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People with learning disabilities and the interpersonal construction of self-determination

Brown, Philippa Hannah (2014) People with learning disabilities and the interpersonal construction of self-determination. D.Clin.Psychol thesis, University of Leeds.

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People with learning disabilities experience limited self-determination and have very little opportunity to take control and make choices affecting their own lives (Stancliffe and Wehmeyer, 1998). In recognition of this, government policy emphasises the importance of empowering people with learning disabilities to take more control and make choices that influence their own lives (DoH 2001, 2009). In order to meet the values set out in policy, the interactions between people with learning disabilities and the staff who support them is of particular importance. This study focuses on the interpersonal construction of self-determination between service users with learning disabilities and front line staff. Discourse analysis, informed by principles of discursive psychology, was used to examine naturalistic data from video recorded interactions. Secondary data was generated through the use of a recall session where staff and service users met separately with the researcher to watch the recording and comment on parts of the video they felt were important. The analysis revealed a number of actions present within the talk that served to facilitate or limit self-determination. Staff frequently occupied a position of power in influencing the available opportunities for self-determination. Actions used within the talk included but were not limited to: recruitment of parental view, colluding to enable choice, coaching, using constructions of competence and incompetence. Repertories of incompetence and competence, protection and independence were identified. Ideological dilemmas around protecting service users vs encouraging self-determination and autonomy were also found. The research is discussed in relation to the wider literature concerning empowerment and self-determination. The findings suggest that the policy goals of facilitating choice, control and enhancing service user’s self-determination are complex in practice and difficult for frontline staff to achieve. A number of clinical implications are identified including the use of video material as an effective training tool for interventions aimed at developing staff confidence and competence in empowering practices.

Item Type: Thesis (D.Clin.Psychol)
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds)
The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds)
Identification Number/EthosID: uk.bl.ethos.635386
Depositing User: Leeds CMS
Date Deposited: 11 Feb 2015 11:47
Last Modified: 25 Nov 2015 13:47
URI: http://etheses.whiterose.ac.uk/id/eprint/8055

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