Beyond the Impasse Systemic Consultation and

Understanding Complex Cases

Systemic consultation provides an opportunity for clinicians working with complex cases and behaviours of concern to reflect on interpersonal dynamics that may be inhibiting change. This approach to case review is drawn from systemic family therapy, a model that is gaining some acceptance within the field of intellectual disability.

Systemic Hypothesising for Challenging Behaviour in Intellectual Disabilities A Reflecting Team Approach

The treatment of challenging behaviour in intellectual disabilities has evolved dramatically since the 1950s, from a reliance on psychopharmacological restraint and operant conditioning to a multifaceted support plan that recognises the communicative intent of the client alongside their need for meaningful community participation. In recent years there has also been an increasing recognition of the critical role of family relationships in the maintenance and amelioration of challenging behaviour, as well as in attempts to integrate the fields of family therapy and applied behaviour analysis. The aim of this article is to describe a model of tertiary consultation that draws on the skills of systemic family therapy to assist clinicians who might be struggling with responding to challenging behaviour in settings characterised by complex and ‘stuck’ mediation problems. This model applies principles of reflective practice to assist such clinicians to develop a sophisticated understanding of the nature of interactions and relationships in the client's life, a critical prerequisite to the application of behavioural intervention. A detailed description of the model and a case study will be provided.

Review of Psychiatry Clinics Serving People with Intellectual

Disability in NSW Australia

The most common mental illnesses in Australia are anxiety, affective and substance use disorders with low prevalence conditions including eating disorders and severe personality disorder. The economic cost of mental illness (psychiatric disorders) in the community is high. Outlays by governments and health insurers on mental health services totaled $5.32 billion in 2007-2008 representing 7.5% of all government health spending. An additional $4.63 billion was spent by the Australian Government in providing other support services for people with mental illness, including income support, housing assistance, community and domiciliary care, employment and training opportunities. This may not, however, be the entire mental health picture in Australia. There is a substantial group of people with intellectual disability (PWID) who for many reasons have poor access to mental health and psychiatric service

The sector makes steps towards ensuring the ethical conduct of research

For a while now, some of us in the disability sector have struggled with understanding the "rules of the game" for the ethical conduct of research. A hypothetical scenario highlights the range of potential challenges: Phoebe works part time at a respite service, and is studying for a Masters degree in disability. Most of the children accessing the respite are young children and teenagers. Phoebe wishes to interview a couple of the teens for a university assignment. She indicated to you, her manager, that she would perhaps include some background information from their files and because she has "known these people for ages" might include some other information but isn’t sure yet. Phoebe has asked you if this would be okay.