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Contains fulltext : 306746.pdf (Publisher’s version ) (Closed access), Forensic mental health professionals are frequently exposed to inpatient aggression, which may negatively affect their physical and mental health. Current studies offer limited insight into how this may affect staff-patient interactions in the aftermath of aggression. A qualitative study was conducted to explore professionals' experiences with exposure to aggression. Thirteen semi-structured interviews and three focus groups were conducted with 25 professionals working in a high secure forensic mental health unit. A thematic analysis was conducted in consensus among three researchers. Five main themes were generated in the analysis: exposure to different forms of aggression, factors that shape the impact of aggression, emotional reactions, managing emotional reactions, and managing relationships with patients. These themes form a complex interplay. Feelings of anger and fear, intrusive memories, and avoidant or agitated behavior toward patients are frequently reported, affecting both the personal and professional lives of participants. Interpersonal relationships between team members can promote or hinder adequate management of feelings that arise after exposure to aggressive incidents. The tremendous impact that exposure to inpatient aggression may have on professionals, and the way that they care for their patients requires more attention., 21 mei 2024, 12 p.

Item does not contain fulltext, Dit artikel is een vertaalde en aangepaste versie van het eerder verschenen Engelstalige artikel: Van Herwaarden, A., Peters-Scheffer, N., & Didden, R. (2022). Eudaimonic well-being in individuals with mild to moderate intellectual disability. Research in Developmental Disabilities, 128, 104273.

21 juli 2023, Contains fulltext : 295404.pdf (Publisher’s version ) (Closed access), Forensic vigilance is a hypothesized specialty of forensic mental health professionals which seems to play a role in maintaining safety in forensic hospitals. It is unclear exactly how forensic vigilance relates to preventing incidents. We used standardized reports of severe incidents that occurred in forensic hospitals to investigate how forensic vigilance plays a role in the occurrence of incidents. Eight forensic psychiatric hospitals in the Netherlands contributed 69 anonymized incident reports, which were investigated by means of thematic analysis and interpretative phenomenological analysis. Analysis revealed five important themes. Four core skills needed by professionals, namely observation, integration, communication and action, which each need a number of prerequisites (e.g., knowledge). The fifth theme specifies that the professional needs to "connect the dots" meaningfully. This is a highly cyclical process in which the core four skills are steps. The process is unique to the forensic context in terms of how the "dots" are connected and weighed, and which risks need to be considered. We present a model of this process and prerequisites needed in professionals. This model can inform policy makers, aid assessment of and communication between forensic professionals and can form the basis of a training for forensic mental health professionals.

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Item does not contain fulltext, Objectives: Animal-assisted therapy with dogs is regularly used in children with behavioural and developmental disorders. Aims of this systematic review were threefold: to analyse the methodological quality of studies on dog-assisted therapy (DAT) for children with behavioural and developmental disorders, to determine to which extent the studies on DAT adhere to the quality criteria developed by the International Association of Human Animal Interaction Organisation (IAHAIO) and to describe the characteristics of the participants, the intervention and the outcomes. Method: Three databases (i.e. PsycInfo, MedLine and Eric) were searched, and 14 studies on DAT were included. The Joanna Briggs Institute checklist (JBIC) and the quality criteria developed by the IAHAIO were used during data extraction. Characteristics of the participants, the intervention, the therapy dogs and the outcomes of the studies were summarised. Results: Six of the 14 included studies reported significant outcomes of DAT, whereof six in the social domain and two in the psychological domain. However, scores on the JBIC indicated low to moderate methodological quality and only three of the included studies adhered to the IAHAIO quality criteria. Conclusions: DAT is a promising intervention for children with behavioural and developmental disorders, especially for children with autism spectrum disorder. A clear description of the therapy’s components, the role of the therapy dog and analysis of the treatment integrity and procedural fidelity would improve the methodological quality of the studies and the field of dog-assisted interventions.

