A cross sectional study of trauma symptomatology among staff working with people with intellectual disabilities who present challenging behaviour

Background: Staff have a hugely important role in the causation and management of challenging behaviour presented by children and adults with intellectual disabilities. The emotional wellbeing of staff is therefore considered to be a critical variable in determining the quality of support offered to people with intellectual disabilities. The impact of challenging behaviour on the emotional wellbeing of staff is not straightforward, and is to a large extent determined by organisational variables.
Objective: The present aim is to study the prevalence of trauma related symptomatology in staff working with children and adults who present impactful challenging behaviour, and to identify the role of organisational support and type of incident in their reported responses.
Method and materials: This is a cross-sectional study performed in four adult social care and two special school settings in service units with high reported incidents. Staff were asked to complete the Impact of Events Scale-Revised, the Staff Wellbeing Questionnaire, and the Challenging Behaviour Exposure Measure.
Results: 126 staff working in adult social care and educational settings with high reported incidents of challenging behaviour participated in the study. 113 complete IES-R were collected with 69% below the cut off, 10.6% of clinical concern and 20.4% reporting scores suggestive of post-traumatic stress. Significant variation of scores was found across service environments. There were associations between trauma symptomatology and items of the SWQ, with staff experiencing their work environments as supportive less likely to report trauma symptomatology. Significant differences in levels of perceived support were also found across service environments. Only one association between type of challenging behaviour experienced, and trauma symptomatology, was found.
Conclusions: Concerning levels of trauma symptomatology were reported by a number of participants in this study. Whilst the data would suggest that these responses are related to dealing with incidents of challenging behaviour, that may well be mitigated by organisational support factors. A call for the development of an evidenced based multi-tiered model of staff support is made.