1
|
Paris A, Grindle C, Baker P, Brown FJ, Green B, Ferreira N. Exposure to challenging behaviour and staff psychological well-being: The importance of psychological flexibility and organisational support in special education settings. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 116:104027. [PMID: 34274761 DOI: 10.1016/j.ridd.2021.104027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 06/13/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND AIMS The present study examines the levels of psychological distress (anxiety, depression, stress) and burnout and their relationship to challenging behaviour, amongst staff working in a special education setting. It further examines the relationships between psychological distress and burnout and psychological flexibility, role clarity and workplace support. METHODS AND PROCEDURES This was a cross-sectional survey of staff (N = 145) self-report data on exposure to challenging behaviour (CB), and contingent emotional reactions as well as psychological distress, burnout, perceived organisational support and psychological flexibility. OUTCOME AND RESULTS Results revealed high levels of psychological distress and burnout amongst special education staff, which correlated with lower levels of psychological flexibility, negative emotional reactions to CB, role-clarity, perceived organisational support and job satisfaction. CONCLUSIONS AND IMPLICATIONS Results suggest that prevalence of psychological distress and burnout amongst staff in ID settings is high. Also that organisational and individual psychological factors have a role in this relationship. Results provide initial support for the need for psychological interventions for staff dealing with CB within a multi-tiered support model. Future research suggestions are provided, and clinical and organisational implications are discussed in terms of increasing staff well-being. WHAT THIS PAPER ADDS The paper primarily reveals high prevalence of psychological distress and burnout amongst ID staff in relation to their exposure to CB. The study also presents initial evidence that organisational and psychological factors (psychological flexibility) influence the latter relations and provides the basis for further research and exploration. Lastly, it highlights the need of proactive and reactive psychological interventions for staff dealing with CB within a multi-tiered support model and provides initial evidence for the potential employment of contextual behavioural science interventions.
Collapse
Affiliation(s)
- Andreas Paris
- Centre for Behaviour Solutions Ltd., UK; Calthorpe Academy School, Birmingham, UK; Centre for Educational Development, Appraisal and Research, University of Warwick, UK.
| | - Corinna Grindle
- Centre for Behaviour Solutions Ltd., UK; Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | | | - Freddy Jackson Brown
- Centre for Behaviour Solutions Ltd., UK; Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | | | | |
Collapse
|
2
|
Martínez-Tur V, Estreder Y, Tomás I, Gracia E, Moliner C. Coping with Burnout Symptoms through Task Significance in Professionals Working with Individuals with Intellectual Disability. REVISTA DE PSICOLOGÍA DEL TRABAJO Y DE LAS ORGANIZACIONES 2021. [DOI: 10.5093/jwop2021a2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
3
|
Klaver M, van den Hoofdakker BJ, Wouters H, de Kuijper G, Hoekstra PJ, de Bildt A. Exposure to challenging behaviours and burnout symptoms among care staff: the role of psychological resources. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:173-185. [PMID: 33331049 PMCID: PMC7839462 DOI: 10.1111/jir.12800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Staff supporting individuals with intellectual disabilities are at risk of burnout symptoms. Evidence suggests an association between exposure to challenging behaviours of individuals with intellectual disabilities and burnout symptoms of staff, but the protective role of staff psychological resources in this relation has been understudied. METHOD We investigated the association between exposure to challenging behaviours and burnout symptoms of staff and the direct and moderating effects of several psychological resources. Staff (N = 1271) completed an online survey concerning burnout symptoms (subscale Emotional Exhaustion of the Maslach Burnout Inventory), exposure to challenging behaviours and a range of potential psychological resources. We examined main and moderating effects with multilevel analyses. In order to control for the multiple comparisons, P values corrected for false discovery rate (PFDR ) were reported. RESULTS We found a direct relation between exposure to challenging behaviours and increased levels of burnout symptoms in staff (b = .15, t(670) = 4.466, PFDR < .0001). Perceived supervisor social support (b = -.97, t(627) = -7.562, PFDR < .0001), staff self-efficacy (b = -.23, t(673) = -3.583, PFDR < .0001), resilience (b = -.19, t(668) = -2.086, PFDR < .05) and extraversion (b = -.20, t(674) = -3.514, PFDR < .05) were associated with reduced burnout symptoms. None of the proposed psychological resources moderated the association between exposure to challenging behaviours and burnout symptoms of staff. CONCLUSIONS Of the psychological resources found to be associated with reduced risk of burnout symptoms, staff self-efficacy and access of staff to supervisor social support seem to be the factors that can be influenced best. These factors thus may be of importance in reducing the risk of developing burnout symptoms and improving staff well-being, even though the current study was not designed to demonstrate causal relations between psychological resources and burnout symptoms.
