• De-escalation of Violence in the Context of Learning Disability: Working with complexity

      Lovell, Andy; University of Chester (Oud Consultancy, 2017-10-26)
      The use of physical interventions as a response to violence has come under increasing critique over recent years, particularly when the service user group is perceived as vulnerable, such as with elderly populations and those with intellectual disabilities. A 2-day educational workshop was devised for a whole population of qualified nurses and support workers currently working with people with intellectual disabilities detained under conditions of security in the north of England. The workshops were delivered between October 2016 and March 2017, and evaluated on an ongoing basis to ensure immediate feedback to service management. The basis of the workshop was a model of understanding the de-escalation of violence derived from several inter-linked components. Firstly, the process of violence is analysed in relation to how a situation becomes enflamed and violent behaviour results. The concept of de-escalation is then deconstructed so that the various components can be considered in relation to each other. Finally, the concept of complexity is unpicked, specifically around intellectual disability, and this constitutes the final element of the model. The three elements are subsequently developed in relation to each other to constitute a better way of understanding the process of de-escalating violence. The workshop, in effect, demands that participants reflect on their own work, and the therapeutic relationships developed over time with service users. The relationship between knowledge and practice is explored in some detail. The emphasis is placed on how the successful de-escalation of potentially violent situations directly relates to the effective translation of this knowledge, in all its diversity, into practice; and, perhaps, this is less understood than might immediately appear.