Stakeholder perspectives on intensive support teams for adults with intellectual disabilities who display behaviour that challenges in England

Athanasia Kouroupa, Angela Hassiotis, Leila Hamza, Ken Courtenay, Ian Hall, Peter E. Langdon, Laurence Taggart, Vicky Crossey, Brynmor Lloyd‐Evans, Nicola Morant

Research output: Contribution to journalArticlepeer-review

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Background: Adults with intellectual disabilities often display behaviour that challenges that is a result of biological differences, psychological challenges, and lack of appropriate social support. Intensive Support Teams (IST) are recommended to support the care needs of this group and avoid hospitalisation. However, little attention has been paid to the perspectives of stakeholders who manage, work in, or use ISTs. Method: Interviews and focus groups were conducted with 50 stakeholders (IST service managers and professionals, adults with intellectual disabilities, and family and paid carers) of ISTs. Services operated according to one of two service models previously identified in ISTs in England (enhanced or independent). Results: Thematic analysis identified accessible and flexible support, individualised care, and the involvement of carers and other relevant agencies in management plans and reviews as features of good IST care highlighted by all stakeholder groups. IST managers and professionals described the key challenges of current IST provision as unclear referral criteria, limited interfaces with other local services, and perceived threats associated with funding and staff retention. Findings were similar between the two IST models. Conclusions: ISTs are able to offer care and specialist support that is valued by families, service users and other care providers. However, they face several operational challenges that should be addressed if ISTs are to reach their potential along with community intellectual disability services in supporting adults with intellectual disabilities who display behaviour that challenges in the community.
Original languageEnglish
Pages (from-to)1101-1112
Number of pages12
JournalJournal of Applied Research in Intellectual Disabilities
Issue number5
Early online date4 Jun 2023
Publication statusPublished online - 4 Jun 2023

Bibliographical note

Funding Information:
The authors are grateful to the study participants who participated in the study. The research team is also grateful to the NIHR Clinical Research Network (CRN), all 21 Research and Development offices, and to the Project Advisory Group of experts by experience for their support and commitment to the study. In particular, we acknowledge the support and contribution of Narender Kaur, Lorna Bryan, Janet Seamer, Sandy Smith and Brendan Leahy from the Camden Disability Action (Synergy). We would also like to thank the Study Steering Committee, chaired by Professor Nora Grace, for their oversight of the study. Finally, we are grateful to previous members of the research team: Dr Victoria Ratti, Jessica Budgett, Peiyao Tang for their contribution to delivering the IST-ID study.

Funding Information:
This project was funded by the National Institute for Health and Care Research (NIHR) Health Services and Delivery Research (HS&DR) programme (NIHR Ref. No. 16/01/24). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2023 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.


  • intensive support
  • challenging behaviour
  • intellectual disabilities
  • qualitative methods
  • community care


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