The Emotional Landscape of Working in a Learning Disability Service

Abstract

Aims: The UK policy documents ‘Valuing people’ (DOH, 2001) and ‘Valuing people now’ (DOH, 2009) presaged a new direction in learning disability services: towards a human-rights model of care with the underlying principles of rights, choice, inclusion, freedom and independence. However, despite such legislative changes, a recent review (DOH, 2008a) candidly described that people with learning disabilities have greater need for healthcare than other people, yet have worse access to the care that they actually need and poorer health outcomes. Whilst some research has explored this from the perspective of people with learning disability (Jones & Donati, 2009; Jones & Parry, 2008) there is significantly less from the perspective of support workers. This research seeks to examine the emotional and psychological experience of support workers in learning disability services. Although research has explored the experience of support workers from the perspectives of ‘stress’ and ‘burnout’, there is a dearth of research in areas such as emotions, sense-making, their constructing of systems, relationships and their underlying motivations. Method: Semi-structured interviews were carried out with seven support workers from three learning disability care homes. Verbatim transcripts of interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced two superordinate themes, both with two main themes. The superordinate theme ‘Emotional Motivation’ had the main themes ‘Personal Fulfilment and motivation’ and ‘The Emotional Struggle’. The superordinate theme ‘Demands and Coping’ had the main themes ‘Safety and Conflict within Coping’ and ‘Persecution and Protective Positions’. Implications: This research suggests that the support worker role may evoke strong feelings of pleasure but also powerlessness, blame, deficit, injustice, responsibility and anger. Support workers seem to manage these emotions in various ways: such as compensating by striving to be the ‘ideal’ carer, protecting themselves by avoiding and not elaborating on difficulties, and also projecting their difficulties onto others. Problematically, this may reinforce a work culture in which no individual actually takes responsibility for the ongoing difficulties, conflict and struggles. Thus, political and legislative changes may be negated or ineffective unless addressed within the context of this dynamic; namely, the value, emotional and meaning systems within services, i.e. the nature of the relationship between the support worker and resident. Indeed, paid staff are often the only meaningful relationship that people with learning disability have in their lives. Such findings are discussed in light of existing theory, research and practice.