• Adult attachment and care staff functioning

      Clegg, Jennifer (2016)
      Care staff around the world make huge differences every day in the lives of people with intellectual disabilities (ID). Care staff provide support, advice and protection, and may scaffold the autonomous exploration and development of people with ID. By doing so, they enrich the network of meaningful social relationships that humans need to flourish. Similar to family relationships of young people with ID, better quality relationships between care staff and people with ID have been linked with fewer challenging behaviours in services. The goal of this chapter is to make a case for including attachment among the perspectives that should be considered in research, policy and practice around client-staff relationships. The central message of this chapter is that in order to improve care interactions and relationships, attention is required to understand attachment processes in people with ID and attachment processes in care staff as well. Implications of the small body of research on this issue will be discussed with regards to: policy and quality control, service development and organization, care staff and clients (PsycINFO Database Record (c) 2017 APA, all rights reserved) (Source: chapter)
    • Attachment and learning disability: A theoretical review informing three clinical interventions

      Clegg, Jennifer (1995)
      Attachment theory makes sense of 2 phenomena observed in some people with learning disabilities: it provides a reason for their limited exploration of the world and it explains discontinuities in the pattern and intensity of their expressions of anger. Applying this framework to 3 enmeshed relationships occurring between an adult with learning disabilities and a member of care staff achieved at least partial resolution of their problems. All of the interventions yielded significant client change in 3 areas: reduction in anger and distress; increased exploration of physical and intellectual environments; and an increase in the range of people to whom the client relates. The following sequence of priorities for intervention are proposed for guidance: working with ambivalent carers, building a secure base, and enabling emotional development within the setting. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Carer satisfaction with telephone consultations in a community intellectual disability unit

      Bains, Harinder (2010)
      This paper reports on a survey of carer satisfaction with telephone consultations with doctors in a community service for people with intellectual disability (also known as learning disability in the UK health services). A 10-item anonymized carer satisfaction questionnaire was sent out following telephone consultations over a 4 week period with questions about suitability, effectiveness, efficiency and appropriateness of telephone consultations. Out of 13 questionnaires sent, 11 were returned. There was a high level of satisfaction with accessibility, effectiveness and suitability. Similar numbers felt that telephone consultations were an efficient use of time. However more than one-third of carers said they would have preferred a face-to-face consultation with the doctor. Telephone consultations, although routine practice in psychiatry, need further research to establish them as a viable alternative to face-to-face consultations.;
    • Challenging behaviour and insecure attachment

      Clegg, Jennifer (2002)
      The present authors previously investigated a database about people with severe intellectual disability (ID) to explore whether secure/insecure attachment plays a role in challenging behaviour. This study took the form of a survey of staff and carers involved with a cohort of 54 school-leavers with severe ID. 34% percent of students were rated by placement staff as "overinvesting in one or a few relationships which become a source of jealousy". Students without such problems were significantly less likely to show challenging behaviours, while those with them were significantly more likely to be living outside the family home. These preliminary results justify more detailed and longitudinal research into the relationship between attachment status and challenging behaviour. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Death, disability, and dogma

      Clegg, Jennifer; Lansdall-Welfare, Richard (2003)
      Mourning exists at the nexus between individual experience, professional discourses, research, and culture, making it a complex issue for health services that has shown vibrant change in recent years. By contrast, bereavement discourse in intellectual disability is suffused by dogmatic assertions about correct intervention: we describe four vignettes to illustrate bereavement issues in intellectual disability. Suggestions concerning issues and management are made, but the article focuses primarily on the conceptual issues that underpin clinical intervention. The analysis shows how challenges to the meaning of the disabled life, and to the understandings carers and staff draw on, tend to be resisted. We hypothesize this is most likely to surround issues that evoke cultural uncertainty, such as bereavement. The thesis is that the field of intellectual disability tends to be isolationist because meaning is difficult to create and easily dissolved, especially when addressing culturally contested topics. Dialogue with other disciplines is necessary to stop the field from atrophying, but needs to be carried out in ways that enable carers and clinicians to continue providing the support that people with intellectual disability require. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • An ecological approach to reducing the social isolation of people with an intellectual disability

