Stakeholder views on the barriers and facilitators of psychosocial interventions to address reduction in aggressive challenging behaviour in adults with intellectual disabilities

Athanasia Kouroupa, Leila Hamza, Aisha Rafiq, Angela Hassiotis, Penny Rapaport, Andrew Jahoda, Laurence Taggart, Liz Steed, Sally-Ann Cooper, Craig Melville, Louise Marston, Rachel Royston, Afia Ali

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Abstract

BACKGROUND: Success of psychosocial interventions in reducing aggressive challenging behaviour is likely to be related not only to mechanistic aspects, but also to therapeutic and system factors. The study aims to examine the facilitators and barriers that influence whether psychosocial interventions for aggressive challenging behaviour in adults with intellectual disabilities lead to positive change.

METHODS: We conducted 42 semi-structured interviews with adults with intellectual disabilities and aggressive challenging behaviour, family/paid carers, and professionals engaged in or delivering a psychosocial intervention across the UK. Data were analysed thematically using a framework approach.

RESULTS: Stakeholders considered therapeutic and supportive relationships and personalised care as facilitating factors of psychosocial interventions to address aggressive challenging behaviour. The operational structure of community intellectual disability services and conflicting expectations of professionals and carers were the main contextual barriers that impeded the implementation of psychosocial interventions addressing aggressive challenging behaviour in adults with intellectual disabilities.

CONCLUSIONS: Findings highlight the valued components that maximise positive change in adults with intellectual disabilities who display aggressive challenging behaviour. Several operational adjustments including referral criteria, roles of professionals and workforce issues need to be addressed in services to maximise the implementation of psychosocial interventions to reduce aggressive challenging behaviour in adults with intellectual disabilities.

Original languageEnglish
Pages (from-to)1-19
Number of pages19
JournalNIHR open research
Volume3
Issue number40
Early online date14 Aug 2023
DOIs
Publication statusPublished (in print/issue) - 2023

Bibliographical note

The authors are grateful to the study participants, the NIHR Clinical Research Network (CRN) and to the Project Advisory Groups of experts by experience for their support and commitment to the study. We acknowledge the support and contribution of Vivien Cooper from the Challenging Behaviour Foundation and Brendan Leahy from the Camden Disability Action (Synergy). Finally, we thank the former PETAL researcher Maria Lahab, for data collection relating to this work.

Copyright: © 2023 Kouroupa A et al.

Keywords

  • challenging behaviour
  • aggression
  • Intellectual disabilities
  • qualitative methods
  • community care
  • interventions

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