"I'm not a patient, I'm a person": The experiences of individuals with intellectual disabilities and challenging behavior—A thematic synthesis of qualitative studies.

Abstract

Individuals with intellectual disabilities (ID) and challenging behavior often have complex care needs and may be reliant on care support services. This thematic synthesis examines published qualitative research on the experiences of individuals with ID in relation to received service supports and interventions. Seventeen studies met criteria. Four themes emerged: (1) Imbalance of power, (2) Causal attributions about challenging behavior, (3) Experiences of restrictive interventions, and (4) Opportunities for improvement: proactive interventions. The accumulative stressors of living in a residential placement were regarded as a cause of continued challenging behaviors.The impersonal attitude of support staff was regarded as a major contributory factor. The findings can inform service providers about how best to support individuals with ID and challenging behavior.

How service‐users with intellectual disabilities understand challenging behaviour and approaches to managing it

“…The buffering impact of positive relationships on challenging behaviour is also consistent with previous research in this area (Ruef & Turnbull, ; Ruef, Turnbull, Turnbull, & Poston, ), although relationships with staff in this analysis were perceived more positively than in previous research (Brown & Beail, ; Duperouzel & Fish, ; Fish & Culshaw, ; Griffith et al, ). Our analysis points to some of the features of positive staff relationships, in addition to adding to previous research by elucidating the mechanisms through which positive relationships operate to moderate challenging behaviour.…”

Gendered experiences of physical restraint on locked wards for women

“…Coercive methods for behaviour management should be investigated using concepts of gender, power and control as well as disability (see also Griffith, Hutchinson, and Hastings 2013). Both groups of participants in this study pointed out the unpleasantness of restraint methods, and they emphasised the damage it could do to relationships.…”

“…Griffith, Hutchinson, and Hastings (2013) produced a synthesis of studies investigating service responses to 'challenging behaviour' . They found that people with intellectual disabilities felt powerless due to the negative atmosphere on wards and they experienced a loss of autonomy and violence or indifference from others, which engendered a cycle of frustration and further challenging behaviour.…”

‘Behind This Wall’ – Experiences of Seclusion on Locked Wards for Women

“…I argue that coercive methods for behavior management should be investigated using concepts of power and control (Griffith et al, 2013).…”