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Intensive support for adults with intellectual disability and behaviours that challenge : a survey of provision and service typologies in England
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Hassiotis, Angela , Walsh, Amy, Budgett, Jessica, Harrison, Isobel, Jones, Rebecca, Morant, Nicola, Courtenay, Ken, Crossey, Elisabeth Victoria, Hall, Ian, Romeo, Renee, Taggart, Laurence George, Langdon, Peter E., Ratti, Victoria, Kirchner, Vincent and Lloyd-Evans, Brymor (2020) Intensive support for adults with intellectual disability and behaviours that challenge : a survey of provision and service typologies in England. BJ Psych Open, 6 (2). e20. doi:10.1192/bjo.2020.2 ISSN 2056-4724.
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Official URL: https://doi.org/10.1192/bjo.2020.2
Abstract
Background:
Approximately 18% of adults with intellectual disabilities (ID) living in the community display behaviours that challenge. Intensive Support Teams (IST) have been recommended to provide high quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy inpatient stays.
Aims:
To identify and describe the geographical distribution and characteristics of ISTs, and to develop a typology of IST service models in England.
Method:
National cross-sectional survey of 73 ISTs. A hierarchical cluster analysis was performed based on six pre-specified grouping factors (mode of referrals, size of caseload, use of outcome measures, staff composition, hours of operation, and setting of service). A simplified form of thematic analysis was used to explore free text responses.
Results:
Cluster analysis identified two models of IST provision: 1. Independent and 2. Enhanced Provision based around a Community Intellectual Disability Service (CIDS). ISTs aspire to adopt person-centred care, mostly use the framework of Positive Behaviour Support for behaviour that challenges and report concerns about organisational and wider context issues.
Conclusions:
This is the first study to examine the delivery of intensive support to people with ID and behaviour that challenges. A two-cluster model of ISTs was found to have statistical validity and clinical utility. The clinical heterogeneity indicates that further evaluation of these service models is needed to establish their clinical and cost effectiveness.
Item Type: | Journal Article | ||||||
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Subjects: | B Philosophy. Psychology. Religion > BF Psychology | ||||||
Divisions: | Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR) | ||||||
Journal or Publication Title: | BJ Psych Open | ||||||
Publisher: | Cambridge University Press | ||||||
ISSN: | 2056-4724 | ||||||
Official Date: | 11 February 2020 | ||||||
Dates: |
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Volume: | 6 | ||||||
Number: | 2 | ||||||
Article Number: | e20 | ||||||
DOI: | 10.1192/bjo.2020.2 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 19 January 2020 | ||||||
Date of first compliant Open Access: | 13 February 2020 | ||||||
Funder: | National Institute for Health Research | ||||||
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