Management of people with challenging behaviour

Xeniditis, Kiriakos; Russell, Ailsa; Murphy, Declan

doi:10.1192/apt.7.2.109

Cited by 30 publications

(17 citation statements)

References 14 publications

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“…There are good‐quality studies showing promise of efficacy (outcome studies by Beail & Warden ; Beail ), but, expert opinion remains that further research is needed on the outcomes of psychoanalytically based psychotherapies for challenging behaviour (Xeniditis et al . ; Willner ; RCP/BPS/RCSLT ). Although no such studies were included in the Matrix at levels A or B, in this review the work of Beail () and Prout & Nowak‐Drabik () are both included at level C.…”

Section: Resultsmentioning

confidence: 99%

“…For psychoanalytically based psychotherapies there is evidence that psychodynamic approaches can be effective in the reduction of psychological distress and interpersonal problems associated with challenging behaviour, particularly in people with milder ID (RCP/BPS/RCSLT 2007). There are good-quality studies showing promise of efficacy (outcome studies by Beail & Warden 1996;Beail 1998), but, expert opinion remains that further research is needed on the outcomes of psychoanalytically based psychotherapies for challenging behaviour (Xeniditis et al 2001;Willner 2005; RCP/ BPS/ RCSLT 2007). Although no such studies were included in the Matrix at levels A or B, in this review the work of Beail (1998) and Prout & Nowak-Drabik (2003) are both included at level C.…”

Section: Resultsmentioning

confidence: 99%

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Psychological therapies for people with intellectual disabilities: comments on a Matrix of evidence for interventions in challenging behaviour

Campbell

Robertson

Jahoda

2012

J intellect Disabil Res

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BackgroundPsychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings. MethodsA systematic review of peer-reviewed literature published between 1980-2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best-evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions. ResultsThere is a limited amount of efficacy research that meets the most stringent standards of empirical evidence. ConclusionsIt is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment. Matrix of evidence 2 IntroductionWhilst the move from larger scale to community based models of care for people with intellectual disabilities in Scotland has led to an improved quality of life, there is a concern that existing services have difficulty supporting adults with the most serious challenging behaviours Kiernan, 1993;Allen 1999;Stalker and Hunter, 1999; RCP/BPS/RCSLT, 2007;Emerson & Enfield, 2011).Using an evidence base in relation to effective interventions in health and social care is not new.There are a large number of "what works" reports, identifying the best research evidence and benefits of particular interventions used in the management of specific mental health conditions in the UK (e.g. Royal College of Psychiatrists The evidence related to pharmacotherapy and psychological treatment is, in general, either lacking or poor. This does not suggest that these treatments are necessarily ineffective but that there is not enough good quality evidence tosupport their usefulness. (Antonacci, Manuel & Davis, 2008) In the absence of a credible evidence base for psychological or psychopharmacological interventions, medication continues to be prescribed widely for challenging behaviour (Cullen, 2000;Ahmed et al, 2000; Verhoeven & Tuinier, 1999;Brylewski & Duggan, 1999;Emerson, Robertson, Gregory et al 2000; Royal College of Psychiatrists, 2006;Emerson & Enfield, 2011).In December 2008 the Scottish Government published "The Matrix -A Guide to delivering evidencebased Psychological Therapies in Scotland". The Matrix was produced to help National Health Service authorities in Scotland to efficiently deliver the range, volume and quality of psychological therapy required for the effective treatment of common mental health problems. This was part of a Matrix of evidence 3 larger, national health improvement initiative to establish and measure waiting time targets from referral to treatment for psychological therapies (Scottish Government, 2011a, 2011b. In 2010 the Scottish Government commissioned a review of effective psychological therapies in relation to adults with intell...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Psychological therapies for people with intellectual disabilities: comments on a Matrix of evidence for interventions in challenging behaviour

Campbell

Robertson

Jahoda

2012

J intellect Disabil Res

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“…Teaching staff were also significantly likely to define challenging behaviour in terms of its function. Understanding the function of a behaviour for an individual is central to developing an appropriate intervention, however, identifying the function without undertaking a formal functional analysis can be problematic, as it may result in an inaccurate function being identified (Sturmey 1996; Xeniditis et al. 2001).…”

Section: Discussionmentioning

confidence: 99%

Teaching staff knowledge, attributions and confidence in relation to working with children with an intellectual disability and challenging behaviour

Rae¹,

Murray²,

McKenzie³

2011

Brit J Learn Disabil

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Accessible summaryWe looked at how much teachers knew about helping children with a learning disability who had behaviour that was challenging in school. We found that:• Some teachers knew very little about challenging behaviour and all the different ways to help children with this. • Some teachers had beliefs about challenging behaviour that can be unhelpful. We need to find ways to help teachers find out more about challenging behaviour and to think about it in different ways. One way to do this could be to give them training about it. SummaryThe present study examined Scottish teaching staff knowledge about the definition and management of challenging behaviour displayed by children with an intellectual disability. Knowledge levels were relatively low, and participants were most likely to define challenging behaviour by function or topography. Teaching staff were largely unaware of positive programming strategies, suggesting that they may not be properly equipped to manage challenging behaviour effectively in the longer term. The teaching staff were found to hold attributions which research suggests are associated with reduced helping behaviour and increased anger. This indicates a continuing need to identify effective ways of promoting more accurate knowledge and positive attributions in teaching staff.

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“…In formulating management strategies for challenging behaviour, Xenitidis et al (2001) recommended a systematic approach of identification of target behaviour, quantitative measurement of target behaviour, generation of hypotheses (medical, psychological and social) about the genesis and maintenance of the behaviour, delivery of therapeutic intervention, evaluating the effectiveness of the intervention and generation and testing of alternative hypotheses. Such approach should form the basis of risk management.…”

Section: Risk Managementmentioning

confidence: 99%

Assessment and management of risk in autism

Gunasekaran

2012

Advances in Mental Health and Intellectual Disabilities

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Purpose -This paper aims to describe the issues in risk assessment and management of autism spectrum disorders in secure hospital settings with reference to best practice guidance.Design/methodology/approach -The author undertook a review of the current literature on risk management in autism spectrum disorders and has drawn on clinical experience to highlight key issues.Findings -Risk assessment and management needs to be tailored to individuals. Characteristics of offences differ compared to other mental disorders. Underlying factors for offending differ from other mental disorders and may be misinterpreted.Practical implications -Risk assessment in autism spectrum disorders should take into account individual characteristics and be informed by specialist assessments. Management should be based on a formulation informed by assessments and by recognising individual characteristics.Originality/value -The paper highlights important issues in risk assessment and management of patients with autism spectrum disorders particularly in secure hospital settings.

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Management of people with challenging behaviour

Cited by 30 publications

References 14 publications

Psychological therapies for people with intellectual disabilities: comments on a Matrix of evidence for interventions in challenging behaviour

Psychological therapies for people with intellectual disabilities: comments on a Matrix of evidence for interventions in challenging behaviour

Teaching staff knowledge, attributions and confidence in relation to working with children with an intellectual disability and challenging behaviour

Assessment and management of risk in autism

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