Relabelling behaviour. The effects of psycho-education on the perceived severity and causes of challenging behaviour in people with profound intellectual and multiple disabilities.
A short psycho-education class slightly worsened staff severity ratings and changed nothing else—use BST plus coaching instead.
01Research in Context
What this study did
The team ran a short psycho-education class for direct support staff. The class aimed to lower how severe staff rated challenging behaviour and cut their use of medical explanations.
Staff worked with adults who have profound intellectual and multiple disabilities. The study used a before-and-after design with no control group.
What they found
After the class staff actually rated behaviours as slightly more severe, not less. Their belief that biology causes the behaviour stayed the same.
Overall, the workshop had almost no real impact on staff views.
How this fits with other research
Gormley et al. (2019) ran a stronger cluster-RCT of a one-day BST workshop. That study lifted staff knowledge and on-the-job skills, while Poppes et al. (2016) found next to nothing. The newer RCT shows that active BST with coaching beats a short talk-only class.
Bhaumik et al. (2008) also used BST, not lectures, and saw medium gains in staff attitudes and skills. Again, hands-on practice outdid the psycho-education approach.
Green et al. (2020) interviewed residents and found that stable, well-trained staff lower challenging behaviour. Their qualitative view supports investing in stronger training like BST instead of quick info sessions.
Why it matters
A one-off lecture barely moves staff views. If you want staff to see behaviour as less severe or to drop medical excuses, give them BST with modeling, practice, and feedback. Schedule follow-up coaching and use peer mentors. Skip the slide deck alone.
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02At a glance
03Original abstract
BACKGROUND: Prevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the person with PIMD and attribute challenging behaviour in children and adults with PIMD mainly to a biomedical model. The purpose of this study was to evaluate whether an intervention (psycho-education) had any effect on direct support staff's assessment of challenging behaviour in terms of its severity and their biomedical causal explanations (attributions) for this behaviour. METHOD: A stepped wedge study design was used to evaluate the effects of a psycho-education intervention on the perceived severity and the attributions offered for challenging behaviour of people with PIMD by 198 direct support staff. We used questionnaires assessing the perceived severity of challenging behaviour and staff views of its causes. Data on the dependent variables were collected at four 1-month intervals. RESULTS: The intervention was found to have an effect on the perceived severity of challenging behaviour identified in people with PIMD in the sense that staff generally scored challenging behaviour as more severe in its consequences after the intervention. However, this effect was very small. No significant effects were found in terms of reduction in the biomedical scale scores. CONCLUSION: No evidence for the effectiveness of a psycho-educational approach on the assessment of challenging behaviour in terms of severity and the biomedical attributions for behaviour was found. More research is required to explore further the effects of more elaborate training using methods to enable direct support staff to reflect on the behaviour of people with PIMD and on their own behaviour.
Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12299