How can I use, develop and improve a collaborative music therapy practice to enhance the sense of community at a day programme for adults with learning disabilities?

<p>Everyone needs to belong. People with disabilities often experience belonging to restricted communities of people who usually have similar needs. The purpose of this study is to investigate how music therapy could enhance the sense of community at a day program for adults with learning disabilities. The project focuses on exploring and improving my own collaborative music therapy practice in order to reach the goal of this research. This action research follows three cycles of planning, acting and reflecting. The different cycles observe my own collaborative skills, moments of togetherness as an expression of a sense of community and relationship building with different communities of people. The data analysis involves a thematic analysis of my clinical and reflective notes taken during each cycle. I have used song composition for each cycle as a tool for integrating meaning and summarising my learning. The process of this action research helped me understand that: 1) Effective collaboration with staff required working genuinely as a team, sharing goals and acknowledging individual skills. 2) A sense of community was about connecting with others but also about self- realisation in a group. 3) Building relationships between people, staff, whānau, the local community and communities of musicians contributed to enhance the sense of community at the facility. Collaboration is an essential skill for music therapists aiming at connecting people with their community and to expend connections to a wider horizon.</p>

How can I use, develop and improve a collaborative music therapy practice to enhance the sense of community at a day programme for adults with learning disabilities?

<p>Everyone needs to belong. People with disabilities often experience belonging to restricted communities of people who usually have similar needs. The purpose of this study is to investigate how music therapy could enhance the sense of community at a day program for adults with learning disabilities. The project focuses on exploring and improving my own collaborative music therapy practice in order to reach the goal of this research. This action research follows three cycles of planning, acting and reflecting. The different cycles observe my own collaborative skills, moments of togetherness as an expression of a sense of community and relationship building with different communities of people. The data analysis involves a thematic analysis of my clinical and reflective notes taken during each cycle. I have used song composition for each cycle as a tool for integrating meaning and summarising my learning. The process of this action research helped me understand that: 1) Effective collaboration with staff required working genuinely as a team, sharing goals and acknowledging individual skills. 2) A sense of community was about connecting with others but also about self- realisation in a group. 3) Building relationships between people, staff, whānau, the local community and communities of musicians contributed to enhance the sense of community at the facility. Collaboration is an essential skill for music therapists aiming at connecting people with their community and to expend connections to a wider horizon.</p>

The development and evaluation of an integrated intensive support service

Purpose This paper aims to describe the development and evaluation of integrated intensive support service (ISS) for adults with learning disabilities who have complex needs and are at risk of admission to an inpatient unit. Design/methodology/approach Existing services were remodelled. The service explored external service models and established an integrated ISS comprising intensive community support and intensive support beds. Findings Data indicates that the majority of people referred to the service avoid both admission to an inpatient unit and placement breakdown. Most people admitted to the inpatient unit are not known to community services. Length of stay has significantly reduced. Practical implications Other services can use the information to remodel how to provide intensive support and avoid admission to an inpatient unit. Originality/value It demonstrates how remodelling can drive improvements to reduce placement breakdown and risk of admission.

Understanding the effectiveness and underlying mechanisms of lifestyle modification interventions in adults with learning disabilities: protocol for a mixed-methods systematic review

Background Adults with learning disabilities have an increased disposition to unhealthy lifestyle behaviours which often occur simultaneously. Existing studies focus on complex interventions targeting unhealthy diet, physical inactivity, sedentary behaviour, smoking, and alcohol use to reduce health risks experienced. It is essential to understand how well these interventions work, what works, for whom, in what context and why. This study aims to investigate the effectiveness and underlying mechanisms of lifestyle modification interventions for adults with learning disabilities. Methods This is a mixed-methods systematic review consisting of a network meta-analysis (NMA) and realist synthesis. Electronic databases (ASSIA, CINAHL, EMBASE, MEDLINE, and PsycINFO) will be searched from inception to 14 January 2021 with no language restriction. Additionally, trial registries, grey literature databases and references lists will be searched. Studies related to lifestyle modification interventions on the adult population (>18 years) with learning disabilities will be eligible for inclusion. Two independent researchers will screen studies, extract data and assess its quality and risk of bias using the Cochrane Collaboration’s Risk of Bias Assessment Tool (RoB Version 2) and ROBINS-I. The strength of the body of evidence will be assessed based on the GRADE approach. The NMA will incorporate results from RCTs and quasi-experimental studies to estimate the effectiveness of various lifestyle interventions. Where appropriate, a component NMA (CNMA) will be used to estimate effectiveness. The realist synthesis will complement and explain the findings of NMA and CNMA by including additional qualitative and mixed-methods studies. Studies will be included based on their relevance to the programme theory and the rigour of their methods, as determined by quality appraisal tools appropriate to the study design. Results from both syntheses will be incorporated into a logic model. Discussion The paucity of population-specific lifestyle interventions contributes to the challenges of behaviour change in adults with learning disabilities. This study will provide an evidence-base from which various stakeholders can develop effective interventions for adults with learning disabilities. The evidence will also help prioritise and inform research recommendations for future primary research so that people with learning disabilities live happier, healthier and longer lives. Trial registration PROSPERO CRD 42020223290

Health and social care access for adults with learning disabilities across the UK during the COVID-19 pandemic in 2020

Purpose This paper aims to present data about access to health and social care services during the COVID-19 pandemic for adults with learning disabilities across England, Northern Ireland, Scotland and Wales. Design/methodology/approach Data were collected directly from 621 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 378 adults with learning disabilities. The data were collected between December 2020 and February 2021 and concerned the use of health and social care services since the start of the first COVID-19 national lockdown in March 2020. Findings Access to and use of health and social care services significantly reduced for adults with learning disabilities across the UK during the COVID-19 pandemic between March 2020 and February 2021, with many people not receiving any services at all during that period. Similar patterns were seen across England, Northern Ireland, Scotland and Wales. However, data suggest some variations between countries for some services. Practical implications Future pandemic planning must ensure that access to these essential services is not completely lost for adults with learning disabilities and their family carers, as it was in some cases during the COVID-19 pandemic in 2020. Originality/value This is the largest study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. The authors primarily collected data directly from adults with learning disabilities, and worked with partner organisations of people with learning disabilities throughout the study.

Developing trauma-informed care: using psychodynamic concepts to help staff respond to the attachment needs of survivors of trauma

Purpose Many referrals to our mental health of learning disability service focus on concerns about behaviours that present risks to the referred person and to those around them, including support workers. If the referred person has good verbal ability, psychological therapy may be requested and offered, but the person may find it too difficult to engage for a number of reasons. Even when they do engage in therapy, the authors recognise the importance of helping staff better understand their attachment needs. This paper aims to demonstrate an innovative approach to helping staff provide Trauma-Informed Care (TIC). Design/methodology/approach The authors developed a training programme for support workers using psychodynamic concepts, such as splitting, transference and counter-transference, to help them develop insight into the processes that get enacted during their work. In this paper the authors have generally used the term “care staff”, recognising that an important aspect of the role of those staff is to provide care within an attachment framework; as well as support to maximise independence. Findings The feedback from staff who have attended has been very positive, both at the time and later. Staff who have attended have talked to multidisciplinary colleagues about the impact their learning has had on their ability to work with service users who present great challenges, in the context of their trauma histories. Originality/value The importance of providing TIC is gaining traction across varied settings. The authors are in the process of developing both qualitative and quantitative research programmes to evaluate this approach to increasing TIC for adults with learning disabilities, reducing staff burn out and placement breakdown.