Successful interviews with people with intellectual disability

People with intellectual disability who possess expressive language are able to participate successfully in qualitative interviews, providing the facilitator pays close attention to their communication preferences. This article considers the successes and flaws in interviewing techniques utilised in a study that invited twelve men and 17 women to talk about sex, risk, social and leisure life. Questions were posed in plain language and accompanied by concrete reference tools, namely picture cards and photo-story vignettes. Adjusting the depth of questioning in line with what a respondent wants to or can offer enhanced the quality of data obtained. The discussion highlights that interviewer’s actions may contribute to errors, which have previously been described in individualising terms as acquiescence, recency and unresponsiveness. The overall message of this article is that a responsive approach to each participant’s particular communication style, combined with avoidance of inaccessible question formats, are key ingredients of a successful interview

A realist analysis of treatment programmes for sex offenders with intellectual disabilities

Background: The resources used in treatment for sex offenders with intellectual disabilities have had much research attention, but less has been written about how participants are expected to respond (programme mechanisms). Methods: A realist evaluation of seven programmes from the UK, Canada, USA, Switzerland and Germany was conducted. In semi‐structured interviews, programme designers elucidated how they are intended to work. The data analysis was driven by the realist concern to expose programme mechanisms and intended outcomes. Results: Two main outcomes are increasing risk management capacities and cultivating prosocial identities. These are achieved through developing insights into a person's risks, work on (sexual) self‐regulation skills, sexual boundaries and personal values and by developing meaningful social roles and positive relationships. Conclusions: Over time, there have been changes to some of the treatment resources used. However, there were little differences in terms of the intended programme mechanisms and outcomes, which remained surprisingly consistent

Are we valuing people's choices now? Restrictions to mundane choices made by adults with learning difficulties

In the UK, Valuing People (Department of Health, 2001, 2010b) has shaped services for people with learning difficulties for the past decade. Promoting choices and independence are two of the four key principles that underpin this White Paper and its subsequent delivery plans. This paper assesses the impact that these changes had on the availability of mundane choices. It draws on empirical evidence from interviews with adults with learning difficulties. First impressions of the findings indicate that individuals are indeed able to make an increased range of decisions. At closer inspection, it does however become apparent that not all of these decisions are based on an infinite spectrum of options. Under the guise of choice-based policy rhetoric, some people with learning difficulties are at times presented with a pre-arranged ‘menu of choices’. For instance, a person may be free to choose activities at their day centre, but they may have limited control when deciding whether to attend the service in the first place. The wider implications that tokenistic choice-making processes have for the development of personal autonomy are highlighted. It is argued that a lack of control in respect to mundane choices is disempowering and leads to learned passivity

Successful Community Resettlement of Men with Learning Disabilities Who Have Completed a Hospital-Based Treatment for Sexual Offending

Treatment for sexual offending equips men with learning disabilities with tools required for pro-social community living. In the past, risk aversiveness prevented discharges from hospital, but fieldwork took place at the time of the Transforming Care Agenda, which sought to enable more people to return to their communities. This offered the opportunity to gain unique insights into community resettlement planning in cases that require ongoing risk management. Eleven case studies were examined through qualitative interviews with the men and professionals. A realist evaluation methodology was applied to examine how treatment outcomes manifested longer term. It was evidenced that treatment had equipped men with risk management tools, as well as encouraged them to develop realistic visions for their pro-social futures and that both outcomes come to fruition under conditions that allow positive risk taking. The welfareist and user-led nature of working towards pro-social community living makes this a useful toolkit for social work, whilst input from forensic health services was valued for skilling up the social care workforce. However, discharge practices continued to be influenced by contextual factors, including local availability of resources and personal attributes, such as men’s sexual preferences and levels of compliance and some men remained in hospital

In search of solutions regarding the sex education of people with intellectual disabilities in Poland - participatory action research

Full and equal access to sex education for all citizens is ensured by international legal acts. Research shows, however, that people with intellectual disabilities (ID) receive neither support in understanding their sexual rights, nor access to sex education tailored to their needs. Sex education classes at a special school in Poland are not compulsory for students with ID, therefore they can be omitted from the curriculum. The research aims to learn the state of knowledge about human sexuality and to analyse the needs, barriers, and expectations of adult students with ID as regards their sex education. The methodology used included a qualitative approach (Participatory Action Research) using group interviews (FGI) with 24 ID students ages 18–24. The results of the study indicate that students taking part in the study possess fragmentary and incomplete knowledge about sexuality. They listed TV, the Internet, and friends as sources of information, leaving out school (teachers) and parents. However, their interest and willingness to talk was very high. A didactic tool for sex education was designed together with the student and is being used in schools

‘Love makes me feel good inside and my heart is fixed’: What adults with intellectual disabilities have to say about love and relationships

Background: Adults with intellectual disabilities have historically been hindered, rather than supported, in their desire to form loving relationships. This paper sought to explore with them what kinds of support they wanted in the 21st Century.Method: Semi-structured in-depth interviews were conducted with 40 adults with intellectual disabilities in the UK.Results: Participants placed a high value on having a partner and being supported to maintain and develop a loving relationship. The factors which constrained them in achieving this included a lack of social opportunities, barriers created by social care services and limits on them exercising autonomy. Facilitating factors included access to specialist dating agencies, strong family and staff support and opportunities to learn about relationships.Conclusions: The importance of a loving relationship as a source of pleasure and meaning in the lives of adults with intellectual disabilities who are often disadvantaged in many other spheres of life is emphasised

Constructions of vulnerability in comparative perspective: Scottish protection policies and the trouble with "adults at risk"

This paper places Scottish adult support and protection (ASP) policy in the context of debates about the nature of 'vulnerability' and its usefulness as a defining concept in law and social policy. It examines the construction of 'adults at risk' in ASP policy, using a comparison with the construction of children in Scottish child protection policy, on the one hand, and women in Scottish domestic abuse policy, on the other, to illuminate the nature of the vulnerability that ASP considers itself to be addressing. It then problematises this construction, drawing both on the social model of disability and on an ethic of care. It concludes that current ASP policy remains underpinned by unhelpful assumptions about disabled people, older people and people with mental or physical health problems. A more inclusive understanding of vulnerability would be more empowering to these people and others, in policies concerned with mistreatment and abuse

Promoting sexual well-being in social work education and practice

This paper explores the importance of including sexual well-being within social work practice and education. Social workers often work with individuals for whom opportunities for sexual expression are limited and who face discriminatory attitudes. Sexual well-being is a global concern, and is particularly relevant considering international interest in the influence of notions of well-being on mental and physical health. Implementation of new social care policy in England, underpinned by the well-being principle, provides practitioners with the opportunity to explore what is meaningful to individual’s well-being through person-centred approaches to practice. There is currently little coverage of sexual well-being within social work education, this means students and practitioners lack the knowledge and skills to challenge barriers. Promotion of the concept of sexual citizenship, with its associated rights and responsibilities, enables social workers to engage in rights focused practice. Sexual well-being is a sensitive subject and the social and personal barriers practitioners may experience in addressing this topic are explored