There is limited research that explores the experiences of how behavioural specialists actively involve people with a learning disability and challenging behaviour in the development of their positive behavioural support (PBS) plan. Accordingly, this exploratory research study aimed to explore this little understood area of practice.
Methods:
The study included semi-structured interviews comprised of nine Behavioural Specialists in three focus groups across two health boards. A descriptive thematic analysis study.
Findings:
Three major themes and 11 minor themes were identified illustrating how people with learning disabilities and behaviours that challenge were involved in developing their PBS plan. Significantly, the themes illustrated the complexity of truly involving service users in the process.
Conclusion:
Inclusion of people with a learning disability and behaviours that challenge in their PBS plan poses significant challenges. Person-centred care struggles to be truly embedded in the PBS model.
AllenD (2009) Positive behaviour support as a service system for people with challenging behaviour. Psychiatry8(10): 408–411.
2.
AllenDJamesWEvansJ. (2005) Positive behavioural support: definition, current status and future directions. Learning Disability Review10(2): 4–11.
3.
BakerPAllenD (2012) Use of positive behaviour support to tackle challenging behaviour. Learning Disability Practice15(1): 18–20.
4.
BartonH (2012) Maximising individual’s control over their lives. Learning Disability Practice,15(3): 12–16.
5.
Beadle-BrownJMansellJWheltonB. (2006) People with learning disabilities in ‘out-of-area’ residential placements: 2. Reasons for and effects of placement. Journal of Intellectual Disability Research50: 845–856.
6.
BradshawJ (2001) Complexity of staff communication and reported level of understanding in adults with intellectual disability. Journal of Intellectual Disability Research45(3): 233–243.
7.
BraunVClarkeV (2006) Using thematic analysis in psychology. Qualitative Research in Psychology3(2): 77–101.
Department of Health (DH) (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. London: Department of Health.
14.
Department of Health (DH) (2003) Valuing People: A New Strategy for Learning Disability for the 21st Century. London: Department of Health.
15.
Department of Health (DH) (2007) Services for People with Learning Disability and Challenging Behaviour or Mental Health (Revised Edition). London: Department of Health.
16.
Department of Health (DH) (2008) Real Involvement: Working with People to Improve Health Service. London: Department of Health.
17.
Department of Health (DH) (2009a) Valuing People Now: A New Three Year Strategy for People with Learning Disabilities ‘Making It Happen for Everyone’. London: Department of Health.
18.
Departement of Health (DH) (2009b) Putting People at the Heart of Care: The Vision for Public and Patient Experience and Engagement in Health and Social Care. London: Department of Health.
19.
Department of Health (DH) (2012) Liberating the NHS: No Decision About Me, Without Me. London: Department of Health.
Department of Health (DH) (2014) Positive and Proactive Care: Reducing the Need for Restrictive Interventions. London: Department of Health.
22.
DierchxKDeveugeleMRoosenP. (2013) Implementation of shared decision making in physical therapy: observed level of involvement and patient preference. Physical Therapy93(100): 1321–1330.
23.
DoodyOSlevinETaggartL (2013) Focus group interviews in nursing research: part 1. British Journal of Nursing22(1): 16–19.
24.
DowlingSManthorpeJCowleyS (2007) Working on person-centred planning: From amber to green light?Journal of Intellectual Disabilities11(1): 65–82.
25.
DuffyS (2004) Person centred planning and system change. Learning Disability Practice7(8): 15–19.
26.
DukesESweeneyJ (2009) Recognizing the value of involving service users with intellectual disability in healthcare planning. Learning Disability Practice12(10): 33–37.
27.
DunlapGCarrEGHornerRH. (2008) PBS and applied behaviour analysis. A familial alliance. Behaviour Modification32(5): 682–698.
28.
DunlapGNewtonJSFoxL. (2001) Family involvement in functional assessment and PBS. Focus on Autism and other Development Disabilities16(4): 215–221.
EsmaeiliMCheraghiMSalsaliM (2014) Barriers to patient-centred care: a thematic analysis study. International Journal of Nursing Knowledge25(1): 2–8.
31.
FredR (2010) Person-centred mental health care: myth or reality?Mental Health Practice13(9): 24–28.
32.
FugardAPottsH (2015) Supporting thinking on sample sizes for thematic analyses: a quantitative tool. International Journal of social Research Methodology18(6): 669–688.
GoreNMcGillPToogoodS. (2013) Definition and scope for positive behavioural support. International Journal of Positive Behavioural Support3(2): 14–23.
35.
