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An Interpretative Phenomenological Analysis of the experiences of fairness amongst adults with learning disabilities when engaging with services responding to domestic violence and abuse.

Authors:

Abstract

Women with learning disabilities experience a range of disadvantages across the life course including; social isolation and marginalisation, increased risk of experiencing severe, frequent, and repeated incidents of domestic violence and abuse (DVA), the normalisation of violence and abuse throughout the life course, inquiries into their abilities as mothers, and barriers to accessing effective support services. These experiences impact upon their conceptualisations and experiences of fairness and unfairness. Seven participants were recruited via two services that specifically support people with learning disabilities who have experienced DVA. Each participant took part in a semi structured interview which explored their understandings and experiences of fairness and unfairness in relation to their engagement with support services responding to DVA. Within the context of this research DVA services are defined as any public or private service a person is engaged with in response to experiencing DVA, including but not limited to, the police, adult social services, children’s social services, DVA programs, mental health practitioners, housing officers, and community groups etc. Interpretative phenomenological analysis revealed the complexity of their experiences, with participants reporting what it means to be treated fairly and unfairly when engaging with DVA services, the importance of relationships in making sense of fairness and unfairness, the lack of accessible preventative services, the impact of ableist attitudes on their engagement with DVA services, institutional barriers to accessing DVA services, and the adverse consequences of unfair experiences of interventions from DVA services. To examine the relationship between fairness and unfairness, people with learning disabilities, and DVA services, it was important to explore how fairness and unfairness can be defined and experienced. This thesis presents an experiential definition of fairness and unfairness rooted in the narratives of the participants. Their definitions posit fairness as treating everybody with the same dignity, respect, and common humanity whilst ensuring that the aid required to make choices, undertake day to day tasks, and pursue goals and ambitions is provided without discrimination. Their definition of unfairness was conceptualised as discriminatory treatment within relationships of unequal power which operate to maintain the unequal structure of aid. Unfairness can be experienced as vivid emotional responses to discrimination linked to the unequal structure of aid, this is often linked to experiences of discrimination throughout the life course. The thesis culminates in the development of Fairness Informed Practice (FIP). Drawing upon relationship-based approaches, trauma informed care, anti-discriminatory practice, and reflexive practice, FIP seeks to offer a practice framework, developed through the interpretation of the participants narratives, that seeks fair and equitable access and outcomes from DVA services. The thesis advocates for an increased awareness of DVA and people with learning disabilities and the adoption of Fairness Informed Practice within DVA interventions with people with learning disabilities.
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Author:
Hutchison, Gavin
Title:
An Interpretative Phenomenological Analysis of the experiences of fairness amongst
adults with learning disabilities when engaging with services responding to domestic
violence and abuse.
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Author:
Hutchison, Gavin
Title:
An Interpretative Phenomenological Analysis of the experiences of fairness amongst
adults with learning disabilities when engaging with services responding to domestic
violence and abuse.
General rights
Access to the thesis is subject to the Creative Commons Attribution - NonCommercial-No Derivatives 4.0 International Public License. A
copy of this may be found at https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode This license sets out your rights and the
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An Interpretative Phenomenological Analysis of the experiences of
fairness amongst adults with learning disabilities when engaging
with services responding to domestic violence and abuse.
Gavin Hutchison
School for Policy Studies
University of Bristol
A dissertation submitted to the University of Bristol in accordance with the requirements of
the degree of Doctorate in Philosophy (PhD Social Policy) in the Faculty of Social Sciences
and Law.
27th May 2024
Word Count: 71343
i
Abstract
Women with learning disabilities experience a range of disadvantages across the life course
including; social isolation and marginalisation, increased risk of experiencing severe,
frequent, and repeated incidents of domestic violence and abuse (DVA), the normalisation
of violence and abuse throughout the life course, inquiries into their abilities as mothers,
and barriers to accessing effective support services. These experiences impact upon their
conceptualisations and experiences of fairness and unfairness.
Seven participants were recruited via two services that specifically support people with
learning disabilities who have experienced DVA. Each participant took part in a semi
structured interview which explored their understandings and experiences of fairness and
unfairness in relation to their engagement with support services responding to DVA. Within
the context of this research DVA services are defined as any public or private service a
person is engaged with in response to experiencing DVA, including but not limited to, the
police, adult social services, children’s social services, DVA programs, mental health
practitioners, housing officers, and community groups etc.
Interpretative phenomenological analysis revealed the complexity of their experiences, with
participants reporting what it means to be treated fairly and unfairly when engaging with
DVA services, the importance of relationships in making sense of fairness and unfairness,
the lack of accessible preventative services, the impact of ableist attitudes on their
engagement with DVA services, institutional barriers to accessing DVA services, and the
adverse consequences of unfair experiences of interventions from DVA services.
ii
To examine the relationship between fairness and unfairness, people with learning
disabilities, and DVA services, it was important to explore how fairness and unfairness can
be defined and experienced. This thesis presents an experiential definition of fairness and
unfairness rooted in the narratives of the participants. Their definitions posit fairness as
treating everybody with the same dignity, respect, and common humanity whilst ensuring
that the aid required to make choices, undertake day to day tasks, and pursue goals and
ambitions is provided without discrimination. Their definition of unfairness was
conceptualised as discriminatory treatment within relationships of unequal power which
operate to maintain the unequal structure of aid. Unfairness can be experienced as vivid
emotional responses to discrimination linked to the unequal structure of aid, this is often
linked to experiences of discrimination throughout the life course. The thesis culminates in
the development of Fairness Informed Practice (FIP). Drawing upon relationship-based
approaches, trauma informed care, anti-discriminatory practice, and reflexive practice, FIP
seeks to offer a practice framework, developed through the interpretation of the
participants narratives, that seeks fair and equitable access and outcomes from DVA
services. The thesis advocates for an increased awareness of DVA and people with learning
disabilities and the adoption of Fairness Informed Practice within DVA interventions with
people with learning disabilities.
iii
Acknowledgements
For me, to acknowledge someone or something means to highlight impact. Impact can be
great or small. Each moment of my life, whether joyful or painful (and everything in
between) has been impactful in some way, supporting me to grow, re-evaluate, forge new
understandings of myself and others, try new things, and explore new and interesting ideas.
These experiences have contributed to who I am today, and thus has played a role in the
completion of this PhD.
I would like to acknowledge every personal and professional relationship, group
membership and interaction, idea, theory, art form, trial, tribulation, and success, that has
aided me on this journey. Whether we know each other well, had a fleeting interaction, or
have never actually met in person, I couldn’t have done it without you. Thank you.
A special mention is reserved for my Bozo, thank you for your patience, support, belief, and
love.
iv
Author’s Declaration
I declare that the work in this thesis was carried out in accordance with the requirements of
the University's Regulations and Code of Practice for Research Degree Programmes and that
it has not been submitted for any other academic award. Except where indicated by specific
reference in the text, the work is my own work. Work done in collaboration with, or with
the assistance of, others, is indicated as such. Any views expressed in the dissertation are
those of the author.
SIGNED:
Gavin Hutchison
v
Contents
Abstract .................................................................................................................................................... i
Acknowledgements ................................................................................................................................ iii
Author’s Declaration .............................................................................................................................. iv
Contents .................................................................................................................................................. v
List of Figures .......................................................................................................................................... x
List of Tables ........................................................................................................................................... x
List of Acronyms ...................................................................................................................................... x
Chapter 1: Thesis Introduction ............................................................................................................... 1
Chapter 2: Key terms and research context ........................................................................................... 6
2.1. Defining domestic [violence and] abuse ...................................................................................... 8
2.1.1. The Domestic Abuse Act (2021) and defining domestic abuse ............................................ 8
2.1.2. Problematising the term domestic abuse ........................................................................... 11
2.1.3. DVA statistics for England and Wales ................................................................................. 12
2.2. Defining learning disability......................................................................................................... 15
2.2.1. Valuing people (2001) ......................................................................................................... 15
2.2.2. Intellectual disabilities ........................................................................................................ 17
2.2.3. Ableism and Disablism ........................................................................................................ 19
2.2.4. DVA and learning disabilities .............................................................................................. 20
2.3. Defining fairness ........................................................................................................................ 23
2.3.1. Building understandings of fairness, equality, and good relations ..................................... 25
2.3.2. Justice as fairness ................................................................................................................ 27
2.3.3. Fairness theory: Justice as accountability ........................................................................... 29
2.3.4. Procedural fairness ............................................................................................................. 30
2.3.5. Fairness as the absence of unfair discrimination ................................................................ 31
2.4. Chapter Summary ...................................................................................................................... 33
Chapter 3: Literature review ................................................................................................................. 35
3.1. Literature search and evaluation strategies .............................................................................. 35
3.1.1. Literature search design ...................................................................................................... 37
3.1.2. Literature evaluation strategy ............................................................................................ 39
3.2. Phase one (2019) ....................................................................................................................... 42
3.2.1. Phase one: Literature search outcome ............................................................................... 42
3.2.2. Phase one: COREQ checklist ............................................................................................... 43
3.2.3. Phase one: Simplified CASP checklist for qualitative research. .......................................... 45
3.2.4. Summary of the extracted literature (Phase one) .............................................................. 46
vi
3.3. Phase two (2023) ....................................................................................................................... 54
3.3.1. Phase two: Literature search outcomes ............................................................................. 54
3.3.2. Phase two: COREQ checklist ............................................................................................... 55
3.3.3. Phase two: Simplified CASP checklist for qualitative research. .......................................... 56
3.3.4. Summary of the extracted literature (Phase two) .............................................................. 56
3.4. Emergent themes ....................................................................................................................... 60
3.4.1. Theme 1 Marginalisation and isolation ............................................................................ 62
3.4.2. Theme 2 - Increased vulnerability ....................................................................................... 65
3.4.3. Theme 3 Motherhood ...................................................................................................... 68
3.4.4. Theme 4 Service provisions .............................................................................................. 72
3.4.5. Theme 5 Unfairness and injustice .................................................................................... 76
3.5. Chapter summary, The Research Question, and the Research Aims ........................................ 78
Chapter 4: Methodology ....................................................................................................................... 80
4.1. Qualitative research design ....................................................................................................... 80
4.1.1. Ontology .............................................................................................................................. 81
4.1.2. Epistemology ....................................................................................................................... 81
4.1.3. Neo-Positivism .................................................................................................................... 83
4.1.4. Limited realism .................................................................................................................... 83
4.1.5. Radical constructionism ...................................................................................................... 84
4.1.6. Contextualism ..................................................................................................................... 85
4.2 Methodology ............................................................................................................................... 87
4.2.1. Interpretative Phenomenological Analysis ......................................................................... 87
4.3. Researcher reflexivity .............................................................................................................. 101
4.3.1. What is reflexivity?............................................................................................................ 101
4.3.2. The insider and the outsider ............................................................................................. 102
4.4. Recruitment ............................................................................................................................. 104
4.4.1. Sampling and selection criteria ......................................................................................... 105
4.4.2. Sample size ........................................................................................................................ 107
4.4.3. Participant demographics ................................................................................................. 109
4.4.4. Advisory Group ................................................................................................................. 111
4.5. Advice and guidance offered by the advisory group on the research materials. ................... 113
4.6. The interviews .......................................................................................................................... 115
4.6.1. Remote semi structured interviews .................................................................................. 116
4.6.2. Using a vignette during interviews ................................................................................... 117
4.6.3. Interview preparation ....................................................................................................... 119
4.6.4. The interviews ................................................................................................................... 120
vii
4.6.5. Reflections on the interviews ........................................................................................... 122
4.6.6. Using the self in interviews ............................................................................................... 124
4.7. Analysis and IPA ....................................................................................................................... 127
4.7.1. The process ....................................................................................................................... 128
4.8. Ethical considerations .............................................................................................................. 132
4.8.1. Informed consent .............................................................................................................. 132
4.8.2. Confidentiality and anonymity .......................................................................................... 134
4.8.3. Safe data storage .............................................................................................................. 135
4.8.4. Avoidance of harm ............................................................................................................ 136
4.9. Chapter Summary .................................................................................................................... 137
Chapter 5: Findings ............................................................................................................................. 138
5.1. Group Experiential Themes (GETs) .......................................................................................... 140
5.1.1. GET 1 - What it means to be treated fairly. ...................................................................... 140
5.1.2. GET 2 - What it means to be treated unfairly ................................................................... 152
5.1.3. GET 3 Relationships and People with Learning Disabilities who have experienced
Domestic Violence and Abuse..................................................................................................... 161
5.1.4. GET 4 - Unfairness and access to DVA interventions ........................................................ 170
5.2. Chapter Summary .................................................................................................................... 179
Chapter 6: Discussion .......................................................................................................................... 181
6.1. What does fairness mean to people with learning disabilities who have experienced DVA
interventions? ................................................................................................................................. 182
6.1.1. Equality, Equity, and Fairness ........................................................................................... 183
6.1.2. Fairness as the absence of discrimination ........................................................................ 187
6.1.3. Fairness as respect ............................................................................................................ 191
6.1.4. How is fairness defined in relation to the research findings and discussion? .................. 193
6.2. What does unfairness mean to people with learning disabilities engaged with DVA
interventions? ................................................................................................................................. 193
6.2.1. Unfairness means being discriminated against ................................................................ 195
6.2.2. How unfairness was experienced by the participants within the context of DVA
interventions ............................................................................................................................... 198
6.2.3. Unfairness and relationships with professionals .............................................................. 199
6.2.4. How is unfairness defined in relation to the research findings and discussion? .............. 207
6.3. Unfairness and institutional barriers in relation to accessing DVA services for people with
learning disabilities. ........................................................................................................................ 207
6.3.1. Lack of preventative services ............................................................................................ 208
6.3.2. The role of the criminal justice system in DVA interventions as a barrier to accessing DVA
services ........................................................................................................................................ 212
viii
6.3.3. Other threshold criteria as a barrier to accessing DVA services. ...................................... 215
6.4. Introduction to Fairness Informed Practice (FIP) A practice framework for supporting people
with learning disabilities who have experienced DVA. ................................................................... 217
6.4.1. FIP and the definitions of fairness and unfairness ............................................................ 219
6.4.2. FIP is Relationship Based ................................................................................................... 220
6.4.3. FIP is Trauma Informed ..................................................................................................... 222
6.4.4. FIP is Anti-Discriminatory .................................................................................................. 224
6.4.5. FIP is reflexive ................................................................................................................... 226
6.4.6. Summary of FIP ................................................................................................................. 228
6.5. Validity, Quality, and Theoretical Generalisability ................................................................... 229
