Towards a framework in interaction training for staff working with clients with intellectual disabilities and challenging behaviour

Abstract

In conducting a functional analysis of staff interpersonal behaviour, the results of this study can be used both as a framework in staff-client interaction training and in clinical practice for treating challenging behaviour. The emphasis in training and practice should not only be on the bidirectional dynamics of control and affiliation between staff and clients, but also - in order of importance - on the impact of staff emotions, self-efficacy, self-reflection and insight, coping style, team climate and attributions on staff interpersonal behaviour.

The role of emotion regulation, coping, self‐reflection and insight in staff interaction with patients with a diagnosis of personality disorder in forensic settings

“…As aggression towards staff by patients in forensic settings is common (Broderick, Azizian, Kornbluh, & Warburton, ; Freestone et al, ; Nicholls, Brink, Greaves, Lussier, & Verdun‐Jones, ), these findings suggest that emotion regulation may influence the way in which staff working with patients with a diagnosis of personality disorder in forensic settings cope with the challenging behaviour of their patients. In the study by Willems et al (), emotion regulation was missing, and possibly therefore, no relation was found between task‐focused coping style and interpersonal staff behaviour, while the results for avoidance‐focused coping style were ambiguous. We expect that the task‐focused or avoidance‐focused coping skills of staff will only improve their behaviour towards patients if they adequately regulate their emotions by reappraising the situation and by refraining from suppressing their emotions.…”

“…In a related field of clients with intellectual disabilities and challenging behaviour, Willems, Embregts and colleagues (Willems, Embregts, Stams, & Moonen, ; Willems, Embregts, Hendriks, & Bosman, ; et al, 2014; Willems, Embregts, Hendriks, & Bosman, ) used Leary's interpersonal circumplex model (Leary, ) in research on which factors influence the interaction between staff and clients. Therefore, the results of research on the interaction between staff and clients with intellectual disabilities and challenging behaviour may be relevant to staff working with patients with a diagnosis of personality disorder in forensic settings.…”

“…In a study among 318 staff working with clients with intellectual disabilities and challenging behaviour (Willems et al, ), the most influential determinant of staff interpersonal behaviour was the emotional reactions of the staff members, with more positive emotions leading to more friendly behaviour and more negative emotions leading to more controlling, more hostile and more support‐seeking (needing support, encouragement and back‐up) behaviour towards their clients. Self‐reflection and insight by staff led to less controlling and less hostile behaviour of staff.…”

“…Furthermore, research is lacking on the relation between emotion regulation of the staff and their behaviour towards patients with a diagnosis of personality disorder in forensic settings. This is remarkable, because on the one hand, emotions have been proven to have the highest impact on interpersonal staff behaviour towards clients with intellectual disabilities and challenging behaviour and, on the other hand, emotion regulation has been suggested as a technique to train staff in dealing with their negative emotions (Goussinsky & Livne, ; Willems et al, ). Support for the hypothesis of a relation between emotion regulation and interpersonal staff behaviour can be found in studies that have shown that different emotion regulation strategies have different effects on emotions (Koole, ).…”

“…Self‐reflection has been shown to be related to more anxiety and stress (Grant, Franklin, & Langford, ). Despite these higher negative emotions, self‐reflection was related to less negative interpersonal staff behaviour (Willems et al, ), suggesting that self‐reflection is also related to adequate emotion regulation. Therefore, we expect that self‐reflection contributes to reappraising the situation and, as such, has a positive influence on interpersonal staff behaviour.…”