GowlandS (2011) Enabling people to give feedback about their health care. Learning Disability Practice14(8): 32–36.
36.
GriffinR (2015) Understanding the code: working in partnership. British Journal of Community Nursing20(5): 250–252.
37.
HaganLThompsonH (2013) It’s good to talk: developing the communication skills of an adult with an intellectual disability through augmentative and alternative communication. British Journal of Learning Disabilities42(1): 68–75.
38.
HayesR (2015) Collaboration in caring a new approach to healthcare. Alberta RN71(20): 18–19.
39.
HooleLMorganS (2011) It’s only right that we get involved: service-user perspectives on involvement in learning disability services. British Journal of Learning Disabilities39(1): 5–10.
40.
IngramCLovellA (2011) Understanding and working with challenging behaviour. Learning Disability Practice14(2): 32–38.
41.
Institute Health Research (2005) The Impact of Person Centred Planning. Lancaster: Institute Health Research.
42.
JamesN (2013) Enhancing relationships between family carers and professionals. Learning Disability Practice16(6): 34–37.
43.
JingreeTFinlayWMLAntakiC (2006) Empowering words, disempowering actions: an analysis of interactions between staff members and people with learning disabilities in residents’ meetings. Journal of Intellectual Disability Research50(30): 212–226.
44.
KoskiKLaunoneK (2012) Assessing the communication skills of carers working with multiple learning disabilities: a case study. International Journal of Language and Communication Disorders47(6): 685–695.
45.
KylieSMelvilleCJonesA (2009) Effective communication training interventions for paid carers supporting adults with learning disabilities. British Journal of Learning Disabilities39(4): 210–216.
46.
LarssonISahlstenMSjostromB. (2007) Patient participation in nursing care from a patient perspective: a Grounded Theory study. Scandinavian Journal Caring Science21(3): 313–320.
47.
LoweKAllenDBrophyS. (2005) The management and treatment of challenging behaviours. Learning Disability Review10(2): 34–37.
48.
MartinACareyE (2009) Person-centred plans: empowering or controlling?Learning Disability Practice12(1): 32–37.
McGarthA (2013) Carers’ commitment to behavior support plans. Learning Disability Practice16(7): 22–24.
51.
McKenzieKPaterson (2010) Evaluating an assertive outreach team for supporting clients who present with behaviour that challenge. British Journal of Learning Disabilities38(4): 319–327.
52.
McKenzieK (2009) Evaluating a community-based project for supporting clients with challenging behaviour. Learning Disability Practice12(4): 27–32.
53.
MeadowsK (2003) So you want to do research? An introduction to qualitative methods. British Journal of Community Nursing8(10): 464–469.
MinichielloVSullivanGGreenwoodK. (2004) Research Methods for Nursing and Health Science, 2nd ed. Australia: Pearson Education Australia.
56.
NdoroS (2014) Effective multidisciplinary working: the key to high quality care. British Journal of Nursing23(13): 724–727.
57.
OsgoodT (2005) Managing the tensions between the interests of organisations and service users. In: CambridgePCarnabyS (eds) Person Centred Planning and Care Management with People with Learning Disabilities. London, Philadelphia: Jessica Kingsley Publishers.
58.
ParahooK (2006) Nursing Research Principles, Process and Issues, 2nd ed. Basingstoke: Palgrave Macmillan.
SalmonRHolmesNDoddK (2013) Reflections on change: supporting people with learning disabilities in residential services. British Journal of Learning Disabilities42(2): 141–152.
VaismoradiMTurunenHBondasT (2013) Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nursing and Health Sciences15(3): 398–405.
67.
VauseTRegehrKFeldmanM. (2009) Right to evidence-based treatment for individuals with development disabilities: issues of the use of therapeutic punishment. In: OwenFGriffithsD (ed) Challenges to the Human Rights of People with Intellectual Disabilities. London: Jessica Kingsley Publishers, pp. 219–239.
68.
VeselinovaC (2014) Principles and positive risk taking for individuals with disabilities. Nursing and Residential Care16(9): 526–529.
69.
WalmsleyJ (2004) Involving users with learning disability in health improvement: lessons from inclusive learning disability research. Nursing Inquiry11(1): 54–64.
70.
WebberLMcVillyKFesterT. (2011) Factors influencing quality of behaviour support plans and the impact of plan quality on restrictive intervention use. International Journal of Positive Behavioural Support1(1): 24–31.
71.
Welsh Assembly Government (WAG) (2007) Statement on policy and practice for adults with a learning disability. Available at: http://www.ldiag.org.uk/ (accessed on 10 January 2017).