6.5.1. Validity and the consolidated criteria for reporting qualitative research (COREQ) checklist.
.................................................................................................................................................... 231
6.5.2. Quality of the research - Smith’s IPA quality evaluation guide ........................................ 232
6.6. Good quality IPA - Quality indicators of good IPA ................................................................... 234
6.6.1. Good quality indicator 1: Constructing a compelling, unfolding narrative ...................... 234
6.6.2. Good quality indicator 2: Developing a vigorous experiential and/or existential account
.................................................................................................................................................... 235
6.6.3. Good quality indicator 3: Close analytic reading of the participants’ words .................... 236
6.6.4. Good quality indicator 4: Attending to convergence and divergence .............................. 236
6.7. Summary of research quality ................................................................................................... 236
6.8. The advisory group and theoretical generalisability ................................................................ 237
6.8.1. Summary (Theoretical Generalisability) ........................................................................... 240
6.9. Concluding remarks regarding validity, quality, and theoretical generalisability ................... 242
6.10. Chapter Summary .................................................................................................................. 243
Chapter 7: Thesis conclusion and recommendations ......................................................................... 244
7.1. The research findings ............................................................................................................... 244
7.1.1. The experience of fairness and unfairness amongst people with learning disabilities
engaging with services responding to DVA ................................................................................. 245
7.1.2. How people with learning disabilities want to be supported by services responding to
DVA. ............................................................................................................................................ 247
7.1.3. Contributions to knowledge ............................................................................................. 247
7.1.4. Recommendations ............................................................................................................ 248
7.2. Limitations of the research ...................................................................................................... 251
7.2.1. Recruiting participants ...................................................................................................... 251
7.2.2. What is quality data? ........................................................................................................ 253
7.3. Concluding remarks ................................................................................................................. 254
References .......................................................................................................................................... 256
ix
Appendices .......................................................................................................................................... 273
Appendix one Reflexivity statement ............................................................................................ 273
Appendix two - Reflexivity and visibility ......................................................................................... 278
Appendix three Researcher diary extracts ................................................................................... 281
Appendix four Advisory group poster .......................................................................................... 291
Appendix five Welcome Sheet (InPrint) ....................................................................................... 292
Appendix six Information sheet (InPrint) ..................................................................................... 294
Appendix seven (a) Consent form - Video conferencing interviews ............................................ 298
Appendix seven (b) - Consent form - Telephone interviews .......................................................... 302
Appendix eight Recruitment protocol ......................................................................................... 306
Appendix nine Interview guide .................................................................................................... 310
Appendix ten How to reply .......................................................................................................... 315
Appendix eleven Participants demographic information ............................................................ 316
Appendix twelve The vignette ..................................................................................................... 318
Appendix thirteen The aims and objectives of the research easy read. ................................... 319
Appendix fourteen Pre interview checklist .................................................................................. 320
Appendix fifteen - Ethical approval letter ....................................................................................... 321
Appendix sixteen Stopping the interview .................................................................................... 322
Appendix seventeen Third party confidentiality agreement ....................................................... 324
Appendix eighteen Confidentiality Protocol ................................................................................ 325
Appendix nineteen An example of transcribed consent conversation ........................................ 328
Appendix twenty Example of an interview transcript - Summer ................................................. 332
Appendix twenty-one Example of Exploratory Notes and Experiential Statements: ‘Summer’ . 347
Appendix twenty-two Example of clustering Summer ............................................................. 376
Appendix twenty-three Example of personal experiential themes table Summer .................. 380
Appendix twenty-four Clustering of all several participants PETs ............................................... 392
Appendix twenty- five - Initial Exploration of participant Group Experiential Themes .................. 394
Appendix twenty-six - Final Group Experiential Themes (GETs) ..................................................... 399
Appendix twenty-seven Where to get help (no symbols) ........................................................... 408
Appendix twenty-eight GH thesis COREQ (COnsolidated criteria for REporting Qualitative
research) Checklist .......................................................................................................................... 409
Appendix twenty-nine Themes identified in the extracted literature for the literature review . 414
Appendix thirty Blank source evaluation form ............................................................................. 415
Appendix thirty-one Phase one and phase two literature evaluations ....................................... 417
Appendix thirty-two Summary of the research findings (easy read) ........................................... 418
x
List of Figures
Figure 1: Thompsons PCS model (adapted) source (Herriot 2013)
Figure 2: Fairness informed practice
List of Tables
Table 1: Search parameters for phase one and two literature searches
Table 2: Outcome of phase one literature search
Table 3: Outcome of phase one COREQ checklist scoring
Table 4: Outcome of phase two literature search
Table 5: Outcome of phase two COREQ checklist scoring
Table 6: Recruitment process summary
Table 7: Action plan for research materials as advised by the advisory group
Table 8: Table of Final GETs
Table 9: Where to find the evidence for meeting the criteria for acceptable IPA
Table 10: IPA quality indicators
Table 11: The experiences of fairness and unfairness amongst the advisory group and thesis
participants when engaged with professional support due to experiences of DVA
List of Acronyms
ABI - Acquired Brain Injury
ADP Anti Discriminatory Practice
AOP Anti Oppressive Practitioner
APM Annual Progress Monitoring
BA Bachelor of Arts
CASP - Critical Appraisal Skills Programme
CBT Cognitive Behavioural Therapy
COREQ Consolidated Criteria for Reporting Qualitative Research
CSEW - Crime Survey for England and Wales
DA Discourse Analysis
DfE Department of Education
DVA Domestic Violence and Abuse
FIP Fairness Informed Practice
GCSE General Certificate of Secondary Education
GETs Group Experiential Themes
xi
GP General Practitioner
GT Grounded Theory
HM Her/His Majesty
MCA Mental Care Act (2005)
MSc Master of Science
NHS National Health Service
IPA Interpretative Phenomenological Analysis
LD Learning Disability/Disabilities
NCCJD (American) National Center on Criminal Justice & Disability’s
ND No Date
OFCOM Office of Communication
PC Personal Computer
PCS Personal, Cultural, Structural
PETs Personal Experiential Themes
PhD Doctor of Philosophy
RBP Relationship Based Practice
RSE - Relationships Education and Relationship and Sex Education
SEND Special Educational Needs and Disabilities
TIC Trauma Informed Care
TV Television
UK United Kingdom
1
Chapter 1: Thesis Introduction
The fundamental aim of this thesis is to examine how people with learning disabilities
experience fairness and/or unfairness when engaged with services responding to domestic
violence and abuse (DVA). Through an interpretive phenomenological analysis of semi-
structured interviews with seven adults with learning disabilities, and drawing on the
relevant theory and literature, the thesis defines fairness and unfairness within the context
of the participants experiences of engaging with DVA services. Further to this the thesis
explores how their experiences of fairness and unfairness informs how the participants
want DVA services to support them. This culminated in the development of Fairness
Informed Practice (FIP). FIP places the participants experience of fairness and unfairness at
the centre of the development of DVA practice and advocates for practice that is
relationship-based, trauma informed, anti-discriminatory, and reflexive. Within the context
of this research support services were defined as any public or private service a person is
engaged with in response to experiencing DVA, including but not limited to, the police, adult
social services, children’s social services, DVA programs, mental health practitioners,
housing officers, and community groups etc.
Having a learning disability impacts upon a person’s ability to understand complex
information, learn new skills, and cope independently (Department of Health 2001). People
with a learning disability are often diagnosed along a continuum, as either mild, moderate,
severe, or profound and multiple (National Health Service 2018). As such people with
learning disabilities exhibit a wide range of different strengths and abilities. However there
persists a common misconception that most people with learning disabilities have a severe
learning disability and/or can do few things for themselves (Scior and Werner 2015, Scior,
2
Hamid et al. 2020). In reality more than 80% of people diagnosed with a learning disability
have mild or moderate learning disabilities and can be largely independent in their daily
lives (Scior and Werner 2015). Misconceptions about the abilities and strengths of people
with learning disabilities impacts upon how society interacts, engages, and values them. For
example people with learning disabilities are not thought to have the same emotional,
psychological, or social needs as other people, with supporting them to meet their basic
physical needs prioritised over living full and rich adult lives (McCarthy, Bates et al. 2022).
Concerningly, these misconceptions impact negatively upon people with learning disabilities
experiences of DVA, this is particularly salient for women with learning disabilities. For
example, both professional and societal misconceptions towards women with learning
disabilities can lead perpetrators to believe they are easier to manipulate (Macintyre and
Stewart 2022). Misconceptions also impact upon professional support, with professionals
sometimes overlooking the possibility of DVA being perpetrated against women with
learning disabilities (Macintyre and Stewart 2022).
When a support need is identified and sought, the level of support available is subject to a
‘patchwork of provision’ (Domestic Abuse Commissioner 2021 p.2). This is a reality for all
survivors, with fewer than half of them able to access the community-based support that
they want (Domestic Abuse Commissioner 2021). Counselling support for survivors accounts
for the largest disparity between different parts of England and Wales, with a 21-percentage
point difference between the highest area (where 58% of survivors in the Northeast of
England could access it) and the lowest (37% in Wales) (Domestic Abuse Commissioner
2021). Significant variations are also present for access to mental health support amongst
survivors (47 per cent are able to access mental health support in the Northeast of England
3
compared to 31 per cent in the Southwest of England) (Domestic Abuse Commissioner
2021). Further to this there is disparity regarding the number of refuge bed spaces across
England. Whilst the number of refuge bed spaces has increased in England, it remains 22.2%
below the minimum number of bed spaces recommended by the Council of Europe, the
continent’s leading human rights organisation (Council of Europe 2024). Only London and
the West Midlands exceeded the minimum recommended bed spaces in 2023 (Office for
National Statistics 2023). Further to this specialist DVA organisations have reported that
staff are struggling with increased and more challenging workloads (63.5%), that that some
of their staff at moving on to occupy higher paid posts elsewhere (48.1%), and that they are
struggling to recruit for vacant posts in their organisations (57.7%) (Clark, Dean et al. 2024).
This post code lottery impacts upon certain groups more prominently. Almost half of all
specialist ‘by and for’ DVA organisations that support minoritised victims are based in
London and the South-East of England. Along with being sparse, ‘by and for’ services are
disproportionately under-funded across all geographical areas and across all types of
intervention (Domestic Abuse Commissioner 2021). This lack of funding runs parallel to a
lack of both specialist knowledge amongst professionals (re: meeting women with learning
disabilities support needs in relation to experiences of DVA) (Walter-Brice, Cox et al. 2012,
McCarthy, Bates et al. 2019, TalkBack 2020, Macintyre and Stewart 2022) and limited
learning disability informed DVA specialised services (London & Quadrant Group 2020,
TalkBack 2020, Domestic Abuse Commissioner 2021).
Little is known about how people with learning disabilities experience engagement with
DVA services, particularly how they experience service engagement in terms of fairness and
unfairness. This thesis addresses this gap in the knowledge by presenting an interpretive
4
phenomenological analysis of the experiences of fairness amongst seven adults with
learning disabilities when engaging with services responding to DVA.
This thesis begins with a narrative review of the key terms in chapter 2. The narrative review
identifies sources that describe key terms such as domestic violence and abuse, learning
disability, and fairness. Chapter 3 reviews the handful of studies that have directly or
indirectly investigated the experiences of fairness amongst people with learning disabilities
engaged with support services responding to DVA. Given the scarcity of research that
directly seeks to understand people with learning disabilities experiences of fairness and
unfairness in relation to DVA interventions the literature review is wide-ranging in its scope.
The literature review predominantly investigates how professional support in response to
DVA is facilitated by services and experienced by women with learning disabilities.
The methodology is presented in chapter 4. The chapter begins by setting out the
ontological and epistemological considerations including the adoption of a contextualist
framework. The use of interpretative phenomenological analysis is also explored. The
research design is also explained. Finally, ethical considerations are presented and
discussed.
Findings from the data analysis are presented in chapter 5. This is organised into group
experiential themes which are drawn from the participants narratives. The participants
discuss what it means to be treated fairly and unfairly by DVA services, the centrality of
relationships in relation to experiences of fairness, and experiences of unfairness within the
context of the ability of services to keep people safe.
In chapter 6 the findings are synthesised with the wider literature and theory base with
particular attention to how people with learning disabilities define and experience fairness
5
and unfairness in relation to their experiences of DVA interventions. New definitions of
fairness and unfairness, rooted in the experiences of the participants and the literature, are
presented alongside the practice framework Fairness Informed Practice (FIP). FIP puts the
experience of fairness at the centre of professional practice with people with learning
disabilities who are experiencing, or have experienced, DVA. Finally, this chapter presents
implications for services and policies.
Chapter 7 offers reflections upon the research process, findings, and discussions as well as
how the thesis contributes to the existing knowledge base and policy recommendations.
6
Chapter 2: Key terms and research context
Before conducting a more systematic search of the literature it was important to both
conceptualise the key terms and explore the research context. This chapter is constructed to
provide a road map to highlight how the key terms intersect, how they are measured within
the context of national statistics, and how the experiences of people with learning
disabilities are omitted from the definition, statutory guidance, and ONS governmental
statistics that relate to DVA.
In this chapter I begin by exploring the legal definition of domestic abuse in England and
Wales and its discontents. I then explore the data regarding prevalence and incidence of
DVA in England and Wales. Gaps in the data are identified in relation to marginalised
groups, and in particular people with learning disabilities. I then defined the term learning
disabilities in the context of England and Wales and explored the relationship between DVA
and learning disabilities. Finally, I examined definitions of the central experiential concept of
the thesis, fairness. I also explore the justification for my specific focus on the concept of
fairness and conclude that a definitive definition of fairness is difficult to ascertain. As a
result, the thesis sought to understand how people with learning disabilities define and
experience fairness in relation to engagement with DVA interventions. This supported me to
construct new definitions of fairness and unfairness rooted in the participants experiences
and narratives of DVA interventions. These new definitions form one aspect of the thesis’s
contribution to the knowledge and can be utilised by researchers and services engaging with
people with learning disabilities to examine whether DVA service provision is being
experienced as fair and/or unfair.
7
Definitions of each key concept are initially defined according to well established contextual
legal, medical, social, and political understandings, and then expanded upon with a
particular focus upon how language is used to construct meaning and my own professional
and academic standpoints. This has been done to demonstrate my understanding of the key
terms, the context in which the definitions used are embedded, and why this is relevant.
Defining the key terms and explorations of the context in which these terms are embedded,
was facilitated using a narrative review. The purpose of a narrative review is to identify
sources that describe the key terms, or problem, of interest (Demiris, Oliver et al. 2019).
Narrative reviews have no predetermined research question or specified search strategy,
only topic[s] of interest to be explored (Demiris, Oliver et al. 2019). The narrative search
review process was thus not systematic and followed no specified protocol (Demiris, Oliver
et al. 2019). The sources identified were in relation to the key terms, or ‘problems of
interest’, central to the PhD, namely DVA, learning disabilities, and fairness. To support me
to define the key terms, I identified sources searching UK government and NHS websites for
relevant legal, policy, and guideline documents, both the University of Bristol library and
google scholar search engines, and relevant books. A more systematic approach to
searching the literature, including developing and implementing a search strategy, was
implemented for the review of the academic literature (see chapter 3).
Throughout the narrative review I was aware of the importance of language when defining
key terms. Language is ingrained in our day-to-day life and can often be taken for granted. It
was important to remember that language is closely associated to power (Foucault 1983,
Foucault 1990, Foucault 2000), and sensitivity was needed to ensure that the language I
8
used did not contribute to the discrimination and oppression of people (Thompson 2011), in
particular people with learning disabilities who have experienced DVA.
2.1. Defining domestic [violence and] abuse
Domestic abuse has been legally defined in England and Wales in the Domestic Abuse Act
(2021). It is not within the scope of this thesis to explore whether people with learning
disabilities, professionals, or academics agree with the content of this definition. What was
important to the thesis was the scope of the legal definition, its contextual relevance in
relation to the thesis, and the potential impact of its use of language upon marginalised
groups. I was particularly sensitive to any potential trivialisation of people’s experiences.
In this section I outline the statutory definition, its use of the term domestic abuse, and why
I have opted to use the term domestic violence and abuse throughout the PhD to recognise
both the serious consequences of violence and abuse in relationships, and DVA as a
gendered issue (Aldridge 2020).
2.1.1. The Domestic Abuse Act (2021) and defining domestic abuse
The Domestic Abuse Act (2021) created a cross government statutory definition of domestic
abuse. By putting the definition, and the accompanying guidance, on a statutory footing the
Home Office (2022b) aimed to ensure that domestic abuse was properly understood, whilst
also providing support services, public agencies, and others with a common definition to
apply in the course of their work. It was thus important for me to ensure that I maximised
the alignment and transferability of my research to other academic, professional, and peer
led settings in England and Wales by adopting this common definition. Humphreys, Hester
et al. (2000) state that without an agreed definition monitoring and screening of DVA is
unlikely to happen. Whilst I adopt the definition of domestic abuse offered in the Domestic
Abuse Act (2021), I do problematise the use of the term domestic abuse and instead use the
9
term domestic violence and abuse (DVA) throughout the thesis as it covers the range of
perpetrator behaviour and the experiences of its victims and survivors (Aldridge 2020).
