• Evaluating neuropsychologically informed rehabilitation training for staff within a high secure intellectual disability service

      Annesley, Phyllis; Hamilton, Zoe; Akiens, Sam; Hicks, Rachel; Clarke, Martin (2020)
      Purpose: Neuropsychologically informed rehabilitation (NIR) is one approach to supporting people with intellectual disabilities, cognitive impairment and challenging behaviour. This study aims to evaluate a five-day training course in NIR for staff working with adult male offenders with intellectual disabilities in a high secure hospital. The impacts on both the staff who undertook the training and the patients with challenging behaviour were explored. Design/methodology/approach: Participants were psychology, nursing and day services staff and male patients. The staff completed a post-training questionnaire and three measures at pre-NIR training, post-NIR training and one-year follow-up. Patients completed four questionnaire measures within the same periods. Findings: NIR training was positively evaluated by staff. Staff members’ perceived efficacy in working with challenging behaviour significantly increased post-training which was maintained at follow-up. Thematic analysis showed that the training staff members built their confidence, knowledge and skills. Because of these being high to start with, the study could not evidence statistically significant changes in these. Thematic analysis yielded two main themes, namely, benefits and quality of training, each with their own subthemes. The impacts of the training on patients were difficult to assess related to various factors. Research limitations/implications: The knowledge and confidence measures used were limited in scope with an experienced staff group and required development. Practical implications: NIR training could assist staff in other secure and community settings in working with people with intellectual disabilities and challenging behaviours. Originality/value: This study positively contributes to an area that requires more research. © 2020, Emerald Publishing Limited.
    • Nurses’ discourses of challenging behaviour in inpatient mental-health services

      Mellow, Amy; Tickle, Anna C. (2018)
      Purpose Nurses working in acute mental-health services are vulnerable to occupational stress. One stressor identified is the challenging behaviour of some service users (Jenkins and Elliott, 2004). The purpose of this paper is to discuss the discourses drawn on by nurses to understand challenging behaviour and talk about its management. Design/methodology/approach Nurses working on acute and psychiatric intensive care unit (PICU) wards were interviewed, and data were analysed using discourse analysis. Findings Biomedical and systemic discourses were found to be dominant. Alternative psychosocial and emotional discourses were drawn on by some participants but marginalised by the dominant biomedical construction of challenging behaviour. Originality/value Existing studies have not considered how discourses socially construct challenging behaviour and its management in inpatient mental-health services.
    • Unlocking offence paralleling behaviour in a custodial setting - A personal perspective from members of staff and a resident in a forensic therapeutic community

      Jones, Lawrence F. (2010)
      A democratic therapeutic community (TC) is based on the principle of a flattened hierarchy, in which all those involved have a say in how it runs. In line with this ideal, this chapter is written by staff and a resident from HMP Grendon: Helen has worked as a prison officer for seven years; Geraldine has worked as a forensic psychologist for 10 years; and Lawrence is a resident at Grendon who has been imprisoned for over 20 years. During that time we have experienced life behind bars from the perspective of staff members and as a resident in several different establishments. These include dispersal prisons (i.e. high-security prisons for prisoners who are considered to be a major threat to public safety), a Category B local male establishment (i.e. a medium-secure prison housing remand prisoners or those who have just been sentenced), prison landings, as facilitators of sex offender treatment groups, a young offender institute and a prison run as a TC. In this chapter we describe the similarities and differences in offence paralleling from a clinical point of view in the different prison environments as described above, and then concentrate on HMP Grendon, a Category B prison that operates as a TC. In addition, the opportunities, challenges and dangers associated with assessing risk and measuring change using the concept of offence paralleling behaviour (OPB) are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(chapter)