Reducing Challenging Behaviors in Intellectually Disabled Individuals: A Comparison of Organizational Culture and Treatment Approach
Abstract
The deinstitutionalization of the intellectually disabled (ID) and their transition to community living in New York State necessitated training initiatives for staff to manage challenging behaviors safely and humanely. However, the use of physical interventions to control self-injury and physical aggression may have become organizationally habituated, and limited research has compared programs that use physical versus nonphysical interventions. This mixed-method, comparative case study compared a restraint-free day habilitation program with one that used physical interventions, examining the differences in reducing self-injury, aggression, and types of interventions applied. Qualitative differences in philosophical approach to behavior intervention strategies and staff training protocols were examined using semi-structured interviews with employees (n ¬=11). Insufficient sample size precluded inferential analyses, but descriptively the results revealed more incidents of physical assault and self-injury in the program that used physical interventions. Further, behaviors ceased without intervention more frequently than they did in the restraint-free program. Qualitative results revealed shared qualities of person-centered organizational culture across both programs. These results suggest that an organizational culture that incorporates training and staff support in the use of restraint-free strategies may influence the type and frequency of challenging behaviors in this population. This study promotes positive social change by providing information that the Office of Persons with Developmental Disabilities can use to inform the development of ID-serving agency policies and staff training protocols to promote safety, respect, and well-being in ID persons who access community learning services.