Collapse
Affiliation(s)
- M. Klaver
- Centre for Intellectual Disability and Mental HealthGGZ DrentheAssenThe Netherlands
- Department of Child and Adolescent PsychiatryUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - B. J. van den Hoofdakker
- Centre for Intellectual Disability and Mental HealthGGZ DrentheAssenThe Netherlands
- Department of Child and Adolescent PsychiatryUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
- AccareUniversity Centre for Child and Adolescent PsychiatryGroningenThe Netherlands
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenThe Netherlands
| | - H. Wouters
- General Practitioners Research InstituteGroningenThe Netherlands
| | - G. de Kuijper
- Centre for Intellectual Disability and Mental HealthGGZ DrentheAssenThe Netherlands
- Department of Child and Adolescent PsychiatryUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - P. J. Hoekstra
- Department of Child and Adolescent PsychiatryUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - A. de Bildt
- Centre for Intellectual Disability and Mental HealthGGZ DrentheAssenThe Netherlands
- Department of Child and Adolescent PsychiatryUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
- AccareUniversity Centre for Child and Adolescent PsychiatryGroningenThe Netherlands
| |
Collapse
|
4
|
McKenzie K, Martin R, Metcalfe D, Murray G, McNall A, Noone S. “Look, all our hard work is paying off”: A qualitative evaluation of a system‐wide, workforce development model to promote positive behavioural support. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1512-1522. [DOI: 10.1111/jar.12778] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - George Murray
- Northumbria University Newcastle upon Tyne UK
- NHS Lothian Newcastle upon Tyne UK
| | - Anne McNall
- Northumbria University Newcastle upon Tyne UK
| | - Steve Noone
- Northumbria University Newcastle upon Tyne UK
| |
Collapse
|
5
|
Ryan C, Bergin M, Wells JS. Work-related stress and well-being of direct care workers in intellectual disability services: a scoping review of the literature. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:1-22. [PMID: 34141395 PMCID: PMC7942790 DOI: 10.1080/20473869.2019.1582907] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Background: Understanding the nature of work-related stress and burnout among intellectual disability care staff is important to protect the well-being of these workers and encourage their retention in the sector. Though reviews of specific aspects of this literature have been conducted no article has sought to fully chart the range and nature of this research. Objective: This article addresses this gap by synthesizing the findings of such research with consideration to the future implications for protecting the well-being of care workers. Methods: A scoping review of the published literature was undertaken using a framework described in a previous article. Results: The findings of this review are presented thematically across six primary categories: challenging behavior; reciprocity; coping and stress; role issues; individual differences; and settings. A seventh theme, namely the positive aspects of intellectual disability care work was also identified through this process and is discussed. Conclusion: Occupational stress and strain is an internationally experienced issue in this sector. Challenging behavior and inequality in the relationships between staff and their clients, their colleagues, and their organization appear to exert a significant impact on the stress and well-being of workers in this sector. Excessive workplace demands, a low level of control, and a lack of support have been shown to be related to higher levels of stress and burnout among intellectual disability care workers.
Collapse
Affiliation(s)
- Cathal Ryan
- Department of Nursing and Health Care, School of Health Sciences, Waterford Institute of Technology, Ireland
- Correspondence to: Cathal Ryan, Department of Nursing and Health Care, School of Health Sciences, Waterford Institute of Technology, Ireland.
