Pub Date : 2020-11-25DOI: 10.1108/tldr-10-2020-0031
Mark Haydon-Laurelut
Purpose This paper is a commentary inspired by Laura McKenzie-Smith’s review paper. Design/methodology/approach This commentary provides a personal perspective on the intersections of narrative practice and the support of people with a learning disability. Findings This commentary highlights some further possibilities of narrative ideas beyond therapy. This paper explores examples of record keeping and research as sites for story construction about lives and identities. Research limitations/implications This is a personal perspective of a systemic psychotherapist and academic working with people with a learning disability. Practical implications This paper argues that the stories we tell ourselves and others about our work and the people we support are powerful in ways of which we may not always be aware. Social implications In common with person-centred planning, narrative ideas highlight the power of the stories circulating about a person and their network and the implications they may have for their lives and identities. Originality/value This commentary explores narrative practices beyond the context of therapy, highlighting organisational, administrative and research practices as story-constructing activities that co-create identities of persons with a learning disability, their networks of support and health and social care professionals.
{"title":"Commentary on “Narrative therapy groups for people with intellectual disability: a critical review of the literature”","authors":"Mark Haydon-Laurelut","doi":"10.1108/tldr-10-2020-0031","DOIUrl":"https://doi.org/10.1108/tldr-10-2020-0031","url":null,"abstract":"\u0000Purpose\u0000This paper is a commentary inspired by Laura McKenzie-Smith’s review paper.\u0000\u0000\u0000Design/methodology/approach\u0000This commentary provides a personal perspective on the intersections of narrative practice and the support of people with a learning disability.\u0000\u0000\u0000Findings\u0000This commentary highlights some further possibilities of narrative ideas beyond therapy. This paper explores examples of record keeping and research as sites for story construction about lives and identities.\u0000\u0000\u0000Research limitations/implications\u0000This is a personal perspective of a systemic psychotherapist and academic working with people with a learning disability.\u0000\u0000\u0000Practical implications\u0000This paper argues that the stories we tell ourselves and others about our work and the people we support are powerful in ways of which we may not always be aware.\u0000\u0000\u0000Social implications\u0000In common with person-centred planning, narrative ideas highlight the power of the stories circulating about a person and their network and the implications they may have for their lives and identities.\u0000\u0000\u0000Originality/value\u0000This commentary explores narrative practices beyond the context of therapy, highlighting organisational, administrative and research practices as story-constructing activities that co-create identities of persons with a learning disability, their networks of support and health and social care professionals.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"223-227"},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46512462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-25DOI: 10.1108/tldr-05-2020-0008
L. McKenzie-Smith
Purpose Narrative therapy has been suggested as particularly relevant to people with intellectual disability (ID), with group formats potentially offering additional benefits. This paper aims to critically review studies which evaluated narrative group interventions for people with ID. Design/methodology/approach The seven papers identified for review were critically appraised for their quality using a quality appraisal tool appropriate to their design, along with additional factors including adaptations made to improve accessibility. Findings The studies suggest that there may be some small benefits of narrative group therapy for those with ID. However, alongside issues limiting the studies’ evaluations, it is noted that the research paradigms used in the studies conflict with narrative approaches. Research limitations/implications The limited evidence base suggests the need for further research. The randomised controlled trial would ordinarily be seen as the gold standard for such research. However, narrative interventions may require a different approach to evaluation. Originality/value This is the first review of published literature on the evaluation of narrative therapy groups for people with ID.
