What is the Who’s Challenging Who? project?

Approximately one in six people with a learning disability (LD) engage in “behaviours that challenge”. Behaviours that challenge are defined by their negative impact on the person (e.g., injury, exclusion from the community) and others (e.g., physical harm, stress). The actions of staff members can make behaviours that challenge more likely to occur, or make these behaviours worse. In particular, staff negative attitudes and lack of understanding about the reasons for behaviours that challenge are contributory factors. To address lack of staff empathy and negative attitudes, we worked directly with people with LD to design a staff training course.

‘Who's Challenging Who?’ was funded by the National Institute for Health Research (NIHR) School for Social Care Research, and was in collaboration with Cardiff University and Mencap. The primary objective was to determine the impact of the training programme on staff attitudes (empathy) towards people with learning disability and behaviours that challenge. The secondary objectives were to determine the impact of the training on: staff confidence, attitudes and work-related wellbeing; incidence of behaviours that challenge in residential homes, and use of restrictive practices.

The training “Who’s Challenging Who?” (WCW) was designed to emphasise the role of staff as a challenge also to people with learning disabilities. WCW is a half day training course with follow on coaching to ensure implementation. WCW is delivered jointly by a trainer with LD who has been labelled as having behaviours that challenge, along with a trainer without LD.

Easy Read versions about why we needed to do the research and what we found can be downloaded from here: 

Link to easy read versions of both 

A copy of the Policy Briefing for Who’s Challenging Who? can be downloaded from here:

Link to policy briefing

We also filmed a series of short videos about the trainers’ experiences of being involved in the WCW project. They are all available on the WCW YouTube channel:https://bit.ly/2Ixx2EN

 

We published the protocol for this study in Trials:

Randell, E., Hastings, R. P., McNamara, R., Knight, R., Gillespie, D., & Taylor, Z. (2017). Effectiveness of the ‘Who’s Challenging Who’ support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial. Trials, 18(1), 460. doi: 10.1186/s13063-017-2175-1

The findings from this study have been published:

• Hastings, R.P., Gillespie, D., Flynn, S., McNamara, R., Taylor, Z., Knight, R., Randell, E., Richards, L., Moody, G., Mitchell, A., Przybylak, P., Williams, B., Hunt, P. (2018). Co-produced training to improve support staff attitudes and empathy towards adults with intellectual disability and behaviours that challenge: A cluster randomised controlled trial of the Who’s Challenging Who? intervention. Journal of Intellectual Disability Research, 62(9), 798-813. doi: 10.1111/jir.12536
• Flynn, S., Hastings, R. P., Gillespie, D., McNamara, R., Randell, E. (2019). Trainer and support staff experiences of engaging with the Who’s Challenging Who? challenging behaviour training course. Journal of Intellectual Disabilities, Online First. doi: 10.1177/1744629518821789
• Flynn, S., Hastings, R. P., Gillespie, D., McNamara, R., & Randell, E. (2018). Is the amount of exposure to aggressive challenging behaviour related to staff work-related well-being in intellectual disability services? Evidence from a clustered research design. Research in Developmental Disabilities, 81, 155-161.

And we worked with the WCW trainers to write and publish a paper about their experiences co-producing and delivering the training:

Richards, L., Williams, B., Przybylak, P., & Flynn, S. (2018). The experiences of people with learning disabilities in co-produced challenging behaviour training. Learning Disability Practice, 21(4), 28-35.

An overview of the findings from this study has been published: 

Flynn, S., Hastings, R., McNamara, R., Gillespie, D., Randell, E., Richards, L. and Taylor, Z. (2019), "Who’s Challenging Who?: a co-produced approach for training staff in learning disability services about challenging behaviour", Tizard Learning Disability Review, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/TLDR-03-2019-0013