Attachment behaviours in adults with intellectual disabilities in assisted living facilities: representations from direct-care staff.
Direct-care staff view attachment behaviors in adults with ID as challenging and need guidance to respond sensitively without over-involvement.
01Research in Context
What this study did
Subramaniam et al. (2023) talked to direct-care staff in assisted-living homes for adults with intellectual disabilities.
They asked staff to describe times residents sought closeness, hugged them, or got upset when they left.
The team wanted to know how staff made sense of these attachment behaviors.
What they found
Staff saw the same acts—hugging, following, calling for help—as both sweet and stressful.
Workers worried that being "too close" broke professional rules, yet pushing people away felt cold.
Most staff had no clear script for balancing warmth with boundaries.
How this fits with other research
Chou et al. (2010) warned that institutions reward staff for acting distant and "secure." R et al. show this still happens; the new study gives staff words to the feelings the older paper predicted.
Whitehouse et al. (2014) found staff turn harsh when clients act out. R et al. add that even loving behaviors can trigger the same unease, revealing a wider emotional gap.
Mount et al. (2011) showed staff bend risk rules to respect autonomy. The 2023 paper reveals they also bend emotional rules, but without guidance they feel guilty either way.
Why it matters
If you supervise residential staff, use these findings to open a team huddle. Ask: "What cuddles or clingy acts confuse you?" Then write a shared plan—maybe two-minute hand-holding is okay, longer hugs need a shift-lead check-in. Giving tiny rules lowers staff anxiety and keeps resident trust alive.
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02At a glance
03Original abstract
BACKGROUND: Studies on individuals with intellectual disabilities (IDs) indicate that primary care staff are potential attachment figures. Therefore, the ability to interpret and respond to attachment behaviours with sensitivity is crucial for professionals working with adults with IDs. However, little is known regarding representations and understanding of these attachment behaviours among professionals. This study investigated the representations of attachment behaviours among adults with IDs, as observed and interpreted by direct-care staff in assisted living facilities. METHODS: Semi-structured interviews were conducted with 19 support workers in seven assisted living facilities in the French community of Belgium. A thematic content analysis was performed. RESULTS: Professional discourse elicited various forms of attachment behaviours that were sometimes considered challenging. Staff reported difficulties in finding a balance between supporting selective attachment and maintaining 'the right distance' to prevent a negative impact on their work conditions. CONCLUSIONS: This study gives insight to how using an attachment-informed framework may provide a new perspective on behaviours of adults with IDs in assisted living facilities, as well as the need to offer professionals the opportunity to reflect upon their practices in relation to this dimension.
Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13062