{"title":"Are narrative therapy groups effective for people with intellectual disabilities? A critical review of the literature","authors":"L. McKenzie-Smith","doi":"10.1108/tldr-05-2020-0008","DOIUrl":"https://doi.org/10.1108/tldr-05-2020-0008","url":null,"abstract":"\u0000Purpose\u0000Narrative therapy has been suggested as particularly relevant to people with intellectual disability (ID), with group formats potentially offering additional benefits. This paper aims to critically review studies which evaluated narrative group interventions for people with ID.\u0000\u0000\u0000Design/methodology/approach\u0000The seven papers identified for review were critically appraised for their quality using a quality appraisal tool appropriate to their design, along with additional factors including adaptations made to improve accessibility.\u0000\u0000\u0000Findings\u0000The studies suggest that there may be some small benefits of narrative group therapy for those with ID. However, alongside issues limiting the studies’ evaluations, it is noted that the research paradigms used in the studies conflict with narrative approaches.\u0000\u0000\u0000Research limitations/implications\u0000The limited evidence base suggests the need for further research. The randomised controlled trial would ordinarily be seen as the gold standard for such research. However, narrative interventions may require a different approach to evaluation.\u0000\u0000\u0000Originality/value\u0000This is the first review of published literature on the evaluation of narrative therapy groups for people with ID.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"213-222"},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47067887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-25DOI: 10.1108/tldr-09-2020-0023
Catherine Sholl
The purpose of this paper is to consider the needs of children and young people with intellectual disabilities (ID), autism and challenging behaviour including those with mental health difficulties in the light of the article “A reflective evaluation of the Bradford Positive Behaviour Support – In Reach Service”.,The author’s reflections on experiences of working with this cohort as a clinician and manager are presented in this paper. Also, this paper presents the following: consideration of recent policy, guidance and literature associated with the provision of support to children and young people with ID or autism at risk of residential placement or hospital admission; reflection on gaps in research and practice in how to best support this group of children, young people and families with complex and diverse needs.,The success of the Bradford and other similar services is discussed along with a reflection about the benefits and potential gaps in Positive Behavioural Support services working to meet the needs of this group of children and young people, and their families.,The importance of areas providing more consistent and high quality multi-agency early preventative support and intensive support for those in crisis is discussed. The need for further research and development of ways of working with this cohort, including harder to reach young people and families, is discussed.
{"title":"Commentary on “A reflective evaluation of the Bradford positive behaviour support – in reach service”","authors":"Catherine Sholl","doi":"10.1108/tldr-09-2020-0023","DOIUrl":"https://doi.org/10.1108/tldr-09-2020-0023","url":null,"abstract":"The purpose of this paper is to consider the needs of children and young people with intellectual disabilities (ID), autism and challenging behaviour including those with mental health difficulties in the light of the article “A reflective evaluation of the Bradford Positive Behaviour Support – In Reach Service”.,The author’s reflections on experiences of working with this cohort as a clinician and manager are presented in this paper. Also, this paper presents the following: consideration of recent policy, guidance and literature associated with the provision of support to children and young people with ID or autism at risk of residential placement or hospital admission; reflection on gaps in research and practice in how to best support this group of children, young people and families with complex and diverse needs.,The success of the Bradford and other similar services is discussed along with a reflection about the benefits and potential gaps in Positive Behavioural Support services working to meet the needs of this group of children and young people, and their families.,The importance of areas providing more consistent and high quality multi-agency early preventative support and intensive support for those in crisis is discussed. The need for further research and development of ways of working with this cohort, including harder to reach young people and families, is discussed.","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"193-196"},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42728423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-25DOI: 10.1108/tldr-07-2020-0013
M. Clifton, Steve Chapman
Inspired by the work of the Keep Safe Advisory Group, this paper aims to explain and make the case for co-production as a powerful model for working alongside people with learning disabilities.,The collaborative approach of the Keep Safe advisory group is the authors’ springboard for a deep dive into the power and potential of co-production as a model. As organisational leaders – one with and one without a learning disability – the authors draw on their personal experience to argue that co-production is essential to recognising the adulthood of people with learning disabilities.,Co-production means the equal sharing of power and responsibility from the start, best served by the leap of faith of a blank agenda. Co-production values different kinds of expertise as complementary – broadly considered as expertise from lived experience and professional expertise. When working co-productively, a deep investment of time to understand people pays dividends in outcomes and everyone’s personal and professional growth. Co-production enriches the lives of everyone taking part.,Co-production, though common currency in health and social care, remains too rarely understood and practiced. Readers will benefit from this reflective viewpoint, which aims to clarify and deepen what co-production really means. In particular, enabling people with learning disabilities to take responsibility for themselves and others is rarely considered but is presented here as foundational to human maturity and adulthood.