The statutory definition is outlined in two parts. The first part is related to the relationships
between the perpetrator and victim/survivor (Home Office 2022b). The second part defines
what constitutes abusive behaviour (Home Office 2022b).
The definition is outlined below.
Behaviour of a person (“A”) towards another person (“B”) is “domestic abuse” if— (a)
A and B are each aged 16 or over and are “personally connected” to each other, and
(b) the behaviour is abusive. (3) Behaviour is “abusive” if it consists of any of the
following (a) physical or sexual abuse; (b) violent or threatening behaviour; (c)
controlling or coercive behaviour; (d) economic abuse (see subsection (4)); (e)
psychological, emotional, or other abuse; and it does not matter whether the
behaviour consists of a single incident or a course of conduct. For the purposes of this
Act, A’s behaviour may be behaviour “towards” B despite the fact that it consists of
conduct directed at another person (for example, B’s child). Two people are
“personally connected” to each other if any of the following applies — (a) they are, or
have been, married to each other; (b) they are, or have been, civil partners of each
other; (c) they have agreed to marry one another (whether or not the agreement has
been terminated); (d) they have entered into a civil partnership agreement (whether
or not the agreement has been terminated); (e) they are, or have been, in an intimate
personal relationship with each other; (f) they each have, or there has been a time
when they each have had, a parental relationship in relation to the same child; (g)
they are relatives (Home Office 2022a:21-22).
10
The Domestic Abuse Act (2021) also recognises that children (under 16) can also be victims
of DVA when they see, hear, or experience the effect of abuse perpetrated by A towards B
(Home Office 2022a).
Whilst I have already established the pragmatic reasoning for the adoption of this definition
it was important for me to consider the definitions scope. This was important to reassure
myself that there were no significant gaps in the definition and that by adopting it I would
not be unwittingly contributing to the discrimination or oppression of people. Using good
practice indicators set out in Humphreys, Hester et al. (2000) I assessed the scope of the
statutory definition. These practice indicators are essential to good practice and can be used
as parameters to evaluate practice (Humphreys, Hester et al. 2000). I specifically used good
practice indicator 1: definitions setting the parameters, to evaluate the statutory
definition. Humphreys, Hester et al. (2000) state that definitions of domestic abuse “should
acknowledge diversity and the gendered nature of domestic violence, including different
types of abuse” (p.24) and “should acknowledge the issue of power and control” (p.25).
The Domestic Abuse Commissioner, Nicola Jacobs, states that the scope of the definition is
broad, going “well beyond physical violence” and “ensuring that different types of
relationships are captured” (Jacobs 2021). The definition also extends “the offence of
coercive and controlling behaviour, no longer making it a requirement for abusers and
victims to either still be in a relationship or to still live together” (Jacobs 2021). The
definition further recognises children who witness or experience domestic abuse as victims
(Home Office 2022a). However it is important to note that the statutory definition is gender-
neutral by design (Home Office 2022b). In their online Statutory definition of domestic
abuse fact sheet, the Home Office (2022b) state that gender neutrality ensures that “all
11
victims and all types of domestic abuse are sufficiently captured, and no victim is excluded
from protection or access to services”. However, a gendered definition could have guided
the development of policies and interventions that were more effective in protecting victims
and survivors, most of whom are women. The supporting statutory guidance does recognise
that many victims of domestic abuse are women, and the majority of perpetrators are men
(Home Office 2022b). I concluded that the combination of the statutory definition and its
accompanying statutory guidance provides an adequate definition of domestic abuse.
2.1.2. Problematising the term domestic abuse
Whilst the statutory definition and statutory guidance meets the criteria as set out in good
practice indicator 1: definitions setting the parameters (Humphreys, Hester et al. 2000),
Aldridge (2020) states that the notable shift in language from domestic violence to domestic
abuse is problematic. Whilst Aldridge (2020) welcomes the recognition of coercive and
controlling aspects of domestic abuse, they conclude that this should not be at the expense
of overlooking, minimising, or obfuscating violence in its destructive definitional sense
(whether physical, sexual, verbal, or emotional), nor in terms of its devastating physical,
psychological, and/or emotional effects on women who experience it” (p.1833).
Aldridge (2020) advocates for the use of the term domestic violence and abuse, a term used
in most national and global contexts, as it covers the range of perpetrator behaviour and the
experiences of its victims and survivors. Aldridge (2020) concludes that experiences of
domestic violence and abuse are neither an “either/or” situation. Carlisle, Coumarelos et al.
(2022) also found that domestic violence and abuse was seen as a more accurate term as it
encompasses multiple, distinct forms of violence and abuse, which can co-occur as a pattern
of behaviour. Further to this Cole (2023) states that DVA provides a more comprehensive
understanding of the mechanisms and experiences of survivors of DVA.
12
Aldridge (2020) continues that for women survivors of DVA, their experiences of
victimisation are sometimes difficult to delineate as violence or abuse, but it is clear that
both have a part to play in women’s chances and opportunities for survival (Aldridge 2020).
Aldridge (2020) also comments that the subscription to a gender symmetry paradigm
suggests a “watering down” of the government’s response to DVA (p.1823), despite its
mention in the statutory guidance. Aldridge (2020 p.1825-1826) establishes the gendered
nature of DVA and argues that it is a serious oversight for government to ignore or overlook
this as it could have wide-reaching consequences for victim/survivors. For example it could
make it difficult for professionals such as teachers, social workers, and police officers as
working under a non-gendered definition could impact upon the recognition of the signs
and triggers for violence and abuse experienced by women (Aldridge 2020).
In conclusion the term domestic abuse used in the statutory definition does not accurately
reflect the gendered nature of DVA nor the realities of women’s experiences of violence and
abuse. As a result, I use the content of the statutory definition to enhance the thesis’s
transferability across settings in England and Wales, whilst using the term DVA to highlight
the gendered nature of violence and abuse and the importance of understanding distinct
forms of violence and abuse, which can co-occur as patterns of behaviour.
2.1.3. DVA statistics for England and Wales
DVA data is published by the ONS through its yearly publication Domestic Abuse in England
and Wales overview. The ONS publications often draw from the data collected via the Crime
Survey for England and Wales (CSEW), police recorded crime, and other government
organisations and DVA service data. This data is used to present trends and changes over
time.
13
The Figures show that an estimated 2.1 million people in England and Wales aged 16 years
and over (1.4 million women and 751,000 men) experienced DVA in the year ending March
2023, representing a prevalence rate of approximately 6 in 100 women and 3 in 100 men
(ONS 2023b). In the same period, the number of DVA related incidents and crimes recorded
by the police stood at 1,453,867 (excluding Devon and Cornwall) of which 889,918 were
recorded as DVA related crimes. This represents a 14.4% rise in DVA related crimes when
compared to the year ending March 2020 (ONS 2023c). The ONS publication indicates that
only a minority of perpetrators are charged and prosecuted. Of the 889,918 DVA related
crimes 47,361 suspects were charged and 39,198 offenders were convicted (ONS 2023a).
The ONS categorised the data to explore trends amongst groups. The characteristics used to
explore the statistics included; sex, age, ethnicity, marital status, employment status and
occupation, household structure, area, and domestic homicide (ONS 2023b). The
characteristic ‘disability’ is not used in the latest ONS statistics, a point we return to later in
the chapter. To summarise the ONS states that a significantly higher proportion of people
aged 16 to 19 were victims of DVA. The percentage of women who experienced DVA in the
last year was significantly higher than men. Almost twice as many women in the White
ethnic group experienced DVA in the last year (6.0%) compared with Black or Black British
women (3.1%) and Asian or Asian British women (3.0%) (ONS 2023b).
It is important to note that the ONS (2023) statistics are problematic as the data is based on
eight months of data collection instead of twelve. This was due to an error in the survey,
which resulted in missing data (ONS 2023a). As a result of this caution should be taken when
using the data due to the potential impact of the reduced data collection period on the
quality of the statistics (ONS 2023a). Further to this the ONS’s 2023 publications did not
14
explore trends in relation to DVA and disability. It is not clear why this year’s data was not
aggregated in this way and is particularly perplexing given that disability and DVA has
previously been explored, albeit briefly, by the ONS in 2022. I noted that this is not the only
aggregation omission as despite evidence that highlights the importance of hearing the
voices of people from the LGBTQ+ communities in relation to DVA (Barnes and Donovan
2023, McGregor 2023) and the recognition of literature on spiritual abuse in relation to DVA
(Chowdhury 2023), these groups were also omitted. Of particular importance to this thesis
is the absence of data on people with learning disabilities, this does not negate the
importance of other omissions.
Whilst the publication from 2023 by the ONS neglects to explore trends related to disability
and DVA, there is data available in the disability and crime data published by the ONS in
2019, and within the DVA victim characteristics, England and Wales: year ending March
2022 (ONS 2022). In the year ending March 2019, around 1 in 7 (14.1%) disabled adults aged
16 to 59 years experienced DVA, compared with 1 in 20 (5.4%) non-disabled adults of the
same age (ONS 2019c). Similar trends were observed in the year ending March 2014 (14.4%
and 5.6% respectively) (ONS 2019c). For the year ending March 2022, the Crime Survey for
England and Wales showed that a significantly higher percentage of adults with a disability
experienced DVA in the last year than those without (ONS 2022).
There continues to be issues around data aggregation insofar as the reports do not
adequately explore the statistics in relation to ‘impairment type’, nor does the report
explore disability specific experience of DVA. However, the 2019 dataset (which is separate
from the report) does categorise the proportion of disabled people aged 16 to 59 that
experienced any DVA. However, some of the categorisations of impairment are ill defined.
15
For example, there are impairment type categories designated ‘learning or understanding or
concentrating impaired, and socially or behaviourally impaired. There are no explanatory
notes that conceptualise what this means and who this includes or excludes. In my
experience the category ‘learning or understanding or concentrating impaired’ could relate
to learning disabilities, learning difficulties, autism, chronic fatigue syndrome etc. It is also
difficult to understand what behaviourally impaired means and who this refers to.
It can be concluded that data from sources such as the Crime Survey for England and Wales,
do not go far enough to reflect the lived experience of DVA amongst all groups (including
disabled women and men) (Hester, Walker et al. 2023).
2.2. Defining learning disability
In this section I rationalise the use of the term learning disabilities and explain why a
pragmatic approach to adopting the term and definition from Valuing People - A New
Strategy for Learning Disability for the 21st Century (Department of Health 2001) was
contextually important. I then introduce the term intellectual disabilities. This is important
as the term is used in some of the literature extracted and discussed in the literature review.
It was thus important to understand how the term learning disability (used in the thesis) and
intellectual disability (used in some of the literature) converge and diverge and the impact
this has on making inferences when searching for themes across relevant literature. I then
explore the definition of learning disabilities in relation to ableism and disablism and finish
by investigating the omission of people with learning disabilities from the recent ONS
statistics in relation to DVA (ONS 2023a, ONS 2023b, ONS 2023c), and the Domestic Abuse
Act statutory guidance (Home Office 2022a).
2.2.1. Valuing people (2001)
In Valuing People (2001) a learning disability is defined as the presence of:
16
a significantly reduced ability to understand new or complex information, to learn
new skills (impaired intelligence), with; reduced ability to cope independently
(impaired social functioning); which started before adulthood, with a lasting effect on
development (Department of Health 2001).
This definition is widely adopted in frontline practice within England and Wales (Cluley
2018).
The diagnosis of a learning disability is done along a continuum (National Health Service
2018). The continuum makes a concerted attempt to explain the wide range of different
abilities amongst people with learning disabilities to support the assessment and
identification of care and support needs. The NHS categorises learning disabilities as either
mild, moderate, severe, or profound and multiple. It is suggested that the higher up the
continuum the more difficulties an individual will have in learning new skills, coping
independently and understanding new or complex information (National Health Service
2018).
It is important to note that Emerson and Heslop (2010) argue that many people with
learning disabilities prefer to use the term ‘learning difficulty’, and the two terms are often
used interchangeably within the context of health and social care for adults. Despite this
Mencap (N.D.) highlight a distinction between the two terms. Mencap state that “learning
disability is often confused with learning difficulties such as dyslexia, dyscalculia and
dysgraphia.” This distinction is rooted in education services (Emerson and Heslop 2010). In
this context a learning difficulty is a condition which creates an obstacle to a specific form of
learning but does not present a significantly reduced ability to learn new skills, understand
complex information or cope independently (Sycamore Trust 2023).
17
Learning disabilities are also often conflated with other conditions such as Autism (Mencap
N.D.). Autistic people are neurodivergent and their neurodiversity may impact upon how
they interact with others in a social situation, how they communicate with others, and how
they experience the world around them (National Health Service 2019).
2.2.2. Intellectual disabilities
The term intellectual disability is used in some of the extracted literature explored in
chapter 3. The term intellectual disability has significant traction internationally and has an
increased presence in the UK context. As such it is important to explore what intellectual
disability means and its applicability to the research context.
The World Health Organisation (WHO) (2017) provides an international definition of
intellectual disability. The WHO define intellectual disability as
a significantly reduced ability to understand new or complex information and to learn
and apply new skills (impaired intelligence). This results in a reduced ability to cope
independently (impaired social functioning), and begins before adulthood, with a
lasting effect on development (World Health Organisation 2010).
The WHOs definition is similar to the definition from Valuing People (2001) outlined earlier
(Cluley 2018). However, the definitions diverge in two ways. Firstly the definition of
intellectual disability offered by the World Health Organisation (2010) includes people who
have been institutionalised because of a perceived disability or family rejection and who
acquire developmental delays and psychological problems as a result of their
institutionalisation.
Secondly, the WHO goes beyond England and Wales’s medical based understanding of
learning disabilities to define the concept of intellectual disability in terms of peoples
18
interactions with environmental factors and how this can impede a person’s full
participation and inclusion in society (World Health Organisation 2010, Cluley 2018). This
represents a social model of disability approach as it dislodges an exclusive association of
disability with individual functional limitations in favour of a collective experience of
disablement (Oliver 1996). Experiences of disablement are often based on the premise that
impairment and disability are separate entities. Within this model disability is
conceptualised as the result of the organisation of society (Bengtsson 2016) and denotes the
interaction of impairment with the social and physical restrictions of everyday environments
(Dockerty, Varney et al. 2015). Impairment, in this context, is conceptualised as an injury,
illness, or congenital condition that causes, or is likely to cause, a loss or difference in
physiological or psychological function (Dockerty, Varney et al. 2015).
I have recognised that the term intellectual disability has started to be used in the context of
England and Wales, however research by Cluley (2018) found that some professionals
shared an explicit scepticism towards the introduction of this term in professional practice.
The participants of this research expressed a preference for the term learning disability as it
was seen as accurate at a descriptive level (Cluley 2018). The term “intellectual disability”
was also seen as an “irritating hindrance to their professional practice” and considered “a
laughable step back in time” (p.31).
Cluley (2018) concludes their research by stating that knowing what a term means and
understanding its background and social context is extremely important. Given its
contextual relevance to my research it was thus pragmatic for me to adopt the definition of
learning disabilities for this thesis. This enabled me to create a selection criteria for
participation in the UK context that was understood by the gatekeepers as well as increasing
19
the possibility that dissemination into peer led or professional settings is as seamless as
possible.
