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The Regional Intellectual Disability Secure Service
The Regional Intellectual Disability Secure Service (RIDSS) in Wellington, New Zealand, provides secure care for people over the age of 17 with an intellectual disability, who have committed an imprisonable offence and present with challenging behaviour and safety concerns that cannot be managed in a mainstream prison. The service consists of an 11-bed medium-secure unit and two four-bedroom cottages designed to foster skills for independence and reintegration back into the community.
Why the need for an emotion regulation programme?
All clients at the RIDSS experience emotion regulation difficulties that typically manifest as challenging behaviours, such as interpersonal violence, self-harm and property destruction. Following aggressive incidents the clients encounter legal consequences, reduced self-esteem and feelings of powerlessness. Staff morale and job satisfaction is also adversely affected.
The idea of establishing an emotion regulation programme at the RIDSS was first discussed in 2007. At that time there was significant volatility on the medium-secure unit. Most clients required physical de-escalation during times of distress and only a small number were able to engage in individual psychological work.
The search for a solution: Professor William Lindsay and the 2007 ACSO Forensic Disabilities Conference
The authors attended Professor William Lindsay's workshop at the 2007 ACSO Forensic Disabilities Conference in Melbourne, Australia. In addition to teaching us about the content and process of an evidence-based anger management programme specifically designed for use with offenders with an intellectual disability ([1] Murphy et al. , 2007), Professor Lindsay gave us confidence that his programme could be implemented with extremely dysregulated clients as long as group members were able to adhere to the fundamental group rule of maintaining confidentiality.
Anxious beginnings: the implementation of the [1] Murphy et al. (2007) anger management programme
Although there was enthusiasm at the RIDSS for implementing the [1] Murphy et al. (2007) treatment programme, there was also a sense of trepidation amongst the staff team about how to manage the risk of having emotionally dysregulated people together in a group setting. In addition, the facilitating team (made up of a social worker, an occupational therapist, a registered nurse, and the authors) queried the clients' ability to maintain engagement and comprehend the seemingly difficult concepts discussed in the programme.
Despite our anxieties, four...