{"title":"Commentary on “Keep safe: collaborative practice development and research with people with learning disabilities”","authors":"M. Clifton, Steve Chapman","doi":"10.1108/tldr-07-2020-0013","DOIUrl":"https://doi.org/10.1108/tldr-07-2020-0013","url":null,"abstract":"Inspired by the work of the Keep Safe Advisory Group, this paper aims to explain and make the case for co-production as a powerful model for working alongside people with learning disabilities.,The collaborative approach of the Keep Safe advisory group is the authors’ springboard for a deep dive into the power and potential of co-production as a model. As organisational leaders – one with and one without a learning disability – the authors draw on their personal experience to argue that co-production is essential to recognising the adulthood of people with learning disabilities.,Co-production means the equal sharing of power and responsibility from the start, best served by the leap of faith of a blank agenda. Co-production values different kinds of expertise as complementary – broadly considered as expertise from lived experience and professional expertise. When working co-productively, a deep investment of time to understand people pays dividends in outcomes and everyone’s personal and professional growth. Co-production enriches the lives of everyone taking part.,Co-production, though common currency in health and social care, remains too rarely understood and practiced. Readers will benefit from this reflective viewpoint, which aims to clarify and deepen what co-production really means. In particular, enabling people with learning disabilities to take responsibility for themselves and others is rarely considered but is presented here as foundational to human maturity and adulthood.","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"181-184"},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44722952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-23DOI: 10.1108/tldr-06-2020-0010
M. Hodder, Tom Syson, Zobia Aziz, Anthony Handy, Hafsa Khan, J. Lancaster
Purpose Without effective support and intervention, young people with learning disabilities and severe challenging behaviour are at risk of placement in out-of-area residential settings or highly specialist child and adolescent mental health service (CAMHS) units. Such placements may be inappropriate and result in significant reductions to the quality of life of young people and their families. This paper aims to evaluate the effectiveness of the Bradford positive behaviour support (PBS) service model in terms of its aims to improve quality of life, develop skills and maintain children living with their families in their own homes. Design/methodology/approach A service evaluation using quantitative and qualitative data from a range of sources to review the effectiveness of the PBS model being applied in Bradford and Calderdale was the methodology used. Findings When consistently implemented, the Bradford positive behaviour support–in reach service may improve quality of life, facilitate skill development in young people and their carers and reduce placements in residential and CAMHS inpatient units. Avoidance of such placements is likely to reduce the overall costs of service commissioning in Bradford. Originality/value This paper evaluates a novel approach being applied by a third sector agency to implement effective PBS with a small group of children, their families and networks. There is scope for this model to be successfully implemented in other areas.
{"title":"A reflective evaluation of the Bradford positive behaviour support – in reach service","authors":"M. Hodder, Tom Syson, Zobia Aziz, Anthony Handy, Hafsa Khan, J. Lancaster","doi":"10.1108/tldr-06-2020-0010","DOIUrl":"https://doi.org/10.1108/tldr-06-2020-0010","url":null,"abstract":"\u0000Purpose\u0000Without effective support and intervention, young people with learning disabilities and severe challenging behaviour are at risk of placement in out-of-area residential settings or highly specialist child and adolescent mental health service (CAMHS) units. Such placements may be inappropriate and result in significant reductions to the quality of life of young people and their families. This paper aims to evaluate the effectiveness of the Bradford positive behaviour support (PBS) service model in terms of its aims to improve quality of life, develop skills and maintain children living with their families in their own homes.\u0000\u0000\u0000Design/methodology/approach\u0000A service evaluation using quantitative and qualitative data from a range of sources to review the effectiveness of the PBS model being applied in Bradford and Calderdale was the methodology used.\u0000\u0000\u0000Findings\u0000When consistently implemented, the Bradford positive behaviour support–in reach service may improve quality of life, facilitate skill development in young people and their carers and reduce placements in residential and CAMHS inpatient units. Avoidance of such placements is likely to reduce the overall costs of service commissioning in Bradford.\u0000\u0000\u0000Originality/value\u0000This paper evaluates a novel approach being applied by a third sector agency to implement effective PBS with a small group of children, their families and networks. There is scope for this model to be successfully implemented in other areas.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"185-192"},"PeriodicalIF":0.6,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49178846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-23DOI: 10.1108/tldr-07-2020-0015
T. Joyce
Purpose The purpose of this paper is to describe the current situation in relation to restrictive interventions, and some actions that could be taken to reduce them. The quality of care provided by inpatient services for people with intellectual disabilities has come under increasing scrutiny in recent years – from Winterbourne View in 2011 to Whorlton Hall in 2019, there has been increasing concern that admission to hospital does not always result in a good outcome for the patients. For some people, it has resulted in further deterioration in their physical and mental health, separation from families and supports and reduced probability of living as part of their community. This is in spite of knowledge and evidence of what good practice looks like. Design/methodology/approach This paper examines the extent to which inpatient services deliver good practice in treatment and care and, where this is not happening, the extent to which they are subject to effective governance. Findings People admitted to inpatient services can be at risk of poor-quality care and the overuse of restrictive interventions. There is guidance available that addresses what should be in place for them to receive high-quality care and treatment, and this clearly is available to many people. However, others can find themselves placed in increasingly restrictive environments and in circumstances where their human rights are at risk of being breached. There is increasing evidence that these services do not follow good practice guidance in terms of staff skills, development and implementation of effective care plans and governance arrangements that address these issues. Regulators, commissioners and managers could, and should, focus on these issues to ensure that the most vulnerable receive the care and treatment they need while in hospital. Originality/value Service providers are aware of the difficulties in developing alternative community services. This places even more importance on the need to ensure that care and treatment in hospital is of a good standard, and that the use of restrictive interventions is minimised. McGill et al. (this issue) describe the features of a capable environment and it may be that hospitals consider that the requirements are unlikely to be implemented effectively in a ward/unit setting. However, a shift of focus in doing this could result in a reduction in restrictive interventions and a better experience – potentially for both the staff and the patients. And families could have some reassurance that their relative was receiving the best quality care and treatment, and that their human rights were being upheld.