2.2.3. Ableism and Disablism
It has been established that the term learning disabilities in England and Wales represents a
traditional medicalised approach to disability and learning disabilities (Race 2002). This is
clear when compared to the term intellectual disability. The medical model of disability
locates the ‘problem of disability’ in dependency and vulnerability in relation to physical
limitations or psychological losses (Radford, Harne et al. 2006, Hague, Thiara et al. 2007a).
This approach is based upon the scientific understanding of the human body as an isolated
biological or physiological system (Boxall 2002). Functional limitations are seen as the root
cause of any disadvantages experienced by people with a disability (Crow 1996). The aim of
medical intervention or treatment is to ‘fix’ an individual’s impairments and help those who
cannot be ‘fixed’ adapt and learn to function (Georing 2015). ‘Fixing’ is conceptualised as
the best path toward functionality and independence (Roush and Sharby 2011).
The medical model of disability reinforces ableist and disablist attitudes towards disabled
people (Shyman 2016). Disablism and ableism are both ways of describing the difficulties
and discrimination that disabled people face. However, to fully understand the experience
of fairness and unfairness amongst people with learning disabilities engaging with services
responding to DVA it is important to take note of how they differ. Ableism represents social
biases against people whose bodies function differently to those bodies considered to be
normal, and the beliefs and practices that result from and interact with these biases to serve
discrimination (Goodley 2017). Within an ableist society it is assumed that the normal way
to live is as a non-disabled person. As a result non-disabled people are unfairly favoured and
hold more value and desirability in society (Goodley 2014).
20
Thomas (2019) defines disablism as
the social imposition of avoidable restrictions on the life activities, aspirations and
psycho-emotional well-being of people categorised as ‘impaired’ by those deemed
‘normal’. Disablism is social-relational in character and constitutes a form of social
oppression in contemporary society alongside sexism, racism, ageism and
homophobia. As well as enacted in person-to-person interactions, disablism may
manifest itself in institutionalised and other socio-structural forms (p.1040).
The definition of disablism offered by Thomas resonates with Thompson’s (2021) concept of
unfair discrimination. Unfair discrimination refers to when a person or group experiences
disadvantage because they are identified as different in ways that are deemed socially
and/or politically significant (i.e., in terms of their protected characteristics). This
disadvantage is a source of oppression (Thompson 2021).
2.2.4. DVA and learning disabilities
The lived experiences of women with learning disabilities who are victims/survivors of DVA
are often forgotten or ignored with many people not expecting them to want or be involved
in romantic relationships (Scottish Commission for People with Learning Disabilities 2022).
This ableist societal belief leads to a lack of preparedness and adequacy in DVA support
services (Scottish Commission for People with Learning Disabilities 2022).
These attitudes are reflected in the omission of people with learning disabilities from ONS
reports and the statutory definition of ‘domestic abuse’. As discussed, these publications
made limited attempts at acknowledging and exploring the specific statistics, experiences,
and types of DVA experienced by people with learning disabilities. Further to this people
with learning disabilities are only mentioned four times in the domestic abuse statutory
21
guidance (Home Office 2022a), and only once in relation to being victims/survivors of DVA.
This single reference reads as follows:
Disabled victims (this may include, but is not limited to, victims with physical or
sensory impairments, mental health issues, learning disabilities, cognitive
impairments, long-term health conditions and neuro diverse victims) can face
additional forms of abuse where the perpetrator is exploiting the victim’s particular
vulnerabilities to abuse them (Home Office 2022a p61).
Whilst it is welcome that the statutory guidance acknowledges that people with learning
disabilities experience additional forms of abuse, their absence from the remainder of the
domestic abuse statutory guidance is worth noting. This is particularly important given that
women with learning disabilities, autism or both are three times more likely to experience
DVA than their non-disabled peers (Us Too 2021).
Women with learning disabilities are at increased risk from severe, frequent and repeated
incidents of DVA by a wide range of perpetrators (Scottish Commission for People with
Learning Disabilities 2022). This is often more intense and prolonged resulting in profound
emotional and psychological distress (McCarthy, Bates et al. 2019). In conjunction with the
increased risk, women with learning disabilities experience disability specific risks including
the perceptions that women with learning disabilities are asexual (Walter-Brice, Cox et al.
2012), devaluation and rejection in childhood and limited public presence (Pestka and
Wendt 2014), a lack of independence in their finances and a lack of appropriate housing and
transportation (Elstein, Frantz et al. 2015), social isolation and reduced community inclusion
and a reliance on their abuser for assistance with daily living skills (i.e. communicating with
others and paying bills) (Douglas and Harpur 2016), difficulty in identifying manipulative and
22
coercive behaviours (Dixon and Robb 2016, SafeLives 2017), low social status (McCarthy,
Hunt et al. 2017), a lack of appropriate support networks, jobs and activities (McCarthy,
Hunt et al. 2017) and a lack of education on healthy relationships and DVA (Carmarthen
Domestic Abuse Services 2019). Further to this McCarthy (2017b) argues that women with
learning disabilities often endure abuse to gain social value as partners and parents. This is
discussed further in the literature review.
Despite the increased and disability specific elements of risk, women with learning
disabilities encounter significant barriers to support and justice (Scottish Commission for
People with Learning Disabilities 2022). This includes challenges in reporting crimes, such as
limited access to safe spaces and appropriate adults and not being believed or taken
seriously (Scottish Commission for People with Learning Disabilities 2022). There is also a
lack of dedicated services in the UK with only one specialist refuge for women with learning
disabilities, and one specialist refuge for men with learning disabilities, fleeing DVA. Further
to this research has indicated that generic support services lack specialised training to
enable them to better identify women with learning disabilities experiencing DVA (McCarthy
2017b). Additional barriers to engagement with generic services were also identified in the
literature. These include a lack of knowledge amongst women with learning disabilities
regarding; what constitutes DVA and what their individual rights are (Elstein, Frantz et al.
2015), knowing what services are available and how to access them (Douglas and Harpur
2016, McCarthy, Hunt et al. 2017), as well as a lack of appropriate support when help is
sought (Walter-Brice, Cox et al. 2012). The research also highlighted fear as an additional
barrier to help seeking behaviours (Elstein, Frantz et al. 2015, Douglas and Harpur 2016).
Examples of fear include the fear of; intervention from children’s social services (Douglas
and Harpur 2016), retribution from perpetrators, not being believed and fear of being
23
blamed for the actions of others (Elstein, Frantz et al. 2015, Carmarthen Domestic Abuse
Services 2019). Finally, some professionals believe that women with learning disabilities
often ‘cry wolf’ (TalkBack 2020:24) because of a perceived lack of understanding of DVA and
perceived inability to make sense of what they’re experiencing.
The intersection of gender and disability creates a unique vulnerability (Brigden and
Ahluwalia 2020). Women with disabilities face multiple layers of discrimination and
marginalisation, making it even harder for their voices to be heard and their experiences to
be validated (Wickenden 2023). These multiple layers of discrimination may explain, in part,
why reports of DVA by women with learning disabilities are not always taken seriously
and/or are sometimes defined as behavioural problems (TalkBack 2020).
It is important to note that when people experience discrimination this can negatively
impact upon the level of trust they place in national institutions such as the police (Marien
and Werner 2018). Individuals often use evaluations of fairness to appraise the nature of
their relationship with others, particularly, how much to trust those they are engaged with
(Brockner 2002) and the likelihood they could make a difference to their lives (Ruch, Turney
et al. 2010).
2.3. Defining fairness
Fairness is the central experiential concept used in my research. I opted to use the term
fairness, instead of justice, for two main reasons.
Firstly, it was important to select either justice or fairness as the central experiential
concept as they are not the same thing (Colquitt and Rodell 2015, Colquitt and Zipay 2015,
Goldman and Cropanzano 2015). For example, Goldman and Cropanzano (2015) argue that
justice denotes conduct that is morally required. This involves the adherence to rules that
24
reflect appropriateness within the context of the decision being made/action taken (Colquitt
and Zipay 2015). In contrast fairness symbolises an evaluative judgment as to whether
conduct is morally praiseworthy (Goldman and Cropanzano 2015). This judgement manifests
through a person’s perceptions of appropriateness in relation to the decision being
made/action taken. (Colquitt and Zipay 2015). The differences between the concepts are
illustrated when social systems are perceived by individuals and groups as “just” (within the
rules or required by law) but “unfair” (not praiseworthy) or “fair” (praiseworthy) but
“unjust” (not within the rules, or required by the law) (Goldman and Cropanzano 2015). It
was thus important that the thesis did not conflate these two terms.
Once I established that fairness and justice were different terms, I set about determining
which term would be appropriate for the research. Both terms are inherently subjective,
however fairness is a term that is used widely in everyday discourse (Fenton 2021). I opted
to use fairness as I felt that its everyday use increased its accessibility as a topic for
discussion amongst people with learning disabilities.
Despite its everyday use fairness is a contested term and is difficult to explore in the
absence of a definitive context (Jones, Bromley et al. 2010). In this section I will summarise
both the findings of Building understandings of fairness, equality and good relations, which
explored the public’s understanding of the concepts ‘equality’, ‘fairness’ and ‘good relations’
(Jones, Bromley et al. 2010), and theories of fairness such as, justice as fairness (Rawls 1999,
Rawls 2001), fairness theory: justice as accountability (Folger and Cropanzano 2001),
procedural fairness (Brockner 2002), and fairness as the absence of unfair discrimination
and equal fairness (Thompson 2003, Thompson 2007, Thompson 2011, Thompson 2012,
Thompson 2016, Thompson 2017a, Thompson 2017b, Thompson 2018, Thompson 2019,
25
Thompson 2021). Where available, theories of fairness have been supplemented with
research exploring victim/survivors’ thoughts and experiences of justice and/or fairness in
relation to DVA interventions. It is important to note that the searches for literature
regarding fairness and the experiences of people with learning disabilities was lacking (both
in relation to DVA and in general).
2.3.1. Building understandings of fairness, equality, and good relations
In this section I describe how fairness and unfairness was defined in the report Building
understandings of fairness, equality, and good relations (Jones, Bromley et al. 2010). This
report was generated through a study commissioned by the Equality and Human Rights
Commission. The broad aims of the study were to explore the UK public’s understanding of
the terms equality, fairness and good relations; the key factors that influence people’s
attitudes to these issues (including how attitudes are shaped within communities and how
they vary across them); and the implications of people’s understanding and attitudes for
achieving change (Jones, Bromley et al. 2010). The result was conducted using a series of 23
focus groups throughout England, Scotland, and Wales, followed by two stakeholder
seminars. Focas group participation data can be found in the report.
Two views of fairness were identified within the research. Fairness was defined as ‘treating
people equally’ and ‘treating people differently’ (Jones, Bromley et al. 2010). Treating
people ‘equally’, or the importance of ‘even handedness’ was described as equal treatment
in relation to race, gender, ethnicity, faith and disability etc (Jones, Bromley et al. 2010).
Treating people differently referred to treating people fairly according to their particular
circumstances or characteristics and making allowances for an individual’s specific situation
and requirements (Jones, Bromley et al. 2010). An example given in the research was as
26
follows: a wheelchair user needs to have wheelchair access to buildings and is thus treated
differently to everyone else, yet this is fair (p.39).
There were also two broad elements identified as central to defining unfairness. The first
was when people are treated differently because of personal characteristics that are beyond
their control (Jones, Bromley et al. 2010). This experience of unfairness was seen as
synonymous with discrimination (Jones, Bromley et al. 2010). Participants took this
definition even further and talked about unfairness existing even where one person feels
that they are better than another, irrespective of whether they act on those feelings or not
(Jones, Bromley et al. 2010).
The second element related to a disparity between what people put into a system and what
they took out. It was felt that there were some people who got the same treatment as
everyone else but who didn’t deserve it because “they had not pulled their weight” (p.41).
This was spoken about in several contexts including unemployment and immigration (Jones,
Bromley et al. 2010).
Both disabled participants and non-disabled participants explored fairness and disability,
however this was rarely explored spontaneously, and required prompting to illicit views.
This could suggest that either people view fairness and disability as less of an important
social issue when compared to fairness and sex/gender, or fairness and race, or that the
participants had fewer personal experiences of it (Jones, Bromley et al. 2010). When
prompted, participants did discuss disability in relation to two main areas: access, and
treatment (Jones, Bromley et al. 2010). There was a sense among participants that disabled
people were often treated differently, for example that they do not enjoy the same access
to employment as everybody else (Jones, Bromley et al. 2010).
27
Whilst the research by Jones, Bromley et al offers an insight into British attitudes towards
fairness and equality, the paper discusses this generally and does not attempt to elevate the
voices of marginalised communities to ascertain how their experiences converge and
diverge with the general population. Of the 186 participants involved in the focus groups
across England, Scotland, and Wales, only 38 reported having a physical or mental disability.
This represents only 20.4% of the sample. Further to this it is unclear if there is any
representation from people with a learning disability. This indicates that more research is
needed to understand how people with learning disabilities experience fairness and
unfairness within England, Scotland, and Wales
2.3.2. Justice as fairness
Contemporary discussions and ideas regarding fairness are frequently associated with the
work of John Rawls and his theory of justice as fairness. A central feature of Rawls work on
justice as fairness is the original position (Rawls 1999, Rawls 2001). The original position
involves a thought experiment that invites people to imagine that they are temporarily
ignorant about certain things, including important facts about themselves (i.e. how wealthy
they are, whether or not they are talented, and their core personal values) (Hinton 2016).
Whilst under this veil of ignorance people are asked to think about what principles of justice
they would choose to regulate the basic institutions of their society (Hinton 2016). Rawls
(1999) states that under such circumstances it would be rational for the following two
principles of justice to manifest, liberty and equality. In this context liberty refers to a robust
package of liberal rights such as freedom of conscience, freedom to vote and stand in
elections, and rights to due process in law (Hinton 2016). Equality in this context refers to
both equality of economic opportunity and shares of income and wealth that are beneficial
to people with the least amount of income and wealth (Hinton 2016).
28
In essence, the principle of liberty refers to basic rights and liberties afforded equally to all
(Rawls 1999, Rawls 2001, Metz, Rawls et al. 2002). These fundamental basic rights and
liberties include; political liberty, liberty of conscience and freedom of thought, freedom
from psychological oppression and physical assault, the right to hold property and the
freedom from arbitrary arrest and seizure (Rawls 1999). In addition to this, individuals
should have as much freedom as possible if this does not infringe upon the freedom of
others (Rawls 1999, Rawls 2001, Metz, Rawls et al. 2002).
Rawls principle of equality refers to the fair distribution of primary goods (Rawls 1999,
Rawls 2001). Rawls defined primary goods as the freedom of movement, free choice among
a wide range of occupations (including the powers of offices and positions of responsibility);
income and wealth; the social bases of self-respect; recognition by institutions; a sense of
self-worth and the confidence to carry out life plans and goals (Rawls 1999, Rawls 2001).
Central to Rawls (1999) concept of equality is the ‘Difference Principle’. The difference
principle embodies equality-based reciprocity and diverges from strict equality to ensure
that economic inequalities benefit the most disadvantaged (Rawls 1999, Rawls 2001, Metz,
Rawls et al. 2002).
Research by Hester, Williamson et al. (2023) highlights that victims/survivors of DVA
partially define fairness as reparation. This links to distributive justice insofar as
victims/survivors seek the socially just allocation of goods and services as well as the
recognition of economic loss, housing loss, and loss of standing in the community as a result
of their experiences of DVA.
29
2.3.3. Fairness theory: Justice as accountability
In fairness theory: Justice as accountability Folger and Cropanzano (2001) attempt to answer
the question “what do people mean when they say they have been treated rightly or
wrongly?” (p.3). Fairness theory presumes that the central topic of social justice is blame
(Folger and Cropanzano 2001). This means that when people identify an instance of unfair
treatment, they are holding someone accountable for an action or inaction that threatens
their own, or another persons material, or psychological well-being (Folger and Cropanzano
2001).
