Skip to main content

The PETAL Programme: What could reduce aggressive behaviour in adults with learning disabilities?

You are here

NIHR Shares insights from UCL study: Personalised Treatment Packages For Adults With Learning Disabilities Who Display Aggression in Community Settings (PETAL)

The National Institute for Health and Care Research (NIHR) has published highlights from the PETAL study led by researchers at University College London. The project reviewed 59 relevant studies to identify the effective elements of interventions to reduce aggressive challenging behaviour. The findings have been built into a personalised approach named PETAL Therapy, now being tested as part of a randomised controlled trial.

Aggressive or challenging behaviour is present in 7 - 10% of adults with learning disabilities, most common in those with more severe learning disabilities. It can reduce their quality of life, put them at risk of injuries and cause social exclusion. The evidence for what interventions work or are effective is not widely understood and the study has reviewed previous research to tackle this. 

The results of the study will help staff to promote a calm environment and support productive relationships between service users, therapists, carers and staff.

Rachel Royston, Study Author and Research Programme Manager, PETAL Programme, University College London, said:

“Aggressive challenging behaviour is one of the most common reasons for hospital admissions and the use of restrictive practices in people with learning disabilities. This work highlights the importance of understanding the individual needs of each person and the circumstances and context in which the behaviour may occur and how the therapy should be delivered.

We believe this review sheds light on the wide variation within the learning disability population and the elements of therapies that have supported the management of aggressive challenging behaviour in community settings in other population groups.

Often, medications are used to address challenging behaviours. However, there is limited evidence for their effectiveness and there is always a high risk of unwanted side-effects. There is a need for new therapies that are tailored to the person and their behaviour, and also considers the person’s support system and environment.”

Angela Hassiotis, Professor of Psychiatry of Intellectual Disability, University College London, is the Chief Investigator for the programme. The Petal Programme is working with Camden & Islington NHS Foundation Trust / North London Mental Health Partnership. Funding was part of a Programme Grants for Applied Research from the National Institute for Health and Care Research (NIHR).

The content of this article is from the NIHR Evidence page: What could reduce aggressive behaviour in adults with learning disabilities?

The original article was published in PLOSONE in May 2023: Complex interventions for aggressive challenging behaviour in adults with intellectual disability: A rapid realist review informed by multiple populations

The NHS has guidance on How to deal with challenging behaviour in adults

Further information on the programme, is available on the UCL dedicated site page: The PETAL Programme

Information on the NIHR grant: NIHR200120



Photo by George Liapis on Unsplash