Item does not contain fulltext, Background: Measuring eudaimonic well-being is important to gain a complete picture of the well-being of individuals with mild intellectual disabilities or borderline intellectual functioning (MID-BIF), but there is no measurement instrument available for this population coding for multiple dimensions of eudaimonic well-being. Aims: The current study developed and piloted a new instrument coding for eudaimonic well-being in individuals with MID-BIF. Methods and procedures: The instrument (SPWB-ID) was adapted from Ryff’s scales of psychological well-being, including subscales addressing purpose in life, environmental mastery, positive relationships, self-acceptance, personal growth, and autonomy. Adaptations were based on the literature and interviews with people with MID-BIF and experts in the field. The SPWB-ID was piloted among 103 adults with MID-BIF. Outcomes and results: The trimmed version of the SPWB-ID showed sufficient to good internal consistency and test-retest reliability. Hypothesis testing for construct validity suggested the subscales of the SPWB-ID measured well-being, showing moderate to high correlations with quality of life, and differences in eudaimonic well-being between participants with and without clinically relevant depression scores. Conclusions and implications: The SPWB-ID reliably measures eudaimonic well-being in individuals with MID-BIF. This enables support providers to collect information on eudaimonic well-being, providing input for person-centred care and support for individuals with MID-BIF.

Item does not contain fulltext, In high security forensic institutions, patients are sometimes placed on small-scale wards to be treated individually if their psychiatric condition and behaviour do not allow for them to live and interact more freely with other patients. On these so-called individual wards, there is little contact between patients and more security measures are in place, such as higher numbers of staff members per patient than on group wards. The present study investigated the experienced safety of staff members (n = 41) and patients (n = 21) of such individual wards, compared to staff members (n = 55) and patients (n = 55) of group wards with the Essen-CES. The mean item score on the scale experienced safety of the Essen-CES for the entire sample was 2.1 (SD = .9) with a range from 0 to 4 and higher scores reflecting a higher experienced safety. Staff on individual wards had a significantly lower experienced safety than patients on both ward types and staff on group wards. It is advised, therefore, to implement additional measures to support professionals who work on these individual wards.

Item does not contain fulltext, Background: Psychomotor therapy (PMT) is often applied in Dutch clinical practice to address aggressive behaviour in individuals with mild intellectual disabilities or borderline intellectual functioning. However, the literature on clients' experiences is lacking. Methods: An interpretative phenomenological analysis was used to analyse the semi-structured interviews of seven participants (19-60 years; four male, three female) who completed PMT targeting anger regulation problems. Results: According to the participants, becoming aware of increasing tension and/or learning to downregulate the tension were the main goals of PMT. They emphasised both the possibility to learn by doing and the therapeutic alliance as essential to create a safe context, where participants can experiment with alternative behaviour. After completing PMT, participants perceived fewer aggressive outbursts and an increased self-esteem. Conclusions: Participants in our sample experienced PMT as being helpful in targeting anger regulation problems and aggressive behaviour. The experiential nature of the program was perceived as a valuable aspect of PMT.

04 april 2022, Item does not contain fulltext, Forensic psychiatric inpatients are frequently exposed to aggression from fellow patients during their treatment, but research on how this impacts patients' well-being and treatment progress is lacking. In this study, we interviewed nine patients on their experiences of victimization during mandatory psychiatric treatment. The interviews were analyzed using a Grounded Theory approach combined with elements from Consensual Qualitative Research and Interpretative Phenomenological Analysis. Three main themes emerged from the data, namely situational descriptives, intrapersonal and interpersonal consequences. Patients were not only exposed to both physical violence and verbal aggression by other patients, but also to a more ubiquitous flow of micro-aggressive comments. Options to escape these situations were limited. This means that victimization processes, which for most patients started much earlier in life, continue during forensic psychiatric treatment. Intrapersonal consequences include fear, hypervigilance, reactive aggression, flashbacks and avoidance and withdrawal. Interpersonal consequences include increased power differences between patients and adverse treatment consequences, such as difficulties with self-esteem. Victimization processes are not always timely noticed in an environment that focuses on risks and treatment of delinquent behavior. A higher level of trauma sensitivity in forensic mental health care is thus required. Recommendations for the implementation of trauma informed care are provided.

