The upshot of these needs for change is both dismaying and exciting, both disturbing in the destruction of long-familiar patterns of dealing with human suffering, and paradoxically hopeful in raising the possibility that significant failures in our health care systems of the past — limited access to medical care and grossly inadequate public sector “non-systems”, for example — may now be addressed more successfully.

Administration and policy in mental health

Tomorrow's doctors

Positive Behavior Support for People With Developmental Disabilities: A Research Synthesis

Handbook on Quality of Life for Human Service Practitioners

Training staff serving clients with intellectual disabilities: a meta-analysis of aspects determining effectiveness.

Staff working directly with people who have challenging behaviour in learning disability services need to be D good at what they do. These staff are trained by their employers to manage and to treat challenging behaviours and to improve the quality of life of people in their care. While such training is generally well evaluated by care staff, there is limited evidence that training alone changes poor attitudes or improves staff performance. Training has not been linked to quality of outcomes for service users. From research on treating challenging behaviour, achieving maintenance of behavioural gains after treatment has been discontinued is the exception rather than the rule. Can the same be said for maintaining gains achieved through staff training in the area of challenging behaviour? This discussion article reviews the value of training for staff working with people with challenging behaviour.

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Staff training and challenging behaviour : Who needs it?

The healthcare setting is a rich learning environment for students to experience interprofessional working (IPW) and interprofessional education (IPE). However, opportunities for IPE are limited, and student experiences of effective IPW are varied. This raises the question of how IPW and IPE are valued by health or social care professionals. A search of the literature was carried out to identify studies of health and social care staff attitudes to IPW and IPE. This review provides a summary of the main factors found to influence attitudes and the strengths and limitations of these studies. Professional background and prior IPE experience were identified as the influencing factors for which there is most evidence. The main limitations of the studies accessed included a focus on the value of IPE for staff, as opposed to students, and a limited number of studies considering the relationship between attitudes to IPW and the value placed on IPE. It is important that health and social care professionals lead by example by working collaboratively and providing students with opportunities for IPE. Identifying the variables influencing attitudes to IPW and IPE may assist in improving IPW and experiences of IPE for students learning in the healthcare setting.

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Health and social care professionals' attitudes to interprofessional working and interprofessional education: A literature review.

Staff working directly with adults' challenging behaviours in learning disability services need to be very good at what they do. They also need to want to do the job. A theory-practice gap exists, however, between what is known about effective, evidence-based approaches and whether and how these are used in person-centred community services. Many frontline staff working with people with the most serious challenging behaviours do not have the skills to implement programmes to change behaviour. This discussion article reviews workforce development in the context of clinical and service guidelines and asks whether the legitimate purview of frontline staff is treating challenging behaviour, managing it or simply coping with it on a daily basis, whilst maintaining the best quality of life possible for service users.

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Workforce development and challenging behaviour: training staff to treat, to manage or to cope?

This publication reports on the systematic review of evidence funded by NHS Education for Scotland.

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

An open learning course, ‘Approaches to Sexual Abuse of Adults with Learning Disabilities’, was undertaken with a range of staff working with adults with learning disabilities. Using a specially designed questionnaire based on the research and practice literature on sexual abuse, the present authors evaluated the impact of the course on staff knowledge of: (1) sexual abuse, and its antecedents and consequences; (2) the procedures to be followed once abuse is suspected; and (3) the practices most likely to minimize abuse. In addition, the effect of the course on attitudes was also assessed. Staff knowledge of sexual abuse was significantly increased following completion of the course. Staff attitudes at the outset of the course tended to be highly consistent with the values and practices reflected in the course material. However, changes in acceptance of formal practices to deal with abuse, confidence in having the skills to deal with incidents and awareness of the vulnerability of people with learning disabilities to abuse were all enhanced. The implication of sample attrition during the course is considered with respect to the nature of the environment in which staff work and the feasibility of the open learning model.

Martin Campbell

Papers

Staff training and challenging behaviour : Who needs it?

Health and social care professionals' attitudes to interprofessional working and interprofessional education: A literature review.

Workforce development and challenging behaviour: training staff to treat, to manage or to cope?

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

Evaluation of the Effect of an Open Learning Course on Staff Knowledge and Attitudes Towards the Sexual Abuse of Adults with Learning Disabilities