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Thinking on your feet: understanding the immediate responses of staff to adults who challenge intellectual disability services.

BACKGROUND
A gap prevails between the conceptualization of good practice in challenging behaviour management and its implementation in intellectual disability services. This study aimed to investigate staff members' perspectives of managing clients with challenging behaviours in residential services.


MATERIALS AND METHODS
Semi-structured interviews were conducted with eleven staff in two services. Additionally, service documents on challenging behaviour management were examined in these services. A qualitative methodology was used to investigate staff members' immediate responses to clients' difficult behaviours and their decision-making processes.


RESULTS
The immediate responses of staff were conceptualized as the result of complex appraisals shaped by their service context involving the core processes of making the right choice and prioritizing the best interests of all involved.


CONCLUSIONS
Staff members' responses were understood as a dynamic and retroactive process, where their past and current challenging behaviour management experiences in the service influenced their responses to clients in the future.