GPs and practice nurses do not address sexual health issues proactively with patients, and this area warrants further attention if policy recommendations to expand the role of primary care within sexual health management are to be met.

Background Intensive Interaction is an approach to developing the pre-verbal communication and sociability of people with severe or profound and multiple learning disabilities and autism. Previous research has indicated many potential benefits; however, the approach is not consistently used in social care. Aim To report on the significant and influential issues for care staff when adopting Intensive Interaction as a novel approach in the social care setting for clients with profound and multiple learning disabilities. Materials and Methods Twenty-nine care staff from four residential settings were trained and supported in the use of Intensive Interaction over a 6-month period.Interviews with staff members and researcher field-notes were analysed using a Grounded Theory methodology. Results and ConclusionsIncreased and novel client responses were reported which were consistent with previous research. However, some practical and philosophical difficulties were highlighted by staff regarding their adoption of the approach. Consideration of care staff's experiences and perspective could enable future Intensive Interaction interventions to be more successfully planned and supported.

Background  Restraint is sometimes used on people with intellectual disabilities who display challenging behaviours, and may be justifiable as a last resort to prevent harm. A substantial proportion of such people are cared for within the family home. The aim of this paper is to explore parents’ experiences of using restraint with their son/daughter with intellectual disabilities. Materials and Methods  Seven participants took part in the study. Interpretative Phenomenological Analysis (IPA) was used to analyse the interviews, due to its dual perspective of understanding of participants’ experiences and acknowledging the interpretative process of the research. Results  Restraint was described as a ‘very fine line’, drawn in an attempt to strike a balance between right and wrong, safety and danger, humanity and dehumanising, and helping and harming. Interactions regarding restraint with professionals also presented a fine line between being heard and being ignored, being supported and being isolated, and being informed and being kept in the dark. Conclusions  Decisions about restraint present many complex dilemmas. It is recommended that professionals can support parents pro‐actively by providing advice on challenging behaviour and sufficient support in the caring role. Where restraint is necessary support can be provided by recognising the complexity of such decisions, working in partnership with parents, promoting a culture of openness and honesty about restraint use in services, and providing training and advice about restraint.

Claims have been made that reminiscence has benefits for older people's psychological well-being, and that writing memories may be a therapeutic process. This paper describes an exploratory study in which five nursing home residents engaged in a process of writing their memories by themselves, in a series of booklets containing memory prompts and photographs, over a period of four weeks. Each completed booklet was typed up by researchers and returned to participants the following week, with a bound copy provided to participants at the end of the study period. Analysis focuses on two sets of data: an in-depth case study of one participant, and a thematic analysis of field notes, researcher reflections, and the written material produced by the other study participants. The case study revealed three main themes: views on the past; sharing the past; and confidence in writing about the past. The field note analysis indicated the presence of four themes: proof and maintenance of skills; psychological or internal processes; social contact; and pleasure in reminiscence. The writing was seen as cathartic and provided a meaningful purpose, an opportunity to exercise writing skills and memory, and a focus for participants to share key stories with others. This exploratory study suggests that there is potential in using solitary writing within a reminiscence framework to improve psychological well-being in older people. However, caution should be exercised when encouraging older people to write their stories. Issues of confidentiality, audience, support, and appropriateness of the activity for the individual need consideration.

The study findings are discussed with reference to Eriksonian theory, reminiscence functions, and the potential for reminiscence in psychological therapy for older people.