| | - Michael Bergin
- Head of Department of Applied Arts, School of Humanities, Waterford Institute of Technology, Ireland
| | - John S.G. Wells
- Head of School of Health Sciences, Waterford Institute of Technology, Ireland
| |
Collapse
|
6
|
Finkelstein A, Bachner YG, Greenberger C, Brooks R, Tenenbaum A. Correlates of burnout among professionals working with people with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:864-874. [PMID: 30141530 DOI: 10.1111/jir.12542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 04/27/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Although burnout has been recognised as an important stress-related problem among staff working with people with intellectual and developmental disabilities (IDD), literature on the subject is limited yet emerging. The aim of this study is twofold: (1) to evaluate the level of burnout within different professions working with IDD; (2) to examine the association between socio-demographic, professional and organisational characteristics and burnout. METHOD One hundred ninety-nine professionals working with people with IDD were enrolled in the study (66% response rate). Participants were recruited from several facilities that provide care for people with IDD of all ages, in the Jerusalem area and in other cities in central Israel. The anonymous questionnaires included valid and reliable measures of burnout, socio-demographic variables, professional variables and organisational variables. RESULTS Participants' mean age was 38.3 years, and most were women. There were no significant differences in burnout levels among the different professionals. Role ambiguity, perceived overload, care-recipient group and job involvement were significant predictors of burnout. The model explained a high percentage (46.8%) of the observed variance. CONCLUSIONS Most of these predictors are organisational measures. These findings demonstrate that organisational variables are more significantly associated with burnout of staff working with people with IDD than the socio-demographic factors or professional characteristics. Identifying and better understanding the specific factors associated with burnout among professionals working with IDD could facilitate unique intervention programs to reduce burnout levels in staff.
Collapse
Affiliation(s)
- A Finkelstein
- Department of Nursing, Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Y G Bachner
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - C Greenberger
- Department of Nursing, Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - R Brooks
- Department of Pediatrics, Hadassah Medical Center Mt. Scopus, Jerusalem, Israel
| | - A Tenenbaum
- Department of Pediatrics, Hadassah Medical Center Mt. Scopus, Jerusalem, Israel
| |
Collapse
|
7
|
Quilliam C, Bigby C, Douglas J. Being a valuable contributor on the frontline: The self‐perception of staff in group homes for people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:395-404. [DOI: 10.1111/jar.12418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Claire Quilliam
- Living with Disability Research Centre La Trobe University Melbourne Vic. Australia
| | - Christine Bigby
- Living with Disability Research Centre La Trobe University Melbourne Vic. Australia
| | - Jacinta Douglas
- Living with Disability Research Centre La Trobe University Melbourne Vic. Australia
- The Summer Foundation Melbourne Vic. Australia
| |
Collapse
|
8
|
Ó Donnchadha S. Stress in caregivers of individuals with intellectual or developmental disabilities: A systematic review of mindfulness-based interventions. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:181-192. [PMID: 28833964 DOI: 10.1111/jar.12398] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The efficacy of mindfulness-based interventions (MBIs) for stress and psychological distress in professional caregivers supporting individuals with intellectual or developmental disabilities (IDDs) is reviewed. METHODS Eight studies met inclusion criteria and were systematically reviewed, including RCTs and single-group designs. RESULTS As per Reichow, Volkmar, and Cicchetti (Journal of Autism and Developmental Disorders, 38, 2008), three studies were classified as "adequate quality" and five were classified as "weak." There were inconsistent findings in relation to stress, with significant reductions or increases reported by caregivers following MBIs. MBIs consistently improved caregivers' ratings of distress. Process outcomes suggested increased mindful awareness, increased cognitive defusion and reduced thought suppression. Treatment effects were maintained or continued to grow at follow-up. CONCLUSIONS Caregivers of individuals with IDDs face multiple challenges on a daily basis. This review supports, at least, short-term benefits for MBIs in the management of stress and distress in caregivers of individuals with IDDs.
