Feasibility study of Critical Incident Stress Management (CISM) to support staff in learning disability adult social services

Peter Baker In progress  


Staff who work with people with learning disabilities (LD) who present with behaviours that challenge are at risk of experiencing stress and trauma related to their work. Being stressed can have a direct impact on the quality of care staff can provide. Research has indicated that staff who feel more supported are better equipped to deal with the emotional impact that behaviours that challenge has on them.

In learning disability services approaches that work with the whole care system around a person are often recommended to facilitate positive interactions between support staff and people with LD and to promote wellbeing. To ensure sustained and effective support for care staff within organisations, thinking about the whole care system is also likely to be important. A recent systematic review, however, found no current literature on systems wide wellbeing support models for staff working in LD services; some evidence was found for some narrower stress support interventions such as training staff in mindfulness skills. Looking beyond the LD field to identify system wide strategies that may offer a solution for supporting staff experiencing stress and trauma associated with behaviours that challenge.

Critical incident stress management (CISM) is a model designed to enable organisations to support their staff in dealing with potentially impactful incidents. It includes proactive elements designed to ensure resilience, and reactive elements to provide support after the incidents have occurred. CISM has been widely used in non-LD contexts (e.g., emergency services and the military) with only a limited evidence in LD services.


This study aims to adapt CISM as a service wide intervention specifically for adult social care staff working with people with LD who present with behaviours that challenge, and explore the feasibility of implementing and evaluating CISM’s effectiveness and cost effectiveness.


This study involves:

  • developing an adapted version of CISM for adult social care staff who work with people with LD who present behaviours that challenge with the assistance of key adult social care stakeholders and experts in the field of LD challenging behaviour & organisational trauma
  • piloting the implementation of the adapted CISM support model with the assistance of two adult social care independent providers to identify four service units with high reported incidents of impactful behaviours that challenge. The pilot will explore the feasibility of implementation along with gathering outcome data and initial cost information.