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This service evaluation comprised pre- and post measures with service users and their carers on admission to and discharge from an assessment and treatment (A&T) unit. The Behaviour Problems Inventory (BPI), Psychiatric Assessment Scale for Adults with Developmental Disabilities Checklist--Revised (PASSAD) and World Health Organisations Quality of Life Scale (WHO-QOL 8; adapted for people with intellectual disabilities) were used to evaluate outcomes of their admission to the unit. Significant improvements were found after admission in relation to behaviour that challenges (measured by the BPI), mental health symptoms (measured by the PASSAD) and quality of life (measured by the WHO-QOL). The importance of completing outcome measures as feedback for the service user, team and wider service managers are discussed, but also in this political context when the role of A&T units are being questioned, the importance of showing good practice and clinical outcomes for individuals.

This article evaluates the effectiveness of a multidisciplinary intensive community support service, using positive behavioural support (PBS) as a core intervention model to reduce behaviours of concern and to improve the quality of life and occupational involvement of individuals with a learning disability who present with behaviours that challenge. The service used outcome measures to evaluate the effectiveness of the PBS model. The study looks at pre- and post-outcome measures which showed a significant improvement in behaviour, quality of life and occupational outcomes for individuals with a learning disability presenting with complex behaviours of concern. This study contributes to the growing evidence base for PBS being delivered by specialist community learning disability teams.

This study evaluates the implementation of Safewards on an assessment and treatment unit (ATU) for people with an intellectual disability. There are no previous studies evaluating this model in this context and previous research has focused largely on acute mental health services. The 'Patient-Staff Conflict Shift Report' was used at baseline for 1 month and 1 year later, after all the interventions had been implemented, to evaluate the impact of Safewards. Significant reductions were found in conflict and containment measures used within the service after the implementation of Safewards. Staff who led on the interventions were also asked to give feedback on their experiences, the challenges they faced and how they would like to move forward. Safewards was generally seen as a positive approach by the team. Limitations of this study are highlighted and suggestions for future research are made.

Background: There are very few studies that investigate the qualitative experiences of people with a learning disability who have engaged in psychological therapy. Indeed, having a learning disability has traditionally been an exclusion criterion for good quality research about psychological treatments ("Psychotherapy and Learning Disability. Council Report CR116." London: Royal College of Psychiatrists, 2004; "Journal of Applied Research in Intellectual Disabilities," 19, 2005 and 5). The current research was developed in response to a clinical psychology service recognizing the need to evaluate their psychological service and, as part of this evaluation, the importance of consulting with service users about their experience of psychological therapies. The overall aim of gaining this feedback would be to improve the service offered and to ensure that people receive the best psychological care. Methods: Six service users with a learning disability were interviewed about their experience of individual psychological therapy. The interviews were analysed using interpretative phenomenological analysis. Results: Themes were generated from the interviews which highlighted both positive and negative feedback on the psychological therapy process. The feedback covered areas such as access to therapy, feelings about therapy, preparing for therapy, skill development and collaborative working, accessibility and making therapy fun, challenges to confidentiality, positive feelings towards the therapist, aspects of the therapeutic relationship, therapy being challenging but helpful, and positive outcomes. Conclusions: These results have contributed to the evidence base that people with a learning disability are able to meaningfully engage in research and provide essential feedback on the services that they receive. No longer can people be excluded from individual psychological therapy or research just because of their label.

This review questions whether a relationship exists between emotional recognition ability and challenging behaviour in people with an intellectual disability. A search was completed of a number of databases to identify relevant articles, and these were then evaluated against defined criteria. Eight articles were reviewed and their aims, study methodology, samples, measurement tools and findings are discussed and evaluated. Overall, studies found no significant deficit in the emotional recognition abilities of those with challenging behaviour when they were asked to identify the emotions of others. Two areas for further investigation were identified. Firstly, to ascertain whether a bias for identifying anger or sadness is found in those with challenging behaviour, and secondly, to understand the role of context in recognition of emotions and the degree to which this is different in those who present with challenging behaviour. A critique relating to the research is provided and suggested clinical and research implications are put forward.

This preliminary study explores the relationships between challenging behaviour and emotional perception in a population of adults with intellectual disabilities, in order to establish whether there are grounds for further study. Cross-sectional data were collected from 96 participants with intellectual disabilities and 95 carers. The service user participants completed the Emotional Perception Questionnaire, whilst carers completed the Checklist for Challenging Behaviour. Correlational analyses were employed to analyse relationships between the variables. A post hoc between-group analysis was conducted to compare the emotional recognition abilities of people with high-frequency challenging behaviour with those with low-frequency challenging behaviour. Significant negative associations were found between emotional perception and challenging behaviour frequency and management difficulty. Significant differences in emotional perception abilities were found between people with high frequency and those with low-frequency challenging behaviours. The study suggests that emotional perception is important in understanding challenging behaviour.

Quality of life for people who use forensic mental health services has been the topic of increased empirical and clinical interest in recent years. Despite this, no well-validated quality of life measure exists for use with this specific clinical population in the UK. The Forensic Quality of Life Questionnaire – Short Version (FQL-SV) is a psychometrically valid quality of life measure developed in the Netherlands and translated into English. The current study aimed to explore the validity of the English version of the FQL-SV (EFQL-SV) using a think aloud and concurrent probing cognitive interviewing procedure. Fifteen service users participated from UK-based forensic mental health services. Comprehension of the EFQL-SV was evaluated systematically. and findings indicated that the most significant difficulty for participants was the understanding of the wording of EFQL-SV items. This meant that the EFQL-SV was limited in the extent to which it measured what it purports to. A number of revisions to the EFQL-SV have been proposed but require further validation. We have titled the adapted measure the UK Forensic Quality of Life – Short Version. [ABSTRACT FROM AUTHOR]

A number of recent influential reports recommend the use of proactive and preventative approaches such as Positive Behavioural Support (PBS) in the management of challenging behaviours. Although evidence supporting the use of PBS is mainly drawn from studies of learning disability and child populations, it is recognised that PBS could have a much wider utility. In this study, PBS was implemented in a medium secure forensic mental health service, a novel context. Impact was evaluated using an adapted version of the Checklist of Challenging Behaviour at baseline and then at 3 monthly intervals for a year. Significant reductions were observed in aggression frequency, management difficulty and severity and other challenging behaviour frequency and management difficulty. Reductions in challenging behaviour were still evident after six months for the full group and twelve months for the sub-group with the exception of other challenging behaviour management difficulty. In contrast, no such significant differences were found for a control group. This study indicated that PBS was an effective intervention in the management of challenging behaviour in this forensic mental health context. [ABSTRACT FROM AUTHOR]

Service-user involvement is important in learning disability services. Historically, professionals have struggled to involve service users fully in their care, and behavioural assessments and plans can be lengthy and complex. This article describes how a service user became fully involved in the development of his positive behavioural support plan and participated in training his care team. Involving service users in this way increases the validity and credibility of plans, empowers service users, promotes ownership and improves insight; and is, therefore, rewarding for service users and professionals. The article encourages nurses to be creative in meeting the challenges associated with service-user involvement to promote a person-centred approach. [ABSTRACT FROM AUTHOR]