Search results

This article describes the design and implementation of the management of aggression care plans (MOACAP) in a secure service for people with learning disability and severe challenging behaviour. The MOACAP is a five‐part document, which has sections for descriptions of challenging behaviour, escalation patterns of the behaviour, non‐physical interventions, physical interventions and post‐incident briefing.Preliminary evaluations suggest that use of MOACAP leads to a reduction in aggressive incidents in the service. The approach should also be relevant to other forensic, mental health and challenging behaviour services and brain injury units. The MOACAP may also be relevant to services that will be affected by the National Institute for Clinical Excellence (NICE) and the National Institute for Mental Health in England (NIMHE) guidelines on the short‐term management of disturbed (violent) behaviour.

Standardised approaches to the management of aggression and violence are critical for all stakeholders of intellectual disability services. The purpose of this paper is to describe the Management of Aggression Care Plan (MoACP). The care plan aims to reduce levels of restrictive interventions, to ensure any interventions relative to aggression and violence are the least restrictive possible, and to promote adaptive behaviours and support life enriching opportunities, in a manner which is personalised to the unique profiles of every patient.

The MoACP was first described by Thomas et al. (2005). This paper describes the rationale, theoretical basis, structure and benefits of the care plan, and provides details of revisions made to the plan in response to evidence-based practice recommendations.

The value of implementing a structured approach to the care planning of management of aggression and violence, in reducing the frequency and impact of restrictive practices, and promoting life enriching opportunities is described.

The paper describes a number of practical features of the care plan which most support its continued effectiveness, including patient involvement, individual patient focused training, and audit.

Although many services undertake localised approaches to the care planning of management of violence and aggression in forensic intellectual disability services, few have been described in the published literature.

Offenders with a learning disability present with greater clinical need than those without a learning disability. However, for this client group, access to and engagement with psychological and criminogenic interventions are often limited. The purpose of this paper is to discuss a potentially useful approach to this issue.

A single case study design was used to evaluate an introductory group programme, delivered over 12 weekly sessions, in a forensic learning disability service. Semi-structured interviews were used alongside psychometric measures, which were completed prior to, and following completion of, the group, in order to assess the individual's experience of the group, their emotional understanding and difficulties, and readiness to change.

Readiness to change and emotional understanding improved following completion of the programme. Self-reported emotional difficulties showed improvement, although not all staff reports corroborated this. Notably, the service user reported a positive experience, with increased confidence and motivation to attend further groups.

Generalisation from the results of single case studies is limited. Although results suggest that motivation to engage further has increased, more research is required to assess whether this impacts on actual ability to engage.

Offering an introductory programme prior to further, more criminogenically focused intervention may be more effective than offering these interventions as the first stage of treatment.

An introductory group programme may be potentially helpful in providing the foundation knowledge, confidence and motivation necessary to attend further intervention focusing on criminogenic need for offenders with a learning disability.

High levels of anger have been associated with forensic learning disabled populations. The role of gender within the experience of anger is not clear. This study aims to start exploring the question “Do female forensic patients with learning disabilities have different needs in relation to anger?”

This study used a between‐subjects design with one independent variable: gender. The Novaco Anger Scale and Provocation Inventory was applied. Scores obtained by 12 females were compared with those of 23 males within a forensic psychiatric service for learning disabled patients.

Significant differences were found between scores, suggesting female forensic patients with learning disabilities experience higher levels of anger than do males, particularly in the arousal domain, and demonstrate difficulties in regulating anger.

The use of a single measure of anger and the small, forensic nature of the sample limits this study. It is recommended that further research address these issues and extend the exploration of this issue to non‐forensic populations.

Gender specific differences, and the potential influence of learning disabilities should be considered when assessing and treating anger difficulties. Female forensic patients with learning disabilities may benefit from a greater emphasis on anger arousal reduction work.

This study highlights how the impact of gender and learning disabilities on the experience of anger is currently insufficiently understood.

This study forms a preliminary study of anger in the under‐researched population of females with learning disabilities.

The purpose of this paper is to explore students’ perceptions and understandings of, and attitudes towards, education for sustainable development (ESD) at Delta Business School (DBS) in New Zealand[1]. The aim is to extend the limited literature on students’ perceptions of ESD within an accounting and business curriculum.

To ascertain the students’ evaluations of their ESD, a survey was administered to 60 accounting and business students at DBS. The survey data were supplemented with interview evidence from 20 of the 60 students to obtain a deeper understanding of the students’ evaluations.

A majority of the students perceive ESD as a “good thing.” Students were supportive of the sustainable business learning experience offered at DBS. The results suggest that students’ knowledge of sustainable business practices improved significantly from their studies.

