Sex Differences and Promotion Prospects in Clinical Psychology in Scotland

The following paper compares the gender bias in the Clinical Psychology profession in Scotland between 1990 and 1997. A larger proportion of females as compared with males are found both at the post-graduate training stage up until 1996 and at all levels of the profession, with the exception of B-grades where there were more males, in 1990. The study gives some evidence of a shift towards parity of the sexes between 1990 and 1996. A more equal ratio of males to female clinical psychology graduates is found in 1996 and a similar ratio of male to female B Grade clinical psychologists was found in 1997. However, the latter suggests that a disproportionate number of males hold B Grade posts when taken in the context of the demographics of the Scottish Clinical Psychology profession as a whole. A number of implications of these findings are discussed

Adaptations and accommodations: The use of the WAIS III with people with a Learning Disability

Evidence of significant impairment in cognitive functioning has always been one of the main criteria of a learning disability (Pulsifer, 1996) and intellectual assessment is, therefore, one of the tasks of clinical psychologists working within learning disability services. Such assessments are commonly used to help establish of an individual’s cognitive strengths and weaknesses, support needs and more specifically, to help determine if an individual falls within the remit of learning disability services (McKenzie & Murray, 2002, Evers & Hill, 1999). Intellectual assessments also have important implications in terms of mental health legislation, accessing benefits and services and informing legal decision-making processes (British Psychological Society, 2001, McKay, 1991). It is, therefore, crucial that the assessments are valid, reliable and used only by appropriately trained and qualified professionals. In Britain, it is emphasised that assessing an individual’s intellectual functioning requires an individually administered, standardised psychometric assessment which is reliable and valid (British Psychological Society, 2001), while in America professional mandates, such as the Standards for Educational and Psychological Testing (AERA,APA & NCME, 1985) highlight the need for high standards of administrative accuracy from psychologists. The Wechsler Adult Intelligence Scales - Third Edition (Wechsler, 1998) are commonly used in intellectual and neuropsychological assessment and are considered to be valid, reliable and well-standardised (Groth-Marnat et al, 2000). The Wechsler Scales have a long history and have undergone a number of revisions with the most recent being in 1997 with the development of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). The purpose of these revisions was to insure that the standardisation sample was representative of current demographics and performance, to update the subtests, incorporate new subtests, and refine the instructions and test materials. Each revision has been well researched and validated (Groth Marnat et al, 2000)

A pilot of the use of the WAIS III in learning disability services

The present study is a pilot examining how a group of people (n=133) with a learning disability perform on the Wechsler Adult Intelligence Scale – Third Edition (1997). The study found that Full Scale IQ was not always predictive of performance on individual subtests or of performance on the Indices. Implications for clinical practice are discussed

The impact of training on teacher knowledge about children with an intellectual disability

The present study examines the impact of a short training session on the knowledge of teaching staff in Scotland about children with an intellectual disability. Despite the majority of participants reporting that they had a child with an intellectual disability in their classroom, the initial level of knowledge concerning intellectual disability was low. This was partly considered to be due to terminology differences that exist between the health and education sectors and a lack of training specific to the needs of children with an intellectual disability. Training was shown to significantly improve the basic knowledge needed to understand intellectual disability immediately after training and at a 1 month follow-up, suggesting that the knowledge gains would be sustained in the longer term

Changes made to the Wechsler Intelligence Scale for Children – Third Edition by Psychologists working in Child Services

Psychologists were found to amend the way they used the WISC-III, by either regularly missing out sub-tests or not following the standardised manual instructions. The majority felt these changes would impact on the test scores of the individual child

Health and social care workers’ understanding of the meaning and management of challenging behaviour in learning disability services.

The present study sought to investigate the relationship between professional background, length of experience, understanding of the term “challenging behaviour” and opinions of factors important in managing challenging behaviour in people with a learning disability. Health Workers identified significantly more definition criteria than Social Care Workers, yet no significant difference was found between their overall scores for management criteria. Rather the emphasis of their knowledge of management principles appeared to be different. A significantly greater percentage of Health Workers identified management criteria relating to psychological principles, while a greater percentage of Social Care Workers identified that of reactive responses. Health Workers seemed more likely to identify challenging behaviour in terms of its impact on the service while Social Care Workers appeared to concentrate on the type of behaviour evident. Finally, the longer the experience of the Social Care Worker, the higher their overall scores for the definition and management criteria. However, no significant relationship was found between experience and overall scores amongst Health Workers. Implications of the findings are discussed

The Impact of Training and Staff Attributions on Staff Practice in Learning Disability Services: A Pilot Study

The present study examines the impact of a training course which has previously been found to significantly increase the knowledge of staff working in learning disability services on staff attributions and practice. No significant changes were found in staff (n = 39) attributional dimensions following training. However, a decrease in the use of the attributional category ‘communication deficit’ was found 8 weeks after training. Staff rated their knowledge levels as higher both immediately following training and 8 weeks later. The subgroup (n = 14) of staff who were examined in relation to staff practice were found to change their practice significantly from baseline to follow-ups 4 and 5 months later. Methodological limitations and implications of the study are discussed

The use of therapeutic untruths by learning disability nursing students

Background: The use of therapeutic untruths raises a number of ethical issues, which have begun to be explored to some extent, particularly in dementia care services, where their use has been found to be high. Little is known, however, about their use by health professionals working in learning disability services. Research question: The study aimed to explore the frequency of use of therapeutic untruths by student learning disability nurses, and by their colleagues; how effective the students perceived them to be as a means of responding to behaviours that challenge; and their level of comfort with using them. Research design: A correlational design was used to gather data from an online version of the Best Interest Scale, adapted for a learning disability context. Participants were 30 learning disability student nurses (female = 28, ages 18–48 years, M = 26.8, standard deviation = 7.3) studying at a university in the North-East of England. Ethical considerations: The study was reviewed and received ethical approval from the first author’s university ethics committee. Findings: Overall, 96% of participants reported using therapeutic untruths. ‘Omission’ was the most frequently used type of therapeutic untruths, the most effective and the type that the students felt most comfortable using. Frequency of use of therapeutic untruths correlated significantly and positively with perceived effectiveness and the level of comfort that the students felt when using them, for all types of therapeutic untruths. Conclusion: The use of therapeutic untruths by the student nurses was consistent with that found in research in dementia care services in the United Kingdom and abroad. Further research to explore the generalisability of the results to the wider context of learning disability services is needed. The study highlights that there may be a need for more formal guidance and educational input to student nurses in the use of therapeutic untruths with people with a learning disability

The postnatal support needs of mothers with an intellectual disability

OBJECTIVE: there is growing evidence that many parents with intellectual disabilities can parent successfully when given adequate support. This paper aims to explore the postnatal care experiences of mothers with an intellectual disability. DESIGN: a qualitative design was used and data were collected using a semi-structured interview format and analysed using Interpretative Phenomenological Analysis. SETTING: the study took place in community settings in Scotland. PARTICIPANTS: six mothers with intellectual disabilities were interviewed about their experiences. MEASUREMENTS AND FINDINGS: two super-ordinate themes are discussed with accompanying subthemes: challenges of providing support and how support was delivered. KEY CONCLUSIONS: the mothers valued formal postnatal care, but this was secondary to informal support. How mothers perceived the support impacted on its effectiveness and building effective relationships with professionals presented challenges. IMPLICATIONS FOR PRACTICE: the study suggests the structure and quality of the wider support networks of mothers with an intellectual disability are central and should be taken account of by professionals. Providing information and advice in ways that validates the mother's role is also important, particularly as the mother's perception of how help is given can impact on the degree to which mothers engage with professional