1. The Moral Web Adults with learning disabilities’ views about challenging behaviour Martin Stevens, Social Care Workforce Research Unit martin.stevens@kcl.ac.uk

2. Introduction Background Background Approach and methods Approach and methods Ethical issues Ethical issues The ‘Moral Web’ The ‘Moral Web’ Limitations Limitations Implications for practice Implications for practice

3. Background Third phase Third phase Aimed at informing a SSD policy Aimed at informing a SSD policy Wider significance Wider significance Few studies exploring service user perspectives Few studies exploring service user perspectives

4. Approach and methods Exploring experiences Exploring experiences Sample Sample Interviews and group discussions Interviews and group discussions Observations Observations Limitations Limitations

5. Information Sheet Changes Picture Bank Changes Picture Bank http://www.changepeople.co.uk/ http://www.changepeople.co.uk/ Would you like to talk to Martin? About the things some people do or say that make other people feel unsafe

6. Ethical issues Consent Consent Confidentiality Confidentiality Accessible materials Accessible materials Time Time

7. ‘The Moral web’ Challenging Behaviour is: Bad Bad Has negative consequences Has negative consequences Altered by intention Altered by intention Altered by quality of relationships Altered by quality of relationships

8. Bad in its own right Awful, really, a really awful word, when you say that F-in (pronounced as f-in) word. Int 2-1 Right. So what do you think when he does that, Graham? It’s naughty. dg3-1(interviewer in bold)

9. Negative emotional consequences What did you think about that. I got angry and annoyed and I told someone. You got angry and annoyed. I told someone. 5-1, (Interviewer in bold)

10. Negative emotional consequences Sometimes he keeps on about people dieing, Martin, I just don’t wanna, I don’t like him keeping on about it, because it makes me all upset and crying, what have you Int 2-1

11. Negative consequences for those responsible I wanted her banned all week. Int5-3

12. Importance of intention Yeh, he doesn’t bully people like David does. Dg4-2 … there’s a lot of people here who have special needs and yeh, you’ve got to be tolerant. dg4-2

13. Altered by quality of relationship This is a different Jill. Jill Waters. dg31 Waters. dg32 Not Jill who was throwing things. Yes. dg32 Oh yeh, Jill Waters, she’s my girlfriend, yes. dg31(interviewer in bold)

14. The Moral Web Own /others intervention Episodes Causal factors Staff interventions Impact on behaviour Ongoing problems Emotional Impact Resolution

15. Causal factors Relationships Relationships Behaviour Behaviour Contexts Contexts

16. Episodes Verbal Aggression Verbal Aggression Physical aggression Physical aggression Anti-social/disconcerting Anti-social/disconcerting Self-injurious/stereotypical Self-injurious/stereotypical

17. Consequences Emotional/Negative for those responsible? Emotional/Negative for those responsible? Lifestyle Lifestyle Staff sorting it out Staff sorting it out Staff care Staff care …and staff control …and staff control

18. Limitations of the research Small-scale Small-scale Participants users of SSD units Participants users of SSD units Participants more able, less challenging Participants more able, less challenging Perspectives of witnesses and ‘victims’ Perspectives of witnesses and ‘victims’

19. Implications for practice Attending to moral assessments Attending to moral assessments Understanding relationships Understanding relationships Raise awareness of different levels of understanding Raise awareness of different levels of understanding Develop realistic expectations of staff Develop realistic expectations of staff Further research Further research