Collapse
Affiliation(s)
- Seán Ó Donnchadha
- School of Psychology, College of Social Sciences and Law, University College Dublin, Dublin 4, Ireland.,Department of Clinical Psychology, Health Service Executive, Dublin North East, Ireland
| |
Collapse
|
9
|
Judd MJ, Dorozenko KP, Breen LJ. Workplace stress, burnout and coping: a qualitative study of the experiences of Australian disability support workers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1109-1117. [PMID: 27882630 DOI: 10.1111/hsc.12409] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
Disability support workers (DSWs) are the backbone of contemporary disability support services and the interface through which disability philosophies and policies are translated into practical action. DSWs often experience workplace stress and burnout, resulting in a high turnover rate of employees within the non-professional disability service workforce. The full implementation of the National Disability Insurance Scheme in Australia is set to intensify the current challenges of attracting and retaining DSWs, as the role becomes characterised by greater demands, ambiguity and conflict. The aim of this study was to explore DSWs' perceptions of enjoyable and challenging aspects of disability support work, sources of stress and burnout and the strategies they use to cope when these issues arise. Twelve DSWs workers providing support for adults living with intellectual and physical disabilities were interviewed. Thematic analysis revealed a superordinate theme of 'Balance' comprising three sub-themes: 'Balancing Negatives and Positives', 'Periods of Imbalance', and 'Strategies to Reclaim Balance'. Participants spoke of the rewarding and uplifting times in their job such as watching a client learn new skills and being shown appreciation. These moments were contrasted by emotionally and physically draining aspects of their work, including challenging client behaviour, earning a low income, and having limited power to make decisions. Participants described periods of imbalance, wherein the negatives of their job outweighed the positives, resulting in stress and sometimes burnout. Participants often had to actively seek support and tended to rely on their own strategies to manage stress. Findings suggest that organisational support together with workplace interventions that support DSWs to perceive the positive aspects of their work, such as acceptance and mindfulness-based approaches, may help to limit experiences of stress and burnout. The further development and evaluation of emotion-focused workplace therapies, and interventions that consider organisational (macro) factors is suggested.
Collapse
Affiliation(s)
- Megan J Judd
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Kate P Dorozenko
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Lauren J Breen
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
10
|
Etheridge L, Senior H. 'It's a matter of your personality more than anything else'. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2017; 21:40-52. [PMID: 26928770 DOI: 10.1177/1744629516634587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The impact on full-time carers of children with intellectual disabilities who exhibit challenging behaviour has been well researched (e.g. Lach et al., 2009; Shah et al., 2010; Wodehouse and McGill, 2009), however, there is to date no published research into the impact of behaviour that challenges on seasonal carers. Five participants who had been employed in summer playschemes for children and young people (up to the age of 18) were interviewed about their experiences of behaviour that challenges. The transcripts were analysed using interpretative phenomenological analysis, which revealed six superordinate themes: the belief in and sanctuary of temporary work, emotional impact, personality and gender, strength through knowledge, communication difficulties and the belief in integration. Seasonal workers discussed suppressing their emotions in order to stay in control of a challenging situation, using coping styles developed through experience or based on personal skills; it is suggested that formalized training, particularly regarding non-verbal communication, would support playscheme workers in the management of and adaption to challenging behaviour.
Collapse
|
11
|
Smyth E, Healy O, Lydon S. An analysis of stress, burnout, and work commitment among disability support staff in the UK. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:297-305. [PMID: 26469377 DOI: 10.1016/j.ridd.2015.09.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/01/2015] [Accepted: 09/22/2015] [Indexed: 06/05/2023]
Abstract
Previous research has suggested that challenging behaviour emitted by persons with intellectual and developmental disabilities negatively impacts upon the levels of stress and burnout of those who support and care for them. In the current study a sample of disability support workers in the UK (N=138) reported their levels of perceived stress, burnout, and commitment to their work. The relationship between the frequency and severity of aggressive/destructive behaviours to which they were exposed, and these three measures were examined. Results showed that participants scored lower on measures of burnout in the current study than has been reported by similar research studies in the UK and North America. The results revealed an association between challenging behaviours experienced and participants' perceived stress and emotional exhaustion. Perceived stress and burnout were also associated with participants' commitment to their work. Finally, a series of regression analyses identified a number of predictors of emotional exhaustion, depersonalization, and personal accomplishment among disability support workers. The results and their implications for the consideration of disability support worker wellbeing and future research in this area are discussed.
Collapse
|
12
|
Evaluation of the Work Safety and Psychosocial Wellbeing of Disability Support Workers. ACTA ACUST UNITED AC 2015. [DOI: 10.1017/orp.2015.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study investigated organisational factors impacting disability support worker (DSW) psychosocial wellbeing and work safety to understand the relationship between wellbeing, using measures of burnout and job satisfaction, and work conditions and safety performance. This study also investigated factors predicting wellbeing using the Job Demand-Control-Support (JDCS) model. A sample of 87 DSWs completed normed measures of burnout, work conditions, and safety climate. Results showed DSWs experienced significantly higher personal and work-related burnout but significantly lower client-related burnout. Although the JDCS model components did not all predict any single wellbeing measure, they each predicted aspects of burnout and job satisfaction, with these wellbeing measures associated with safety performance. Findings highlighted the importance of monitoring worker job demands, support availability, and job control to improve safety performance. Compared to normative data, DSWs were experiencing significantly higher role conflict, the negative impact of which was effectively moderated by support for personal and work-related burnout and job satisfaction. Findings suggest the need to consider DSW work conditions, and particularly work practices contributing to role conflict, as well as increasing support for DSWs to prevent the development of personal and work-related burnout. Findings suggest further research associated with client-related burnout is required.
