Consensus‐based good practice guidelines for clinical psychologists to support care staff in enabling sexual expression in people with intellectual disabilities—A Delphi study

Abstract

Background Care staff supporting people with intellectual disabilities (PWID) report accepting views on PWID's sexual expression, but people with intellectual disabilities report their sexual expression is restricted by care staff. Methods We recruited a panel of 17 UK clinical psychologists experienced in helping care staff support PWID's sexual expression. We used the Delphi Method to develop consensus‐based practice guidelines for UK clinical psychologists supporting care staff in this way. Results Having proposed three guidelines each in Round One, panel members reached consensus (≥90% agreement) that 12 were important, falling under four themes: “Addressing staff attitudes,” “Addressing uncertainty about rights and responsibilities of people with intellectual disabilities,” “Locating the problem, being part of the solution,” and “Supporting care staff to understand and reflect upon their role.” Conclusions Clinical psychologists help care staff support PWID's sexual expression by normalizing care staff concerns, encouraging reflection, clarifying PWID's rights, and prompting those at managerial and service level to support care staff.

Social educator students' readiness to address sexual health in their future profession

“…Thus, the result of this study may indicate a positive development since 2013 by showing an increased readiness among future social educators to meet the sexual health needs of clients. This may in turn decrease negative restrictions, abuse, risk of violence, discrimination as well as social, environmental and structural barriers often experienced and imposed by staff on people with intellectual disabilities, as described in previous studies (Black & Kammes, 2019; Byrne, 2018; English et al, 2020; Fitzsimons, 2020; Grove et al, 2018; McDaniels & Fleming, 2016; Starrs et al, 2018; Stoffelen et al, 2019). The positive attitudes, perceived readiness and education among social educator students may improve the currently missing professional support in relation to sexual issues for people with intellectual disabilities.…”

Protocol for a Delphi consensus study to select indicators of high-quality general practice to achieve Quality Equity and Systems Transformation in Primary Health Care (QUEST-PHC) in Australia

“…The levels of consensus in the Delphi methodology vary depending on size of the expert panel and the aim of the research [ 24 , 25 ]. Consensus target for this study are defined ‘a priori’ based on previous research experience [ 26 ].…”

Sexuality, Education and Support for People with Intellectual Disabilities: A Systematic Review of the Attitudes of Support Staff and Relatives

“…Acknowledgement and acceptance toward the sexual rights of people with intellectual disabilities began to increase over the course of the normalization movement [3], and, culminated in the Declaration of Sexual Rights in 2014 [4]. Notwithstanding such notable shifts, research exploring the sexuality of people with intellectual disabilities over the last two decades has predominantly focused on barriers, risks, and prejudice [2,5,6]. Today, despite the increased acceptance of equal rights, neither the ability to exercise free sexual expression nor the possibility to engage in (intimate) relationships are self-evident for people with intellectual disabilities [5,7,8].…”

“…Notwithstanding such notable shifts, research exploring the sexuality of people with intellectual disabilities over the last two decades has predominantly focused on barriers, risks, and prejudice [2,5,6]. Today, despite the increased acceptance of equal rights, neither the ability to exercise free sexual expression nor the possibility to engage in (intimate) relationships are self-evident for people with intellectual disabilities [5,7,8]. It is well-established that engaging in sexual expression and relationships is integral to developing a healthy and positive sexuality [9].…”

“…Various scholars have highlighted the uncertainty that many support staff and relatives have concerning their roles and responsibilities toward the sexuality of people with intellectual disabilities [5,7,30,31]. Therefore, an up-to-date overview of extant research on the attitudes of support staff and relatives concerning the sexuality of people with intellectual disabilities, considering both supportive and restrictive attitudes.…”