Hannah Timpson, Lindsay Eckley, Harry Sumnall, Marissa Pendlebury and Gordon Hay
Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose…
Abstract
Purpose
Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose of this paper is to explore these factors, and understand how service user experiences align to current understandings of “recovery capital”.
Design/methodology/approach
This paper draws on qualitative interviews with 32 individuals from six UK recovery communities, including those commissioned by a statutory service (n=8) and a peer-led recovery community (n=24).
Findings
Meanings of recovery differed between people in abstinence-based communities and those not; however, all had consistent views on their own recovery outcomes and the benefits they believed recovery brought. All viewed recovery as a process; a continuous journey with no end-point. Internal motivation, peer support, social networks and daily structure were integral to supporting individuals achieve and maintain recovery. Key benefits of recovery reflected recovery capital and included positive relationships, sense of belonging, increased self-worth and confidence, employment and education.
Research limitations/implications
This research shows that recovery experiences and outcomes are not centred entirely on the individual but are wider, more holistic. Maintaining recovery involves being connected to themselves and to the wider environment: family, friends, peers and society. Although the recovery capital model has many elements that were discussed by the participants of this research, the discourse they used does not align with the model. To validly measure and quantify recovery outcomes, individuals need to identify with the measures themselves.
Practical implications
From policy and commissioning perspectives, these findings suggest benefits of recovery that were viewed by participants as indicators of success: demonstrate elements which support recovery; and highlight key social value outcomes which people attribute to recovery.
Social implications
These “softer”, qualitative benefits should be considered by policy-makers, commissioners, statutory and non-statutory services in order to evidence outcomes. However, it should also be recognised that a temporally static approach to assessing recovery may be in contradiction to the meaning and perspectives held by those in recovery communities who conceptualise it as a long term and ongoing process.
Originality/value
This paper adds to understandings of experiences and meanings of recovery, with a particular focus on the measurement of outcomes and their meanings, and the role of abstention and continued drug use within the recovery process.
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Marta Codina, Diego A. Díaz-Faes and Noemí Pereda
Over the last few decades there has been increased interest in studying the phenomenon of violence among people with intellectual disabilities (ID). Research addressing offending…
Abstract
Over the last few decades there has been increased interest in studying the phenomenon of violence among people with intellectual disabilities (ID). Research addressing offending and victimization among this population suffers from generalised androcentrism by extrapolating findings to women, and is also homogenising, ignoring any individual and gendered differences. Existing research also demonstrates a clear focus on vulnerability and increased risk of victimization, but very little attention has been paid to women with ID as perpetrators of crime. Many factors play a role in the process of victimisation and offence, which implies the need to deconstruct the hegemonic vision of violence and examine its different manifestations and nuances. Therefore, this chapter provides a critical and historical review of the role of women with ID as victims and perpetrators of crime, by synthesising the different levels of analysis of the subject using an intersectionality approach. In conclusion, the evidence so far does not elucidate the prevalence or characteristics of these offenders. What we do know is that this group faces interacting, individual, social and environmental difficulties. They report high rates of victimisation and mental health comorbidity. Altogether they reveal an overlapping status of victim and offender.
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Deborah J. Morris, Shubhinder Shergill and Elizabeth Beber
People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and…
Abstract
Purpose
People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and impairments in neurological, physiological and psycho-social systems and functioning. In response, van der Kolk et al. (2009) have put forward the concept of developmental trauma disorder (DTD) to reflect the “constellation of enduring symptoms” and complex care needs of this population. The purpose of this paper is to ascertain the level of exposure to adverse childhood events and the prevalence of DTD in an inpatient forensic ID population.
Design/methodology/approach
A retrospective file review and consensus approach to diagnosis were used in a sample of adults with an ID detained in a secure forensic service.
Findings
Results revealed that 89 admissions (N=123) had been exposed to at least one significant ACE, with 81 being exposed to prolonged ACEs. A total of 58 admissions (47 per cent) met criteria for PTSD and 80 (65 per cent) met the criteria for DTD. Significant gender differences were noted in MHA status, primary psychiatric diagnoses, exposure to ACEs and DTD.
Research limitations/implications
The discussion explores the implications for working with forensic ID populations who report high incidents of childhood trauma and the utility, strengths and weaknesses of the proposed DTD, its relationship to ID diagnoses is explored.
Originality/value
The study outlines the prevalence of DTD and PTSD in ID forensic populations and suggests additional key assessment and treatment needs for this population.
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Gozde Aydin, Claire Margerison, Anthony Worsley and Alison Booth
Schools have long been perceived as an ideal setting to support the healthy eating behaviours of children. The aim of the study was to examine the views of Australian primary…
Abstract
Purpose
Schools have long been perceived as an ideal setting to support the healthy eating behaviours of children. The aim of the study was to examine the views of Australian primary school parents regarding school food and nutrition, including education, practices and policy.
