Disability and support relationships: What role does policy play?

Abstract

Very little is known about how relationships between people with disabilities and their paid support workers are positioned in policy. With the policy shift toward choice of provider, individualised approaches, person centredness and self‐directed funding, the nature of their relationship assumes a more prominent role in the quality of support practice. The policy analysis in this article explores the extent to which current disability policy acknowledges, promotes, or diminishes the relationships between people with disabilities and workers, in their organisational context. It uses Honneth's conditions for recognition—love (cared for), rights (respected) and solidarity or social esteem (valued)—to understand how policy positions mutuality in the relationship. The policy review applied a three‐stage process: categorisation of policies, textual analysis and content analysis to policy documents at four levels—international, Australian federal, state and organisational in two case studies. The analysis revealed that while a rights framework is explicit in most policies, the emphases on the conditions for recognition within a relationship between people with disabilities and workers are compromised in instructional policies that attempt to manage the tension between choice and risk, particularly at the organisational level.

Impact of organisational practices on the relationships between young people with disabilities and paid social support workers

“…In contrast, direct funding or self-management, is more likely to have a starting advantage with the direct control of the organisational mediators by the person and their social supports. Both direct funding and organisations with employees will continue to be organisationally mediated by the macro-level policy context (Fisher, Gendera, Graham, Johnson, Robinson, & Neale, 2019). These national policies must also then seek to remove constraints and facilitate the conditions for recognition between people receiving and providing support.…”

Understanding paid support relationships: possibilities for mutual recognition between young people with disability and their support workers

“…Institutionally mediated constraints have been recognised as organisational rules denying emotionally rewarding authentic engagement with clients (Fisher and Byrne 2012), and system-and structural-level abuse ( Fisher et al 2018;Robinson 2015). Interpersonal relationships are built on unequal groundaspirations of people with disability are mediated by support workers; access to resources is determined outside the interpersonal relationship; and when the pair need to negotiate tensions, young people are reliant on the quality of the support for successful resolution.…”

Using the ‘in-between’ to build quality in support relationships with people with cognitive disability: the significance of liminal spaces and time

“…The personalisation of social support for people with disability is an international trend (Malbon et al, 2019). Personalisation is altering how, where and with whom support is received, in a diverse landscape of people -personal assistants, support workers, advocates and family members -and places -independent and supported living, voluntary organisations, community sites, and workplaces (Fisher et al, 2018;Laragy et al, 2015). Responsibility is increasingly handed to people with disability (and in many cases, to families and voluntary organisations), to make choices about what support is received and to control how it is accessed and paid for (Hall., 2011;Hamilton et al, 2017).…”