Contains fulltext : 250620.pdf (Publisher’s version ) (Open Access), Background: Subjective well-being research in individuals with intellectual disability (ID) has a large hedonic focus and eudaimonic well-being is understudied in this population. Knowledge on eudaimonic well-being of individuals with ID is however necessary to improve their experienced well-being and support them in leading meaningful and flourishing lives. Aims: The current study adopted a qualitative design to examine whether and how people with ID experience elements of eudaimonic well-being. Methods and procedures Eleven adults with mild to moderate ID participated in individual semi-structured interviews about their subjective well-being. Interviews with their relatives and their direct support providers were conducted to contextualize the data. Outcomes and results: By means of an interpretative phenomenological analysis, social relationships, accomplishment, purpose and balance, individuality, autonomy, and growth could be identified as relevant elements of eudaimonic well-being. Eudaimonic well-being of individuals with ID seemed to be mediated by acceptance of others. Conclusions and implications; The results provide insight in eudaimonic indicators of well-being, expanding the current view on well-being in individuals with ID. Efforts to use these elements in the care and support for individuals with ID are discussed.

Item does not contain fulltext, Purpose: The purpose of this study is to provide an in-depth account of how individuelas with a mild intellectual disabilitiy or borderline intellectual functioning (MID-BIF; IQ 50–85) perceive their group climate in a secure forensic setting. Giving voice to these service users may provide relevant insights for secure forensic settings. Design/methodology/approach: The interpretative phenomenological analysis was used to explore what individuals with MID-BIF experience with regard to their group climate. Findings: In the interviews about the four domains of group climate (i.e. repression, support, growth and atmosphere), five overarching dimensions appeared, namely, autonomy, uniformity, recognition, competence and dignity. Depending on the person and the (treatment) context in which he/she resides, these five dimensions relate to all four factors of the group climate instrument. Originality/value: From the perspective of individuals with MID-BIF, this study contributes by providing a framework to "fine-tune" group climate on five dimensions. Training socio-therapists to be sensitive to interpret ambiguous signals on these dimensions can contribute to optimizing group climate in secure forensic settings.

Item does not contain fulltext, s of the Proceedings of the 6th IASSIDD Europe Congress: Value Diversity

Contains fulltext : 219459.pdf (Publisher’s version ) (Open Access), Objectives: Although an extensive amount of research has been devoted to models defining cultural competence of healthcare professionals in short-term care, there is unclarity about the cultural competencies that professionals providing lifelong care and support should have. The current study aimed to explore which cultural competencies are used by these healthcare professionals, and whether these competencies enabled them to make cultural adaptations to their regular care practices. Design: To investigate cultural competencies and cultural adaptations, semi-structured in-depth interviews were conducted with eight professionals who provide lifelong care and support to individuals with intellectual disabilities. Five cultural competencies were explored: awareness, knowledge, skills, motivation, and encounters. Results: A thematic analysis of the interviews revealed that professionals providing lifelong care and support used all cultural competencies in their care practices. Moreover, our analysis suggested that these competencies could be categorized as either practical or analytical cultural competencies. Although these competencies were conditional in order to make cultural adaptations to care practices, the presence of cultural competencies did not automatically lead to these cultural adaptations. Conclusions: All five cultural competencies were used by professionals in lifelong care and support. Our analysis revealed that both practical and analytical cultural competencies were essential in providing culturally sensitive lifelong care and support. We additionally suggest that the cultural competence of professionals is necessary, but not sufficient, for making cultural adaptations to lifelong care and support for individuals with intellectual disabilities. In many cases, other factors also played a role in a professional's final decision to adapt their care practices.

Contains fulltext : 220947.pdf (publisher's version ) (Open Access), The aim of this study is to present a robot-assisted therapy protocol for children with ASD based on the current state-of-the-art in both ASD intervention research and robotics research, and critically evaluate its adherence and acceptability based on child as well as parent ratings. The robot-assisted therapy was designed based on motivational components of Pivotal Response Treatment (PRT), a highly promising and feasible intervention focused at training "pivotal" (key) areas such as motivation for social interaction and self-initiations, with the goal of establishing collateral gains in untargeted areas of functioning and development, affected by autism spectrum disorders. Overall, children (3-8 y) could adhere to the robot-assisted therapy protocol (Mean percentage of treatment adherence 85.5%), showed positive affect ratings after therapy sessions (positive in 86.6% of sessions) and high robot likability scores (high in 79.4% of sessions). Positive likability ratings were mainly given by school-aged children (H(1) = 7.91, p = .005) and related to the movements, speech and game scenarios of the robot. Parent ratings on the added value of the robot were mainly positive (Mean of 84.8 on 0-100 scale), while lower parent ratings were related to inflexibility of robot behaviour.