      Clegg, Jennifer (2012)
      An ecological approach to understanding insecure attachments and social isolation among people with an intellectual disability is constructed using Gibson’s (1979/1986) affordance-based theory. Although environmental affordances and individual limitations interact to limit the development of social competence, we believe that by focusing on the immediate environment, community-based approaches to helping people with an intellectual disability are often ignored, which increases the burden on individual caregivers. A more comprehensive strategy, which extends Gibson’s theory of affordances, allows us to consider how higher level social systems influence the immediate environment and provides the context for understanding why successful change occurs when a multifaceted, holistic approach that works on several levels is adopted. Examining these systems within an ecological framework fundamentally redefines our thinking by shifting the focus from a person’s disability to a more nuanced understanding of a person’s abilities within the context of appropriate environmental supports in which the person’s disability becomes less salient. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)
    • Emerging themes

      Clegg, Jennifer (2010)
    • Friend or foe? A selective review of literature concerning abuse of adults with learning disability by those employed to care for them

      Moore, Debra (2001)
      Adults with learning disabilities are often the targets of acts of violence, aggression, bullying and humiliation. This review of the literature considers as problematic the prevention and detection of abuse, and the effect it has on relationships between carer and client, the therapeutic environment and the culture of wider society. This article seeks to inform prevention strategies by identifying not just the characteristics of the abusers and the victims but the reality of relationships between them and how this can be the most effective safeguard against abuse. The article suggests that at the core of a valuing relationship between a carer and a person with learning disabilities is a concept of humanness, and a willingness to see reciprocity and warmth in their alliance with one another. The article concludes that a challenge facing leaders and managers of services is how to replicate, cherish and maintain that connection and interdependence between 'carer' and 'cared for'. © 2001 Sage Publications.
    • 'Just being selfish for my own sake . . .': Balancing the views of young adults with intellectual disabilities and their carers in transition planning

      Clegg, Jennifer (2011)
      In contrast to other forms of family caregiving, becoming the parent or carer of a child with an intellectual disability (ID) implies an ongoing responsibility beyond the attainment of chronological adulthood (Meyers et al., 1985; Todd and Shearn, 1996). At the same time, a discourse of self-determination pervades policy around transition to adult services in ID in England ( Valuing People, 2001). In this paper we present a subset of data from a project which aimed to examine how the process of transition from child to adult services in ID is managed. Using data from 8 tape-recorded meetings in which transitions were planned and discussed, we examine what happens when the views of the parent/carer and the young adult are in apparent conflict. Drawing on the growing body of interactional work in the field (eg Rapley, 2004; Finlay, Antaki and Walton, 2008), we use conversation analysis to examine how professionals manage and negotiate this conflict and how some points of view or courses of action ultimately prevail over others. While the discourse of self-determination may prevail in English policy terms, we show how the fact that parents or carers ultimately have a key role in enabling the choices of the young person has a significant impact on these interactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved) (Source: journal abstract)
    • Living with contested knowledge and partial authority

      Clegg, Jennifer; Lansdall-Welfare, Richard (2003)
      Responds to comments by S. Colman (see record 2003-07847-012), G. Casenave (see record 2003-07847-013), and H. Reinders (see record 2003-07847-014) to the authors' original article (see record 2003-07847-011) which considers issues and approaches particular to those helping the intellectually disabled understand and cope with bereavement. J. Clegg and R. Lansdall-Welfare defend their view that ambiguities associated with meaning in the disabled life make it more likely that professional service providers will make dogmatic responses to bereavement, responses that are defended by isolationism. (PsycINFO Database Record (c) 2016 APA, all rights reserved)