For an event, action, or decision to prompt fairness evaluations, individuals must perceive
harm (e.g., feel injured or observe injury), that someone is to blame, and that the act
violated a social norm or moral belief (Wiseman and Stillwell 2022). These accountability
assessments of unfairness involve counterfactual thinking (i.e. could the event, decision, or
action have gone differently; should the offender have acted differently, and would the
outcome be different if leaders had made different decisions?) (Wiseman and Stillwell
2022).
Research by Hester, Williamson et al. (2023) resonates with fairness theory as it identifies
fairness as accountability, specifically in relation to the experiences of victims/survivors of
DVA. In their research Hester, Williamson et al, (2023) identified a range of sub-themes
including accountability as recognition from perpetrators, authorities, and/or community of
harm done to the victim, punishment, and rehabilitation. It was particularly important for
recognition to come from the perpetrator themselves. Where perpetrators did not
acknowledge the harm they had done, the next best thing was for another party (the state,
the police, their friends and family) to offer this recognition, and to hold the perpetrator
(rather than the victim) responsible. “This recognition was important for victims-survivors in
30
the process of feeling fairness, and ultimately being empowered, and in control of their own
lives” (p.21). Criminal sanctions were welcomed because they represented recognition of
the harm done by perpetrators.
Hester, Williamson et al, (2023) suggest that for the participants in their study it was
important that they were not made to feel accountable for the DVA they experienced. This
resonates with research by Walter-Brice, Cox et al. (2012) who found that women with
learning disabilities who were survivors of DVA felt that they had been treated unfairly
when they were made to feel accountable and responsible for the violence and abuse they
experienced.
Justice as accountability suggests that people being held accountable for what they have
done constitutes justice and when accountability is misattributed, this creates injustice.
2.3.4. Procedural fairness
In their paper Making sense of procedural fairness: How high procedural fairness can reduce
or heighten the influence of outcome favourability, Brockner (2002) considers the interactive
effects of procedural fairness and outcome favourability on people’s reactions to
organisational decisions. Brockner (2002) argues that people care about procedural fairness
due to its implications for material and moral outcomes and the impact upon a persons
and/or groups social stature and psychological wellbeing. Prevailing ethical standards and
social norms typically mandate that decision makers behave in a procedurally fair way
(Brockner 2002).
Brockner (2002) states that people are more likely to believe they will receive their share of
favourable outcomes, including having their social and psychological needs met, when
procedures and interactions with decision makers are relatively fair. If interactions are
31
procedurally unfair, decision makers are often held accountable for the outcomes of the
exchange (Brockner 2002). Brockner (2002) explains that people may feel uncertain about
their relationships with an institution when procedural unfairness increases the risk of
discrimination or exploitation (Brockner 2002).
The concept of procedural fairness is prominent in some of the literature which explores
DVA and justice. Heydari (2019) argues that victim’s perception of the fair use of
discretionary power by police officers is crucial to managing risk. The extent to which people
feel they have been treated fairly when they have had contact with the police impacts upon
the sense that they have experienced procedural justice (Heydari 2019). By embracing
procedural justice, police officers can exercise their power in a just and fair way through the
‘quality of treatment’ they offer victims/survivors as well as the ‘quality of the decision
making process’ (Heydari 2019).
Malangone (2015) argues that integrating procedural fairness in DVA cases is important as it
is crucial for survivors to see professionals as an access point for protection and safety. If
professionals are perceived as trustworthy, survivors are more likely to access help
(Malangone 2015). Procedural fairness may also negate re-traumatisation by disrespectful
court staff or feelings of hopelessness over the litigation process (Malangone 2015).
Research conducted by Hester, Williamson et al. (2023) found that victims-survivors located
fairness and justice in relation to the community that is that fair decisions are judged on
the appropriateness in relation to all the people they impact.
2.3.5. Fairness as the absence of unfair discrimination
In his book Social Problems and Social Justice Thompson (2017a) states that social justice is
about the social context of fairness and the fairness of the social context (p.3). This means
that fairness is not just about individual issues in specific contexts, but rather, how
32
individual issues reflect wider patterns of injustice, discrimination, and oppression
(Thompson 2017a). A concern about fairness in relation to discrimination and oppression is
reflected in the research conducted by Hester, Williamson et al. (2023). In their research
victims/survivors stated that vulnerability contributed to experiences of unfairness when
navigating the criminal justice system.
Thompson thus advocates for equality. Thompson defines equality as the absence of unfair
discrimination (Thompson 2011, Thompson 2021). Unfair discrimination denotes when
someone is being discriminated against and, as a result, they are denied access, given less,
and/or expected to accept disparaging treatment (Thompson 2021). Thompson (2017, 2021)
states that equality is a matter of equal fairness. Equal fairness involves giving more to those
who need it, proportionate to their own circumstances, to ensure that they have access to
the same opportunities (Thompson 2019). Thompson (2019) has problematised his use of
equality in relation to equal fairness and has stated that equal fairness is more akin to the
term equity. University College London (2020) offers a concise definition of equity.
Equity considers the different starting points for different individuals and aims to
achieve fairness by providing resources according to need. Equity acknowledges the
historical, systemic and structural disadvantages that different cultural and social
groups may have been subjected to and strives to reduce barriers (University College
London 2020).
In addition to equity, Thompson (2019) advocates for a diversity approach to equal fairness.
This involves recognising and valuing diversity in society and understanding that societal
diversity is an asset to be drawn upon, rather than a problem to be solved. Valuing diversity
thus means valuing people for what they bring and not seeing difference as a barrier or a
33
basis for unfair treatment (Thompson 2019). If people define equality as equal fairness, then
diversity and difference become important parts of making equality a reality. This means
that valuing diversity is a part of promoting equality and not an alternative to it (Thompson
2019).
2.4. Chapter Summary
It is important to note that this is not an exhaustive examination of the literature on
fairness, and much more can be said on the topic. As stated in the introduction it was highly
unlikely that a definitive definition of fairness would be arrived at. However, for the purpose
of transparency it is important to note that it is the work of Thompson that resonates with
me in terms of my own academic and professional experiences and positions on the topic.
As such, at this point of the thesis I define fairness as the absence of unfair discrimination,
and in terms of equal fairness, with a particular emphasis on the importance of equity and
diversity.
To reiterate, given the broad spectrum of definitions of fairness it was imperative to provide
those that participated in my research the opportunity to define fairness/unfairness and
discuss the impact this has on their experiences of DVA interventions. This thesis ultimately
conceptualises fairness and unfairness through participants conceptualisations,
understandings, and experiences. This is further explored in the discussion chapter.
The narrative review of key terms explored both the definitions of the key terms used in this
thesis, and the context in which the thesis fits. Both DVA and learning disabilities have been
defined using definitions grounded in the context of national law and statutory guidance,
policy, and professional practice to support the transferability of the findings and support
the design of the research activities (i.e., the inclusion criteria see chapter 4). I have
34
considered the use of language, specifically around domestic abuse and domestic violence
and abuse, learning disabilities and intellectual disabilities, and equality and equity,
justifying the words I will use and why. I have also established that despite their limited
representation in statutory definitions and guidance women with learning disabilities,
autism, or both are three times more likely to experience DVA than their non-disabled
peers. Despite the increased and disability specific elements of risk in relation to DVA,
women with learning disabilities encounter significant barriers to support and justice,
including limited representation in statutory definitions of domestic abuse and statutory
guidance, and limited specific representation in relevant national statistics. People with
learning disabilities also receive limited representation with regards to the theorisation and
articulation of experiences of fairness.
35
Chapter 3: Literature review
The literature review aims to provide a comprehensive overview of the existing research
that informs the thesis as well as identifies the gaps and limitations that justify the need for
further investigation. Within the literature review I explore the design of the literature
search and evaluation strategies, describe the process of searching for and appraising
literature, provide a summary of key points from the extracted literature, and then analyse
the literature in relation to the themes identified. This process culminates in the
identification and discussion of the gap in the knowledge. Finally, I formalise and present
the aim of the thesis and the research objectives.
It was important to document each stage of the process to evidence that the literature
reviews design, processes, and execution were robust and comprehensive. By keeping
comprehensive records, I was also able to evidence how the identified themes were a
representative interpretation of the literature reviewed. I used a number of forms including,
search logs, source evaluation forms, a log of identified themes using excel, COREQ
(COnsolidated criteria for REporting Qualitative research) checklists (Tong, Sainsbury et al.
2007), and simplified quality appraisal checklists for qualitive research (Cabral 2022) to
evidence the search and evaluation process, log the themes identified, and appraise the
quality of the extracted literature.
3.1. Literature search and evaluation strategies
The literature search and evaluation strategies were designed and executed to meet a
‘good’ standard as set out by Savin-Baden and Howell Major (2013). This involved providing
clear search, selection, and exclusion criteria and taking a critical stance on the extracted
literature (Savin-Baden and Howell Major 2013). Further to this, the search and evaluation
36
strategies were designed to take account of the time scales afforded for the completion of
the research. This involved completing search and evaluation strategies in both 2019 (phase
one) and 2023 (phase two).
Phase one of the literature search and evaluation was conducted in 2019, prior to the
research activities commencing, to identify any gaps in the then existent knowledge and
support and inform the research design.
Phase two consisted of the replication of literature search and evaluation processes in 2023.
This was done to ensure that the literature review was up to date and to re-evaluate the
themes and gaps in the knowledge that were initially identified in 2019. Further to this it
was also important to update the literature review to ensure that any policy
recommendations from the thesis were not misleading. The only major deviation from the
parameter of phase one’s search strategy was the time frame selected in phase two. During
phase two I searched for relevant literature from 2020-2023.
Cumpston and Flemyng (2023) state that reporting the details of updated searches
alongside an existing review can be complex. They suggest three approaches to reporting
the results of an updated literature search:
1. An integrated approach that describes all searches together, which may be most
feasible if the same search was repeated.
2. An incremental approach that adds information at each update to describe
explicitly which searches were done for the update, retaining all information about
previous searches.
37
3. A replacement approach that only describes the searches done for the update,
using the previous review as one source of studies.
I have opted for reporting method one as the search was repeated. The outcome of this
integrative approach is summarised in this chapter.
3.1.1. Literature search design
Phase 1 and phase 2 literature searches involved in-depth searches of google scholar, JSTOR
and SCOPUS databases, and a citation search of the extracted literature.
The use of google scholar alongside academic databases is an effective way of searching
available literature (Bramer, Rethlefsen et al. 2017). I acknowledge that academic databases
are often the starting point when searching for literature as they provide quick and focused
access to full text articles within disciplinary boundaries (Zientek, Werner et al. 2018,
Martin-Martin, Orduna-Malea et al. 2019). However, the selection and search of specific
databases for literature can lead to bias in the information they return as the results are
intrinsically linked to the disciplinary focus of the database (Savin-Baden and Howell Major
2013 p116).
By using google scholar for my initial literature search I was able to span the boundaries of
disciplines and include a wide range of source types such as journal and conference papers,
theses and dissertations, academic books, pre-prints, abstracts, technical reports, and other
scholarly literature (Zientek, Werner et al. 2018). This supported me to go beyond subject
specific borders of curated databases in exchange for broad search coverage (Martin-
Martin, Orduna-Malea et al. 2019). This is particularly important given the complex and
inter-disciplinary nature of theories of fairness, as outlined in chapter 2, and the importance
of inter-professional approaches to DVA interventions (Hester 2011, Notko, Husso et al.
38
2022). By doing this I took on the role of a boundary spanner. A boundary spanner works
across disciplines integrating different types of knowledge with the aim of producing more
creative research with greater translational, policy, and practical relevance (Goodrich,
Sjostrom et al. 2020).
Having decided upon the search paths (google scholar, database searches, and a search of
the extracted literatures bibliographies) I began to define the search parameters to make
the search more relevant to the PhD topic. To limit the search parameters, I utilised search
limiters such as date of publication and language (English). I also used Boolean operators to
support the search engine and databases to use logic to limit and narrow the search results
(JSTOR 2022). The search parameters for phases one and two are outlined below.
Table 1: Search parameters for phase one and two literature searches
Search
Engine/Database
Search parameters
Google Scholar
Search: Domestic violence and abuse AND Learning disabilities AND social
justice or fairness
With at least one of the words: fairness, domestic, learning, disability, abuse,
violence
Phase 1 - Times: From 2009 (to 2019)
Phase 2 Times: 2020-2023
JSTOR
Search: ((((domestic abuse) OR (domestic violence)) AND (social justice)) AND
(learning disabilities )) AND la:(Eng OR EN)
Phase 1 - From 2009 (to 2019)
Phase 2 2020-2023
Content I can access
SCOPUS
Search: within Article title, abstract, keywords: domestic AND violence OR
domestic AND abuse AND learning AND disabilities
Phase 1 from 2009
Phase 2 2020-2023
39
Bibliographical
extractions
Subject to interpretation of relevance to research topic
I managed the extracted citations using EndNote x9.
3.1.2. Literature evaluation strategy
Upon conducting literature searches I had to narrow down the search results and identify
literature for extraction. The initial stage of evaluating the identified literature was to assess
the titles of each of the search results. Where I deemed a title to appear relevant to the
study, I then read the abstract and conclusions to get a general sense of the aims,
objectives, participants, and findings of the research (Savin-Baden and Howell Major 2013).
By the end of this initial screening, I had compiled a list of literature that appeared relevant
to my research. Each of the documents that passed the initial evaluative screening where
subjected to a source evaluation form (see appendix 30). The role of the source evaluation
form was to begin the process of moving beyond the summary to engaging in an assessment
of the literatures fitness for inclusion in the literature review (Savin-Baden and Howell
Major 2013). The source evaluation form was created using suggested questions for
evaluating a qualitative study identified by Savin-Baden and Howell Major (2013 p:123). This
included the literatures relevance to the PhD, what the source does and doesn’t say, and
the suitability of the methodology etc (Savin-Baden and Howell Major 2013).
Of the 21 sources across phase one and two scrutinised via source evaluation forms, 9
sources were extracted for an analysis of research quality. Two additional sources of
literature were identified through bibliographic searches. 11 sources were excluded upon
completion of a source evaluation form. There were several reasons for the exclusion of 11
sources including being over 10 years old and not referring directly to the experiences of
people with learning disabilities in relation to DVA interventions. Only two of the extracted
40
studies mentioned fairness or social justice explicitly , a point I will return to in the summary
of the extracted literature.
It is important to note that the initial search strategy was not successful in eliminating
international research. I decided that, considering the small pool of British research
available to me, I would include the international research discovered through the search
strategy. Each international paper extracted was from a reputable journal and provided
information that shed light on my research question.
The next phase of the literature evaluation strategy involved the quality appraisal of the 11
remaining studies (see appendix 31). There are over 100 appraisal tools for assessing the
quality of qualitative research (Majid and Vanstone 2018). The variety of tools reflects the
lack of consensus as to what constitutes appropriate quality criteria for qualitative research
(Majid and Vanstone 2018). It was important to carefully consider which tools to use for the
quality appraisal process for the extracted literature.
Majid and Vanstone (2018) conducted a systematic literature review alongside specific
quality eligibility criteria to identify and compare 8 quality appraisal tools that they
categorised as ‘high quality’ (p.2118). Of the eight appraisal tools analysed by Majid and
Vanstone (2018), two were utilised in this literature review. I used both the Criteria for
Reporting Qualitative Studies (COREQ) (Tong, Sainsbury et al. 2007), and a simplified quality
appraisal checklist (Cabral 2022) based upon the Critical Appraisal Skills Programme (CASP)
tools (Long, French et al. 2020) to quality appraise the extracted literature.
