Children with Learning Disabilities and Challenging Behaviour: Relationship between Parents and Professionals

This multi-perspectival Interpretive Phenomenological Analysis (IPA) study explored how people in the ‘networks of concern’ talked about how they tried to make sense of the challenging behaviours of four children with severe learning disabilities. The study also aimed to explore what affected relationships between people. The study focussed on 4 children through interviewing their mothers, their teachers and the Camhs Learning Disability team members who were working with them. Two fathers also joined part of the interviews. All interviews were conducted separately using a semi-structured approach. IPA allowed both a consideration of the participant’s lived experiences and ‘objects of concern’ and a deconstruction of the multiple contexts of people’s lives, with a particular focus on disability. The analysis rendered five themes: the importance of love and affection, the difficulties, and the differences of living with a challenging child, the importance of being able to make sense of the challenges and the value of good relationships between people. Findings were interpreted through the lens of CMM (Coordinated Management of Meaning), which facilitated a systemic deconstruction and reconstruction of the findings. The research found that making sense of the challenges was a key concern for parents. Sharing meanings were important for people’s relationships with each other, including employing diagnostic and behavioural narratives. The importance of context is also highlighted including a consideration of how societal views of disability have an influence on people in the ‘network of concern’ around the child. A range of systemic approaches, methods and techniques are suggested as one way of improving services to these children and their families. It is suggested that adopting a ‘both/and’ position is important in such work - both applying evidence based approaches and being alert to and exploring the different ways people try and make sense of the children’s challenges. Implications for practice included helping professionals be alert to their constructions and professional narratives, slowing the pace with families, staying close to the concerns of families and addressing network issues.

Medicated bodies: Mental distress, social media and affect

Social media are increasingly being recruited into care practices in mental health. This paper analyses how a major new mental health social media site (www.elefriends.org.uk) is used when trying to manage the impact of psychiatric medication on the body. Drawing on Henri Bergson's concept of affection, analysis shows that Elefriends is used at particular moments of reconfiguration (e.g. change in dosage and/or medication), periods of self-experimentation (when people tailor their regimen by altering prescriptions or ceasing medication) and when dealing with a present bodily concern (showing how members have a direct, immediate relationship with the site). In addition, analysis illustrates how users face having to structure their communication to try to avoid 'triggering' distress in others. The paper concludes by pointing to the need to focus on the multiple emerging relationships between bodies and social media in mental health due to the ways the latter are becoming increasingly prominent technologies through which to experience the body when distressed.