Change processes within team formulations in intellectual disabilities services: what do multi-disciplinary staff find helpful?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gemma Hymers ◽  
Dave Dagnan ◽  
Barry Ingham
Keyword(s):  
Intellectual Disabilities ◽  
Change Processes ◽  
Case Formulation ◽  
Content Type ◽  
The People ◽  
Collaborative Working ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
Further Development ◽  
Multi Disciplinary Team

Purpose A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that formulation meetings develop staff understanding of individuals they support. This study aims to explore the change processes that occur as a result of professional team formulation meetings, and the mechanisms that facilitate and hinder these events. Design/methodology/approach Eight clinicians who took part in multi-disciplinary team-based formulations in an inpatient mental health service for adults with intellectual disabilities were interviewed. Interviews were examined using thematic analysis. Findings The key themes identified were: “gaining information”, “altered thoughts” and “focused goals”. These themes were supported by “collaborative working” and “time for reflection” and were hindered by “poor communication and interaction” and inconsistent “staff attendance”. Originality/value Multi-disciplinary team formulation meetings may have a number of change processes that affect staff knowledge and perception of the people that they support. The facilitation of these processes should be a focus for further development.

“When other people try to understand”: exploring the experiences of people with intellectual disabilities, who also have mental health problems

2020 ◽  
Vol 14 (3) ◽  
pp. 91-101
Author(s):  
Sasha Martine Mattock ◽  
Kieron Beard ◽  
Amy Baddeley
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Focus Group ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
The People ◽  
People With Intellectual Disabilities

Purpose Recent guidelines from the National Institute of Health and Care Excellence highlight that service users (SUs) with intellectual disabilities and co-occurring mental health problems rarely get the opportunity to share their experiences of mental health services. Over the past 20 years, policy documents have stated that these individuals (SUs) must be included in decisions about their care. Research suggests that often this is not the case. Therefore, this paper aims to create a space for SUs to share their experiences of mental health services, and what they found helpful. Design/methodology/approach A focus group was held with five SUs, two psychologists and two researchers. The audio recording of the discussion was transcribed and analysed using thematic analysis. Findings Three main themes were identified, namely, “relationships with others”, “inclusion and communication” and “challenges”. This focus group highlighted that although some SUs felt supported, they reported having little control in their lives and wanted to be listened to. Research limitations/implications Including a SU in the planning and facilitation of the focus group would have made this research more inclusive. Practical implications The implications of this research suggest that by listening to and involving SUs and developing more person-centred services, recovery rates may increase as the services provided would be more targeted. Originality/value Very little research has previously been conducted to explore SUs’ experiences. This paper highlights the value of being heard and the knowledge that is often lost if the authors do not take the time to listen to the people for whom a service is designed.

IAPT practitioners’ experiences of providing therapy to people with intellectual disabilities

2015 ◽  
Vol 9 (4) ◽  
pp. 206-214 ◽  
Author(s):  
Jennifer Shankland ◽  
Dave Dagnan
Keyword(s):  
Intellectual Disabilities ◽  
Online Survey ◽  
Training And Development ◽  
Content Type ◽  
Psychological Therapies ◽  
The North ◽  
Survey Results ◽  
People With Intellectual Disabilities ◽  
Qualitative Responses ◽  
Further Development

Purpose – The purpose of this paper is to describe the views and experiences of Improving Access to Psychological Therapies (IAPT) practitioners in providing therapy to patients who have an intellectual disability in order to support IAPT services in increasing their capability in this area. Design/methodology/approach – An online survey was conducted of IAPT practitioners in four IAPT services in the north of England. The survey collected respondents demographic information and their experience, confidence and attitudes to working with people with intellectual disabilities. Qualitative responses regarding respondents attitudes, views of barriers, problems, successes and possible solutions to the delivery of therapy to people with intellectual disabilities within IAPT services were collected. The survey results were interpreted by thematic and statistical analysis. Findings – The majority of respondents report having worked with people with intellectual disabilities and identify the need to adapt therapy, but also believe that such therapy should be offered within mainstream services. Thematic analysis identifies the needs for support in training, therapy adaptation and adjustment to pathways. However, the majority of respondents could identify positive outcomes and experiences. Research limitations/implications – This data supports the further development of pathways and offers some broad frameworks for the focus of training and development work for people with intellectual disabilities within IAPT. Social implications – This project has identified a positive attitude and willingness to consider adaptation of therapy for people with intellectual disabilities in practitioners working within IAPT services. Originality/value – Until now the views and experiences of IAPT practitioners in working with this patient group were relatively unknown.

scholarly journals Using Photovoice as a method to engage bereaved adults with intellectual disabilities in research: listening, learning and developing good practice principles

2017 ◽  
Vol 11 (5/6) ◽  
pp. 196-206 ◽  
Author(s):  
Gulshan Tajuria ◽  
Sue Read ◽  
Helena M. Priest
Keyword(s):  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Good Practice ◽  
Evidence Base ◽  
Content Type ◽  
Research Engagement ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
Principles Of Good Practice ◽  
Photovoice Methodology

