Physical Interventions with People with Intellectual Disabilities: Staff Training and Policy Frameworks

Abstract

Background Physical intervention or restraint with people who have intellectual disabilities is sometimes necessary, even though it is known to present dangers to both staff and service users (some service users have died as a result of restraint). Aims This study aims to investigate the extent to which staff in intellectual disability services were trained in the use of physical interventions or restraint. Their views of a recent policy framework on physical interventions were also sought. Methods There were three groups of participants: (i) group 1 included staff who had attended conferences on the Policy Framework (the conference sample); (ii) group 2 included staff from two geographical areas (the geographical sample); (iii) group 3 included staff in specialist assessment and treatment services (the SpAT sample). All participants were sent a questionnaire asking them about their training in (and use of) physical intervention methods and their opinions on the policy document. Results There were at least 12 different types of training recorded, including a number of varieties of Control and Restraint (C&R). By no means did all the senior staff did have training in physical intervention methods. The degree of training varied with the sample and the type of training varied with the employing organization. Most participants in group 1 were very positive about the BILD & NAS Policy Framework but few staff in groups 2 and 3 had read the document. About two‐thirds of the participants said their services had (or were developing) a written policy on physical interventions. Conclusions There remained a clear need for further training in physical interventions and evidence on which the effectiveness of different methods of physical interventions could be judged.

Physical Interventions for Adults with Intellectual Disabilities: Survey of Use, Policy, Training and Monitoring

“…Of these 26 referred to SCIP or variants. Compared to the figures found by Murphy et al. (2003) there was a significant reduction (from 15% to 0%) in services reporting using C&R training (χ 2 = 14.67, d.f.…”

“…Most services (94%) using PI reported monitoring its frequency and/or restrictiveness and such monitoring was significantly related to having a policy. Services reported no use of training based on C&R in contrast to Murphy et al. (2003) survey which found that 15% of services had used C&R methods.…”

Characteristics and experiences of children and young people with severe intellectual disabilities and challenging behaviour attending 52‐week residential special schools

“…One of the questions on communication was drawn from the Behaviour Development Survey (Conroy & Bradley 1985), the questions on challenging behaviour came from McGill et al . (2006), the questions on physical intervention came from Murphy et al . (2003), and the questions on service access and community participation were based on the Guernsey Community Participation and Leisure Assessment (Baker 2000).…”

Restraint and Seclusion in Services for People with Mental Health Problems and Learning Disabilities: A Literature Review

“…They stated that they are reactive practices with no theoretical framework for professional use, and criticised the pain and discomfort inherent in these techniques and proposed a 'non-aversive' therapeutic holding approach. In their examination of different types of training for physical intervention Murphy et al (2003) identified the need for studies of effectiveness, claiming there was no clear leader and that inconsistencies in type and level of training compounded the problem.…”