Contains fulltext : 214428.pdf (Publisher’s version ) (Closed access), Background: Culturally sensitive care is essential for improving healthcare for ethnic minorities with intellectual disabilities (ID), who require intensive, sometimes lifelong, care and support. Aims: The present study aimed to uncover factors that may complicate the delivery of culturally sensitive care for ethnic minorities with ID, which have not previously been studied for this group. Methods and procedures: By means of in-depth interviews with care professionals we identified these factors at the care receiver, professional, and institutional levels. Outcomes and results: Eight factors were found to complicate the delivery of culturally sensitive care: abilities of the individuals with ID, communication with the family of the care receiver, cultural competency of the professional, personal attitude and experience of the professional, job position and responsibilities of the professional, resources, legislation and protocols, and the team of colleagues. The factors at the care receiver level were specific for the delivery of culturally sensitive care to individuals with ID. Conclusions and implications: In addition to the complicating factors previously identified for other forms of culturally sensitive healthcare, we identified novel complicating factors for the care of individuals with ID. Future research should investigate how these complicating factors could be overcome.

Item does not contain fulltext, Since the first publications more than 40 years ago, the functional analysis approach has significantly contributed to improving the lives of individuals with developmental disabilities, including autism. Important gains in both conceptual and applied work have been made in the teaching of adaptive skills and the assessment and remediation of problem behavior. Functional analysis methodology provides an empirically validated framework for the assessment and treatment of challenging behavior. In this chapter, we describe basic assumptions of this approach, review methods for conducting functional analysis in clinical practice, review function-based treatments, and present a brief example of its application.

Item does not contain fulltext, Verschillende studies hebben onderzocht hoe de toegang tot en kwaliteit van zorg voor mensen met een migratieachtergrond verbeterd kan worden. Hoewel er al meerdere kaders en instrumenten voor cultuursensitieve zorg ontwikkeld zijn, ontbreekt het nog steeds aan een eenduidig model met daarin alle benodigde componenten voor cultuursensitief werken in de geestelijke gezondheidszorg. In dit onderzoek is op basis van systematisch literatuuronderzoek een dergelijk model ontwikkeld. Uit zestien studies op het gebied van culturele sensitiviteit in de (geestelijke) gezondheidszorg werden alle aanbevelingen geselecteerd die door meer dan één studie werden genoemd. Dit resulteerde in een model bestaande uit drie niveaus: cliëntenzorg, personeelsbeleid en organisatiebeleid. Binnen dit model werden bovendien inhoudscriteria (de benodigde componenten van culturele sensitiviteit) en procesfactoren (acties die kunnen helpen bij het nastreven van culturele sensitiviteit) onderscheiden. De drie niveaus bestonden respectievelijk uit vier, twee en twee inhoudscriteria. Daarnaast werden er voor ieder niveau verschillende procesfactoren geïdentificeerd die zorginstellingen kunnen helpen om cultuursensitief te worden. Dit model is toepasbaar binnen instellingen voor geestelijke gezondheidszorg, gehandicaptenzorg, jeugdzorg en sociaal werk, die op zoek zijn naar manieren om tegemoet te komen aan de wensen en behoeften van een cultureel diverse cliëntpopulatie.

