Nienke Peters-Scheffer

(1) Background: Dog-assisted therapy (DAT) integrates dogs into therapeutic sessions to enhance participants’ physical, emotional, and social well-being. Despite its growing popularity, little is known about the interaction dynamics between the dog, participant, and therapist during sessions. (2) Methods: This study examined these dynamics, focusing on active participation, focus direction, joint focus, and physical contact. Video data from sessions 1, 5, and 9 of 10 individual therapy sessions with five participants were analysed using behavioural observations and an ethogram. (3) Results: Results indicated that therapists’ active participation increased over time while participants’ activity levels remained stable. Dogs were most active during the initial and final sessions. Participants’ focus on therapists remained consistent, but their focus on the dog stabilised after an initial decline. Dogs are primarily focused on their surroundings. The joint focus between participants and therapists increased, and physical contact with dogs varied significantly among participants and dogs. (4) Conclusions: The findings partially support the “icebreaker” theory, whereby dogs help establish initial rapport. However, the trend was not consistent across all participants. Therapist–dog interactions remained low and stable. Differences in dog characteristics (e.g., breed and fur type) and participant needs may explain variation in physical contact. These findings underline the complexity of DAT and highlight the need for further research into interaction patterns relate to participants and dog characteristics.

Adults with severe or moderate intellectual disabilities frequently experience traumatic events, placing them at higher risk for trauma-related disorders. Although these events also affect their relatives, their experiences have not been studied. Thematic analysis was conducted on interviews with eight first-degree relatives of adults with severe or moderate intellectual disabilities who had experienced traumatic events, as identified through a trauma interview. Four themes emerged: (1) the impact varied, with some relatives developing trauma-related symptoms; (2) characteristics of events in terms of severity and frequency, accompanied by feelings of helplessness, guilt, and inadequacy; (3) coping strategies, including social support, persevering and avoidance; and (4) the link between impact and long-term care for the client, potentially increasing relatives' susceptibility to complaints. Professionals must be aware of the effects of trauma on relatives of individuals with severe or moderate intellectual disabilities. Further research needs to explore differences among relatives.

A qualitative process evaluation was carried out to investigate implementation of Active Support in services for people with mild and moderate intellectual disability in the Netherlands, and to identify contextual factors that may contribute to variation in implementation, perceived effectiveness, and pathways to successful outcomes. Qualitative semi-structured interviews were conducted with stakeholders who were involved with the Active Support implementation. Interviews with practice leaders (n = 6), Active Support trainers (n = 4), direct support staff (n = 8), and residents with mild intellectual disabilities (n = 7) were analysed through a thematic analysis. Organisational and managerial preparation appeared to lead to positive Active Support training experiences, in turn leading to behavioural changes in staff, resulting in resident wellbeing. Practice leaders' coaching, staff collaboration, and additional staffing resources through volunteers and students facilitated implementation of Active Support. Identification of these factors enhances our understanding of the dynamic process of Active Support implementation in a Dutch context.

Objectives: Posttraumatic stress disorder (PTSD) in individuals with intellectual disabilities (ID) or borderline intellectual functioning (BIF) often remains underdiagnosed. This review updates Daveney et al.’s (2019) review of studies on screening and assessment instruments for PTSD in these individuals. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Results: This review covers eight studies in which a total of five PTSD instruments are investigated. Three studies focused on individuals with mild ID and/or BIF (Impact of Event Scale-Intellectual Disabilities and Diagnostic Interview Trauma and Stressors-Intellectual Disability), two on mild to moderate ID (Lancaster and Northgate Trauma Scales), and two on severe to moderate ID (Diagnostic Interview Trauma and Stressors—Severe Intellectual Disability). One study did not specify the severity of ID (International Trauma Questionnaire-Intellectual Disabilities). Most instruments focus primarily on identifying PTSD symptoms, while some also integrate the assessment of traumatic and/or stressful events. Conclusions: There is growing attention on PTSD assessment in individuals with ID or BIF. While most PTSD instruments have been developed for adults with mild to moderate ID or BIF, further research is needed to validate PTSD instruments in these populations. Additionally, research is needed on PTSD assessment in individuals with more severe levels of ID and in children with ID. Cross-cultural validation studies and larger sample sizes are required. Development of guidelines for PTSD screening and assessment in individuals with ID or BIF is recommended.