Purpose People with intellectual disabilities experiencing loss or bereavement are at risk of developing additional mental health problems, and may struggle to access suitable support. The purpose of this paper is to present the adaptations done while using Photovoice as a creative method for bereaved people with intellectual disabilities participating in a research exploring loss and support. This paper will further briefly add information on how the use of Photovoice supported the development of whole research project. Design/methodology/approach This paper explores the use of Photovoice as a method of research engagement for bereaved adults with intellectual disabilities. Photovoice enables participants to take and discuss photographs illustrating their loss and support experiences. The paper focusses on a preparatory Photovoice workshop with the research participants, outlining the processes and activities used to maximise involvement, promote learning and achieve shared understanding. Findings Preparation was the key to the effectiveness of this workshop and it recommends that appropriate adaptions are useful in Photovoice with adults with intellectual disabilities effectively. The paper outlines principles of good practice for using Photovoice in this research context, which may transfer to other similar research settings. Using Photovoice facilitated later one-to-one interviews with the participants, where their photographs were discussed together. Originality/value This paper illustrates the innovative use of Photovoice methodology in research involving bereaved people with intellectual disabilities. Photovoice has not previously been used with this specific population within the bereavement and loss context, so this paper adds to the developing evidence base.

Intellectual disability and dementia: perspectives on environmental influences

2019 ◽  
Vol 20 (4) ◽  
pp. 179-189
Author(s):  
Alisa Jordan Sheth
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Environmental Influences ◽  
Nominal Group Technique ◽  
Ecological Systems ◽  
Nominal Group ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
Group Technique

Purpose The purpose of this paper is to improve understandings of environmental influences on participation in routine and familiar activities for people with intellectual disabilities and dementia from first-person and caregiver perspectives. Design/methodology/approach Four adults with intellectual disabilities and dementia participated in 2 nominal group technique sessions and 12 family and staff caregivers participated in 5 standard focus groups. Transcripts were analyzed utilizing thematic analysis centering the findings from nominal group technique sessions and an ecological systems lens. Findings Participants with intellectual disabilities and dementia identified six important themes: activity access, caregiver assistance, social interactions, responsibilities, privacy, and health and wellness. Their perspectives focused primarily at an immediate environment level, while caregiver input added additional understandings from broader ecological systems levels. Originality/value This study provides a beginning point to establishing a framework for creating supports and addressing barriers to participation for adults with intellectual disability and dementia based on direct input from potential service consumers and their caregivers. People with intellectual disabilities and dementia provide valuable insights into their experiences through engagement in accessible research.

Conceptualising the therapeutic alliance: exploring the relevance of Bordin’s model for adults with intellectual disabilities

2020 ◽  
Vol 14 (5) ◽  
pp. 169-179
Author(s):  
Sarah Cameron ◽  
James Swanton ◽  
Dave Dagnan
Keyword(s):  
Therapeutic Alliance ◽  
Intellectual Disabilities ◽  
Design Methodology ◽  
Qualitative Methodology ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Therapy Alliance ◽  
Adults With Intellectual Disabilities ◽  
The Impact ◽  
Therapeutic Model

Purpose This study aims to explore the applicability of Bordin’s model of therapeutic alliance in talking therapies for people with intellectual disabilities. Design/methodology/approach People with intellectual disabilities and therapists in six therapy dyads were interviewed using a qualitative methodology. Data were analysed using thematic analysis to explore how people with learning disabilities constructed the dimensions of therapeutic alliance. Content analysis was then used to focus on therapy bond, therapy tasks and goals to explore the agreement on these dimensions between the therapist and client. Findings People with intellectual disabilities reported their experience of therapy in a way that initially validates the alliance dimensions of Bordin’s model. There was clear overlap within most dyads in the description of the characteristics of the bond, the tasks undertaken and the goals of therapy. Some therapists described additional goals based on their therapeutic model that were not clearly described by the client working with them. Research limitations/implications This study is limited by only including six therapy dyads; however, the results suggest further research on the impact of therapy alliance and how goals and tasks are agreed would be valuable. Originality/value Very few studies have explicitly examined the client’s view of therapy alliance.

scholarly journals Sexual Health in Spanish People with Intellectual Disability: the Impact of the Lockdown due to COVID-19

2021 ◽  
Author(s):  
M. Dolores Gil-Llario ◽  
Irene Díaz-Rodríguez ◽  
Vicente Morell-Mengual ◽  
Beatriz Gil-Juliá ◽  
Rafael Ballester-Arnal
Keyword(s):  
Sexual Abuse ◽  
Sexual Behavior ◽  
Sexual Health ◽  
Intellectual Disabilities ◽  
Sexual Activity ◽  
Policy Implications ◽  
The People ◽  
People With Intellectual Disabilities ◽  
Technological Improvements ◽  
The Impact