Collapse
|
13
|
de Knegt NC, Lobbezoo F, Schuengel C, Evenhuis HM, Scherder EJA. Self-Reporting Tool On Pain in People with Intellectual Disabilities (STOP-ID!): a Usability Study. Augment Altern Commun 2015; 32:1-11. [DOI: 10.3109/07434618.2015.1100677] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
14
|
McConachie DAJ, McKenzie K, Morris PG, Walley RM. Acceptance and mindfulness-based stress management for support staff caring for individuals with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1216-27. [PMID: 24685937 DOI: 10.1016/j.ridd.2014.03.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 02/25/2014] [Accepted: 03/06/2014] [Indexed: 05/14/2023]
Abstract
UNLABELLED Support staff working with individuals with intellectual disability (ID) and challenging behaviour experience high levels of work-related stress. Preliminary theoretical and experimental research has highlighted the potential suitability of acceptance and mindfulness approaches for addressing support staff stress. This study examines the effectiveness of an acceptance and mindfulness-based stress management workshop on the levels of psychological distress and well-being of support staff working with individuals with ID and challenging behaviour. Support staff (n=120) were randomly assigned to a workshop intervention condition (n=66) or to a waiting list control condition (n=54). Measurements were completed at three time points (pre-, post and 6 week follow-up) for: psychological distress, well-being, perceived work stressors, thought suppression, and emotional avoidance/psychological inflexibility. MAIN FINDINGS The intervention led to significantly greater reductions in distress in the intervention group than in the control group. This was largely maintained at 6 week follow-up. This effect was more pronounced amongst a subsample that had shown higher levels of psychological distress at baseline. Thought suppression was found to reduce significantly in the intervention group between post intervention and follow-up, although no significant change was found in well-being or experiential avoidance/psychological inflexibility. Overall, results demonstrated support for the effectiveness of an acceptance and mindfulness-based intervention in reducing distress.
Collapse
Affiliation(s)
- Douglas Alexander James McConachie
- University of Edinburgh, Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, Scotland EH8 9AG, UK.
| | - Karen McKenzie
- University of Edinburgh, Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, Scotland EH8 9AG, UK
| | - Paul Graham Morris
- University of Edinburgh, Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, Scotland EH8 9AG, UK
| | - Robert M Walley
- NHS Lothian, Department of Clinical Psychology, Bonnyrigg Health Centre, Midlothian, Scotland EH19 2ET, UK
| |
Collapse
|
15
|
Ingham B, Riley J, Nevin H, Evans G, Gair E. An initial evaluation of direct care staff resilience workshops in intellectual disabilities services. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2013; 17:214-222. [PMID: 23803644 DOI: 10.1177/1744629513494642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The emotional responses to challenging behaviour of direct care staff who support people with intellectual disabilities is thought to be an important mediating factor within the stress experienced by staff and a potential maintaining factor in challenging behaviour. A brief workshop to improve direct care staff resilience was developed and initially evaluated using a measure of emotional reaction to challenging behaviour and a measure of burnout. It was found that negative emotional reactions to challenging behaviour significantly reduced following the workshop, but a measure of burnout did not. This may indicate the usefulness of this intervention with direct care staff in managing their emotional reactions to challenging behaviour. However, further development and evaluation of such interventions with direct care staff is required to explore ways of impacting upon burnout and managing the display of challenging behaviour.