It is important to outline why I used both the COREQ checklist and a simplified CASP quality
appraisal checklist to critique the extracted literature. I initially intended to use the COREQ
checklist exclusively to appraise the extracted literature. I rationalised that this was
41
appropriate as the COREQ checklist is widely used and endorsed by researchers
internationally as it was developed through a systematic review of other appraisal tools
(Majid and Vanstone 2018). Using established criteria, the extracted literature COREQ
compliance was coded as either good ( 25 items), moderate (17 to 24), poor (9 to 16), or
very poor ( 8) based on the number of items addressed in each study (Walsh, Jones et al.
2020).
However, when reflecting upon the scoring outcomes of the literature extracted during
phase one literature searches, I began to question whether the COREQ checklist was the
right tool to use exclusively. Many of the extracted papers by well-established academics
were scoring very poor and poor. I began to reflect upon whether the results of the COREQ
checklist did in fact reflect the quality of the papers extracted. Using inappropriate quality
appraisal tools can result in an underrated appraisal of the extracted literature, which may
adversely have affected the trustworthiness of the conclusions I drew from the literature
(Carroll, Booth et al. 2012).
Whilst the COREQ checklist provided me with an initial overview of what quality markers
had been included in each study I concluded that I needed to employ a secondary appraisal
tool in addition to the COREQ checklist. The COREQ checklist does not account for the
quality of the content of the research extracted. In addition to the COREQ I used the
simplified CASP quality appraisal checklist for qualitative research developed by Cabral
(2022) as part of the ConnectED project. The ConnectED project aims to create a research
culture in adult social care by increasing the ability of adult social care staff to use research
well (The National Institute for Health and Care Research 2023). This is one of several
variations of the CASP tool (CASP N.D.). CASP tools are considered to be a user-friendly
42
option for quality appraisal and are endorsed by Cochrane and the World Health
Organisation for use in qualitative evidence synthesis (Long, French et al. 2020). By using the
simplified quality appraisal checklist, I was able to add a second layer of quality appraisal
that enabled me to reflect upon key elements of the research’s quality such as the
literatures credibility (whether the extracted literature represents the views of its target
demographic), transferability (the extent to which the extracted literature is transferable to
other settings), dependability (logical, traceable, and well documented research process),
and confirmability (whether the analysis is grounded in the data) (Hannes 2011).
3.2. Phase one (2019)
3.2.1. Phase one: Literature search outcome
The outcome of the literature searches during phase one of the literature search is outlined
below.
Table 2: Outcome of phase one literature search
Date/Time
Search
Engine/Database
Search
returns
Extracted
for quality
assessment
09/09/2019
1310
Google Scholar
749
7
23/09/2019
1200
JSTOR
459
0
01/10/2019
1734
SCOPUS
191
3 -
duplications
16/10/2019
1033
Bibliographical
extractions
0
0
The papers extracted during phase one where:
43
1. What do women with learning disabilities say about their experiences of domestic
abuse within the context of their intimate partner relationships? (Walter-Brice, Cox
et al. 2012)
2. Belonging: women living with intellectual disabilities and experiences of domestic
violence (Pestka and Wendt 2014)
3. Violence, Abuse and Bullying Affecting People with Intellectual/Developmental
Disabilities: A Call to Action for the Criminal Justice Community (Elstein, Frantz et al.
2015)
4. Working with Women with a Learning Disability Experiencing Domestic Abuse: How
Social Workers Can Negotiate Competing Definitions of Risk (Dixon and Robb 2016)
5. Intellectual disabilities, domestic violence and legal engagement (Douglas and
Harpur 2016)
6. ‘I Know it was Every Week, but I Can’t be Sure if it was Every Day’: Domestic Violence
and Women with Learning Disabilities (McCarthy, Hunt et al. 2017)
7. ‘What kind of abuse is him spitting in my food?’:reflections on the similarities
between disability hate crime, so-called ‘mate’ crime and domestic violence against
women with intellectual disabilities (McCarthy 2017b)
3.2.2. Phase one: COREQ checklist
The results of the COREQ checklist’s undertaken on the remaining extracted literature
during phase one of the literature review are outlined in the table below.
Table 3: Outcome of phase one COREQ checklist scoring
Phase one
Literature source
COREQ score
COREQ compliance
score (Walsh,
Jones et al 2020)
What do women with learning disabilities
say about their experiences of domestic
13/32
Poor
44
abuse within the context of their intimate
partner relationships? (Walter-Brice, Cox et
al. 2012)
Belonging: women living with intellectual
disabilities and experiences of domestic
violence (Pestka and Wendt 2014)
11/32
Poor
Violence, Abuse and Bullying Affecting People
with Intellectual/Developmental Disabilities: A
Call to Action for the Criminal Justice
Community (Elstein, Frantz et al. 2015)
0/32
Very Poor
Working with Women with a Learning Disability
Experiencing Domestic Abuse: How Social
Workers Can Negotiate Competing Definitions
of Risk (Dixon and Robb 2016)
0/32
Very Poor
Intellectual disabilities, domestic violence and
legal engagement (Douglas and Harpur 2016)
10/32
Poor
‘I Know it was Every Week, but I Can’t be Sure if
it was Every Day’: Domestic Violence and
Women with Learning Disabilities (McCarthy,
Hunt et al. 2017)
14/32
Poor
‘What kind of abuse is him spitting in my
food?’:reflections on the similarities between
disability hate crime, so-called ‘mate’ crime and
domestic violence against women with
intellectual disabilities (McCarthy 2017).
11/32
Poor
The COREQ ratings of the extracted literature were scored as either poor or very poor.
Walsh, Jones et al (2020) suggest that there could be several explanations for consistent
COREQ scores of moderate or below in qualitative studies. Firstly it may be the case that the
authors of the literature were not aware of, or did not see the value in, using the COREQ
guidelines (Walsh, Jones et al. 2020). It is also reasonable to suggest that authors, when
initially writing up their full research reports, addressed COREQ items more
comprehensively but were subsequently required by editors or reviewers of journals to
remove methodological detail considered unnecessary (Walsh, Jones et al. 2020).
The use of the COREQ checklist was none the less useful in considering which of the
extracted literature should be excluded from the literature review at this stage. Both
Violence, Abuse and Bullying Affecting People with Intellectual/Developmental Disabilities: A
Call to Action for the Criminal Justice Community (Elstein, Frantz et al. 2015) and Working
45
with Women with a Learning Disability Experiencing Domestic Abuse: How Social Workers
Can Negotiate Competing Definitions of Risk (Dixon and Robb 2016) scored zero under the
COREQ checklists. The score of zero strongly indicates a severe lack of reporting that is
problematic as it means that it is very difficult to make any conclusions regarding research
quality. These two sources were not dependable insofar as they did not have a traceable
research process (Hannes 2011) and were resultingly excluded from the literature review.
3.2.3. Phase one: Simplified CASP checklist for qualitative research.
The remaining 5 studies were explored using the simplified quality appraisal checklist
devised by Cabral (2022). The overall assessment of the trustworthiness of the 5 remaining
sources was as follows: 4 sources were assessed as trustworthy (Walter-Brice, Cox et al.
2012, Pestka and Wendt 2014, McCarthy, Hunt et al. 2017, McCarthy 2017b) and one’s
trustworthiness was unclear (Douglas and Harpur 2016). All of the sources were included in
the literature review as they were relevant to the research and not deemed to be
untrustworthy.
The phase one CASP checklist highlighted a few points to consider when exploring cross
literature themes. Firstly, none of the researchers evidenced considerations of how their
own views, status, or identity influenced the research, nor what steps they took to reduce
this.
Secondly, the use of language and the definitional parameters used around participants
learning disabilities is inconsistent. This includes reference to people with learning
disabilities, people with learning difficulties, people with intellectual disabilities, and autistic
people. Further to this, one paper conflates the experiences of people who have
experienced brain damage and people who have experienced adverse childhood
46
experiences with people with learning disabilities. One might expect the diversification of
the use of terms such as learning disabilities and intellectual disabilities as some of the
included research was from countries outside the UK. This would not be problematic as the
definitions of these terms are almost identical. However, the conflation of conditions and
experiences in relation to brain injury, childhood trauma, autism, and learning
disabilities/intellectual disabilities is difficult to reconcile. Carlisle, Coumarelos et al. (2022)
states that the use of non-specific and inconsistent definitions of marginalised groups
impacts negatively upon the recognition of violence and abuse experienced by them by the
public, professionals, and survivors. This means that the results of the analysis of themes
cannot be generalised to people with learning disabilities. Whilst this may be the case, the
literature does provide insights into the experiences of the research participants, many of
whom have a learning disability, and thus supports the identification of gaps in the
literature.
The literature also uses variations of language in terms of DA, DV, and DVA. The definitions
used by each author is broadly consistent.
3.2.4. Summary of the extracted literature (Phase one)
In this section I will summarise the literature extracted upon completion of phase one of the
literature search and evaluation. Summaries will add context to the outline of the themes
identified across all the extracted literature (phase one and phase two). This is outlined later
in the chapter. When summarising the extracted literature, I use the terminology employed
by the researchers in their papers, this ensures that I do not misrepresent their work.
47
What do women with learning disabilities say about their experiences of domestic abuse
within the context of their intimate partner relationships? (Walter-Brice, Cox et al. 2012)
The main aim of this research was to ask women with learning disabilities about their
experiences of domestic abuse within the context of intimate relationships. A secondary aim
of the research was to examine whether having a learning disability label influenced their
access to services and support. 5 women with learning disabilities were recruited to take
part in the research, each of the participants had experienced domestic abuse by male
partners. The women were recruited through purposive sampling from two groups for
women with learning disabilities. Each person was interviewed using a semi structured
interview. Interpretative phenomenological analysis was selected as the method of data
analysis.
Five main themes were drawn from the interviews. Although each of the five themes were
described by the authors as relevant, only four themes were presented in the paper due to
restrictions upon the word count. The themes identified in this paper were as follows;
theme 1: abusive experiences, theme 2: disclosure of abuse to services, theme 3: unfairness
and injustice, and theme 4: the importance of support networks.
Theme 1 highlighted the range of domestically abusive experiences amongst the
participants, including physical and emotional abuse against them, theft, sexual abuse,
physical and verbal harassment, and re-victimisation.
Theme 2 explored how the participants experienced inappropriate or unhelpful responses
from services when they disclosed domestic abuse. Unhelpful responses manifested as a
perceived lack of action by services, services attributing shared responsibility for the abuse
between the victim and perpetrator, and the dismissal of pleas for help by children’s social
services.
48
Theme 3 discussed the “common experience of injustice” amongst the five participants
(p.511). Injustice manifested through services protecting the ‘rights’ of perpetrators, the
actions of services invoking feelings similar to those felt in response to experiences of
domestic abuse, the denial of help, or help that increased feelings of vulnerability, and a
lack of understanding amongst professionals regarding domestic abuse (particularly its
psychological impact on women).
Theme 4 explored how positive experiences of support networks provided comfort and
support to the research participants. This was particularly salient when professionals were
experienced in supporting people from a learning disability perspective and when attending
support groups for women.
The paper concludes that the meanings that the participants made of their experiences
reflected “the current marginalisation and oppression that they experience as women with
learning disabilities living in a society that discriminates against them” (p.514). This involved
the internalisation of the oppression of their partners and the dual abuse from the systems
that failed them resulting in feelings of powerlessness and self-blame.
Belonging: women living with intellectual disabilities and experiences of domestic violence
(Pestka and Wendt 2014)
Pestka and Wendt (2014) state that the aim of their research was to examine how the
search for belonging by women with intellectual disabilities contributes to vulnerability of
abuse in relationships with intimate partners. Purposive sampling methods were employed
to recruit four participants through three disability services in Australia. The method of data
collection was semi-structured narrative interviews focusing on a life story approach. The
data was analysed using performative dialogical analysis using elements of thematic and
structural narrative analysis. By using performative dialogical analysis Pestka and Wendt
49
(2014) attempt to show both similarity across narratives and how narratives are co-
produced with the researcher in the setting of the interaction.
Pestka and Wendt (2014) found that the concept of belonging provided insights into the
lives of participants in relation to having an intellectual disability and experiencing domestic
violence. They conclude that experiences of rejection across the life course resulted in the
women internalising the oppression and marginalisation inflicted on them by an ableist and
patriarchal society. This contributed to reduced public presence and the acceptance of
abuse to gain social value as partners and mothers (Pestka and Wendt 2014).
Intellectual disabilities, domestic violence and legal engagement (Douglas and Harpur 2016)
In this paper Douglas and Harpur (2016) report on 6 interviews with women who identified
as having an intellectual disability or learning disability. The six interviews were drawn from
the then incomplete Douglas study. The Douglas study was a large scale research project
exploring both women’s experiences of domestic violence and their engagement with the
legal system in Australia (Douglas 2018). Engagement with the legal system included
engagement with child protection services, police, lawyers, and magistrates. Five of the
participants were recruited from the Working Alongside People with Intellectual and
Learning Disabilities Sexual Violence Prevention Association. The sixth participant was
recruited from another support organisation in Brisbane.
The 6 interviews reported upon highlighted three key areas of discussion, the experience of
abuse, child protection and the police, and judges, lawyers and getting a protection order.
When discussing the experience of domestic violence two types of abuse where often
explored by the participants, social and physical isolation, and economic abuse. The
participants described these experiences as being related to having an intellectual disability.
50
These experiences of domestic violence were often experienced in an overlapping way.
Through an examination of the participants narratives Douglas and Harpur (2016) concluded
that an interrelated mix of disability, illiteracy, and poverty likely contributed to a particular
susceptibility to economic abuse.
All six participants had engaged with social services and/or the police when reporting
instances of domestic violence. There were mixed experiences of engaging with these
services. For example, some participants reported frustration and annoyance during
engagement with social services as they experienced some interactions with them as
patronising. The experiences of the participants engagement with the police were mixed,
underlining the inconsistency of their approach. One participant explained how she felt she
was treated as being “dumb” (p.312) because of her learning difficulties, and that the police
treated the domestic violence as if it were “childish” (p.312).
Douglas and Harpur (2016) conclude that when a survivor with an intellectual disability
interacts with legal institutions without support, there is a risk that they may be unfairly
disabled when navigating the legal system. This research demonstrates how intersecting
vulnerabilities enhance the challenges for women with intellectual disabilities who have
experienced DVA.
‘I Know it was Every Week, but I Can’t be Sure if it was Every Day’: Domestic Violence and
Women with Learning Disabilities (McCarthy, Hunt et al. 2017)
In this paper McCarthy, Hunt et al. (2017) reported upon one aspect of a multi-method
research project. This paper reports upon findings from semi-structured interviews
conducted with 15 women with mild learning disabilities who had experienced domestic
violence and were no longer in the violent relationship. During the interviews the
51
participants were asked about their experiences, the impact of the violence upon them and
their children, their coping strategies, and their help seeking behaviours.
McCarthy, Hunt et al. (2017) utilised purposive sampling to recruit the participants. In
addition to the eligibility criteria mentioned above all participants were over the age of 18,
willing and able to speak about their experiences, and had experienced domestic violence
within 5 years prior to their engagement with the interviews. Women in same sex
relationships were eligible to participate in the research, but none were referred to
participate.
The data was “analysed using thematic analysis” and “some of the principles and practices
of Interpretative Phenomenological Analysis (IPA) to guide the data analysis” (p.272). There
were six main themes emerging from the data: theme 1: severity of the abuse, theme 2:
psychological impact, theme 3: women’s resistance strategies, theme 4: perpetrator issues,
theme 5: seeking help, and theme 6: life after the abuse.
