Beyond the Surface of Consumer-Staff Relationships

Individuals diagnosed with an intellectual disability (ID) demonstrate higher rates of challenging behaviors (CB) than do the general population [1-3]. The literature shows that environmental factors, including negative interactions with others, can contribute to CBs [4-6]. In their thematic analysis of 17 articles on the perspectives of consumers with CBs, Griffith, Hutchinson, and Hastings (2013) found that environmental factors such as “imbalances of power, “experiences of restrictive procedures†, and “impersonal attitudes of support staff†were “accumulative stressors of living in a residential placement†that potentially perpetuated CBs (p. 469). The authors described the “Cycle of Challenging Behaviors†(p. 482) where environments containing consumer-staff relationship imbalances potentially triggered individuals to engage in CBs, which lead to restrictive procedures; these interventions increased the individuals’ dissatisfaction, creating more power imbalances and cyclical patterns that elicited more CBs.