People with learning disabilities experience physical interventions as painful and emotionally distressing

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Physical interventions are still widely used in learning disability services, with BILD estimating their use in around half of all people with learning disabilities and challenging behaviour. The experience of people with learning disabilities of such interventions is not something that has been reported widely in the literature, but the researchers in this study set out to explore this issue by using semi- structured interviews with a small number of people using services who had either directly experienced or had witnessed restrictive physical interventions.

They found that the service users concerned experienced restrictive physical interventions as

painful, emotionally distressing, and as indistinguishable from abuse, or from general violence in the environment”

They also found some interesting views about the way in which people who used services attributed motivations to the staff who were involved. Many felt that the use of restrictive physical interventions was not justified in the instances they reported. The researchers also point out that many of the service users had practical suggestions for more positive alternatives.

The reporting of the experience of physical interventions by people with learning disabilities is a relatively new addition to the literature, and the authors suggest that this small qualitative study proves further evidence of the adverse effects of restrictive physical interventions.

They recommend that practitioners should continue to reduce the need for such interventions and suggest a broader application of proactive approaches to positive behaviour support.

‘You squeal and squeal but they just hold you down’ MacDonald Aet al., in: International Journal of Positive Behavioural Support, 1,  1, 45-52

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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