DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

A triangular pattern of protection against distress, between practitioners, parents and the
person with learning disability is common (Goldberg et al, 1995; Pote, King and Clegg,
2004). Pote (2004) used an interpretative phenomenological approach to analyse seven
interviews with professionals working with individuals with learning disability. These
interviews highlighted the tensions that the protection triangle can create such as feelings
of anger from the protector if they feel that their protection is not effective which can lead
to blaming the protected individual or others in the system. These tensions may then
make it hard for the professional to work systemically, maintaining a curious and nonblaming
attitude towards all the system members, when their priority is to give the client
a voice.
Pote suggested the “problem-determined” system as a systemic idea that may be helpful
in addressing the ‘alignment’ dilemma described. This involves developing a clear
understanding of the relationship each system member has to each of the others, to the
presenting problems and to the practitioner themselves as well as to how they each affect
the system and how they are organised by it. Furthermore, developing a “decisional
subsystem” and sharing systemic ideas and formulations within the system has also been
suggested (Bloomfield, Nielson and Kaplan, 1984). The use of systemic models of
consultation may also be useful to help practitioners remain neutral within the system i.e.
by understanding that organisational change and new ideas are interpreted according to
the system’s and the individual member’s existing beliefs and assumptions and
developing the connections between these belief sets (Campbell, 1995).
Approaches such as narrative therapy developed by White and Epston (1990), are based
on an analysis of power and its effects on people’s lives. Drawing out new narratives is
key to the therapy. Language is however privileged and narrative therapy excludes those
without advanced language skills from participating fully in shaping constructions which
may disempower these individuals further. Attempts can be made to use simplified
language or other expressive mediums such as drawings or role-plays to enable the use of
this approach with those without developed language skills.
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