Consensus‐based good practice guidelines for clinical psychologists to support care staff in enabling sexual expression in people with intellectual disabilities—A Delphi study

2019 ◽  
Vol 33 (2) ◽  
pp. 268-282
Author(s):  
Brad English ◽  
Anna Tickle ◽  
Roshan Nair ◽  
Kate Moore
2013 ◽  
Vol 203 (4) ◽  
pp. 288-296 ◽  
Author(s):  
Paul Willner ◽  
John Rose ◽  
Andrew Jahoda ◽  
Biza Stenfert Kroese ◽  
David Felce ◽  
...  

BackgroundMany people with intellectual disabilities find it hard to control their anger and this often leads to aggression which can have serious consequences, such as exclusion from mainstream services and the need for potentially more expensive emergency placements.AimsTo evaluate the effectiveness of a cognitive–behavioural therapy (CBT) intervention for anger management in people with intellectual disabilities.MethodA cluster-randomised trial of group-based 12-week CBT, which took place in day services for people with intellectual disabilities and was delivered by care staff using a treatment manual. Participants were 179 service users identified as having problems with anger control randomly assigned to either anger management or treatment as usual. Assessments were conducted before the intervention, and at 16 weeks and 10 months after randomisation (trial registration: ISRCTN37509773).ResultsThe intervention had only a small, and non-significant, effect on participants' reports of anger on the Provocation Index, the primary outcome measure (mean difference 2.8, 95% Cl −1.7 to 7.4 at 10 months). However, keyworker Provocation Index ratings were significantly lower in both follow-up assessments, as were service-user ratings on another self-report anger measure based on personally salient triggers. Both service users and their keyworkers reported greater usage of anger coping skills at both follow-up assessments and keyworkers and home carers reported lower levels of challenging behaviour.ConclusionsThe intervention was effective in improving anger control by people with intellectual disabilities. It provides evidence of the effectiveness of a CBT intervention for this client group and demonstrates that the staff who work with them can be trained and supervised to deliver such an intervention with reasonable fidelity.


1995 ◽  
Vol 19 (2) ◽  
pp. 5-15 ◽  
Author(s):  
Peter Mittler

It is axiomatic that people with intellectual disabilities have the same human and civil rights to education as other citizens and that they must therefore have the same opportunities to attend their local schools and educational facilities. This is a fine vision. But it is far from the reality experienced by the majority of people with intellectual disabilities across the world.No country in the world has reason to be satisfied with the quality of the educational facilities which it provides for people with intellectual disabilities. But enough examples of good practice exist in different countries to make it possible for all of us to reappraise ways in which a higher quality of inclusive education and schooling could be provided for people with intellectual disabilities and the contribution that we can make personally and professionally to that process.In the field of intellectual disabilities, we need to define education in very broad terms as anything which systematically promotes learning and development. Defined in this way, education is a lifelong process which neither begins nor ends with schooling. Similarly, it is carried out by many people who are not teachers. Parents are at the heart of this process from the outset. The years spent at school are clearly of vital importance but they are only one element of the educational process. There is a sense in which all work with people with intellectual disabilities is educational, whatever the setting, in so far as it helps them to learn and to develop knowledge, skills and understanding.


2019 ◽  
Vol 39 (3) ◽  
Author(s):  
Alan Santinele Martino ◽  
Jordyn Perreault-Laird

This exploratory study examined the attitudes and experiences of a small sample of direct care workers' experiences of addressing the sexual expression and practices of their clients with intellectual disabilities. Drawing on in-depth interviews with direct care workers in Alberta, Canada, we use Foucault's work to examine the way power is exercised through organizational policies, personal values, and employment contexts. Altogether, the accounts of direct care workers seem to illuminate a culture that commonly sees disability and sexuality as antithetical and a topic to be avoided for fear of reprisal.


2013 ◽  
Vol 19 (1) ◽  
pp. 25-28
Author(s):  
Hilary Brown

Purpose – This paper is a commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review” by Chris James and James Stacey. The purpose of this paper is to illustrate the thesis that standardised ways of evaluating health care interventions may have the inadvertent effect of undermining the case that people with intellectual disabilities should be offered the same opportunities to address their emotional and mental health difficulties as other citizens. Design/methodology/approach – The commentary argues that while the evidence base focuses on the outcomes of orthodox one-to-one interventions, sometimes broader “contextual reformulation” and systemic interventions are called for. However, family- or service-based interventions tend not to feature in studies. Findings – The commentary illustrates these issues by discussing two case studies, which demonstrate how relational issues tend to be unhelpfully focused on the person with intellectual disabilities to the detriment of family members or direct care staff, who may be struggling to make sense of the person's behaviour or distress. Originality/value – The commentary supports the argument put forward in the longer paper and also argues for mental health services to be offered on a non-discriminatory basis to people with intellectual disabilities and to their family members. But it also suggests that one of the additional impacts of service level psychotherapeutic interventions is to re-establish respect for the work of direct care staff whose work is often presented as if it is little more than domestic drudgery when in fact it involves negotiating and responding to people and their issues with great sensitivity and balance.


Sign in / Sign up

Export Citation Format

Share Document