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Who’s Challenging Who?: a co-produced approach for training staff in learning disability services about challenging behaviour

Samantha Flynn (CEDAR, University of Warwick, Coventry, UK)
Richard P. Hastings (CEDAR, University of Warwick, Coventry, UK) (Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia)
Rachel McNamara (Centre for Trials Research, Cardiff University, Cardiff, UK)
David Gillespie (Centre for Trials Research, Cardiff University, Cardiff, UK)
Elizabeth Randell (Centre for Trials Research, Cardiff University, Cardiff, UK)
Leisa Richards (CEDAR, University of Warwick, Coventry, UK)
Zac Taylor (Royal Mencap Society, London, UK)

Tizard Learning Disability Review

ISSN: 1359-5474

Article publication date: 3 October 2019

Issue publication date: 5 November 2019

799

Abstract

Purpose

The purpose of this paper is to outline the development, piloting and evaluation of the Who’s Challenging Who? (WCW) training intervention for social care staff to improve their empathy and attitudes towards people with learning disabilities (LD) and challenging behaviour (CB).

Design/methodology/approach

A phased approach was taken to the development and testing of the intervention. Initially, the existing literature was reviewed, the theoretical background of the intervention was developed, and then the intervention was designed. A pilot study was undertaken, followed by further development, and a large-scale randomised controlled trial (RCT).

Findings

WCW had a small positive effect on staff empathy 20 weeks after the intervention, and small to moderate effects for other staff reported outcomes (e.g. positive empowerment attitudes and positive work motivation). Being trained by people with LD and CB encouraged staff to reflect on the impact they have on the people they support. The trainers with LD valued their role, and saw benefits beyond this (e.g. friendships).

Research limitations/implications

It is possible to carry out high-quality RCT evaluations of social care practice, and research should continue to generate evidence in this way, as in healthcare settings. However, there were difficulties in retaining participants.

Practical implications

People with LD can be actively involved in the co-production and delivery of social care training.

Social implications

Employment and a fair wage can increase the confidence and empowerment of people with LD.

Originality/value

This is the first large-scale RCT of an intervention that aimed to improve empathy/change attitudes in social care staff who work with people with LD and CB.

Keywords

Acknowledgements

The literature reviews and pilot study were funded by a Knowledge Transfer Partnership (funded by the Royal Mencap Society, the Technology Strategy Board and Welsh Government). The RCT was funded by the National Institute for Health Research School for Social Care Research (No. CO88/T14-035/WURH-P64). This paper summarises independent research by the National Institute for Health Research School for Social Care Research. The views expressed in this presentation are those of the authors and not necessarily those of the NIHR SSCR, NHS, the National Institute for Health Research or the Department of Health. The funder of the study had no role in the study design, data collection, analysis, interpretation or preparation of this manuscript. The authors would like to thank all of the participants in all stages of this work, as well as all of the WCW trainers (Clare Bowler, Martin Banks Ben Williams, Philip Przybylak and Andrew Mitchell), and all members of the research teams, study steering committee and advisory group. Two of the WCW trainers, Philip Przybylak and Ben Williams, passed away between the project ending and the submission of this paper. Their contributions to the project were invaluable, and continue to be impactful.

Citation

Flynn, S., Hastings, R.P., McNamara, R., Gillespie, D., Randell, E., Richards, L. and Taylor, Z. (2019), "Who’s Challenging Who?: a co-produced approach for training staff in learning disability services about challenging behaviour", Tizard Learning Disability Review, Vol. 24 No. 4, pp. 192-199. https://doi.org/10.1108/TLDR-03-2019-0013

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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