Real Work Opportunities: establishing an accessible vocational rehabilitation programme within a forensic intellectual disability service

2014 ◽  
Vol 5 (4) ◽  
pp. 160-166 ◽  
Author(s):  
Alyssa Cox ◽  
Hayley Simmons ◽  
Ginny Painter ◽  
Pippa Philipson ◽  
Rachel Hill ◽  
...  

Purpose – Patients treated within secure/forensic settings experience numerous barriers to meaningful vocation, including restrictions under the Mental Health Act, which limit community access. The purpose of this paper is to describe the development of Real Work Opportunities, an inclusive and accessible vocational rehabilitation programme within a forensic intellectual disability service. The programme involved setting up employment and interview workshops, interviews, and interview feedback, and job roles within the secure service, to simulate the real work process. Design/methodology/approach – A reflective account of the development and implementation of the Real Work Opportunity programme with a forensic intellectual disability population. Findings – The programme was well received by the patients involved and a high attendance rate was maintained over time despite the demands that were expected. Roles have been advertised for two employment periods and have had two sets of successful candidates. Patients demonstrated skills development throughout the employment process, including general work-based skills, punctuality and time management, managing duties, responsibility, specific role-related skills, interpersonal skills and personal presentation. Research limitations/implications – Despite limited experience of work prior to admission, many patients were enthusiastic and motivated to work. The initial trial of the programme has been well received by both patients and staff. Future developments will include widening the number and types of opportunity offered by the programme. Originality/value – This paper describes a vocational rehabilitation programme for a particularly marginalised population, people with intellectual disabilities within a forensic service. The programme proved highly popular with patients, and enabled them to develop transferable employment skills.

2015 ◽  
Vol 9 (4) ◽  
pp. 186-195 ◽  
Author(s):  
Lucinda Cheshire ◽  
Verity Chester ◽  
Alex Graham ◽  
Jackie Grace ◽  
Regi T Alexander

Purpose – There is little published literature about the number of home visits provided to patients within forensic intellectual disability units, and there is no published data on variables that affect home visits. There is a need for a baseline audit that can formulate standards for future practice. The paper aims to discuss these issues. Design/methodology/approach – This paper describes the home visit programme within a forensic intellectual disability service, and a baseline audit of the programme. The audit measured the number of home visits, any factors that adversely affect home visits, and the extent of family contact. The authors propose audit standards for evaluation of good practice in this area. Findings – The audit involved 63 patients over a one-year period. In total, 81 per cent of patients had some form of family contact and 54 per cent of patients at least one home visit. However, 19 per cent of patients had no contact with their family due to a variety of reasons. There were no significant differences in the number of home visits between men and women, patients on civil vs criminal sections or those treated “within area” or “out of area”. Patients in rehabilitation wards had significantly more visits than those in low or medium secure. Originality/value – Conventional wisdom is that reduced family contact is the direct result of patients being placed “out of area”. The results of this audit suggest that, at least in this group, the reasons may be much more nuanced and that the current definition of “out of area” has to be improved to incorporate the actual distance between the patient’s current family home and the service. Audit standards have been proposed to monitor family contact and home visits. Future work should focus on the relationship between family contact and treatment outcomes.


2015 ◽  
Vol 6 (3/4) ◽  
pp. 204-210 ◽  
Author(s):  
Kenneth MacMahon ◽  
Ricky McClements

Purpose – There is a general consensus that healthcare for people with intellectual disabilities should be provided by multi-disciplinary teams. Within a forensic setting, recommendations are often made for separate or “parallel” forensic teams, operating independently of generic mental health or intellectual disability teams. An alternative to this model is an “integrated” service, where specialist forensic clinicians work within the general intellectual disability service, to provide support for clients with forensic needs. For clients with intellectual disabilities and forensic needs, there may be advantages to providing access to a wider multi-disciplinary team, through the application of an integrated model. The purpose of this paper is to illustrate the working of an integrated forensic service within a learning disability team, to identify positive aspects of this model, and how potential shortcomings may be overcome. Design/methodology/approach – Literature review, description of service outline with case example. Findings – Although some studies have compared parallel and integrated forensic models within mental health services, there are no evaluations that compare models of forensic services for individuals with intellectual disabilities. However, specific advantages of an integrated model may include availability of multi-disciplinary clinicians, development of forensic skills across wider groups of clinicians, reduction in stigma and avoidance of delay in transfer of care between services. In addition, in areas with smaller populations, parallel services may not be feasible due to low case numbers. Originality/value – There has been no formal evaluation of parallel vs integrated forensic services within an intellectual disability setting. However, the authors describe a fully integrated service and suggest means by which the potential shortcomings of an integrated model may be overcome.


Author(s):  
Deborah Morris ◽  
Nathalie Gray

Purpose – The purpose of this paper is to describe the evaluation of the “Living with a Personality Disorder” group (Morris, 2011a). This intervention is a psycho-education group for women with an intellectual disability (ID) and a personality disorder (PD). It draws on psycho-education, biosocial theory (Linehan, 1993) and compassionate mind approaches (Gilbert, 2009). It aims to increase knowledge of personality, PDs, to increase awareness of the “non-disordered” parts of self and to increase knowledge of psychological treatments for PD’s. Design/methodology/approach – The intervention was delivered to women detained in a specialist women’s learning disability forensic service. It was delivered over 12 group and two individual sessions. The Knowledge of Personality Disorders Questionnaire (D’Silva and Duggan, 2002), the Self-Compassion Scale (Neff, 2003), the University of Rhode Island Change Assessment scale (McConnaughy et al., 1983) and a series of Likert scale questions and statements were used to assess the utility of the intervention. The intervention was piloted between 2012 and 2014 in a series of small groups. The lead facilitator for each intervention was a registered psychologist with training in dialectical behaviour therapy. Findings – Completing the intervention resulted in an increase in knowledge of PDs, treatments, increased self-compassion and therapeutic optimism and awareness of the limitations of a PD diagnosis. Originality/value – A new intervention that may increase knowledge of PDs, of personal strengths and increase optimism about change that may be a useful component to the treatment for service users with PDs and an ID.


