Working Systemically in a Learning Disability Service: What do Colleagues and Carers Think?

Smyly, Selma Rikberg; Elsworth, Julie; Mann, Judith; Coates, Emma

doi:10.1108/13595474200800014

Cited by 7 publications

(11 citation statements)

References 10 publications

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“…Themes of "uncertainty regarding 'forum' composition" and "differing expectations" were consistent with themes in other literature including "feeling unprepared" and "unfamiliar structure-odd/uncomfortable" in Rikberg Smyly et al (2008) and "managing an unusual experience" (Anslow, 2014). Rikberg Smyly et al (2008) it may therefore be beneficial to consider the systemic experience of reflecting team members. In addition in the current study's interviews, there was a feeling that the "forum" consisted of too many people.…”

Section: Considerations For Clinical Practicesupporting

confidence: 77%

“…intellectual disabilities, learning disabilities, multidisciplinary team, systemic consultation, systemic therapy, thematic analysis reflecting team format), "feeling heard," "having strengths recognised" and the "therapeutic relationship." Rikberg Smyly, Elsworth, Mann, and Coates (2008) analysed written data from telephone interviews with 64 participants (five carers or service users; 39 care staff; 20 professionals) on the helpfulness of initial systemic consultations in a CLDS. Content analysis was used to identify themes and to code data into categories of "only positive," "mainly positive," "both positive and negative," "mainly negative" and "only negative."…”

Section: Introductionmentioning

confidence: 99%

“…Content analysis was used to identify themes and to code data into categories of "only positive," "mainly positive," "both positive and negative," "mainly negative" and "only negative." Rikberg Smyly et al (2008) found that most participants gave positive responses (86%) and found consultations helpful/ useful (97%). There were differences between groups where only/ mainly positive comments were given by 100% of carers/service users, 90% of care staff and 75% of professionals.…”

Section: Introductionmentioning

confidence: 99%

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Experiences of two multidisciplinary team members of systemic consultations in a community learning disability service

Johnson

Viljoen

2017

Brit J Learn Disabil

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Accessible Summary People with learning disabilities may have help from their families, paid carers and professionals such as nurses, psychologists etc. Professionals (like psychologists) can help people with learning disabilities and their families, carers and other professionals by meeting to talk about solutions together. This is called a systemic consultation. We asked two people who came to the systemic consultations what they thought was helpful and unhelpful about the systemic consultations. The two people we asked were two professionals who worked with people with learning disabilities. The helpful things were that the systemic consultations might have helped people to feel better about themselves and speak about their worries. People may feel that others care about them too. People with learning disabilities started to find their own answers to the difficulties they had. We found that the people who were responsible for the systemic consultations asked some helpful questions. For example, they spoke in a positive way and tried to talk about the things that people were good at. Another helpful thing was that coming to the systemic consultations helped people to get on better with each other. The unhelpful things were that people coming to the systemic consultations thought that something else would happen at the consultations. They also thought that sometimes there were too many people at the systemic consultations. They said that it was not helpful if the people who help in the systemic consultations change. After looking at the answers the people gave, we talked about the things that can be done to make sure that systemic consultations become more helpful for everyone. Abstract BackgroundSystemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and MethodsThis article presents part of a service evaluation of systemic consultations in a Community Learning Disability Service (CLDS). Two multidisciplinary team professionals were interviewed about what they found helpful and unhelpful in their experiences of attending systemic consultations. Interview data were analysed via applying thematic analysis principles. ResultsFive main themes were elicited: differing expectations, enabling for the client, positive techniques, uncertainty regarding “forum” (“forum” meaning the collective of all of the individuals meet, which could include the professionals, lead therapist, reflecting team, etc.) composition and strengthening the network. ConclusionsSystemic consultations provided some positive and valuable experiences along with important caveats. Considerations for clinical practice are therefore discussed. Continued evaluation of systemic consultations within CLDSs is recommended.

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Section: Considerations For Clinical Practicesupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experiences of two multidisciplinary team members of systemic consultations in a community learning disability service

Johnson

Viljoen

2017

Brit J Learn Disabil

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“…This theme also connects to the themes in the previous research. 'A positive focus' was identified in the research by Rikberg Smyly et al (2008), as described by care staff, professionals and family members after a systemic consultation using the reflecting team. Furthermore, the theme of 'having strengths recognised' was outlined in Petrie's (2011) research.…”

Section: Rebeccamentioning

confidence: 99%

“…Meanwhile, Rikberg Smyly et al (2008) reported on telephone interviews conducted with 39 direct care staff, 20 professional colleagues and five family members after systemic consultations, which used the reflecting team format. Content analysis was used to code notes made about participants' responses.…”

Section: Introductionmentioning

confidence: 99%

Systemic family therapy using the reflecting team: the experiences of adults with learning disabilities

Anslow

2013

Brit J Learn Disabil

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Accessible summary Sometimes people with learning disabilities and their families get upset and want to talk about their problems. They might see a therapist who talks to them and their family together. This is sometimes called family therapy. The therapist might use a team of other therapists to give the family other ideas. This is called the reflecting team. We wanted to know what it was like for the person with learning disabilities when this happened. We showed five adults with learning disabilities a DVD of the reflecting team in their family therapy and asked what it was like for them. They told us interesting things about what was helpful and what was not helpful in their therapy. This will help us give a better service to adults with learning disabilities who have family therapy. Summary This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis (IPA) was appropriate to gather participants' views using semi‐structured interviews. The interviews used DVD‐assisted recall of the reflecting team. Various validation strategies were employed, including respondent feedback and a focus group with the therapists. Insights were gained in the areas of ‘therapists’ focus on strengths and difficulties’, ‘differences in metacognition’, ‘finding a voice in therapy’, ‘frustration with the outcome of therapy’ and ‘managing an unusual experience’. The research has indicated some important factors to consider in the successful inclusion of adults with learning disabilities in systemic family therapy.

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“You’re changing the pattern”: cognitive analytic team formulation with learning disabilities care staff

Russell

Theodore

Lloyd

2022

AMHID

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Purpose This study aims to explore how care staff working with people with learning disabilities experienced psychologist-facilitated team formulation sessions in a cognitive analytic style (contextual reformulation). Design/methodology/approach Eleven participants attended at least one contextual reformulation session regarding a client their team referred because of challenging behaviour. Post-intervention semi-structured interviews were analysed using qualitative inductive thematic analysis. Findings Five themes were developed: multiple roles and functions of sessions and clinicians; challenging behaviour in relationship; making links – understanding can be enlightening, containing and practical; the process of developing a shared understanding and approach; and caught between two perspectives. Findings suggested contextual reformulation helped staff see challenging behaviour as relational, provided them with the space to reflect on their emotions and relate compassionately to themselves and others, and ultimately helped them to focus their interventions on understanding and relationally managing rather than acting to reduce behaviour. Research limitations/implications Qualitative methodology allows no causal inferences to be made. Ten of 11 participants were female. Originality/value This qualitative study adds to the limited research base on team formulation in learning disabilities settings and specifically that using a cognitive analytic approach.

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Working Systemically in a Learning Disability Service: What do Colleagues and Carers Think?

Cited by 7 publications

References 10 publications

Experiences of two multidisciplinary team members of systemic consultations in a community learning disability service

Experiences of two multidisciplinary team members of systemic consultations in a community learning disability service

Systemic family therapy using the reflecting team: the experiences of adults with learning disabilities

“You’re changing the pattern”: cognitive analytic team formulation with learning disabilities care staff

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