Search results

The Adult Support and Protection (Scotland) Act 2007 (ASP Act) mandates public bodies to investigate situations of harm and to support and protect adults at risk. One of the fundamental principles of the legislation is to involve the person in the adult protection process. Older people are highly represented among those defined as adults at risk and have the right to participate in decisions about their lives. However, contextual factors can impact participatory parity, and participation can be tokenistic. Drawing on the author’s practice experience, this paper aims to explore the supports and barriers to meaningful participation in adult protection.

Based on practice during the first decade of the ASP Act, this paper uses amalgamated scenarios involving older adults at risk to illustrate some of the key themes emanating from literature.

Despite Human Rights Conventions and law promoting participatory principles, research evidence and practice experience suggests that ethical principles do not always translate to practice. Within adult protection case conferences (APCCs), participation is nuanced and multifaceted, involving individual and structural facilitators and impediments. APCCs can be inhospitable environments for the adult at risk. But they also have the potential to be collaborative and supportive spaces, promoting the person’s self esteem and agency. The author plans to conduct research with service users and practitioners exploring the extent to which APCCs can facilitate meaningful participation.

This paper contributes to the wider debate about the participatory rights of service users and the value of experiential knowledge.

A systematic investigation of postgraduate leadership programs for health and/or human services offered by Australian higher education institutions was undertaken.

Quantitative analysis identified the core characteristics of the programs. A thematic analysis of the course learning outcomes was conducted and six major themes of disciplinary leadership and management knowledge; research and analytical skills; professional practice; communication and collaboration; creativity and innovation; and system knowledge are shared in this study.

The authors conclude that Australian universities have taken an evidence-based approach to leadership education.

More work might need to be undertaken to ensure leadership theories are incorporated into learning outcomes.

The Adult Support and Protection (Scotland) Act 2007 places a duty on Councils to investigate the circumstances of adults who, because of a disability, health condition or illness are unable to safeguard themselves from harm. Public partner agencies, including the NHS have a statutory obligation to bring to the attention of the Council those individuals who may be at risk of harm. Health professionals cooperate with adult protection investigations and participate in the development of adult support and protection plans, yet do not appear to be initiating adult protection referrals with the Council. Low reporting by health has also been recognised as a national issue. The purpose of this paper is to explore what promotes and what prohibits the identification and reporting of situations of abuse within the Scottish Legislative Framework. Understanding the decision-making processes of prospective reporters would potentially allow the barriers to be reduced and the supports to be strengthened.

The research strategy is based on a literature review, a web-based survey and semi-structured interviews with health professionals within community learning and community mental health teams.

The findings point to a number of inter-related factors which impinge upon the professional’s confidence to initiate adult protection referrals. Workers must first recognise harm as conduct which needs to be reported and addressed. They need to be familiar with referral procedures and be assured that their concerns will be dealt with appropriately. Health professionals are more likely to report if they are based in an environment which supports honest and open discussion regarding harm, without over-concern about agency reputation or resources. Access to multi-disciplinary consultation and support, particularly in relation to more ambiguous protection situations, was viewed as fundamental to reporting.

This small scale study adds to a developing bank of literature providing a Scottish perspective on protecting adults. It offers some insight into reporting decisions from the viewpoint of community health professionals.

Frequent attendance at emergency departments (ED) has been identified in adult protection reviews as a potential warning sign of the escalation of someone’s vulnerability. Concern has been expressed about the engagement of the National Health Service (NHS) in adult protection and the small number of NHS adult protection referrals. More specifically ED departments have been identified as an area of high patient through put where there has been little evidence around how well adult support and protection (ASP) was being delivered. The paper aims to discuss these issues.

A series of audits were undertaken in three different hospitals across a large Scottish Health Board accessing ED at different times of day on different days of the week to test out whether NHS staff working in EDs are identifying adults who meet the criteria of “an adult at risk”.

The audits identified a total of 11 patients from a total sample of 552 records examined who may have met the criteria to be considered an adult at risk, although further information would have been required to make a fully informed decision.

The main study limitation is that the hospitals are all within a single Health Board. The EDs have a large number of admissions and it is possible that a less pressurised area, might have a lower threshold of “risk” than the practitioners involved in the audits. The decision as to whether an adult was considered to meet the three-point test by the three people undertaking the audit was dependent on the quality of information recorded on the patients’ electronic hospital record.

It is essential that NHS Boards proactively support practice in ED settings so staff are able to identify adults at risk of harm under the ASP legislation so that ED staff are responsive to ASP needs.

The research evidence around adult protection in the UK is still emerging. The development of good practice based on the Scottish Government’s ASP legislation is still being shaped. In England and Wales, the principles of identification and multi-agency working underpinning the safeguarding of vulnerable individuals are broadly similar to Scotland. These audits add to the literature by challenging the assumption that patients who would benefit from local authority investigation and possible support are not being identified within EDs.

Low self-esteem is common in people with learning disabilities. There is limited research examining the effectiveness of cognitive behavioural therapy (CBT) focused on low self-esteem within this client group. The purpose of this paper is to add to the limited evidence by describing the use of CBT focused on low self-esteem for a person with a learning disability in the context of emotion regulation difficulties.

An individual case study design was used, with repeated quantitative measures to monitor progress during weekly individual psychology sessions.

There was a reduction in the client’s feelings of anger and an increase in their self-esteem.

Further studies and follow-up would determine longevity of benefits. The inclusion of distress tolerance techniques may have impacted on the findings and limits the conclusions that can be drawn about the impact of CBT focused on low self-esteem.

This case study could make a small contribution to the evidence base for the effectiveness of CBT-based treatments for low self-esteem in people with learning disabilities, which is an under-researched area.

The figure of the female revenger has haunted the western imagination as far back as some of the earliest extant texts, most starkly in Euripides' tragedies Hecuba and Medea (c. 430–420 bc). She has tended to take on one of three forms: the scorned woman, the vengeful mother or the victim of physical violence, almost always sexual violence.

This chapter presents an interdisciplinary and transhistorical understanding of the troubling figure of the violent female revenger in her shifting incarnations. The investigation traces conceptual strands through a variety of cultural texts, focusing on specific instances that are both situated historically and simultaneously analysed for the ways in which they reflect recurring priorities and cultural anxieties through the centuries.

After considering key ideas such as revenge and justice and gender and revenge, the chapter looks more closely at the so-called rape-revenge genre, moving from the earliest examples such as I Spit on Your Grave (1978) to more recent films which are considered for the ways they intersect with the global feminist protest movement #MeToo, and other key cultural moments such as the Harvey Weinstein case and the very public trial of the USA Gymnastics national team doctor Larry Nassar: Revenge (2017), The Nightingale (2018) and Promising Young Woman (2020). The chapter draws direct lines of connection between imaginative works, cultural types and stereotypes, and lived reality in order to come to a fuller understanding of the female revenger.