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Who's challenging who training for staff empathy towards adults with challenging behaviour : cluster randomised controlled trial

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Hastings, Richard P., Gillespie, D., Flynn, Samantha, McNamara, R., Taylor, Z., Knight, R., Randell, E., Richards, L., Moody, G., Mitchell, A., Przybylak, P., Williams, B. and Hunt, P. H. (2018) Who's challenging who training for staff empathy towards adults with challenging behaviour : cluster randomised controlled trial. Journal of Intellectual Disability Research, 62 (9). pp. 798-813. doi:10.1111/jir.12536

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Official URL: https://doi.org/10.1111/jir.12536

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Abstract

Background

One in five adults with intellectual disabilities (ID) known to services display challenging behaviours (CBs), and these individuals are at risk for restrictive practices and poor care. Staff attitudes may contribute to the development and/or maintenance of CBs. We investigated the effectiveness of co‐produced Who's Challenging Who? training delivered by people with ID to staff.

Method

This study involved a cluster randomised controlled trial (RCT) of Who's Challenging Who? training with follow‐up at six and 20 weeks post‐randomisation. Participants: two staff from each of 118 residential care settings for adults with ID at least one of whom displayed aggressive CB. Primary outcome: Self‐reported Staff Empathy for people with Challenging Behaviour Questionnaire. Analysis: intention to treat of all randomised settings. ISCRTN registration: ISRCTN53763600.

Results

118 residential settings (including 236 staff) were randomised to either receive training (59 settings) or to receive training after a delay (59 settings). The primary analysis included data from 121 staff in 76 settings (51% of staff, 64% of settings). The adjusted mean difference on the transformed (cubed) Staff Empathy for people with Challenging Behaviour Questionnaire score at the primary end point was 1073.2 (95% CI: ‐938.1 to 3084.5, P = 0.296) in favour of the intervention group (effect size Cohen's d = .19).

Conclusions

This is the first large‐scale RCT of a co‐produced training course delivered by people with ID. Findings indicated a small positive (but statistically non‐significant) effect on increased staff empathy at 20 weeks, and small to moderate effects for staff reported secondary outcomes in favour of the intervention group.

Item Type: Journal Article
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
Divisions: Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR)
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Intellectual disability, Intellectual disability facilities
Journal or Publication Title: Journal of Intellectual Disability Research
Publisher: Wiley
ISSN: 0964-2633
Official Date: 23 July 2018
Dates:
DateEvent
23 July 2018Published
27 June 2018Accepted
26 June 2018Available
Volume: 62
Number: 9
Page Range: pp. 798-813
DOI: 10.1111/jir.12536
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
CO88/T14-035/WURH-P 64[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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