A course on anger management of eight weeks duration for six people with learning disabilities (in the mildmoderate range), and their keyworkers, is described. The programme drew on a range of techniques to assist in the exploration and control of difficult emotions, including relaxation, role-play, problem-solving and sharing in a group. With reference to the information we received from the participants (clients and staff) about their experience of being in the group, we discuss what appeared to have been helpful to group members in learning how to express angry feelings in appropriate ways, and to keyworkers in supporting clients in the management of aggressive behaviour. IntroductionAnger is an emotional state, the expression of which, through aggression, can lead to considerable distress for people with learning disabilities and for those who work with them (Benson, 1986;Black et al., 1988;Whitaker, 1993). When discussing the running of a group for people with a learning disability on the subject of anger, we became aware of how people come to be referred to psychology services for anger management, and what this might mean for their experience of participation in a group. We thought about how difficult it can be to express anger towards people on whom we are also dependent, for fear of jeopardising the relationship we have with them. We also thought how difficult it may be for people in a devalued or minority group to feel safe in the expression of their anger, and how many contradictory messages we (as professionals and/or carers) often give about what is acceptable with respect to the expression of intense feelings.It has been suggested that people with a learning disability have problems with identifying the emotions of others (Gray ef al., 1983; Reed &Clements, 1989). However, Lindsay et al. (1994) have observed that people with mild or moderate intellectual disability can be accurate reporters of their own emotional state. Others (e.g. Gardner ef al., 1983; Rose, 1996) have pointed out how the problems raised by the consequences of angry feelings can be greatly compounded by the impact of having learning and other disabilities which hamper speech, hearing and understanding.Psychological research on the expression of anger through aggression is under-pinned by assumptions that violent acts are typically attempts to resolve problems, and that human aggression is learned (Blackburn, 1993). Clearly, aggression is a multiply-determined phenomenon, and interventions to reduce the frequency of aggression need to recognise this. In a comprehensive review of psychological methods that have been used with people with disabilities to reduce aggressive behaviour, Whitaker (1993) raises questions about the efficacy of 'traditional' and more recent types of intervention (ranging from behavioural approaches including punishment, to attempts to encourage clients to make use of self-control techniques). Aggression which occurs with low frequency (e.g. monthly rather than daily) presents particular problems in community...

This paper describes a process of asking clients their views about a change in service provision. The questionnaire development, interview process and feedback includes clients' participation. Following a pilot study, an open-ended semi-structured interview format was adopted. A study group (n = 10) and control group (n = 9) were interviewed to find out their views about two day-centre premises as well as finding out possible differences between the views of those responsible for challenging behaviour and those who were not involved in such incidents. All the clients interviewed were able to respond to some aspect of the questionnaire and, of the responses given, 78% were deemed to be valid according to our criteria. The main findings indicated that people liked the new centre better and that a spacious environment was an important factor for clients. N o differences were observed between the two groups. The more exclusive use of qualitative methods, which take into consideration the potential meanings and attitudes underlying responses, help this client group to participate more fully in service evaluation research.

Telephone interviews were conducted with 64 participants who attended an initial systemic consultation meeting within a community‐based psychology service for people with a learning disability. Most participants found the sessions helpful and liked the reflecting conversations, which they said broadened their views on the presenting problems and offered a positive approach to the meeting, as well as enabling as many views as possible to be heard. However, depending on whether they were carers, colleagues or client and family members, participants' views varied on how prepared and comfortable they felt about the format of the meetings. The authors felt that the results lend support to the overall helpfulness of using an initial systemic consultation meeting when working with this client group.

Purpose – Following the development of the post of Trust Intensive Interaction Co-ordinator, it was decided to assess the state of provision of Intensive Interaction within the social care provision of an NHS Trust in the South of England. The purpose of this paper is to: map strengths and weaknesses of current provision; identify successful provision; identify obstacles to successful provision or factors associated with the maintenance of provision throughout the organisation. Design/methodology/approach – Feedback after training sessions offered by the Trust Intensive Interaction Co-ordinator was reviewed; data about teams supporting people needing Intensive Interaction was analysed to ensure the recommended number of people within a team had received training; opinions of managers and support workers on the provision of Intensive Interaction were gathered. Findings – In total, 96 per cent of Trust employees thought training was right for them; 81 per cent of house teams/services had at least three staff and a manager who had received Intensive Interaction training; three areas of concern were identified from the opinions of managers and support workers: discussion of Intensive Interaction in supervision; responsibility for Intensive Interaction happening; and sharing knowledge of successful Intensive Interaction with those connected to the service user. Originality/value – This is one of the first published audits of an Intensive Interaction service. For the Trust, it provides a baseline to allow monitoring of the maintenance of current levels of service provision over time and, following action taken to address areas of concern, whether future provision has been improved.

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