Contains fulltext : 184148.pdf (publisher's version ) (Open Access), This study investigates the understanding of intentions in 100 children with autism spectrum disorder (ASD) and intellectual disability (ID; mean IQ 36) between 2 and 10 years of age. A within-subject design with two conditions was used. In the target condition, the experimenter successfully performed the task; while in the unfulfilled attempt condition, the experimenter attempted but did not successfully completed the task. Children with ASD and ID completed the tasks significantly more frequent and showed less off-task behavior in the target condition than in the unsuccessful attempt condition, which might indicate that children with ASD and ID experience difficulty in understanding the intentions of others. Successful completion of the task after an unsuccessful attempt is predicted by the ability to imitate and behavioral inflexibility and is associated with better performance on receptive and expressive language tests. The latter results are in line with several other studies suggesting a relation between the understanding of intentions and early social communication and language.

Contains fulltext : 194039.pdf (Publisher’s version ) (Open Access), People with sensory impairments combined with intellectual disabilities show behaviours that are similar to Autism Spectrum Disorder (ASD). The instrument Observation of Autism in people with Sensory and Intellectual Disabilities (OASID) was developed to diagnose ASD in this target group. The current study focuses on the psychometric properties of OASID. Sixty individuals with intellectual disabilities in combination with visual impairments and/or deafblindness participated in this study. The OASID assessment was administered and rated by three independent observers. By means of expert consensus cut-off scores for OASID were created. To determine the concurrent validity OASID was compared with the Pervasive Developmental Disorder for People with Mental Retardation (PDD-MRS) and the Childhood Autism Rating Scale second edition (CARS-2). The intra-rater reliability, the inter-rater reliability, internal consistency and concurrent validity of OASID were good to excellent. Cut-off scores were established based on criteria from the DSM-5. OASID was able to differentiate between four severity levels of ASD.

Contains fulltext : 157515.pdf (publisher's version ) (Closed access), Aggressive behavior is common in individuals with intellectual and developmental disabilities (IDDs), and it is most often targeted for intervention. Psychological, contextual, and biological risk factors may contribute to the risk of aggressive behavior. Risk factors are gender (males), level of IDD (lower levels of IDD), autism spectrum disorder (ASD), communication deficits, emotion regulation problems, impulsivity, and mental health problems. Next to this, several genetic syndrome groups (e.g., Prader–Willi, fragile X) are associated with aggressive behavior. This chapter provides a selective review of the evidence based on four major treatment approaches: anger management treatment (AMT), behavioral interventions, psychotropic medications, and mindfulness-based procedures. Studies have shown that relaxation coupled with stress inoculation and a focus on adaptive responses are effective components of AMT. There is evidence that behavioral interventions—especially extinction, differential reinforcement, and functional communication training—are effective in reducing aggression. Prior to behavioral intervention, the function(s) of the aggressive behavior should be determined using functional assessment. On the basis of the scientific evidence, it is difficult either to recommend or to refute the use of psychotropic medications for the management of aggression in people with IDD. Good-quality evidence is available only for risperidone among children with IDD and/or ASD. Before initiating medication, a case formulation should be documented including assessment and rationale for the use of medication. Finally, mindfulness-based procedures have been shown to be effective in reducing aggressive behavior of individuals with IDD in studies by one research group. These results, however, need to be replicated before conclusions may be drawn on whether mindfulness is evidence-based practice for aggressive behavior in individuals with IDD.

Contains fulltext : 157736.pdf (publisher's version ) (Closed access), While most typically developing children learn to communicate without formal teaching, children with developmental disabilities are often delayed in the use of first words and may need guidance to learn how to communicate. Because prelinguistic communication (e.g., facial expressions, natural gestures, and vocalizations.) is seen as a foundation for spoken word production, helping children to develop their prelinguistic communication may facilitate acquisition of spoken language. This chapter explores Prelinguistic Milieu Teaching (PMT), an intervention designed to teach children to initiate nonverbal communication during social routines in their natural environment as a foundation for later spoken word production. First, the theoretical background of PMT, which is typically viewed as a transactional model is discussed. Then, the implementation of PMT is described and the available research reviewed. Finally, suggestions for further research and implications for practitioners are provided.

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Item does not contain fulltext, Perhaps the most common and most debilitating comorbid disorder with autism spectrum disorder (ASD) is intellectual disability (ID). The overlap of these conditions has been studied extensively. This chapter provides an overview of the research that has been published on the topic. Subjects such as how symptoms are displayed, the current notions about prevalence, and how these problems affect prognosis are covered.

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