Abstract Introduction The lockdown due to COVID-19 affected the sexual health of the people with intellectual disabilities by differentially modifying the frequency and characteristics of people’s sexual activity depending on whether or not they lived with a partner during this period. The aim of this study was to analyze the extent to which the sexual behavior of people with intellectual disabilities (with and without a partner) was affected during the lockdown. Methods The sample consisted of 73 people with intellectual disabilities between 21 and 63 years old (M = 39.63; SD = 10.11). The variables analyzed were the physical, social, and technological environment during the lockdown, sexual appetite, sexual behavior, online sexual activity, and sexual abuse. The data were collected between the months of May and June of 2020. Results The lockdown increased the sexual appetite of a third of the sample (38%), especially the youngest participants. Sexual activity focused on autoeroticism and online behavior, particularly sending nude images of oneself (88%) and viewing pornography (83.6%). Rates of sexual abuse during this period were relatively high (6.8%). Conclusions The sexual activity of people with ID was important during the lockdown, and they had to adapt to the circumstances of isolation in a similar way to the general population. Technological improvements in terms of devices and connection quality at home allowed their sexual behavior to be reoriented, opening the door to new risks for the sexual health of people with ID. Policy Implications Cybersex and the increase in sexual abuse due to confinement are aspects that should be included in programs to improve the sexual health of this group.

A practical example of an open disclosure process for people with intellectual disabilities in the Republic of Ireland

2021 ◽  
pp. 174462952110189
Author(s):  
Feabhra Mullally ◽  
Deirdre Corby
Keyword(s):  
Intellectual Disabilities ◽  
Service Providers ◽  
Republic Of Ireland ◽  
Open Disclosure ◽  
The Usa ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
The Republic ◽  
Communication Needs ◽  
The Uk

Literature pertaining to open disclosure predominantly refers to acute care settings; this is the case in, for example, the UK, Republic of Ireland, Australia, Korea and the USA. There is, however, a dearth of literature regarding open disclosure related to people with intellectual disabilities. A practice example of open disclosure is presented here, following a serious adverse event in an organisation supporting adults with intellectual disabilities. The aim of the process was to openly disclose in a meaningful way to adults with significant intellectual disabilities and communication difficulties. An apology pathway was developed by a multidisciplinary team based on individual communication needs. A suite of resources was developed including easy read-picture agendas and sign language to support increased understanding of the apology. Service users received the apology first, followed by meetings with their families. This practice example has positive implications for service providers for people with intellectual disabilities.

A systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chloe Crompton ◽  
Bethany Duncan ◽  
Graham Simpson-Adkins
Keyword(s):  
Systematic Review ◽  
Intellectual Disabilities ◽  
Adverse Childhood Experiences ◽  
World Health ◽  
Inclusion Criteria ◽  
Childhood Experiences ◽  
Content Type ◽  
Adverse Childhood ◽  
People With Intellectual Disabilities ◽  
The Impact

Purpose This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority. Design/methodology/approach Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched. Findings Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions. Originality/value This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.

Teaching playground behavioural expectations to secondary age students with intellectual disabilities attending a special school

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David Simó-Pinatella ◽  
Marisa Carvalho
Keyword(s):  
Intellectual Disabilities ◽  
Secondary Students ◽  
School Setting ◽  
Special School ◽  
Content Type ◽  
Students With Intellectual Disabilities ◽  
Special Education School ◽  
Adults With Intellectual Disabilities ◽  
Materials Used

Purpose School-wide positive behaviour support (SWPBS) is a proactive behavioural support system that fosters behaviour change in individuals in a school setting. This article aims to present a case example of teaching and reinforcing behavioural expectations in a special school. Design/methodology/approach This case study reflects different steps and materials used before and during the intervention in a special education school with 61 secondary students with intellectual disabilities. An AB design (A – baseline; B – intervention) was used to collect and analyze data. Findings Results suggest that teaching behavioural expectations as a universal measure may be feasible and positively impact school climate. Suggestions and recommendations for implementing SWPBS within a school are provided. Originality/value This case study provides a step-by-step guide illustrating the process of teaching and reinforcing behavioural playground expectations to young adults with intellectual disabilities attending a special school.

Commentary on “A family’s battle to understand ‘challenging behaviour’”

2017 ◽  
Vol 22 (2) ◽  
pp. 105-108
Author(s):  
Joann Kiernan
Keyword(s):  
Intellectual Disabilities ◽  
Design Methodology ◽  
Local Communities ◽  
Challenging Behaviour ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Individuals With Intellectual Disabilities

Purpose The purpose of this paper is to provide a commentary on issues raised in the paper “A family’s battle to understand ‘challenging behaviour’”. Design/methodology/approach Drawing on literature associated with issues identified in the paper this commentary will reflect on the evidence associated with providing specialist support to people with intellectual disabilities and challenging behaviour. Findings Families, individuals and services are unable to access timely and appropriate specialist support for individuals with intellectual disabilities and challenging behaviour. As individuals go on to develop behaviours associated with a lack of intervention their levels of vulnerability increase due to their exclusion from services and their local communities. Originality/value The commentary provides a discussion on the issues faced by individuals and their families in relation to intellectual disabilities and challenging behaviour.

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