Theme 1 describes the participants experiences of serious assaults, potentially life-
threatening injuries, coercive control, and emotional abuse. Theme 2 explores the
consequences of the participants experiences in terms of its psychological impact upon the
participants and their children. Theme 3 briefly describes the participants resistance
strategies such as verbally resisting and using contraception secretly. Theme 4 outlines the
participants descriptions of the personal issues of their abusers (such as mental health
issues, history of abusing previous partners, and previous criminal convictions).
Theme 5 explored what happened when participants sought help from services. McCarthy,
Hunt et al. (2017) found that when professionals gained knowledge about experiences of
domestic violence in indirect ways little or nothing was done. Indirect knowledge pertains to
52
when professionals are not explicitly told about experiences of domestic violence and abuse
by women with learning disabilities, but do recognise red flags. Respond (2022) highlight
several red flags that professionals should be aware of when working alongside women with
learning disabilities. This includes when women with learning disabilities are in relationships
with men who do not have a learning disability, and/or have poor mental health, and/or in
addiction, and/or do not work, and/or move in with the women very early on in the
relationship. Red flags also include when women with learning disabilities become more
isolated, have less money than before they met their partner, and there are signs of physical
abuse (Respond 2022). It is important to note that on occasions when the participants did
report domestic violence, some had positive experiences. However, many of the
participants experienced problems in seeking help, particularly those with children. Further
to this, the participants level of knowledge about available services was low, McCarthy,
Hunt et al. (2017) state that this could indicate a lack of accessible information available to
the participants.
The final theme explored life after abuse. McCarthy, Hunt et al. (2017) state that for many
of the participants the end of the relationship was not always the end of the abuse.
However, once free, most of the women explained the improvements to their lives.
McCarthy, Hunt et al. (2017) conclude that “there is nothing about having a learning
disability which protects women from domestic violence” and “that the full range of mental,
physical and sexual cruelty, which is inflicted on other women, is also inflicted on women
with learning disabilities” (p.279). This paper has thus argued that “healthcare and social
care professionals have a clear remit to help women with learning disabilities to avoid and
escape violent relationships” (p.279). This includes recognising indicators of domestic
53
violence, being pro-active in asking women if they need help, enhancing independence,
developing social networks, employment, and other meaningful activities, developing self-
advocacy groups, providing accessible information about available help and support, and
making services accessible.
‘What kind of abuse is him spitting in my food?’:reflections on the similarities between
disability hate crime, so-called ‘mate’ crime and domestic violence against women with
intellectual disabilities (McCarthy 2017b).
This paper was produced by McCarthy (2017b) as part of her reflections upon the data
collected for a larger study. McCarthy states that she was:
Struck by many similarities in the experiences of women with intellectual disabilities
who were on the receiving end of violence and abuse from intimate partners and the
experiences of the many people with intellectual disabilities who have experienced
either hate crime or ‘mate’ crime” (p.596).
It is important to note how McCarthy conceptualises mate crime and hate crime. The term
mate crime refers to the befriending of people who are perceived by perpetrators to be
vulnerable, for the purposes of taking advantage of, exploiting and/or abusing them”
(p.596). A key definitional feature of hate crime involves “targeting people because of
certain characteristics which render them vulnerable (through age, gender, disability status,
etc.)(p. 598).
Despite the similarities of experience regarding domestic violence, mate crime, and hate
crime, the responses by both professionals and wider society can differ (McCarthy 2017b).
McCarthy (p.596) explores how and why this happens through an exploration of personal
autonomy. McCarthy (2017b) identifies problems with autonomy in relation to domestic
violence, hate crime, and mate crime stating that it can be very difficult or impossible for
54
some women with intellectual disabilities to exert their autonomy in intimate partner
relationships.
To conclude, McCarthy (2017b) argues that people who provide services to women with
intellectual disabilities need to heighten their awareness of all forms of abuse. This can be
achieved through training that supports professionals to recognise the indicators of
domestic violence in its many forms, and various dynamics. McCarthy (2017b) also
concludes that professionals, families, friends, and supporters need to recognise that when
women with mild and moderate intellectual disabilities lack supportive social networks,
jobs, interests, and activities, their vulnerability to DVA increases.
3.3. Phase two (2023)
3.3.1. Phase two: Literature search outcomes
The outcome of the literature searches during phase two of the literature search is outlined
below.
Table 4: Outcome of phase two literature search
Date/Time
Search
Engine/Database
Search
returns
Extracted
for
reading
Extracted
for quality
assessment
Used in
literature
review
11/11/23
0900
Google Scholar
693
0
0
0
11/11/23
1700
JSTOR
67
0
0
0
11/11/23
2200
SCOPUS
19
3
2
2
16/02/2019
1033
Bibliographical
extractions
N/A
2
2
2
The papers extracted during phase two are as follows:
55
1. An easy access Freedom Programme: a new initiative in the provision of DVA
services for women with learning disabilities (Cavalier 2019)
2. ‘All I wanted was a happy life’: the struggles of women with learning disabilities to
raise their children while also experiencing domestic violence (McCarthy 2019)
3. Managing risk: social workers intervention strategies in cases of domestic abuse
against people with learning disabilities (Robb and McCarthy 2023)
4. ‘You have to be really careful’: technology and the abuse of women with intellectual
and cognitive disabilities (Woodlock and Harris).
It is important to note that whilst the phase 2 (2023) literature search stipulated a search
parameter of 2020-2023, the two extracted studies dated 2019 were identified and
extracted via the bibliography search of Robb and McCarthy (2022).
3.3.2. Phase two: COREQ checklist
The results of the COREQ checklist’s undertaken during phase is outlined in the table below.
Table 5: Outcome of phase two COREQ checklist scoring
Phase two
Literature source
COREQ score
COREQ compliance
score (Walsh,
Jones et al 2020)
An easy access Freedom Programme: a new
initiative in the provision of DVA services for
women with learning disabilities (Cavalier
2019)
10/32
Poor
All I wanted was a happy life’: the struggles
of women with learning disabilities to raise
their children while also experiencing
domestic violence (McCarthy 2019)
18/32
Poor
‘You have to be really careful’: technology
and the abuse of women with intellectual
and cognitive disabilities (Woodlock and
Harris 2022)
15/32
Poor
Managing risk: social workers intervention
strategies in cases of domestic abuse
22/32
Moderate
56
against people with learning disabilities
(Robb and McCarthy 2023)
All four of the papers were retained at this stage as none of the studies were scored as very
poor. Each paper was then subjected to a simplified CASP checklist.
3.3.3. Phase two: Simplified CASP checklist for qualitative research.
The studies identified during phase two were evaluated using the simplified quality
appraisal checklist. The 4 studies were evaluated as being trustworthy and were included in
the literature review as they were relevant to the research.
The phase two CASP checklist highlighted the same issues as the sources extracted in phase
one, namely that there was no consideration of reflexivity and that the use of language
around learning disabilities and DVA differed amongst some of the studies.
3.3.4. Summary of the extracted literature (Phase two)
In this section I will summarise the literature extracted upon completion of phase two of the
literature search and evaluation process. Summaries will add context to the outline of the
themes identified across all the extracted literature (phase one and phase two). This is
outlined later in the chapter. When summarising the extracted literature, I use the
terminology employed by the researchers in their papers.
An easy access Freedom Programme: a new initiative in the provision of DVA services for
women with learning disabilities (Cavalier 2019)
This paper describes and reflects upon the practice of a UK based Community Learning
Disabilities Team and an evaluation of a local DVA programme. The paper outlines how the
measures taken by the Community Learning Disabilities Team to develop an ‘easy access
freedom programme’. The first step in its development was the formulation of a ‘DVA
Special Interest Group.’ The core group comprised of several professionals from the
Community Learning Disabilities Team with a wider network of professionals and academics
57
attending meetings. The group remained faithful to the content of the original freedom
programme and prominently made changes to the vocabulary, grammar and visual layout of
the written resources and the replacement of inaccessible activities. There members of the
group trained as facilitators of the freedom programme and piloted the tweaked
programme.
The paper evaluates the modified programme using two methods: an evaluation form that
address the same questions at the beginning, middle and end of the programme, and
reflections of a meeting with three participants who had attended both the original and
modified programmes.
The evaluation forms were conducted with nine participants. The researchers highlight
positive trends amongst the women including an increased recognition of what DVA is,
recognition of the warning signs of a bad relationship, where to go for help, how to keep
themselves safe, and feelings of confidence about relationships. Many of the participants
expressed positive experiences of what they had learnt and being a part of the group.
The project was shortlisted for a national Patient Safety Award, and as part of the
presentation preparation, the researchers invited some group participants to a meeting to
find out what they had thought of the adapted programme. Three people attended, and all
had previously attended the ‘mainstream’ programme before engaging with the adapted
version. All three said that they had found the ‘mainstream’ programme too difficult to
understand, and some had not even felt able to complete it. They said that they found the
adapted programme much easier to understand as the facilitators broke the content down
into small words and made it easy.
58
All I wanted was a happy life’: the struggles of women with learning disabilities to raise their
children while also experiencing domestic violence (McCarthy 2019)
For this paper McCarthy conducted a qualitative study with six people with learning
disabilities who are parents and have experienced domestic violence from male partners.
McCarthy used interpretative phenomenological analysis to explore the impact of domestic
violence on the women and the children. All the women in the study were asked about their
understanding and experience of domestic violence; the impact on themselves and their
children; their coping strategies; whether and how they sought help to leave the
relationship, and life after the abusive relationship. All interviews were recorded and
transcribed. The principles and practices of Interpretative Phenomenological Analysis (IPA)
were used to guide the data analysis. The women discussed violent conceptions and
pregnancies, perpetrators sabotaging their mother and child bond, living with a broad
spectrum of abuse and their feelings about having their children removed from their care
(p.101).
McCarthy makes several recommendations at the end of the paper. Firstly, McCarthy states
that the early identification of domestic violence in relationships involving women with
learning disabilities (whether they have children or not) is key to resolving some of the
problems they faced. Secondly, McCarthy advocates for the increased use of peer support
groups to achieve empowerment, improve social networks, and support the recovery of
people with learning disabilities who have experienced domestic violence. Finally, McCarthy
recommends the use of advocacy support and an increase in the availability of accessible
information to support and inform people with learning disabilities.
59
Managing risk: social workers’ intervention strategies in cases of domestic abuse against
people with learning disabilities (Robb and McCarthy 2022)
This paper reports upon the findings from a study conducted with 15 social workers. Whilst
the initial research questions did not specifically seek to address risk or risk management
within practice, themes around risk management intervention strategies and professional
judgement were prominent. The study was designed to incorporate a 2-stage interview
process. The first stage involved a semi-structured interview with social workers to discuss
their experience of case(s) involving domestic abuse perpetrated against adults with
learning disabilities. The second stage interviews involved the use of case vignettes.
Participants were asked set questions about their interpretations of the case vignettes.
The findings and discussion examine how the social workers approached risk management
interventions in cases of domestic abuse perpetrated against adults with learning
disabilities. Interventions often focused on individuals taking responsibility for managing
risk, with either the person with a learning disability or the social worker becoming the risk
decision-maker. Further to this social workers often used bureaucratic tasks to protect the
organisation and individual decision-makers from blame.
The paper concludes with recommendations for practice. These recommendations explore
holistic understandings of risk which seek to promote collective responses to risk
management.
‘You have to be really careful’: technology and the abuse of women with intellectual and
cognitive disabilities (Woodlock and Harris 2022)
This research was initiated by the eSafety Commissioner, who sought to build an evidence
base into the use of technology to abuse women with intellectual and cognitive disabilities.
The eSafety Commissioner leads the Australian government’s regulatory agency committed
to keeping its citizens safer online (Australian Government 2023). The research was
60
conducted in two stages. The first stage involved interviews and focus groups with 15
practitioners who work directly with women with cognitive or intellectual disabilities who
had been subjected to technology-facilitated abuse. The questions covered what types of
technology had been misused to abuse women with cognitive or intellectual disabilities,
what the impacts were on the women, and the challenges women and workers encountered
when seeking to respond to and prevent digital harms.
The second stage involved focus groups with six women with cognitive or intellectual
disabilities who had been subjected to technology abuse. Two focus groups were facilitated
in Queensland with five women (two in one group, and three in another). An interview was
also held with one woman in Queensland.
Three main themes were identified in the authors thematic analysis of the evidence
gathered. Firstly, technology is sometimes used by perpetrators to control and intimidate
women with cognitive or intellectual disabilities. This involved technology use to harass and
stalk women and their children, and image-based sexual abuse. Secondly perpetrators
included male intimate partners and ex-partners, family, friends, carers, and strangers.
Finally, the impact of technology-facilitated abuse on women with cognitive or intellectual
disabilities resulted in some of the participants feeling fearful of using technology.
3.4. Emergent themes
Philbrook (2017) states that literature reviews should be organised thematically to show
what the literature has demonstrated and where the gaps are. Each of the nine extracted
papers from phase one and phase two of the literature search and literature evaluation
process were analysed to identify cross paper themes. The themes were identified in
relation to the thesis area of interest, namely the experiences of fairness and unfairness
61
amongst adults with learning disabilities when engaging with services responding to DVA.
To support me to identify themes I followed the method outlined by Philbrook (2017). This
involved:
1. Reading the sources and noting the major themes from the papers. This was initially
done in the margins of printed versions of the papers.
2. Creating an outline of the emergent themes. This was initially done by clustering
themes using excel.
3. Re-reading the sources to identify things missed during the first read through. By
revisiting the sources, the process of identifying themes became iterative insofar as
my understanding of the themes changed through an evolving understanding of the
literature (Lavallée, Robillard et al. 2014). To be considered a cross literature theme
each potential theme had to be identified in at least half of the extracted literature.
There is precedence for this. When discussing group themes in relation to IPA Smith,
Flowers et al. (2012) identify a 50% recurrence threshold for identifying individual
themes as group themes.
However, it is important to note that themes that do not meet this threshold and are of
particular significance to the thesis should still be explored. This ensures that the main
findings and contributions of previous studies in this area are synthesized, acknowledged,
and contribute to the discussions in the thesis.
Seven relevant themes were identified in the literature; increased vulnerability, legal justice,
intersectionality, marginalisation and isolation, service provision, motherhood, and
unfairness/injustice (see appendix 29). Where present, an example of each theme was
noted alongside the paper it came from. This was done in Excel. I then counted how many
62
extracted sources had each theme present. The themes meeting the 50% threshold were
increased marginalisation and isolation (theme 1) increased vulnerability (theme 2),
motherhood (theme 3), and service provision (theme 4). I made an exception and added
theme 5 unfairness and injustice, as this is pertinent to the focus of the thesis.
Each theme highlighted how women with learning disabilities experience challenges
pertinent to all women, as well as specific challenges due to being both disabled and a
women. It is clear that when these vulnerabilities intersect DVA takes on unique forms, has
unique causes, and results in unique consequences (Ortoleva and Lewis 2012) impacting
upon both the experience of DVA and the search for care, support, and help from services.
3.4.1. Theme 1 Marginalisation and isolation
Theme one, marginalisation and isolation, was mentioned in each of the extracted
literature. Experiences of marginalisation and isolation were articulated in several ways,
including marginalisation and isolation through coercive control, identity as a women with
learning disabilities, and desire to have a family.
