Partnership with social care professionals as a context for promoting self-determination among people with intellectual disabilities

Abstract

Background: People with intellectual disabilities who live in residential facilities may need social support to express self determination. Relationships with social care professionals provide an important context for promoting self-determination. Adopting a socioecological perspective, our study aimed to better understand the nature of these relationships. Method: Over a period of ten months, we held 13 focus group discussions with a total of 20 participants, including both residents and staff at facilities for people with intellectual disabilities. Using transcripts of these discussions, we analysed expressions of self-determination among people with intellectual disabilities and the responses of social care professionals. Results: Our results highlight the importance of relational adjustment in fostering self-determination among people with intellectual disabilities and underline the importance of respective roles within relationships between people with intellectual disabilities and social care professionals. Conclusion:The partnership between people with intellectual disabilities and professionals seems to be the most effective type of relationship in order to support the self-determination of people with intellectual disabilities.This paper provides a fresh perspective on the role played by people with intellectual disabilities in their relationships with social care professionals. By engaging people with intellectual disabilities as partners in fostering self-determination, social care professionals can encourage social participation and feelings of empowerment. Relationships based on partnership offer people with intellectual disabilities a form of hetero-regulation that can help them overcome challenges to behaving in a fully self-determined way. However, partnership also requires changes in professional practices and attitudes.

Preparing adults with intellectual disabilities for their future: How do support services staff view their role?

“…Such an endeavour is likely to call for interventions that support the development of skills and propensities of individuals with intellectual disabilities to act in a self‐determined manner, skill development and attitudinal change of staff, and policy development that explicitly addresses issues such as duty of care and risk taking. There is evidence that explicit teaching of self‐determination can be effective, with concomitant positive outcomes (see Wehmeyer et al, 2017 for an overview) and that both formal (Wong & Wong, 2008) and informal (Cudré‐Mauroux et al, 2020) interventions can support staff to become more effective in supporting the self‐determination of their clients. There is little guidance in the empirical literature regarding the development of policy relevant to assisting staff to balance competing obligations with respect to self‐determination and safety.…”

Persevering professionals: dilemmas of relationships and self-determination in work with people with intellectual disability – a multi-method study based on interpersonal process recall

“…Research involving people with intellectual disability in the empirical material raises special ethical concerns related to information, sampling, and consent, and requires heightened awareness ( Cudré-Mauroux et al, 2020 ). The potential vulnerability and reduced cognitive abilities can also amplify the uneven power relations between researchers and participants ( van der Weele & Bredewold, 2021 ).…”

“…While previous studies on autonomy and self-determination for people with intellectual disability largely have focused on the perspective of parents and professionals, recent studies (e.g. Björnsdóttir et al, 2015 ; Chalachanová et al, 2021 ; Cudré-Mauroux et al, 2020 ; Dodevska & Vassos, 2013 ; Hutchinson & Sandvin, 2019 ; Kittelsaa, 2014 ; Nonnemacher & Bambara, 2011 ; Reisæter, 2021 ; Vaucher et al, 2019 ; Witsø & Hauger, 2020 ) have increasingly brought out voices of the people with intellectual disability. These studies confirm that good relationships with support staff can promote self-determination.…”

“…To know, trust and like the support staff creates a context for all supportive actions to follow. The quality of relationships is crucial ( Chalachanová et al, 2021 ; Cudré-Mauroux et al, 2020 ; Nonnemacher & Bambara, 2011 ), and professionals must be sensitive to the individual’s needs and wishes to create an atmosphere which encourages the communication of preferences and choices ( Björnsdóttir et al, 2015 ). This requires both professional skills and knowledge as well as interpersonal skills ( Dodevska & Vassos, 2013 ; Pallisera et al, 2018 ).…”

Study Protocol for a Randomized Controlled Trial Evaluating the Effectiveness of a Group-Based Self-Determination Enhancement Intervention for Adults with Mild Intellectual Disability and Their Caregivers

“…In Chinese collectivist culture, people may be more comfortable with demonstrating their self-determination competencies than their self-determination autonomy [32]. While recent studies conducted in Western countries have begun to stress autonomy support and partnership in decision-making from paid and unpaid caregivers [40][41][42], people with ID in Chinese societies have less autonomy in financial matters and over major life decisions [43].…”