The paper should assist education providers to assess how students perceive ESD. This may help bring about changes, to improve the teaching of sustainable development. Universities can be the main providers of ESD, but other educational providers such as the professional accounting bodies will also need to manage the development of ongoing education processes. Most students at DBS believe they are obtaining a good understanding of the concept of sustainability.

There is a shortage of research concerning how students perceive sustainable development education. This paper contributes to the discussion of what to incorporate in sustainable education programmes, to help students properly to understand sustainable development. We believe accounting and business education should develop graduates into broad-minded thinkers with a capacity for independent and critical thought. This will prepare them for future leadership roles.

Mindfulness is the practice of focusing attention effectively/purposefully, in a non‐judgemental manner, on current circumstances (Kabat‐Zinn, 2009; Crane, 2009). It has been increasingly used as a tool for managing a range of difficulties associated with personal suffering, including stress and chronic pain, as well as some aspects of mental disorder. In this study the practice of mindfulness was introduced to a medium secure ward for female patients with learning disabilities in the form of twice‐weekly, 30‐minute group sessions. Proxy measures of institutional aggression namely the number of observations (Obs), physical interventions (PI), and seclusions (Sec) were recorded at baseline (during the month prior to the introduction of the mindfulness sessions and at two months and six months following the introduction of the sessions). Friedman's Analysis of Variance and post‐hoc analyses using Wilcoxon's Signed Ranks showed a significant reduction at six months. The potential influence of basic mindfulness practice sessions in reducing aggression is discussed.

The aim of the present study is to explore the psychometric properties of the EssenCES measure (patient report) of social climate in a secure service for people with intellectual disabilities.

Patients (37 men, 14 women, Mean age=33.24 years, SD=11.29, age range: 18‐71 years) residing in a secure intellectual disabilities service completed the EssenCES as part of routine clinical practice.

Reliability analysis revealed acceptable reliability for all three subscales (α=0.76‐0.88). In order to consider one aspect of the construct validity of this measure, a predicted group difference regarding the impact of security level on ratings of social climate was investigated. Analysis revealed that social climate ratings were more positive on low secure wards than medium secure wards as measured by the combined EssenCES subscales F(3, 31)=4.71, p=0.008; Λ=0.69; η²=0.31, and the Experienced Safety subscale, F(1, 33)=7.41, p=0.01.

Future research should consider the link between social climate and treatment outcome within forensic secure intellectual disability services.

Results provide preliminary evidence to suggest that the EssenCES subscales (patient report) are reliable in this previously unconsidered population. However the validity of the measure is still unclear and requires further investigation.

The purpose of this paper is to describe a study which investigated the diverse needs of multiple stakeholders in an adapted sex offender treatment programme (ASOTP) and then evaluated a pilot programme set up to respond to the identified needs efficiently and effectively. The paper reports on an innovative approach to delivering ASOTP in secure learning disability services. It aims to address many of the criticisms and concerns of conventional closed format programmes, particular in the climate of value for money and payment by results.

The multiple views of stakeholders were identified by means of questionnaires and semi‐structured interviews in order to ascertain the key issues necessitating change. Stakeholders included purchasers of Partnerships in Care Learning Disability Services (PiC LDS), referred clients, internal and external clinicians involved in their care, group facilitators and, in some cases, clients' families or advocates. A rolling format ASOTP (based on the content of the Prison and Probation Service ASOTP) was designed and piloted to address highlighted needs, including time frames for the commencement and completion of treatment.

Initial feedback obtained by means of structured interviews and discussions with all stakeholders has been positive. In particular, participants have shown an increase in motivation, knowledge, and, unexpectedly, enhanced levels of risk disclosure. Facilitators have reported increased satisfaction and decreased stress levels. These findings are tentative in light of the small numbers involved and the absence of a randomised control trial.

This study has a number of implications for future research in terms of improving treatment effectiveness by means of increasing knowledge retention and enhancing risk disclosure, as well as a reduction in facilitator burnout.

The programme was tailored to respond to individual treatment needs within a group setting whilst ensuring programme integrity and effective risk management within a forensic learning disability service.

Traditionally, preservice teacher education has been conducted in college and university classrooms and has relied heavily on what Shulman (1992) called “the twin demons of lecture and textbook” (p. 1). This educational model neglects the importance and strength of preservice teachers’ beliefs about teaching and content (Nietfeld & Enders, 2003; Putnam & Borko, 2000) and has been termed a transmission model in which teaching is telling (McLeskey & Waldron, 2004; Russell, McPherson, & Martin, 2001). The type of knowledge conveyed is considered to be declarative (Sternberg, 1999) or formal (Lundeberg & Scheurman, 1997) and is derived from theory and comprised of facts, concepts, and rules. Whitehead (1929) and more recently Bransford, Brophy, and Williams (2000) reported that this type of knowledge tends to remain inert and is unlikely to be retrieved in the very circumstances that call for its use.