Collapse
Affiliation(s)
- Barry Ingham
- Northumberland, Tyne and Wear NHS Foundation Trust, UK.
| | | | | | | | | |
Collapse
|
16
|
Gray JA, Muramatsu N. When the job has lost its appeal: Intentions to quit among direct care workers. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2013; 38:124-133. [PMID: 23356874 PMCID: PMC5807098 DOI: 10.3109/13668250.2012.760728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Previous research indicates that work stress contributes to intentions to quit among direct care workers (DCWs) who provide services to people with intellectual and developmental disability (IDD). Though resources can help DCWs cope and remain in a job, little is known about how various dimensions of work stress and resources (social and personal resources) are associated with intentions to quit. METHODS A total of 323 DCWs from 5 community-based IDD organisations completed a self-administered survey. We conducted multiple regression analyses to examine main and interaction effects of work stress and resources (work social support and internal locus of control) on intentions to quit. RESULTS Work overload was a significant stressor, and work social support (i.e., supervisory support) was associated with low intentions to quit. The association between locus of control and intention to quit depended on the levels of a stressor: DCWs' lack of participation in decision-making. CONCLUSIONS Supervisory support and an internal locus of control may assist DCWs in managing their stress.
Collapse
Affiliation(s)
- Jennifer A Gray
- School of Nursing and Health Studies, Northern Illinois University, Dekalb, IL 60115-2854, USA.
| | | |
Collapse
|
17
|
Kozak A, Kersten M, Schillmöller Z, Nienhaus A. Psychosocial work-related predictors and consequences of personal burnout among staff working with people with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:102-115. [PMID: 22940164 DOI: 10.1016/j.ridd.2012.07.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/23/2012] [Accepted: 07/23/2012] [Indexed: 06/01/2023]
Abstract
The purposes of this study were to investigate the potential predictors of personal burnout among staff working with people with intellectual disabilities and to investigate whether personal burnout is associated with health and work-related outcomes. A cross-sectional survey was carried out in 2011 in 30 residential facilities in northern Germany (N = 409, response rate 45%). The German standard version of the Copenhagen Psychosocial Questionnaire was used. In a multiple logistic regression analysis, we identified factors which were predictive of personal burnout, such as work-privacy conflict (OR = 1.04, 95% CI 1.03, 1.05), emotional demands (OR = 1.03, 95% CI 1.01, 1.05), role conflicts (OR = 1.02, 95% CI 1.02, 1.03), job insecurity (OR = 1.03, 95% CI 1.01, 1.05) and feedback (OR = 0.98, 95% CI 0.97, 0.99). These factors explained 49% of the total variance. Higher levels of personal burnout were significantly correlated with higher rates of intention to leave the job and cognitive stress symptoms (p<.01). Low values of personal burnout were associated with greater job satisfaction, good general health, and higher satisfaction with life (p<.01). The present study indicates that improving the psychosocial work environment at the organizational level may reduce personal burnout and may also diminish unfavorable outcomes, such as intention to leave or job dissatisfaction.
Collapse
Affiliation(s)
- Agnessa Kozak
- University Medical Center Hamburg-Eppendorf, Institute for Health Services Research in Dermatology and Nursing, Martinistr 52, 20246 Hamburg, Germany.
| | | | | | | |
Collapse
|
18
|
Ko C, Lunsky Y, Hensel J, Dewa CS. Burnout among summer camp staff supporting people with intellectual disability and aggression. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 50:479-485. [PMID: 23256690 DOI: 10.1352/1934-9556-50.06.479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Studies have shown that there is an association between exposure to people with intellectual disability who are aggressive and burnout in the staff who support them. Little is known, however, about the experience of summer camp staff who work with this population. This study examined the relationship between aggression and burnout in 169 staff members working at summer camps in Ontario, Canada. The questionnaire used included demographic information, exposure to aggression (frequency and severity), and the Maslach Burnout Inventory--Human Services Survey. Results showed that summer camp staff was exposed to frequent and relatively severe aggression. Severe exposure was associated with higher levels of emotional exhaustion and personal accomplishment. Given that summer camp staff is likely to be exposed to at least some aggression in their summer job, and that this aggression is associated with burnout, greater attention should be paid to training and supporting staff for when aggression occurs.
