ending, the clinical implications for service users are highlighted.
‘I can try and do my little bit’ - training staff about self-injury
- Authors:
- MOORES Paul, FISH Rebecca, DUPEROUZEL Helen
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(1), January 2011, pp.4-7.
- Publisher:
- Emerald
This article is written from the point of view of a service user who is involved in training staff about working with people who self-injure in the secure learning disability service where he lives. Paul has been employed as a trainer since 2007, and was one of the first service users in this service to be involved in training staff. The training is part of a one-day introduction session about self-injury. Paul introduces himself and does a short talk about his experiences, and then staff delegates are invited to ask him questions for a one hour question and answer session. Paul is paid for the work, and he enjoys it and feels that it has made him more confident. Some of the staff take the course as part of an induction, while others may have been employed at the service for many years. This article tells Paul’s story in his own words, and includes his explanations on why he decided to take part, responses from the trainees, how he feels when he is doing the training, and his motivation for training staff and the good things about the experience.
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.