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Structural Equating Modeling (SEM) is a formal model for representing dependency relations between variables of psychological events and may be used for verifying the structural organization of a theoretical model. “Rules of thumb” for the use of SEM are presented regarding each step of its application: specification of the structural model, measurement of the psychological event, and estimation of the adequacy of the model in representing the event. The investigation of the factorial structure of Greenspan's model of personal competence is presented as an example of SEM application with participants with disabilities.

Evidence is mounting to suggest that stress not only influences an individual's well‐being, but can also have an impact on the quality of work they perform. This paper starts with a consideration of some important issues relating to stress in staff who work with people who have learning disabilities, particularly those who work in community group homes. Current research indicates a number of common themes. A model is presented that attempts to summarise some of these. However, it is also clear that there is considerable variability between organisations. This variability must be assessed when considering the needs of individuals and groups of staff. Some groups of staff seem to Report higher levels of stress and can benefit from stress management interventions. For stress management to be effective, assessments that take into account individual and organisational issues are necessary. An example of a successful intervention package is provided. This is based on the assessment of staff teams and implemented within a problem‐solving framework.

This paper briefly reviews the literature on smoking and smoking cessation programmes for people with intellectual disability, and describes the baseline audit of such a programme for patients resident in a forensic service. The audit describes the prevalence of smoking, its significant associations and the effect of an intervention programme. In total, 79 patients participated in the audit, 48 of whom were smokers on admission (60.8%). Roughly a third of smokers gave up during their hospital stay (N = 15). Those who did not give up significantly reduced the number of cigarettes they smoked per day. Female smokers appeared less likely to give up than men. Length of stay and treatment with anti‐psychotic medication were not significantly linked to smoking behaviour. A simple smoking cessation programme with an emphasis on health education and nicotine replacement therapies appeared to be effective in cutting down smoking rates and tobacco consumption in this population. One should be cautious about generalising the conclusions to all forensic hospital services for people with intellectual disability, as the audit was limited by the lack of a control group and conducted in a single service.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. (Declaration of Independence, 1776)

Since the passage of P.L. 94–142, the Education for All Handicapped Children Act of 1975, on November 29, 1975, mandating that handicapped students be educated in the least restrictive environments possible, there has been an increasing demand for information related to the education of the handicapped. A common observation of teachers and administrators is that tedious hours of paperwork and conferences are required to plan individualized programs and meet governmental mandates.

There has been increasing concern about inappropriate or excessive medication of people with learning disabilities. Audits of prescribing practice may guide clinicians towards a more rational use of psychotropic drugs. Most previous studies have come from North America or Europe. This paper reports on a survey of prescribing patterns in an institution that cares for adults with severe to profound learning disabilities in Hong Kong. The survey found that 27% of the 294 hospital patients were receiving psychotropic drugs, but this rate was significantly higher (90%) in the ward for people with challenging behaviours. Most patients (67%) received a single psychotropic drug, 26% received two and 7%, three. Around half the patients (151) had epilepsy, of whom 90% received anticonvulsants. Of these, 52% received a single anticonvulsant, 37% received two and 11% received three or more. Dosages were generally within the recommended ranges. This survey revealed several good aspects of prescribing practice at Siu Lam Hospital, but also areas that need improvement. The latter include a drug‐reduction programme for the people with challenging behaviours, trials of drug‐free periods for seizure‐free patients receiving anticonvulsants and replacement of phenytoin and phenobarbitone with safer alternatives.

Historically, professionals did not consider that people with learning disabilities could make use of psychoanalytic psychotherapy because of limitations of intelligence (Symington, 1981; Symington, 1993; Sternlicht, 1965). Additionally, many believed that people with learning disabilities enjoyed immunity from emotional stress and psychiatric disturbances (Fletcher, 1993). Maladaptive behaviours were perceived as a manifestation of the condition of learning disability and not as a possible sign of psychiatric disorder or emotional problems. However, over the last decade there has been a growing realisation that people with learning disabilities have emotional problems in the same way as others, but are in some ways more vulnerable to developing psychiatric and psychological disturbances. Psychoanalytic practitioners wishing to undertake outcome research have experienced difficulties in finding a measuring device that understands the subtleties of change in the internal psychological structure over time. PORT and DMT (the Percept‐genetic Object Relation Test and the Defence Mechanism Test) are two projective tests that have been extensively validated in Sweden. This paper explores the use of the PORT and DMT outcome measures in the context of Anglo‐Swedish psychotherapy research.

Recidivism is often used to measure the success of the criminal justice initiatives. We explore alternate measures of success that were identified for special offenders through the development of program theory. Using content analysis of 50 closed files from the Special Offenders Services program in Lancaster County, PA, we found that most offenders completed the program without re-offending, maintained their medication, participated in counseling, fulfilled their court cost obligations, and had few housing transitions. However, there were differences between parolees and probationers in terms of their outcomes. We recommend that special offender programs use uniform data-recording procedures.

The UK government is committed to preventative technologies and increasingly they are being incorporated into residential services for people with learning disabilities. This paper describes an evaluation of a sample of settings in which various assistive technology (AT) devices have been installed following the assessment of individual residents' needs. The impact of this on residents' objective quality of life was assessed using a range of quantitative measures and through some qualitative questions. Despite some positive consequences of the AT being reported by staff in response to the qualitative items, there was no significant impact on any of the quantitative measures. In isolation, AT does not appear to be sufficient to significantly improve objective quality of life outcomes for people with learning disabilities in residential services. Equally, AT does not appear to reduce objective quality of life outcomes. The challenge to service providers is to ensure that the introduction of AT and any associated change to staffing levels or support procedures translates into improvements in residents' overall quality of life. To detect such improvements future research might have to broaden the range of quantitative methods used and supplement them with qualitative techniques.

Following the implementation of key actions resulting from Valuing People (DoH, 2001), people with learning disabilities resident in hospital will be relocated into the community. This paper examines psychological, social and quality of life indicators applied to a group of 50 service users, 36 of whom are soon to be relocated into community housing. The methodology employs a range of psychometric measures in order to describe intellectual and social functioning, mental health, levels of challenging behaviour and quality of life and choice opportunities. The aim was to compile a profile of the individuals as a group in order to inform service planning and provision. Results illustrate that the group contains a range of individuals with complex and enduring needs. A discussion of the opportunities and challenges that lie ahead for these individuals and the services that support them is presented. The study presents an opportunity to re‐apply this methodology in future years in order to evaluate whether community living has brought tangible benefits to the group.