{"title":"Challenging behaviour, inpatient services and governance in England","authors":"T. Joyce","doi":"10.1108/tldr-07-2020-0015","DOIUrl":"https://doi.org/10.1108/tldr-07-2020-0015","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to describe the current situation in relation to restrictive interventions, and some actions that could be taken to reduce them. The quality of care provided by inpatient services for people with intellectual disabilities has come under increasing scrutiny in recent years – from Winterbourne View in 2011 to Whorlton Hall in 2019, there has been increasing concern that admission to hospital does not always result in a good outcome for the patients. For some people, it has resulted in further deterioration in their physical and mental health, separation from families and supports and reduced probability of living as part of their community. This is in spite of knowledge and evidence of what good practice looks like.\u0000\u0000\u0000Design/methodology/approach\u0000This paper examines the extent to which inpatient services deliver good practice in treatment and care and, where this is not happening, the extent to which they are subject to effective governance.\u0000\u0000\u0000Findings\u0000People admitted to inpatient services can be at risk of poor-quality care and the overuse of restrictive interventions. There is guidance available that addresses what should be in place for them to receive high-quality care and treatment, and this clearly is available to many people. However, others can find themselves placed in increasingly restrictive environments and in circumstances where their human rights are at risk of being breached. There is increasing evidence that these services do not follow good practice guidance in terms of staff skills, development and implementation of effective care plans and governance arrangements that address these issues. Regulators, commissioners and managers could, and should, focus on these issues to ensure that the most vulnerable receive the care and treatment they need while in hospital.\u0000\u0000\u0000Originality/value\u0000Service providers are aware of the difficulties in developing alternative community services. This places even more importance on the need to ensure that care and treatment in hospital is of a good standard, and that the use of restrictive interventions is minimised. McGill et al. (this issue) describe the features of a capable environment and it may be that hospitals consider that the requirements are unlikely to be implemented effectively in a ward/unit setting. However, a shift of focus in doing this could result in a reduction in restrictive interventions and a better experience – potentially for both the staff and the patients. And families could have some reassurance that their relative was receiving the best quality care and treatment, and that their human rights were being upheld.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"125-132"},"PeriodicalIF":0.6,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42197075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-13DOI: 10.1108/tldr-05-2020-0009
Louise D. Denne, N. Gore, J. Hughes, S. Toogood, E. Jones, Freddy Jackson Brown
There is an apparent disconnect between the understanding of best practice and service delivery in the support of people with learning disabilities at risk of behaviours that challenge. We suggest, is a problem of implementation. The purpose of this paper is to explore reasons why this might be the case: a failure to recognise the collective works of successive generations of research and practice; and a failure to address the macro-systems involved and systems changes needed to support implementation. Design/methodology/approach: This paper reviews the consensus that exists in respect of best practice. Drawing upon ideas from implementation science the paper highlights the complexities involved in the implementation of all evidence-based practices and uses this as a framework to propose ways in which an infrastructure that facilitates the delivery of services in the learning disabilities field might be built. Findings: This paper highlights core recommended practices that have been consistent over time and across sources and identifies the systems involved in the implementation process. This paper demonstrates that many of the necessary building blocks of implementation already exist and suggests areas that are yet to be addressed. Critically, the paper highlights the importance of, and the part that all systems need to play in the process. Originality/value: In the absence of any generalised implementation frameworks of evidence-based practice in the learning disabilities field, the paper suggests that the findings may provide the basis for understanding how the gap that exists between best practice and service delivery in the support of people with a learning disability at risk of behaviours that challenge might be closed.
