Who's Challenging Who? Unique training project showcased online
Research findings, an easy-to-read summary, a policy brief and series of video interviews with people with learning disability who co-created and delivered the Who's Challenging Who training project are published today by the University of Warwick's Centre for Educational Development, Appraisal and Research (CEDAR).
The Who's Challenging Who (WCW) training course is a half-day course for social care staff designed to improve staff attitudes towards people with learning disabilities who display behaviours that challenge. A two-year research project carried out by CEDAR and the Centre for Trials Research at Cardiff University with support from Mencap evaluated the impact of the course on care staff and on the people with learning disabilities who co-developed and co-delivered it.
The project team has compiled and published online a range of resources [LINK] to help communicate why the research was carried out, why it was important for the training to be co-created and co-delivered by people with learning disabilities, and what a large-scale trial discovered about the effectiveness of the training.
A key part of the package is a series of video interviews in which Ben and Phil, two of the trainers, talk about their experiences delivering the training course and what they felt they gained from being involved in the project.
Around one in six people with learning disability engage in behaviours that challenge which can include aggression, self-injury, and damage to property. In social and healthcare settings, the attitudes and actions of staff can make behaviours that challenge more likely, and can influence the quality of care a person receives. The WCW staff training course was designed in partnership with people with learning disability to address lack of staff empathy and negative attitudes.
Each training course was delivered by a person with learning disability whose behaviour had been labelled as 'challenging', facilitated by a person without an learning disability. In the half-day course, staff members heard directly from their trainer about their experiences and feelings on a range of issues including communication, problems in the living situation, medication, restraint and inclusion. Staff were also encouraged to imagine themselves in a range of typical situations, and to discuss what qualities contributed to good care and support. Two follow-up coaching calls also formed part of the intervention.
In a research first, a large-scale cluster randomised controlled trial (RCT) was carried out to evaluate the training. The trial was carried out by the University of Warwick's Centre for Educational Development, Appraisal and Research (CEDAR), and the Centre for Trials Research at Cardiff University, with support from Mencap, and funded by the NIHR School for Social Care Research.
Overall, the study found that the training achieved its goal of positively influencing staff attitudes.
Working in partnership with people with learning disabilities from the outset was one of the key successes of the project. Staff members benefitted from the experience of being trained by people with intellectual disability:-
"A lot of the course I suppose was telling us stuff that we already knew because we work with these adults on a daily basis anyway, but the fact of having it given from a person with a learning disability, from their point of view, that was interesting, that was an eye-opener."
Having a valued role for which they were paid a fair wage for their expertise was important for the trainers with intellectual disability. The trainers also were pleased to use their own lived experiences to advocate for other people:-
"If I've at least changed one person's life in the system for the better, then I've done my job. That's why I do training, for that satisfaction."
Professor Richard Hastings, Professor at CEDAR, commented, "We can now say with confidence that WCW has significant potential to contribute to the range of training staff are offered when working with individuals with behaviours that challenge. WCW is short, low cost to deliver, has some positive outcomes, receives positive evaluations from staff, and is led by people with learning disabilities."
Zac Taylor, Head of Practice Strategy and Design at Mencap, said: "Many people with learning disability experience a life where they are seen as people with little to contribute to the world they live in. The opportunity to have meaningful and paid employment is often limited and people are often treated as passive recipients of support. As a paid trainer with an agreed responsibility to deliver training this is changed—people are recognised as the skilled individuals they are, and are treated as active participants in their community, increasing their own sense of self-worth and offering the opportunity for people to know they have contributed towards something meaningful and worthwhile."
Elizabeth Randell et al. 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 (2017). DOI: 10.1186/s13063-017-2175-1
Who's Challenging Who? warwick.ac.uk/fac/soc/cedar/whoschallengingwho/