Who's Challenging Who?
Research type
Research Study
Full title
Who’s Challenging Who: A cluster randomised controlled trial to test the effectiveness of a staff training intervention to improve support staff attitudes and empathy towards adults with learning disability and challenging behaviours
IRAS ID
179539
Contact name
Richard Hastings
Contact email
Duration of Study in the UK
2 years, 3 months, 31 days
Research summary
Approximately one in six people with learning disability (LD) engage in “Challenging Behaviours” (CB). CBs are defined by their negative impact on the person (e.g., injury, exclusion from the community) and others (e.g., physical harm, stress). The actions of staff members can make CBs more likely to occur, or make these behaviours worse. In particular, staff negative attitudes and lack of understanding about the reasons for CB are contributory factors.
To address lack of staff empathy and negative attitudes, we worked directly with people with LD to design a staff training course. The training - “Who’s Challenging Who?” (WCW) - is designed to emphasise the role of staff as a challenge also to people with LD. WCW is a half day training course with follow-on coaching to ensure implementation. WCW is delivered jointly by a trainer with LD who has been labelled as having CB, along with a trainer without LD.
We have conducted development work on WCW, written a manual, and completed a pilot evaluation the results of which were positive. Staff reported increased empathy for people with LD and CB, increased confidence, and reductions in negative attitudes.
In the new research study, people with LD and CB will co-deliver WCW. Staff (two per group home) from 118 LD residential services will participate. A cluster randomised design at the group home level will be used, with one half of group homes randomised to receive WCW. Following the research evaluation, group homes in the “training as usual” comparison group will also be offered WCW. The primary outcome will be changes in staff empathy towards people with CB. Secondary outcomes at the staff level will include confidence, attitudes, and work-related well-being. Secondary outcomes at the group home level will include recorded incidents of aggressive CB, and use of any restrictive practices.
REC name
Social Care REC
REC reference
15/IEC08/0030
Date of REC Opinion
12 May 2015
REC opinion
Favourable Opinion