Management of aggression care plans in a forensic intellectual disability service: a ten-year progress update

Abstract

Purpose – Standardised approaches to the management of aggression and violence are critical for all stakeholders of intellectual disability services. The purpose of this paper is to describe the Management of Aggression Care Plan (MoACP). The care plan aims to reduce levels of restrictive interventions, to ensure any interventions relative to aggression and violence are the least restrictive possible, and to promote adaptive behaviours and support life enriching opportunities, in a manner which is personalised to the unique profiles of every patient. Design/methodology/approach – The MoACP was first described by Thomas et al. (2005). This paper describes the rationale, theoretical basis, structure and benefits of the care plan, and provides details of revisions made to the plan in response to evidence-based practice recommendations. Findings – The value of implementing a structured approach to the care planning of management of aggression and violence, in reducing the frequency and impact of restrictive practices, and promoting life enriching opportunities is described. Practical implications – The paper describes a number of practical features of the care plan which most support its continued effectiveness, including patient involvement, individual patient focused training, and audit. Originality/value – Although many services undertake localised approaches to the care planning of management of violence and aggression in forensic intellectual disability services, few have been described in the published literature.