{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T20:56:41Z","timestamp":1778360201020,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PB-PG-0817-20010"],"award-info":[{"award-number":["PB-PG-0817-20010"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>People with intellectual disabilities (PwID) are at a higher risk of developing challenging behaviours (CB). Despite the poor evidence for the effectiveness of medications in managing CB, they are used widely among PwID (50\u201363%). The aims of our study were to develop a training programme, SPECTROM for support staff to help reduce overmedication in PwID and carry out field testing of SPECTROM including a process evaluation. We developed SPECTROM using the Experience-based co-design method that included four focus groups and a one-day co-design event. Twenty trainees received SPECTROM training. We used the Management of Aggression and Violence Attitudes Scale-Revised-Intellectual Disabilities (MAVAS-R-ID) and the Psychotropic knowledge questionnaire. A semi-structured interview and a feasibility questionnaire were used for process evaluation. SPECTROM website contains 14 modules, resources, and face-to-face training. MAVAS-R-ID scores showed change in staff attitude to \u2018medication management\u2019 domain was statistically significant (p &lt; 0.05). Psychotropic knowledge questionnaire showed statistically significant post-training improvement in correct responses (p &lt; 0.05). Process evaluation data showed that SPECTROM was acceptable, applicable, practical, and relevant to staff practice, and helped to improve self-reflection, knowledge, and support to PwID. SPECTROM is a useful training that helps to change the support staff\u2019s attitude toward CB and improve their knowledge of psychotropic medications.<\/jats:p>","DOI":"10.3390\/ijerph182413161","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T09:34:25Z","timestamp":1639474465000},"page":"13161","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Short-Term Psycho-Education for Caregivers to Reduce Overmedication of People with Intellectual Disabilities (SPECTROM): Development and Field Testing"],"prefix":"10.3390","volume":"18","author":[{"given":"Shoumitro (Shoumi)","family":"Deb","sequence":"first","affiliation":[{"name":"Department of Brain Sciences, Faculty of Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-0640","authenticated-orcid":false,"given":"Bharati","family":"Limbu","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Faculty of Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Unwin","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Woodcock","sequence":"additional","affiliation":[{"name":"AT-Autism, 20-22 Wenlock Rd, Hoxton, London N1 7GU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivien","family":"Cooper","sequence":"additional","affiliation":[{"name":"The Challenging Behaviour Foundation, The Old Courthouse, New Rd Ave, Chatham ME4 6BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Fullerton","sequence":"additional","affiliation":[{"name":"Achieve Together, Q4, First Floor, The Square, Randalls Way, Leatherhead KT22 7TW, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1097\/NMD.0b013e318183f85c","article-title":"Prevalence of, and Factors Associated With, Problem Behaviors in Adults With Intellectual Disabilities","volume":"196","author":"Jones","year":"2008","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1046\/j.1365-2788.2001.00373.x","article-title":"Mental disorder in adults with intellectual disability. 2: The rate of behaviour disorders among a community-based population aged between 16 and 64 years","volume":"45","author":"Deb","year":"2001","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Singh, N.N. (2016). Aggression. Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities, Evidence-Based Practices in Behavioral Health, Springer International Publishing.","DOI":"10.1007\/978-3-319-26583-4"},{"key":"ref_4","unstructured":"Fletcher, R., Barnhill, J., and Cooper, S.-A. (2016). Disruptive, impulse-control, and conduct disorders. Diagnostic Manual\u2014Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability, NADD Press. [2nd ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1111\/jar.12635","article-title":"A structured programme to withdraw antipsychotics among adults with intellectual disabilities: The Cornwall experience","volume":"32","author":"Shankar","year":"2019","journal-title":"J. Appl. Res. Intellect. Disabil."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Singh, N.N. (2016). Psychopharmacology. Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities, Evidence-Based Practices in Behavioral Health, Springer International Publishing.","DOI":"10.1007\/978-3-319-26583-4"},{"key":"ref_7","unstructured":"Baker, P., and Osgood, T. (2019). Positive Behaviour Support. Understanding and Responding to Behaviour That Challenges in Intellectual Disabilities, Pavilion Publishing and Media Limited. [2nd ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/jir.12736","article-title":"Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis","volume":"64","author":"Bruinsma","year":"2020","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"h4326","DOI":"10.1136\/bmj.h4326","article-title":"Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study","volume":"351","author":"Sheehan","year":"2015","journal-title":"BMJ"},{"key":"ref_10","unstructured":"The National Institute for Health and Care Excellence (NICE) (2021, April 08). Challenging Behaviour and Learning Disabilities: Prevention and Interventions for People with Learning Disabilities Whose Behaviour Challenges. Available online: https:\/\/www.nice.org.uk\/guidance\/ng11."