{"title":"Implementing evidence-based practice: the challenge of delivering what works for people with learning disabilities at risk of behaviours that challenge","authors":"Louise D. Denne, N. Gore, J. Hughes, S. Toogood, E. Jones, Freddy Jackson Brown","doi":"10.1108/tldr-05-2020-0009","DOIUrl":"https://doi.org/10.1108/tldr-05-2020-0009","url":null,"abstract":"There is an apparent disconnect between the understanding of best practice and service delivery in the support of people with learning disabilities at risk of behaviours that challenge. We suggest, is a problem of implementation. The purpose of this paper is to explore reasons why this might be the case: a failure to recognise the collective works of successive generations of research and practice; and a failure to address the macro-systems involved and systems changes needed to support implementation. \u0000Design/methodology/approach: This paper reviews the consensus that exists in respect of best practice. Drawing upon ideas from implementation science the paper highlights the complexities involved in the implementation of all evidence-based practices and uses this as a framework to propose ways in which an infrastructure that facilitates the delivery of services in the learning disabilities field might be built. \u0000Findings: This paper highlights core recommended practices that have been consistent over time and across sources and identifies the systems involved in the implementation process. This paper demonstrates that many of the necessary building blocks of implementation already exist and suggests areas that are yet to be addressed. Critically, the paper highlights the importance of, and the part that all systems need to play in the process. \u0000Originality/value: In the absence of any generalised implementation frameworks of evidence-based practice in the learning disabilities field, the paper suggests that the findings may provide the basis for understanding how the gap that exists between best practice and service delivery in the support of people with a learning disability at risk of behaviours that challenge might be closed.","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"133-143"},"PeriodicalIF":0.6,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49178911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-13DOI: 10.1108/tldr-08-2020-0022
Vivien Cooper
Purpose The purpose of this paper is to provide an individual family-carer perspective on navigating the complex child, adult, education, health and social care systems focussing on what might be needed to get the right support in the right place at the right time for individuals with learning disabilities who display behaviour that challenges. Design/methodology/approach This is a conceptual analysis, drawing on lived experience, policy and practice. Findings Policy and best practice advocate a holistic, person-centred, outcome-focussed approach to supporting individuals with learning disabilities whose behaviour challenges, but the existing complex multiple organisational structures are not conducive to delivering this. Making the system work for people requires focussed leadership across all levels to co-ordinate and align the component parts. It is certainly possible to achieve, but it is currently unclear who will take responsibility for making this happen. Originality/value Families are often the only constant in the lives of people with disabilities. This commentary highlights what is important to and for families when attempts are made to get the right support in the right place at the right time for individuals with learning disabilities who display behaviour that challenges.
{"title":"Commentary on a “unified approach to behaviours that challenge”: getting it right? A family carer perspective","authors":"Vivien Cooper","doi":"10.1108/tldr-08-2020-0022","DOIUrl":"https://doi.org/10.1108/tldr-08-2020-0022","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to provide an individual family-carer perspective on navigating the complex child, adult, education, health and social care systems focussing on what might be needed to get the right support in the right place at the right time for individuals with learning disabilities who display behaviour that challenges.\u0000\u0000\u0000Design/methodology/approach\u0000This is a conceptual analysis, drawing on lived experience, policy and practice.\u0000\u0000\u0000Findings\u0000Policy and best practice advocate a holistic, person-centred, outcome-focussed approach to supporting individuals with learning disabilities whose behaviour challenges, but the existing complex multiple organisational structures are not conducive to delivering this. Making the system work for people requires focussed leadership across all levels to co-ordinate and align the component parts. It is certainly possible to achieve, but it is currently unclear who will take responsibility for making this happen.\u0000\u0000\u0000Originality/value\u0000Families are often the only constant in the lives of people with disabilities. This commentary highlights what is important to and for families when attempts are made to get the right support in the right place at the right time for individuals with learning disabilities who display behaviour that challenges.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":"25 1","pages":"153-157"},"PeriodicalIF":0.6,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47760458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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