Collapse
Affiliation(s)
- Clara Ko
- Centre for Addiction and Mental Health Dual Diagnosis Program, Toronto, Ontario Canada
| | | | | | | |
Collapse
|
19
|
Sandhu DK, Rose J, Rostill-Brookes HJ, Thrift S. 'It's intense, to an extent': a qualitative study of the emotional challenges faced by staff working on a treatment programme for intellectually disabled sex offenders. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 25:308-18. [PMID: 22711479 DOI: 10.1111/j.1468-3148.2011.00667.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study explores the emotional challenges faced by staff working on a sex offender treatment programme for people with an intellectual disability. METHODS Semi-structured interviews were carried out with eight participants working on a treatment programme for sex offenders with an intellectual disability. Interviews were analysed using interpretative phenomenological analysis. RESULTS Staff experienced a range of negative emotions that they dealt with in a variety of ways including through the use of humour and various emotional defences. Empathy was a challenging and complex issue with individuals taking a variety of positions. CONCLUSION Staff awareness and understanding of the role of emotions in relation to their own well-being and in relation to therapeutic processes varied. Emotional intelligence was associated with greater therapeutic understanding. Recommendations are made in relation to personal and professional characteristics and need for clinical supervision to support staff well-being and the development of therapeutic competence and effectiveness.
Collapse
Affiliation(s)
- Daljit K Sandhu
- School of Psychology, The University of Birmingham, Edgbaston, UK
| | | | | | | |
Collapse
|
20
|
Dunn MC, Clare ICH, Holland AJ. Living 'a life like ours': support workers' accounts of substitute decision-making in residential care homes for adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54:144-160. [PMID: 20015161 DOI: 10.1111/j.1365-2788.2009.01228.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In England and Wales, the Mental Capacity Act 2005 (MCA) provides a new legal framework to regulate substitute decision-making relating to the welfare of adults who lack the capacity to make one or more autonomous decisions about their care and support. Any substitute decision made on behalf of an adult lacking capacity must be in his/her 'best interests'. However, the value of adopting established principles and procedures for substitute decision-making in practice is uncertain, and little is known about the legal or ethical dynamics of social care support, including the day-to-day residential support provided to adults with intellectual disabilities (ID). Methods This paper reports a qualitative, grounded theory analysis of 21 interviews with support workers working in residential care homes for adults with ID, and observations of care practices. Results In contrast to the narrow legal responsibilities placed upon them, it is argued that support workers interpret substitute decision-making within a broad moral account of their care role, orientating their support towards helping residents to live 'a life like ours'. In so doing, support workers describe how they draw on their own values and life experiences to shape the substitute decisions that they make on behalf of residents. Conclusions Support workers' accounts reveal clear discrepancies between the legal regulation of substitute decision-making and the ways that these support workers make sense of their work. Such discrepancies have implications both for the implementation of the MCA, and for the role of support workers' values in the conceptualisation and delivery of 'good' care.
Collapse
Affiliation(s)
- M C Dunn
- The Ethox Centre, University of Oxford, UK.
| | | | | |
Collapse
|
21
|
Devereux J, Hastings R, Noone S. Staff Stress and Burnout in Intellectual Disability Services: Work Stress Theory and its Application. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1468-3148.2009.00509.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
22
|
Chung MC, Harding C. Investigating Burnout and Psychological Well-Being of Staff Working with People with Intellectual Disabilities and Challenging Behaviour: The Role of Personality. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1468-3148.2009.00507.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Lambrechts G, Maes B. Analysis of staff reports on the frequency of challenging behaviour in people with severe or profound intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:863-872. [PMID: 19195839 DOI: 10.1016/j.ridd.2008.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 12/26/2008] [Indexed: 05/27/2023]
Abstract
The main goal of this study was to investigate whether staff members vary in their frequency reports on challenging behaviour concerning the same client. Because staff's approaches of challenging behaviour are affected by a range of staff characteristics, we hypothesised that these staff characteristics could explain this variability between staff members. We used questionnaires to investigate the influence of staff's age, gender, experience in working with people with intellectual disabilities, working hours, professional qualifications, sort of education, and their emotional reactions and beliefs regarding the challenging behaviour. This study involved 152 staff members and 51 clients with severe or profound intellectual disabilities who displayed self-injurious behaviour, stereotyped behaviour, and/or aggressive/destructive behaviour. A part of the variability between staff's reports on the frequency of challenging behaviour was indeed explained by differences between the staff members. Working hours, internal attribution, gender, and experience in working with people with severe or profound intellectual disabilities turned out to be influencing variables. Summarising, staff members differ in their reports on the frequency of challenging behaviour. To get an accurate picture of a client's challenging behaviour, perceptions of several staff members are needed.
