Practitioner Development

Exposure to client aggression and burnout among community staff who support adults with intellectual disabilities in Ontario, Canada.

Hensel et al. (2012) · Journal of intellectual disability research : JIDR 2012
★ The Verdict

Client aggression is nearly universal for community ID staff and drives burnout—programs must proactively support staff wellness, not just behavior plans.

✓ Read this if BCBAs supervising adult day or residential programs in Ontario or similar settings.
✗ Skip if Clinicians who only serve short outpatient sessions with no direct-care staff.

01Research in Context

01

What this study did

The team sent a short survey to community staff who support adults with intellectual disabilities in Ontario.

They asked how often clients hit, kicked, or showed other aggression.

They also asked how burned out the staff felt.

02

What they found

Almost every worker said they had faced client aggression.

More exposure linked to higher emotional exhaustion and depersonalization.

Surprisingly, staff still reported strong personal accomplishment.

03

How this fits with other research

Ko et al. (2012) saw the same link at summer camp: more aggression, more exhaustion.

Smyth et al. (2015) found the same pattern in the UK, but overall burnout scores were lower.

Perez et al. (2015) later showed that high self-efficacy and work motivation can soften the blow.

Barton et al. (2019) added that mindful, open staff stay on the job longer despite aggression.

04

Why it matters

You cannot erase client aggression, but you can shield your team.

Add brief mindfulness moments, build clear team goals, and praise small wins.

These steps cut exhaustion and keep staff at work.

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Start team huddles with a two-minute guided breathing and ask each staff to name one win from the prior shift.

02At a glance

Intervention
not applicable
Design
survey
Sample size
926
Population
intellectual disability
Finding
positive

03Original abstract

BACKGROUND: Studies have shown that staff who support adults with intellectual disabilities (ID) are exposed to challenging behaviour in their work including client aggression. Exposure to aggressive behaviour has been associated with staff stress and burnout. Study samples have been small however, and there has been very little data exploring this issue among North American staff. METHODS: A cross-sectional survey which included demographics, measures of frequency and severity (including perceived severity and a standardised severity score) of exposure to client aggression and the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) was completed by 926 community staff who support adults with ID in Ontario, Canada. Relationships between demographic variables and exposure to aggression were examined with descriptive statistics. Pearson correlations were used to analyse exposure variables and MBI-HSS scores. RESULTS: Nearly all staff reported being exposed to client aggression in the prior 6 months. Mean MBI-HSS scores were comparable to previously published data in similar populations with the exception of a higher score in the personal accomplishment domain. All measures of exposure to aggression were significantly positively correlated with MBI-HSS scores in the emotional exhaustion and depersonalisation dimensions of burnout. CONCLUSIONS: The prevalence of burnout in this North American sample is comparable to what has been reported in similar populations in other locations, although these staff may have a higher sense of accomplishment with regard to their work. Findings from this large sample support the evidence that exposure to client aggression affects staff emotional well-being but is by no means the only important factor. Further study is needed to explore the differences and similarities reported here as well as other contributing factors which will guide the implementation of effective strategies to improve staff well-being.

Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01493.x