Clinician experiences of administering the Essen Climate Evaluation Schema (EssenCES) in a forensic intellectual disability service

Abstract

Purpose -Social climate (ward atmosphere) affects numerous treatment outcomes. The most commonly used measure is the Essen Climate Evaluation Schema (EssenCES) (Schalast et al., 2008). Though studies have investigated the psychometric properties of EssenCES in intellectual disability populations, few have focused on the clinical utility, or accessibility of the measure. The purpose of this paper is to examine clinician's experiences of using this measure with this population. Design/methodology/approach -Clinicians experienced in administering EssenCES with forensic intellectual disability patients completed an open-ended questionnaire, which sought qualitative data on their experiences of using EssenCES with this population. Data were analysed using thematic analysis. Findings -A number of issues were raised regarding use of EssenCES with patients with intellectual disability. Four overarching themes arose: Understanding of Language, Commenting on Others, Understanding of Likert Scale, and Scale Positives and Adaptation. Clinicians felt certain items were not uniformly understood by all patients, particularly those that incorporated abstract concepts, double negatives, or complex language. Originality/value -Results suggest forensic intellectual disability patients vary in their ability to understand EssenCES items. This resulted in significant further explanation by the administering clinician, a practice which raised concern regarding reliability. Results provide preliminary evidence to indicate EssenCES use requires further consideration in intellectual disability services, or adaptation for this client group.

Adapting measures of social climate for use with individuals with intellectual developmental disability in forensic settings

“…The suitability of the EssenCES for IDD populations has been questioned in a recent study which investigated clinician experiences of using the EssenCES in forensic IDD settings (Chester et al, 2015). Participants were seven clinicians currently working, or who had previously worked, within the Psychology discipline in one UK forensic IDD service.…”

“…Secondly, the resulting reduction in anonymity of responses can increase the likelihood of nay-saying or socially desirable responding when individuals are asked questions regarding prohibited behaviour or the quality of their care (Finlay & Lyons, 2001). Lastly, it has been suggested that oral presentation of questionnaire measures can lead to administrating staff providing further explanation of the questions, resulting in concerns surrounding staff projecting their own interpretation of a question on to individuals (Chester et al, 2015).…”

“…The achievement of this aim, however, rests on reliable and valid questionnaires to measure the social climate in IDD settings. As demonstrated byChester et al (2015) andAlderman and Groucott (2012), there are significant questions regarding the suitability of existing questionnaire measures of social climate for this purpose. The next part of the review will consider in more detail the particular cognitive deficits experienced by IDD populations and the potential impact this might have on their ability to reliably complete questionnaire measures of social climate.…”

Evaluation of the EssenCES in a neurodevelopmental inpatient service for adolescents

“…This would involve adapting the measure to improve its appropriateness for an intellectual disability population. This has previously been proposed by Chester et al (2015), who posited that the EssenCES may need to be adapted or reconsidered for use within intellectual disability services following their study with forensic intellectual disability SUs. Thus, we suggest that the EssenCES be adapted-using input from speech and language therapy-to facilitate access for LD adolescent SUs through developing SU-rated EssenCES for neurodevelopmental CAMHS settings, with an emphasis on visual aids.…”

“…In contrast, Quinn et al (2012) found initial evidence to support the proposal that the EssenCES was a reliable tool for use with LD secure service population. More recently, however, Chester et al (2015) gathered qualitative data from clinicians who were experienced in administering the EssenCES with a forensic intellectual disability population and garnered results which reflected clinician concerns over patient comprehension of items, around clinician support and interpretation, and of data reliability. In contrast, Willets et al (2014) conducted an EssenCES study which compared LD and non-LD psychiatric services and found that SUs in both services did not differ in their perceptions of social climate.…”