Collapse
Affiliation(s)
- Greet Lambrechts
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | | |
Collapse
|
24
|
Lambrechts G, Kuppens S, Maes B. Staff variables associated with the challenging behaviour of clients with severe or profound intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:620-632. [PMID: 19298503 DOI: 10.1111/j.1365-2788.2009.01162.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Previous research has identified that staff-client interactions play an important role in the origin and maintenance of challenging behaviour. Particularly, the reciprocity between staff behaviour and client behaviour has been considered a key issue. Furthermore, severe challenging behaviour has been found to elicit negative emotional reactions from staff which in turn may influence staff's behaviour. Another variable that has been associated with staff behaviour are staff's attributions regarding clients' challenging behaviour. The present study tested several hypotheses about associations between staff variables and challenging behaviour. METHOD Questionnaires were used to investigate associations between the attributions, emotional reactions and behavioural reactions of 51 staff members towards challenging behaviour of clients with severe or profound intellectual disabilities who displayed self-injurious behaviour, stereotyped behaviour and/or aggressive/destructive behaviour. RESULTS Staff members reported that reactions to challenging behaviour differed according to the type of challenging behaviour. Negative emotional reactions were positively associated with challenging behaviour. Associations between emotional reactions, staff beliefs and staff reactions were inconsistent. CONCLUSIONS The findings suggest that there is a need to look for a better conceptualization and assessment of the variables under investigation.
Collapse
Affiliation(s)
- G Lambrechts
- Katholieke Universiteit Leuven, Faculty of Psychology and Educational Sciences, Belgium.
| | | | | |
Collapse
|
25
|
Devereux JM, Hastings RP, Noone SJ, Firth A, Totsika V. Social support and coping as mediators or moderators of the impact of work stressors on burnout in intellectual disability support staff. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:367-377. [PMID: 18760565 DOI: 10.1016/j.ridd.2008.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Accepted: 07/10/2008] [Indexed: 05/26/2023]
Abstract
Theories applied to work stress predict that coping will mediate and support will moderate the impact of work demands on worker well-being. We explored the mediating and moderating effects of coping and support on the relationship between perceived work demands and burnout in support staff working with adults with intellectual disabilities. Ninety-six support staff completed questionnaires that measured demographic factors, perceived work demands, coping, support, and burnout. A sub-sample participated in a follow-up 22 months later. Cross-sectional regression analyses revealed a relationship between work demands and emotional exhaustion burnout that reduced when wishful thinking coping was introduced as a predictor. Exploration of multiple mediator effects using bootstrap methods revealed that wishful thinking partially mediated the relationship between work demands and emotional exhaustion but practical coping did not. Practical coping had a main effect relationship with personal accomplishment, and there was evidence that support moderated the impact of work demands on personal accomplishment (although not fully consistent with theory). Study variables, other than personal accomplishment, were stable over 22 months but no longitudinal relationships between coping and burnout was found. These findings emphasise the importance of coping in managing work demands and for the development of burnout in support staff.
Collapse
Affiliation(s)
- Jason M Devereux
- School of Psychology, Bangor University, Bangor, Gwynedd, Wales, LL57 2DG, United Kingdom
| | | | | | | | | |
Collapse
|
26
|
White P, Edwards N, Townsend-White C. Stress and burnout amongst professional carers of people with intellectual disability: another health inequity. Curr Opin Psychiatry 2006; 19:502-7. [PMID: 16874124 DOI: 10.1097/01.yco.0000238478.04400.e0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This paper summarizes trends in the research literature about stress and burnout in the lives of people who are the professional carers of people with intellectual disability. The principal time period considered was from 2004 to 2006. RECENT FINDINGS Studies reviewed here focus on several themes including inequities affecting professional carers of people with intellectual disability and the possible effects of some models of care on inequities. Implications for people with intellectual disability are also considered. SUMMARY The diaspora of people with intellectual disability into the community and their accompanying services found a whole new set of unpredicted and unprecedented challenges. Life in the community has rendered professional carers of people with intellectual disability more clearly vulnerable to stress and burnout for a variety of complex reasons, some identified and others as yet unrecognized. Lack of support and lack of role definition are particular problems. Presence of physical and mental health inequities result in major disparities in community care for people with intellectual disability.
Collapse
Affiliation(s)
- Paul White
- Mental Health Policy and Economics Group, Queensland Centre for Mental Health Research (QCMHR), Centre for Mental Health, The Park, Wacol, Queensland, Australia.
| | | | | |
Collapse
|