The social motivation hypothesis states that people with Autism Spectrum Condition (ASC) have a diminished social motivation, that is (1) less priority in attention for objects of social importance, (2) diminished social reward, and (3) less desire to maintain and strengthen relationships. Little is known about the perception of autistic people on their social motivation. This study used semi-structured interviews to explore how eleven autistic men perceived their social motivation, behaviour, and interactions. In the interpretative phenomenological analysis, five themes were identified: (1) social network, (2) importance of social contact, (3) challenges regarding social contact, (4) conditionality of social contact, and (5) the struggle between importance, challenges and conditionality of social contact. Social motivation appeared to be a dynamic concept that varied between individuals and contexts. Most participants struggled between valuing social contact as important and the challenges they faced on a social level over the different contexts in which they participated. Even though elements of the social motivation hypothesis were recognized, the main finding was that this struggle seemed to be the source of the diminished social motivation that was observed in some of these men. Although more research is needed, the findings of this study could imply that social motivation might not be as straightforward for autistic men as described in the social motivation hypothesis.

Forensic mental health professionals are frequently exposed to inpatient aggression, which may negatively affect their physical and mental health. Current studies offer limited insight into how this may affect staff-patient interactions in the aftermath of aggression. A qualitative study was conducted to explore professionals’ experiences with exposure to aggression. Thirteen semi-structured interviews and three focus groups were conducted with 25 professionals working in a high secure forensic mental health unit. A thematic analysis was conducted in consensus among three researchers. Five main themes were generated in the analysis: exposure to different forms of aggression, factors that shape the impact of aggression, emotional reactions, managing emotional reactions, and managing relationships with patients. These themes form a complex interplay. Feelings of anger and fear, intrusive memories, and avoidant or agitated behavior toward patients are frequently reported, affecting both the personal and professional lives of participants. Interpersonal relationships between team members can promote or hinder adequate management of feelings that arise after exposure to aggressive incidents. The tremendous impact that exposure to inpatient aggression may have on professionals, and the way that they care for their patients requires more attention.

Background: The group climate within residential youth care institutions is considered a transactional process, both within a group of youth from various cultural backgrounds and between them and their group workers. The ongoing interaction between the cultural characteristics of these girls may influence the quality of the group climate. This study aimed to provide an in-depth account of the living group climate experiences and perceptions of Dutch girls with a Moroccan cultural background in Dutch residential groups. Method: Interpretative phenomenological analysis was employed to explore the girls’ group climate experiences. Result: Three major themes emerged, namely (a) level of involvement of Moroccan girls in their living group, (b) perceptions of Moroccan girls’ sense of belonging in a living group, and (c) cultural and religious equality or disparity results in two interaction patterns. The findings revealed that equality or disparity in language, culture, and religion affect Moroccan girls’ experiences and perceptions of the living group climate. A crucial finding was that cultural and religious disparity leads to interaction patterns wherein the girls pre-emptively exclude themselves from receiving support from native group workers. Conclusion: Professionals must be aware of the cultural and religious dynamics, including the interplay and impact of cultural and religious equality and disparity, influencing Moroccan girls’ group climate experiences.

(1) Background: Dog-assisted therapy (DAT) is an experiential intervention to promote psychological, physical, and social functioning in children and adults. Only few studies have been conducted on DAT in adults with a mild intellectual disability or borderline intellectual functioning (MID-BIF). The purpose of this study was to explore the experiences of patients with MID-BIF undergoing DAT in a mental health care facility. (2) Method: Seven patients completed 13 to 15 sessions of DAT. Within two weeks of completing the program, they were interviewed using a semi-structured interview. The transcripts of the interviews were analysed using interpretational phenomenological analysis. In addition, the patients’ relatives and the DAT therapist were interviewed, and a focus group discussion took place with each patient’s treatment team. (3) Results: The patients’ experiences were predominantly positive. Physical contact with the dog calmed them down. The dog offered them emotional support and helped them to make contact inside and outside the therapy and the setting where they lived. The patients also liked the fact that DAT focused on the dog rather than their problems, that the therapy was experiential and using a positive approach, and that, during the therapy, they did not feel like a patient but a human being. DAT is a promising therapy for patients with MID-BIF in mental health care facilities, but more research into its effectiveness and cost-effectiveness and ways to implement DAT in clinical practice is needed to make more definitive statements.