Jade Scott, Stephen Weatherhead and Jill Manthorpe
Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of…
Abstract
Purpose
Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI).
Design/methodology/approach
A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed.
Findings
Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted.
Research limitations/implications
The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system.
Originality/value
To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.
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Jade Scott, Stephen Weatherhead, Gavin Daker-White, Jill Manthorpe and Marsha Mawson
The Mental Capacity Act (MCA, 2005) provided a new legal framework for decision-making practice in England and Wales. This study aims to explore qualitative research on…
Abstract
Purpose
The Mental Capacity Act (MCA, 2005) provided a new legal framework for decision-making practice in England and Wales. This study aims to explore qualitative research on practitioners’ knowledge and experiences of the MCA in health and social care settings to inform practice and policy.
Design/methodology/approach
Four electronic databases and Google Scholar were searched in November 2019 for peer-reviewed, qualitative, English language studies exploring practitioners’ experiences and knowledge of the MCA in health and social care settings. Nine studies were included and appraised for methodological quality. Data were analysed using thematic synthesis.
Findings
Data revealed both positive aspects and challenges of applying the MCA in practice within five main themes, namely, travelling the “grey line”, the empowering nature of the MCA, doing the assessment justice, behaviours and emotional impact and knowledge gaps and confidence.
Practical implications
The fundamental principles of the MCA appear to be adhered to and embedded in practice. However, practitioners find mental capacity work remains challenging in its uncertainties. While calling for more training, they may also benefit from further MCA skills development and support to increase confidence and reduce apprehension.
Originality/value
This is the first systematic review to synthesise qualitative literature on practitioners’ experiences and knowledge of the MCA. Findings offer insight into practice experiences of the MCA and provide a basis for the development of training and supervisory support.
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Cynthia Courtois, Maude Plante and Pier-Luc Lajoie
This study aims to better understand how academics-in-the-making construe doctoral performance and the impacts of this construal on their positioning in relation to doctoral…
Abstract
Purpose
This study aims to better understand how academics-in-the-making construe doctoral performance and the impacts of this construal on their positioning in relation to doctoral performance expectations.
Design/methodology/approach
This study is based on 25 semi-structured interviews with PhD students from Canadian, Dutch, Scottish and Australian business schools.
Findings
Based on Decoteau’s (2016) concept of reflexive habitus, this study highlights how doctoral students’ construal is influenced by their previous experiences and by expectations from other adjacent fields in which they simultaneously gravitate. This leads them to adopt a position oscillating between resistance and compliance in relation to their understanding of doctoral performance expectations promoted in the academic field.
Research limitations/implications
The concept of reflexivity, as understood by Decoteau (2016), is found to be pivotal when an individual integrates into a new field.
Practical implications
This study encourages business schools to review expectations regarding doctoral performance. These expectations should be clear, but they should also leave room for PhD students to preserve their academic aspirations.
Originality/value
It is beneficial to empirically clarify the influence of performance expectations in academia on the reflexivity of PhD students, as the majority of studies exploring this topic mainly leverage auto-ethnographic data.
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Andy Cook and Julie Payne
The purpose of this paper is to describe family intervention (FI) with four families in which the service user is under the care of forensic mental health services. There is a…
Abstract
Purpose
The purpose of this paper is to describe family intervention (FI) with four families in which the service user is under the care of forensic mental health services. There is a focus on identifying how systemic practice is used or adapted in working with families who have a family member who has presented risk and caused harm.
Design/methodology/approach
Four case studies are used to provide a basis for the exploration of commonalities in practice between the cases and the utility of FI within forensic services, which have the dual purpose of promoting mental health recovery and reducing offending/risk behaviour.
Findings
Family work can be a key healing tool in the recovery journey of forensic service users and their families. An integrated systemic and psycho-educational FI approach was found to be appropriate in the cases described. Issues particular to forensic services are identified; these include the role of safety planning; the function of talking about the history of trauma in the family including the impact of offending behaviour; mediating difficult relationships between family members and professionals; and overcoming barriers to having difficult and emotive conversations.
Research limitations/implications
The absence of outcome assessments limits the findings to observational data and self-reported experiences from the authors.
Practical implications
FI can be safely and effectively used within forensic settings, facilitated by practitioners competent in working with trauma and complexity, as an integrated component of the therapeutic treatment.
Originality/value
There are recognised barriers to the provision of FI within forensic settings, with limited research regarding the application of such therapies with forensic patients and their families. This paper adds to the small pool of knowledge regarding useful applications of FI in such settings.
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“All things are in a constant state of change”, said Heraclitus of Ephesus. The waters if a river are for ever changing yet the river endures. Every particle of matter is in…
Abstract
“All things are in a constant state of change”, said Heraclitus of Ephesus. The waters if a river are for ever changing yet the river endures. Every particle of matter is in continual movement. All death is birth in a new form, all birth the death of the previous form. The seasons come and go. The myth of our own John Barleycorn, buried in the ground, yet resurrected in the Spring, has close parallels with the fertility rites of Greece and the Near East such as those of Hyacinthas, Hylas, Adonis and Dionysus, of Osiris the Egyptian deity, and Mondamin the Red Indian maize‐god. Indeed, the ritual and myth of Attis, born of a virgin, killed and resurrected on the third day, undoubtedly had a strong influence on Christianity.
Erin Jade Twyford, Farzana Aman Tanima and Sendirella George
In this paper, the authors explore racialisation through human-centric counter-accounts (counter-stories) to bring together critical race theory (CRT) and counter-accounting.
Abstract
Purpose
In this paper, the authors explore racialisation through human-centric counter-accounts (counter-stories) to bring together critical race theory (CRT) and counter-accounting.
Design/methodology/approach
The authors utilise CRT to demonstrate the emancipatory role of counter-stories in (re)telling racialized narratives, specifically the narrative of asylum seekers who arrive by sea and are subjected to the inhumane and oppressive nature of the Australian government's policy of offshore immigration detention.
Findings
Counter-stories, as tools of accountability, can make visible oppressive forces and the hidden practices of racialized social practices and norms.
Research limitations/implications
This paper emphasises that we are not in a post-racial world, and racialisation remains a fundamental challenge. We must continue to refute race as an ontological truth and strive to provide a platform for counter-stories that can spark or drive social change. This requires allies, including academics, to give that platform, support their plight, and offer avenues for change.
Originality/value
The authors introduce CRT as a theoretical tool for examining racialisation, opening space for a more critical confluence of accounting and race with potentially wide-reaching implications for our discipline. The paper also contributes to the limited accounting literature concerning asylum seekers, particularly in the use of counter-stories that offer a way of refuting, or challenging, the majoritarian/dominant narratives around asylum-seeking.