Design/methodology/approach
An online survey was conducted among 787 parents in March 2021, which included closed and open-ended questions.
Findings
The results indicated the inconsistent implementation of policies and/or varying practices among different schools. Parents’ views were slightly associated with some demographic and personal measures including their SES levels, education, age, the main language spoken at home and universalism values. Parents viewed healthy food provision through canteens, policies and informing parents, fruit and vegetable breaks and kitchen and garden programs as the main contributors to the promotion of healthy eating. They believed unhealthy options in canteens, school fairs, events and birthdays are the major contributors to the formation of unhealthy eating habits among children at schools. Results revealed the efforts to establish health promoting school food environments in Australian primary schools; however, inconsistencies and discrepancies among schools should be addressed to ensure equity among all children.
Practical implications
The findings may provide directions for policymakers and school managers and can inform future reforms and initiatives in Australian primary schools and elsewhere.
Originality/value
This is the first study that has examined Australian parents’ views of school food policy, practices and environments using a mixed-methods design.
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Eva Posch, Elena Eckert and Benni Thiebes
Despite the widespread use and application of resilience, much uncertainty about the conceptualization and operationalization in the context of tourism destinations still exists…
Abstract
Purpose
Despite the widespread use and application of resilience, much uncertainty about the conceptualization and operationalization in the context of tourism destinations still exists. The purpose of this paper is to provide a conceptual elaboration on destination resilience and to introduce a model for an improved understanding of the concept.
Design/methodology/approach
Taking a conceptual research approach, this paper seeks to untangle the fuzziness surrounding the destination and resilience concept by providing a new interpretation that synthesizes theories and concepts from various academic disciplines. It analyses the current debate to derive theoretic baselines and conceptual elements that subsequently inform the development of a new “Destination Resilience Model”.
Findings
The contribution advances the debate by proposing three key themes for future resilience conceptualizations: (1) the value of an actor-centered and agency-based resilience perspective; (2) the importance of the dynamic nature of resilience and the (mis)use of measurement approaches; (3) the adoption of a dualistic resilience perspective distinguishing specified and general resilience. Building on these propositions, we introduce a conceptual model that innovatively links elements central to the concepts of destination and risk and combines different narratives of resilience.
Originality/value
The contribution advances the debate surrounding destination resilience by critically examining the conceptualization and operationalization of destination resilience within previous research and by subsequently proposing a “Destination Resilience Model” that picks up central element of the three new frontiers identified in the conceptually driven review. The innovative integration strengthens the comprehension of the resilience concept at destination level and supports building future capacities to manage immediate adverse impacts as well as novel and systemic risks.
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Deborah J. Morris, Elanor Lucy Webb, Emma Parmar, Grace Trundle and Anne McLean
People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well…
Abstract
Purpose
People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service.
Design/methodology/approach
A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years).
Findings
A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses.
Practical implications
Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services’ developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care.
Originality/value
This study explored the early-life and placement experiences of a marginalised and understudied population.
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The purpose of this paper is to focus on the precipitants of physical and psychological abuse of individuals with intellectual disabilities in order to understand why mistreatment…
Abstract
Purpose
The purpose of this paper is to focus on the precipitants of physical and psychological abuse of individuals with intellectual disabilities in order to understand why mistreatment continues to be prevalent. In particular, the importance of contributing factors were explored such as challenging behaviour and lack of staff training, in an attempt to prevent another “Winterbourne”.
Design/methodology/approach
A literature search using the search terms “Intellectual disability”, “learning disability”, “abuse”, “challenging behaviour” and “residential” was conducted. Articles were included using the criteria: adults with intellectual disabilities, concentration on neglect and physical abuse, abuse by staff members and articles written within the last 15 years. Using these criteria, a total of 19 articles were isolated. Additional articles were located through reference to citation lists. In total, 31 relevant articles were identified.
Findings
The majority of research agrees that a meaningful increase in risk of abuse does exist for individuals with intellectual disabilities. There is a lack of recent empirical evidence discussing the incidence of abuse, potential causes and the long-term impact of staff training in reducing the incidence of abuse. These gaps may be due to the subjective definition of abuse, the current “reactive” approach to abuse, the ability of perpetrators to hide mistreatment and difficulty in quantifying the difference that increased staff training has on performance. More research is required to adequately protect individuals with intellectual disabilities in the residential setting.
Originality/value
The paper highlights gaps in the current literature and identifies potential areas that could be improved in order to reduce the prevalence of abuse in residential care.