Abstract
BackgroundLevels of aggression are high in residential settings for juveniles with Mild Intellectual Disability (MID). As a result, treatment is less effective, aggression causes injury, traumatic experiences and longer inhabitation for juveniles. Additionally, inpatient aggression has been linked to burnout and stress among group workers, which has negative consequences such as less job satisfaction or poorer work performanceObjectiveTherefore, it is crucial to diminish aggressive incidents in these settings and to find a way for staff how to respond to aggression properly.MethodsAs there is no intervention method which tackles all of the referred problems efficiently, a new method Non-violent Resistance for MID was introduced into three residential settings for juveniles with MID, in a quasi-experimental stepped wedge design. Reports of aggressive incidents were assessed seven times before, during and after the training in NVR-MID on group level. Multilevel analyses were carried out in order to assess the development of the aggressive incidents over time.ResultsAggressive incidents decreased significantly in time during and after training in NVR-MID, this decrease is seen in all three institutions. Thus, regardless of resident’s age, gender or IQ, NVR-MID seemed successful in diminishing aggressive incidents. Furthermore, a significant interaction effect was found between institution and time, indicating that regardless if incidents of aggression were relatively high at baseline, decrease in incidents was similar to institutions where incidents were relatively low on baseline.ConclusionsImplementing NVR-MID into residential settings for juveniles with MID and comorbid behavioral problems might help to decrease aggressive incidents.
Highlights
The average population of residential youth care settings varies in prevalence of comorbid psychopathology, a substantial part of the admitted juveniles have problems with their anger management (Livingston et al 2010)
This study evaluates whether the method of Non-violent resistance (NVR)-Mild Intellectual Disability (MID) is successful in decreasing the number of aggressive incidents reported in the residential settings for juveniles with MID
This study examined the relationship between the Non-Violent Resistance (NVR) methodology for juveniles with a mild intellectual disability (MID) and comorbid behavioral problems and a possible change in aggressive incidents over time in three residential youth care settings in the Netherlands
Summary
The average population of residential youth care settings varies in prevalence of comorbid psychopathology (such as anxiety, aggression or other psychopathology), a substantial part of the admitted juveniles have problems with their anger management (Livingston et al 2010). When experiencing limitations in their social adaptability juveniles with an IQ between 70 and 85 are included in the definition MID (Zoon 2013) These limitations in social adaptability are found to be one of the explanatory mechanisms for externalizing and aggressive behavior (Van Nieuwenhuijzen et al 2009). Aggressive incidents in residential youth care settings have negative consequences for the juveniles as well as for the group workers. Inpatient aggression has been linked to burnout and stress among group workers, which has negative consequences such as less job satisfaction or poorer work performance Objective it is crucial to diminish aggressive incidents in these settings and to find a way for staff how to respond to aggression properly. Conclusions Implementing NVR-MID into residential settings for juveniles with MID and comorbid behavioral problems might help to decrease aggressive incidents
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