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/j.2051-5545.2009.tb00248.x","article-title":"International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities","volume":"8","author":"Deb","year":"2009","journal-title":"World Psychiatry"},{"key":"ref_12","unstructured":"Glover, G., Williams, R., Branford, D., Avery, R., Chauhan, U., Hoghton, M., and Bernard, S. (2015). Prescribing of Psychotropic Drugs to People with Learning Disabilities and\/or Autism by General Practitioners in England, Technical Report."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1108\/AMHID-02-2018-0004","article-title":"Stopping over-medication of people with intellectual disability, Autism or both (STOMP) in England part 1\u2014History and background of STOMP","volume":"13","author":"Branford","year":"2019","journal-title":"Adv. Ment. Health Intellect. Disabil."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Richter, T., Meyer, G., M\u00f6hler, R., and K\u00f6pke, S. (2012). Psychosocial interventions for reducing antipsychotic medication in care home residents. Cochrane Database Syst. Rev., 2012.","DOI":"10.1002\/14651858.CD008634.pub2"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1186\/s12888-020-02973-7","article-title":"The effectiveness of parent training for children with autism spectrum disorder: A systematic review and meta-analyses","volume":"20","author":"Deb","year":"2020","journal-title":"BMC Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Matson, L.J. (2019). Staff training and supervision. Handbook of Intellectual Disabilities: Integrating Theory, Research and Practice, Springer.","DOI":"10.1007\/978-3-030-20843-1"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e037912","DOI":"10.1136\/bmjopen-2020-037912","article-title":"Short-term PsychoEducation for Carers To Reduce Over Medication of people with intellectual disabilities (SPECTROM): Study protocol","volume":"10","author":"Deb","year":"2020","journal-title":"BMJ Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/acprof:oso\/9780199563623.003.012","article-title":"Developing and evaluating complex interventions: An introduction to the new Medical Research Council guidance","volume":"337","author":"Craig","year":"2009","journal-title":"Evid.-Base Public Health"},{"key":"ref_19","unstructured":"Donetto, S., Tsianakas, V., and Robert, G. (2014). Using Experience-Based Co-Design (EBCD) to Improve the Quality of Healthcare: Mapping Where We Are Now and Establishing Future Direction, Kings College London."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Harper, D., and Thompson, A.R. (2011). Thematic analysis. Qualitative Methods in Mental Health and Psychotherapy: A Guide for Students and Practitioners, John Wiley & Sons.","DOI":"10.1002\/9781119973249"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jar.12357","article-title":"Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with intellectual disabilities","volume":"30","year":"2017","journal-title":"J. Appl. Res. Intellect. Disabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1046\/j.1365-2850.2002.00497.x","article-title":"An evaluation of staff and patient views of and strategies employed to manage inpatient aggression and violence on one mental health unit: A pluralistic design","volume":"9","author":"Duxbury","year":"2002","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Limbu, B., Unwin, G., and Deb, S. (2021). Comprehensive Assessment of Triggers for Behaviours of Concern Scale (CATS): Initial Development. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182010674"},{"key":"ref_24","unstructured":"Deb, S., and Roberts, K. (2005). The Evidence Base for the Management of Imminent Violence in Learning Disability Settings, The Royal College of Psychiatrists. Occasional Paper."},{"key":"ref_25","unstructured":"Skills for Care, Skills for Health (2021, July 23). Arranging and Paying for Training in Positive Behavioural Support. Available online: https:\/\/www.skillsforcare.org.uk\/Documents\/Topics\/PBS\/Guide-to-arranging-and-paying-for-PBS-training.pdf."},{"key":"ref_26","unstructured":"PBS Academy (2021, July 23). Positive Behavioural Support Competence Framework. Available online: http:\/\/pbsacademy.org.uk\/pbs-competence-framework\/."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/13161\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:47:18Z","timestamp":1760168838000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/13161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,14]]},"references-count":26,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182413161"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182413161","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,14]]}}}