Responses of staff towards people with mild to moderate intellectual disability who behave aggressively: a cognitive emotional analysis.
Real client aggression sparks far stronger staff emotion than training scenarios, so rehearse with authentic-feeling drills and monitor staff-client rapport.
01Research in Context
What this study did
Saville et al. (2002) asked 88 disability staff to rate how they would feel if a client hit, bit, or spat. Half answered for a real past event. Half answered for a made-up story.
Each worker also told what they thought caused the blow-up and how much control the client had.
What they found
Real blows hurt feelings more. Staff reported twice as much anger and anxiety when they recalled an actual incident than when they imagined one.
The classic Weiner model—blame drops when you see low control—did not hold. Instead, helpers who saw clients as more likeable felt less upset, no matter the cause.
How this fits with other research
Willner (2015) shows pills rarely curb aggression in this group. Saville et al. (2002) adds that staff emotion, not medication, may be the first lever to pull.
Hsieh et al. (2014) used the same survey style and found that function of self-injury shifts with ID level. Together the two K studies say: ask staff, but ask about both feelings and function.
Modi et al. (2015) found aggression predicts hospital admission. Pair that with Saville et al. (2002): if real-time staff anger is high, early de-escalation may keep clients out of the ward.
Why it matters
Training often uses role-play aggression. Real hits feel hotter. Add in-vivo practice with safe aggression so staff learn calm reactions before the real thing. Track which clients staff like most; low-liking scores flag where extra coaching is needed.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Run a 5-minute “surprise” mock hit during staff meeting and have staff rate their pulse and mood right after—compare to recalled real events.
02At a glance
03Original abstract
BACKGROUND: Traditionally, research into interactions between staff and adults with an intellectual disability who engage in challenging behaviour has been carried out within a behavioural paradigm. Recent work has begun to examine cognitive factors. The majority of this research has drawn upon Weiner's attributional model of helping behaviour. Moreover, staff responses have usually been investigated in relation to client vignettes of challenging behaviour. METHOD: The present study involved 38 staff who worked with frequently aggressive clients and its aims were twofold: (1) to compare different methods of examining the cognitive and emotional responses of staff to aggression; namely, descriptive vignettes and real incidents of aggression which staff could recall; and (2) to attempt to replicate previous findings supportive of Weiner's model with a new carer group (day centre staff). RESULTS: When staff responses were compared across the hypothetical and real scenarios, using a series of one-way analyses of variance, it was revealed that staff experienced more negative emotions in response to the real incidents of aggression. The present study produced little evidence in support of Weiner's model. However, it was found that staff perceptions of the aggressive clients were linked to their cognitive and emotional responses to the aggression. CONCLUSION: The theoretical and clinical implications of these findings are considered, and the possible role played by interpersonal attributions in mediating staff responses to aggression is discussed.
Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00434.x