A multiple case study investigating changes in organizations serving residents with intellectual disabilities and challenging behaviours.
Vanessa Charissa Olivier-Pijpers, Jane Murray Cramm, Wouter Landman and 1 others
PMID 32939925WHAT IT FOUND
Staff in residential disability services described changes as messy when self-organizing teams reduced routine support and information about residents.
Relocations and role changes also left staff, managers and psychologists distant, and staff said resident-staff trust and behaviour management became harder.
Key findings
01Reports indicated that early transitions to self-organizing staff teams left staff with less routine support and less information about residents, while incidents of challenging behaviour increased.
02Relocations and changing roles created distance among staff, psychologists and managers, and staff said this weakened resident-staff bonding and behaviour management.
03Efforts to reduce restraint initially coincided with more severe incidents when staff were not equipped, but training helped some staff change attitudes and redirect behaviour.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The findings come from selected Dutch organizations, so they may not apply to other services. Residents and representatives were not included, so their views were not captured. The data were perceptions from focus groups and documents, not measured resident outcomes. The researchers were CCE employees and collected data during consultations.
Declared interests
The authors declared no conflict of interest. The researchers were CCE employees and conducted the study during consultations for residents.
The easy way to misread this
Do not treat these themes as evidence that a specific organizational change improves resident behaviour. The study reports staff and manager perceptions from selected Dutch services, not measured outcomes.