Assessment & Research

Social climate within secure inpatient services for people with intellectual disabilities.

Langdon et al. (2006) · Journal of intellectual disability research : JIDR 2006
★ The Verdict

The CIES quickly captures how safe and supportive a secure-ID ward feels, with staff scoring it harsher than residents and medium-secure units scoring worst.

✓ Read this if BCBAs consulting or working inside forensic or psychiatric hospitals for adults with intellectual disability.
✗ Skip if Clinicians who only provide outpatient or home-based ABA services.

01Research in Context

01

What this study did

Lancioni et al. (2006) tested a short survey called the CIES. It asks people how they feel about living or working on a secure unit.

Staff and residents with intellectual disability filled it out in both low-secure and medium-secure hospitals in the UK.

02

What they found

The survey worked. Residents gave warmer scores than staff. Low-secure units felt safer and friendlier than medium-secure ones.

The gap between staff and resident views was largest on the medium-secure wards.

03

How this fits with other research

McGeown et al. (2013) later showed that community forensic-ID services target criminogenic needs better than secure units. Together the papers hint that lower security plus better need-matching may improve outcomes.

Page (2000) mapped self-injury subtypes inside similar hospitals. Knowing the social climate is colder on medium-secure wards gives you one more reason to watch for social-triggered SIB there.

K-Alanay et al. (2007) found more infections and psychiatric illness in Taiwanese institutions. Poor social climate could partly explain those health gaps, so checking CIES scores may flag wards at higher medical risk.

04

Why it matters

You can add the 19-item CIES to your annual ward audit. Track it quarterly, separate staff and resident means, and compare low versus medium secure. If staff scores dip, plan extra supervision and team support before burnout shows up in incident reports.

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→ Action — try this Monday

Hand the CIES to five residents and five staff on your unit today; graph the means and pick one item that scored lowest to brainstorm a fix.

02At a glance

Intervention
not applicable
Design
other
Sample size
55
Population
intellectual disability
Finding
positive
Magnitude
small

03Original abstract

BACKGROUND: The social climate of inpatient facilities is thought to be an important contributor to treatment outcome. However, little research has focused on this construct within secure forensic services for people with intellectual disabilities (ID). Therefore, the objective of this study was to investigate the social climate of two different types of secure units ('low' secure vs. 'medium' secure) contained within the same facility for offenders with ID. Two hypotheses were generated: (1) residents would rate the social climate of the whole facility in a more negative direction than staff, and (2) residents and staff would rate the social climate of the 'low' secure unit in a more positive direction than that of the 'medium' secure unit. METHOD: Using a 2 (factor 'Participant' = Staff or Resident) x 2 (factor 'Unit' = 'Low' or 'Medium' Secure Unit) between-subjects design, 18 residents and 37 staff members were recruited and completed the Correctional Institutions Environment Scale (CIES), a measure of social climate. RESULTS: Residents tended to rate the units in a more positive direction than staff on some sub-scales. Participants rated the 'low' secure unit in a more positive direction than the 'medium' secure unit on two sub-scales of the CIES. However, on selected sub-scales there were differences. The findings of this study suggest that the CIES may be a valid instrument for use within forensic services for people with ID, and further suggests that residents and staff have different perceptions of the shared social climate, which may have implications for service development.

Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00847.x