The whole is more A contextual perspective on attitudes and reactions of staff towards aggressive behaviour of clients with ID in residential institutions

Many staff members in care institutions experience aggressive incidents when working with Intellectual Disabilities (ID). In this dissertation the impact of aggressive incidents of clients with ID on staff behaviour and staff attitude is assessed, accounting for the influence of contextual factors, such as the team climate and the assistance external professionals provide.
Special attention is paid to the quality of training programs which have been developed to help staff to deal with aggressive behaviour of their clients with ID.
The findings reported in this dissertation underline the major importance of contextual factors (e.g., characteristics of the living group, team (team climate) and organization (organizational climate) related to staff and client behaviour.
For instance results of the first study reported that for staff using coercive measures, the context even accounted for 66% of the variance, whereas only 8% was explained by individual staff member characteristics. Negative attitudes towards aggression of the direct support team as a whole proved to be an especially strong explaining variable for the use of coercive measures by them.
Staff training programs targeting individual staff members’ behaviour were only moderately effective in changing staff behaviour, whereas no evidence was found for the effectiveness of these programs changing aggressive behaviour of clients with ID. It seems necessary to develop interventions which target not only the aggressive behaviour of the client with ID, but also focus on organizational aspects and on staff collaboration to meet the complex needs of clients with ID.