Survivors of truama: exploring staff experiences working in intellectual disability settings

Background: The experiences of staff working in settings of care for people with intellectual disability and trauma-related difficulties, such as personality disorder or complex post-traumatic stress disorder are not well represented in the literature. The clinical population can be complex to care for in terms of emotional and behavioural dysregulation and high risk, which can expose staff to stressful events. Despite the complexities and demands of the role, little is known in the literature about the experiences and needs of this group. A systematic review of the literature was conducted to shed light on staff experiences working in this complex field.

Method: A systematic literature review was conducted of three databases. Eight articles were included in the review, all of which employed qualitative methods, with one using quantitative elements also. The studies were assessed using quality appraisal tools and findings analysed using thematic synthesis.

Results: The overall quality of literature was strong. Seven themes emerged from the analysis, which were: 1) ‘Nobody liked her’; 2) ‘An involved kind of role’; 3) ‘They tie you up in knots’; 4) Controlled and uncontained; 5) ‘We just didn’t have a clue’; 6) Marginalised; and 7) ‘You don’t seem to move forwards’.

Discussion: Staff in this area appeared to be traumatised. High levels of distress and cynicism were evident, in addition to reports of working environments that were not conducive to occupational wellbeing or high-quality care. Implications for clinical practice and research are discussed.