Stress and residential staff who work with people who have an intellectual disability: a factor analytic study.
A short demands-and-supports survey can pinpoint the workplace stressors that drive anxiety and depression in residential ID staff.
01Research in Context
What this study did
Malone (1999) asked 216 residential staff who support adults with intellectual disability to fill out a new 56-item stress survey. The survey listed job demands (like workload, client aggression) and supports (like team help, supervisor praise). Staff also completed short anxiety and depression scales.
The goal was to see which demands and supports best predict staff mental health.
What they found
Four demand factors emerged: workload, client challenging behavior, poor communication, and lack of control. Three support factors also showed up: team cohesion, supervisor support, and clarity of rules.
Higher demands plus lower supports predicted mild anxiety and depression scores. The model explained about 30 % of the variance—useful, but plenty of stress still comes from other sources.
How this fits with other research
Mulder et al. (2020) extends these results into schools. They gave teachers five behavioral-skills training sessions and saw the same pattern: better supports (skills, feedback) cut stress and boosted confidence.
Hithersay et al. (2014) looks at first glance like a contradiction. Their scoping review found “no effective carer-led health interventions” for adults with ID. But the 1999 paper is not testing an intervention—it is only mapping stress. The two studies sit at different steps of the pipeline: measure first, intervene second.
Capaldi (1992) is the direct predecessor. That paper sketched six behavior-analytic principles for redesigning residential services. Malone (1999) turned the sketch into numbers you can track on a survey.
Why it matters
You now have a free 56-item checklist that flags the exact workplace pressures hurting your residential team. Use it during annual staff surveys, pick the top two demands and top two missing supports, then write a quick action plan—extra team meeting for workload, five-minute daily praise from supervisor, clearer shift rules. Repeat the survey in six months to see if anxiety scores drop.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Hand the 56-item survey to every direct-support professional on your caseload, graph the four demand and three support factors, and start one small fix for the lowest-scoring support this week.
02At a glance
03Original abstract
The present study describes the development of a questionnaire, and the subsequent collection of data, to gather information on the demands and supports which influence stress (as measured by anxiety and depression scales) in direct care staff who work with people with intellectual disability. The results from the questionnaire were also used to explore the relationships between the factors derived from the questionnaire and to consider how these may be influential in building organizational models. The questionnaire was specifically constructed to measure the demands and supports experienced by direct care staff. The participants included 216 staff working in community residential services for people with intellectual disability. These individuals included staff working for two British health trusts and similar staff working for one local authority. The questionnaire consisted of 33 demands items and 23 supports items. Separate factor analyses were conducted on the demands and supports scales. Analyses of the reliability and validity of the resulting factors were conducted. Stepwise multiple regressions were conducted to further explore the relationship of factors with the measures of anxiety and depression. Four factors were extracted from the demands scale and three factors from the support scale. There was some concern over levels of reliability and validity for individual factors; however, the reliability of the main scales appeared to be satisfactory. All but one support factor correlated significantly with levels of anxiety and depression. The factors explained a modest amount of the variance in the regressions. While there are some concerns about the psychometric properties of the questionnaire, it is argued that the scales and factors can be used to confirm and further understanding of the relationship between groups of demands, supports and stress in staff. The usefulness of the questionnaire as a means of diagnosing specific sources of demand and support is considered. It is suggested that the questionnaire could form the basis for assessment and subsequent intervention in houses where staff are reporting relatively high levels of anxiety and depression.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.00210.x