Author(s):  
Deborah J. Morris ◽  
Shubhinder Shergill ◽  
Elizabeth Beber

Purpose People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and impairments in neurological, physiological and psycho-social systems and functioning. In response, van der Kolk et al. (2009) have put forward the concept of developmental trauma disorder (DTD) to reflect the “constellation of enduring symptoms” and complex care needs of this population. The purpose of this paper is to ascertain the level of exposure to adverse childhood events and the prevalence of DTD in an inpatient forensic ID population. Design/methodology/approach A retrospective file review and consensus approach to diagnosis were used in a sample of adults with an ID detained in a secure forensic service. Findings Results revealed that 89 admissions (N=123) had been exposed to at least one significant ACE, with 81 being exposed to prolonged ACEs. A total of 58 admissions (47 per cent) met criteria for PTSD and 80 (65 per cent) met the criteria for DTD. Significant gender differences were noted in MHA status, primary psychiatric diagnoses, exposure to ACEs and DTD. Research limitations/implications The discussion explores the implications for working with forensic ID populations who report high incidents of childhood trauma and the utility, strengths and weaknesses of the proposed DTD, its relationship to ID diagnoses is explored. Originality/value The study outlines the prevalence of DTD and PTSD in ID forensic populations and suggests additional key assessment and treatment needs for this population.


2021 ◽  
Vol 26 (3) ◽  
pp. 160-168
Author(s):  
Faye Banks ◽  
Amy Fielden ◽  
David O'Sullivan ◽  
Barry Ingham

Purpose Research into culture within intellectual disability services, has predominantly focussed on small group homes in Australia. The current investigation aimed to explore the transferability of the dimensions of culture identified in the literature, to a residential Intellectual Disability service in the UK. The purpose of this study was to better understand the impact of informal culture upon the behaviour of direct care staff, particularly around managing behaviour that challenges. Design/methodology/approach Semi-structured interviews were conducted with direct care staff. Interview transcripts were analysed thematically using template analysis. Findings Themes regarding leadership, perceptions of managers, team functioning, and relationships between direct care staff and service users, were identified, corroborating the existing literature. Additional themes relating to being aware of the risks posed by service users, and the emotional impact of behaviour that challenges, also emerged. Originality/value To the best of the authors’ knowledge, this is the first qualitative study to explore informal culture within a community residential Intellectual Disability service in the UK.


Author(s):  
William Jackson

Purpose – The purpose of this paper is to discuss the development and proposal of a values evidence-based model of clinical supervision (CS) for the implementation by nursing staff (registered and non-registered nurses) within a forensic intellectual disability service. Design/methodology/approach – This is a conceptual and technical paper providing a descriptive account for a service provision with nursing staff. Findings – The paper does not present any research findings but does demonstrate a novel and innovative approach to the conceptualisation and implementation of CS. Originality/value – The paper examines the dominant concepts that shape existing thinking around CS and suggests a new interpretation that involves greater pragmatism through a values evidence-based approach.


Author(s):  
Walter Ott

Despite its difference in aspiration, the Meditations preserves the basic structure of perceptual experience outlined in Descartes’s earliest works. The chapter explores Descartes’s notion of an idea and uses a developmental reading to clear up the mystery surrounding material falsity. In the third Meditation, our protagonist does not yet know enough about extension in order to be able to tell whether her idea of cold is an idea of a real feature of bodies or merely the idea of a sensation. By the time she reaches the end of her reflections, she has learned that sensible qualities are at most sensations. As in his earliest stages, Descartes believes that the real work of perceiving the geometrical qualities of bodies is done by the brain image, which he persists in calling an ‘idea,’ at least when it is the object of mental awareness.


2014 ◽  
Vol 22 (1) ◽  
pp. 24-41 ◽  
Author(s):  
Deepa Mani ◽  
Kim-Kwang Raymond Choo ◽  
Sameera Mubarak

Purpose – Opportunities for malicious cyber activities have expanded with the globalisation and advancements in information and communication technology. Such activities will increasingly affect the security of businesses with online presence and/or connected to the internet. Although the real estate sector is a potential attack vector for and target of malicious cyber activities, it is an understudied industry. This paper aims to contribute to a better understanding of the information security threats, awareness, and risk management standards currently employed by the real estate sector in South Australia. Design/methodology/approach – The current study comprises both quantitative and qualitative methodologies, which include 20 survey questionnaires and 20 face-to-face interviews conducted in South Australia. Findings – There is a lack of understanding about the true magnitude of malicious cyber activities and its impact on the real estate sector, as illustrated in the findings of 40 real estate organisations in South Australia. The findings and the escalating complexities of the online environment underscore the need for regular ongoing training programs for basic online security (including new cybercrime trends) and the promotion of a culture of information security (e.g. when using smart mobile devices to store and access sensitive data) among staff. Such initiatives will enable staff employed in the (South Australian) real estate sector to maintain the current knowledge of the latest cybercrime activities and the best cyber security protection measures available. Originality/value – This is the first academic study focusing on the real estate organisations in South Australia. The findings will contribute to the evidence on the information security threats faced by the sector as well as in develop sector-specific information security risk management guidelines.


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