Isolation and marginalisation is often experienced by women with learning disabilities
during childhood, and this continues into adulthood (Pestka and Wendt 2014). The
participants often experienced marginalisation by their own families, describing feelings of
not being wanted and rejected. This was compounded by an already existing devaluation in
society as disabled women (Pestka and Wendt 2014). Pestka and Wendt link these earlier
experiences to the desire for ‘belonging’ in adulthood, “that is, feeling wanted by an
intimate partner” (p.1033). Participants reflected upon their experiences of seeking social
status and belonging within a family of their own. Being in an intimate relationship or giving
birth to their children gave the women with learning disabilities a sense of belonging that
63
they had seldomly experienced (Pestka and Wendt 2014). However, the women’s stories of
love and motherhood where often entangled with examples of violence and abuse
suggesting that the search for belonging increased their vulnerability to DVA (Pestka and
Wendt 2014).
The experiences of marginalisation and isolation in the research conducted by McCarthy,
Hunt et al. (2017) diverge from those articulated in Pestka and Wendt (2014). Participants
discussed experiences of coercive control and its impact on marginalisation and isolation.
Coercive control was experienced as the curtailing of freedoms through unreasonable and
non-negotiable demands, threats, and intimidation. One participant detailed how she was
told by her abuser not to talk to boys and that she was not permitted to see her friends and
family. Another participant stated that her abuser alienated her from her neighbours and
accused her friends of stealing so they would stop visiting her. Some perpetrators even tried
to isolate women from their own children, particularly where the children had been taken
into care. The perpetrators would prevent visits and calls.
Douglas and Harpur (2016) identified similar themes. They found that participants often
experienced physical isolation and economic abuse in ways that overlapped. Social and
physical isolation was defined by Douglas and Harpur as a technique to entrench control
over their victims. Research conducted by Douglas and Harpur (2016) suggested that as
some of the women became isolated and marginalised, the need to be with their partner
intensified as they feared being alone. They would come to be agreeable and
accommodating seeing parenthood and marriage as a way of continuing to live within
society (Douglas and Harpur 2016). This is also reflected in the paper written by McCarthy
(2017b) which reflects upon the similarities between disability hate crime, ‘mate’ crime and
64
DVA. McCarthy (2017b) found that some men would use women with learning disabilities
desire for friendship and acceptance to systematically isolate and control every aspect of
their lives. This was achieved through ‘cuckooing’. Cuckooing is a practice where people
take over a person’s home and use the property to facilitate exploitation. It takes its name
from cuckoos who take over the nests of other birds (Torbay and Devon Safeguarding Adults
Partnership 2023).
McCarthy (2019), citing the work of Stark (2012), also highlights how men deliberately
engineer social isolation in order to increase control over women with learning disabilities.
To achieve this perpetrators use a range of tactics to isolate women from significant others.
One person from McCarthy’s research stated that.
He was nasty to them…I’d lost all my friendships with some of the neighbours…he
made it so that I didn’t have anyone to talk to and things like that…I wasn’t allowed
to see my family, even when I was pregnant and that really hurt (p.108).
Under these circumstances the participant felt that they had no one they could turn to for
support (McCarthy 2019).
Walter-Brice, Cox et al. (2012) concludes that when perpetrators marginalise and isolate,
interpersonal relationships with others are often rare or sometimes non-existent, resulting
in feelings of immense loneliness, anxiety, and depression. Participation in groups for
people who have experienced DVA can support and facilitate friendships through the
collective spirit of sharing personal experiences. This can have a dual purpose in reducing
both physical and psychological isolation. Attending groups can also support women with
learning disabilities to make meaning of their experiences as something that happens to
other women. When women attended groups they often expressed pleasure in things often
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taken for granted including; feeling worthy and valued and having a place in a group
(Walter-Brice, Cox et al. 2012).
3.4.2. Theme 2 - Increased vulnerability
Theme two pertains to women’s increased vulnerability to experiences of DVA. This theme
is closely linked to theme 1 insofar as marginalisation and isolation can contribute to
increased vulnerability.
McCarthy (2019) states that women with learning disabilities are especially vulnerable to
DVA and exploitation from partners, as well as vulnerable to having their children removed
from their care. In the extracted literature increased vulnerability was articulated in several
ways including devaluation and rejection in childhood, a search for belonging, and predatory
perpetrators.
Both Pestka and Wendt (2014) and McCarthy, Hunt et al. (2017) highlight that for some of
their participants increased vulnerability to DVA was related to their childhood experiences.
Some of the women McCarthy, Hunt et al (2017) interviewed told them that they felt as
though their own ‘troubled backgrounds and personal histories’ contributed to them not
being able to stand up for themselves (p.277). One of the women interviewed by McCarthy,
Hunt et al. (2017) commented that they hadn’t witnessed loving relationships when they
were growing up, and as a result they got “messed up” (p.277). This contributed to a crisis in
the persons confidence in adulthood, contributing to their vulnerability in intimate
relationships (McCarthy, Hunt et al. 2017).
Pestka and Wendt (2014) also found that women cited experiences during their childhood
as a contributing factor to increase vulnerability in relation to DVA in adulthood. Many of
the women engaging with Pestka and Wendt discussed childhood abandonment and abuse
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in relation to their fathers’ negative attitudes and feelings towards their disabilities. Child
abuse and neglect can be defined as:
Inflicting harm on a child or young person and also failing to protect them from
harm. Children and young people may be abused by someone they know in a family
or in an institutional or community setting or, more rarely, by someone they don't
know (for example through the internet) (National Institute for Health and Care
Excellence 2017).
As a result of child abuse and neglect some of the participants felt devalued and rejected.
These feelings were often sustained and continued into their adult relationships leading
some of the women to perceive mistreatment in their adult relationships as to be expected
and a ‘normal’ occurrence of their lives (Pestka and Wendt 2014).
In both papers participants articulated limited opportunities to engage with loving
relationships throughout their childhood. McCarthy, Hunt et al. (2017) drew on the work of
Landman (2014) to add weight to the conclusion that some participants sought and
maintained relationships which were damaging as they had so few opportunities to be a
part of relationships that are warm, supportive, and validating. To summarise, for the
participants any connection was seen as better than none (McCarthy, Hunt et al. 2017).
The idea that any connection is better than none resonates with Pestka and Wendt’s (2014)
conclusion that some of the women’s experiences of intimate partner relationships were
not about ‘belonging’, but instead about ‘settling’ or ‘accepting’. Settling or accepting
denotes a form of action that seeks conformity to conventional gender roles to gain access
to institutions such as the family (Pestka and Wendt 2014). The process of settling or
accepting consequently leads to both gains in social value and increased vulnerability to
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DVA from predatory male perpetrators (Pestka and Wendt 2014). Predatory perpetrators
exploit the vulnerabilities of women with learning disabilities, including their search for
belonging and social status. They use romantic relationships as an opportunity to exploit,
mistreat, and/or abuse. Societal and cultural promotion of women’s social value through
care, submission, motherhood and sexual pleasure, and the prevailing medical model that
constructs disabilities as illness, weak or human deficit, regulate DVA as a personal problem
or way of life for women with disabilities instead of a societal problem (Pestka and Wendt
2014).
This point is given additional weight through the findings in Douglas and Harpur (2016). Each
of the participants in the Douglas Study found that their intersecting vulnerabilities had a
significant impact on their experience of DVA (Douglas and Harpur 2016). For example low
social status as women with learning disabilities may increase a person’s vulnerability to
further isolation and entrenched control (i.e. through economic abuse) (Douglas and Harpur
2016). Crenshaw (1991) explains that the violence that many women experience is often
shaped by other dimensions of their identities. What is evident here is that the intersection
between some of the participants disabilities and their sex increases their vulnerability to
DVA. Crenshaw conceptualises this as intersectionality (Crenshaw 1991). In an interview
published online for Time magazine Crenshaw (2020) defines Intersectionality as “a lens, a
prism, for seeing the way in which various forms of inequality often operate together and
exacerbate each other.”
McCarthy (2017b) argues that it is important for professionals, families, friends, and
supporters to recognise and understand women with learning disabilities increased
vulnerabilities. McCarthy (2017b) states that increased vulnerability can be exacerbated by a
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lack of supportive social networks, jobs, interests, and activities as this contributes to
participants low social status and visibility.
Increased vulnerability can be further exacerbated by interventions that seek to manage risk
in relation to DVA. For example, Robb and McCarthy (2022) found that social workers
working alongside women with learning disabilities experiencing DVA sometimes factor in
how to safeguard themselves from criticism of poorly managed risk when making decisions.
A focus on the preservation of professional and organisational reputation can result in
practice that does not acknowledge or mitigate against wider systemic issues such as the
impact of poverty, ableism, and isolation from the community (Robb and McCarthy 2022).
As a result the possibility for systemic change in relation to the experiences of women with
learning disabilities experiencing DVA is often lost (Robb and McCarthy 2022). This is
important because “complex and engrained structural inequalities impact and often limit
choices and decisions to minimise harm” (Robb and McCarthy 2022 p.56).
3.4.3. Theme 3 Motherhood
Motherhood was an important theme within the extracted literature. The literature
explored motherhood as belonging, motherhood as a driver to leave violent and abusive
relationships, and motherhood as something that is exploited by perpetrators of DVA.
Motherhood as belonging is explored by Pestka and Wendt (2014). Pestka and Wendt
(2014) discovered that some participants viewed motherhood as a role they were destined
to perform. They also believed that the role of motherhood would ultimately lead to them
attaining fulfilment in life. One participant was particularly keen to talk about her children
and referred to them many times when sharing her feelings of belonging:
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Having Jacob and Sally they are the happiest days of my life yeah getting married to
Bruce was good Sally was my flower girl and Jacob was the page boy yeah it was
good and then everything just toppled downhill from that I think (p. 1037).
Pestka and Wendt (2014) suggest that the search for belonging increased participants
vulnerability to DVA. The women’s stories of love and motherhood would often change to
examples of DVA (Pestka and Wendt 2014). In the paper by Pestka and Wendt some people
with learning disabilities explained that they would endure DVA because they placed an
importance upon family and their children having a father, something that they hadn’t often
experienced during their own childhood. Many of the women ‘settled’ and ‘accepted’ the
abuse they experienced (Pestka and Wendt 2014 p1042).
However, settling and accepting DVA to achieve social status as a mother and partner was
not the norm across the research. Walter-Brice, Cox et al. (2012) found that some women
with learning disabilities who had children disclosed DVA to children’s social services in a
desperate attempt to leave their abusive relationships. It can be argued that the desire to
leave abusive relationships was often driven by an awareness of the distress and trauma
caused by witnessing the impact of DVA on their children. McCarthy, Hunt et al. (2017)
highlights several examples of where women with learning disabilities explored the impact
of DVA on their children. One women reflected that.
He used to call me names in front of the children, and I think it’s something they do
pick up on, kids, they don’t understand what the names actually mean, but they pick
up on it. I thought it would grow off them, but it doesn’t, it stays with them (p.275).
It would be wrong to assume that women with learning disabilities are always passive
victims who remained in relationships despite an awareness of the impact DVA has on their
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children. Resistance to DVA can take many forms including verbally resisting/standing up to
perpetrators, sometimes hitting back, rejecting apologies, using contraception secretly,
reporting animal abuse to the authorities, making multiple attempts to leave, and
permanently leaving the violent and abusive relationship (McCarthy, Hunt et al. 2017).
Mothers with learning disabilities often sought help and support to leave violent
relationships, however the majority experienced barriers to obtaining the help and support
they needed. One women reported that:
When we ask for help, there’s no one to help us. They seem to take your children
away instead of helping you [sobbing] (McCarthy, Hunt et al. 2017 p 276).
Care and support offered to mothers with learning disabilities who experienced DVA often
centred around their role as a mother and not as a women with learning disabilities
experiencing DVA (Walter-Brice, Cox et al. 2012). They would often receive family support.
This type of intervention was often inadequate leading to an increased monitoring of the
women’s ability to parent their child. An increase in monitoring often leads to services
heightened awareness of subsequent incidents of DVA. This increased monitoring of
parenting ability and DVA incidents often led to children being removed from the care of
their mother.
Alongside increased surveillance, discriminatory perceptions of people with learning
disabilities may be a contributing factor towards negative experiences of DVA services
amongst mothers with learning disabilities. A practitioner interviewed as part of the
research conducted by Woodlock and Harris (2022) stated that
I can think of one particular example in relation to interfacing with child protection.
Because the perpetrator has set up the mother in such a way it really aided in
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creating this narrative around her lack of capacity as a mother and lack of ability to
meet the needs of her children. There was - the eyes were always on her, never back
at dad. Because when he presented, he presented as functioning and fairly normal.
Mum, on the other hand, didn’t (p.15).
This may be experienced as unfair in relation to fairness as accountability, procedural
fairness, and equal fairness. When considering fairness as accountability it is important to
acknowledge that in this scenario there is limited recognition of the harm experience by the
victim/survivor, the perpetrator is not held to account for their actions, and the victim is
made to feel accountable (Hester, Williamson et al. 2023).
When considering procedural fairness it is important to recognise that in this scenario the
procedures are weighted in favour of the perpetrator (Brockner 2002).
Finally, it is important to note that there is also no value placed upon the mothers diversity,
reaffirming her experience of unfair discrimination (Thompson 2019).
Despite often being the victims of DVA, and in many cases taking steps to seek help, some of
the women experienced the removal of children from their care. This sometimes led to
feelings of guilt related to their role as a mother. One participant from Walter-Brice, Cox et
al. (2012) stated that her role was to protect her children because she is their Mum. Walter-
Brice, Cox et al. (2012) also found that DVA could escalate when children are removed. This
is enacted as payback for disclosing DVA to children’s social services. One participant
summarised that they experienced an escalation of DVA because they did what was best for
their child.
McCarthy (2019) found that once participants children had been removed some of the
mothers could no longer access the care and support they needed.
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After my son went, I phoned up Social Services. They didn’t help me at all. I wasn’t
getting no help or anything during my court proceedings…I took an overdose (p.110).
Mothers with learning disabilities appear to face a triple jeopardy insofar as they are
punished by services and the perpetrator for seeking help, they do not receive person
centred support, and help and support is challenging to access when the risk of potential
significant harm to their children is alleviated by removal from their care. It can be
summarised that the experiences of some of the participants from the extracted literature
are procedurally unfair, unfair through a lack of service and perpetrator accountability and
lack of acknowledgement of harm caused, and discriminatory.
3.4.4. Theme 4 Service provisions
Theme four was identified through the participants experiences of service provisions
responding to DVA. Whilst there was evidently positive experience of DVA interventions, the
literature indicates that the participants experiences were predominately negative.
Participants articulated that service providers demonstrated a lack of awareness and
resources to support their care and support needs, that they are inappropriately funded,
and had an interventional focus on their children. Some of the women also articulated a
process of internalisation in relation to receiving a lack of appropriate support.
Positive experiences of DVA interventions were articulated in several ways. This ranged
from participants receiving support to access a place of safety to offering emotional
support. Participants told McCarthy, Hunt et al. (2017) about instances of positive
interventions with social services and the police. One participant shared that their social
worker took them to a safe place where people took care of them. Another participant
stated that the police were really helpful (McCarthy, Hunt et al. 2017). A participant in the
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Douglas study also had a positive experience of interventions from the police. A participant
stated that;
a lot of the police were lovely… It was like, what do you want me to do? Do you want
to stay in the car, or do you want to come in? You can stay in the car until I speak to
[the abuser] (p.312).
Research by Walter-Brice, Cox et al. (2012) outlined how people with learning disabilities
valued being listened to and believed by services responding to DVA. This highlights the
importance of experiences of fairness through accountability as services sought to hold
perpetrators accountable for their actions (Hester, Williamson et al. 2023).
Positive experiences of DVA services were also experienced through person centred
support. Talking to a qualified counsellor experienced in issues from a learning disabilities
perspective was significant to a participants experience of DVA services (Walter-Brice, Cox
et al. 2012).
Having counselling, talking to someone professional who’s helped me to see sunlight.
I’ve got over the fear now, after my children had gone, I tried to end my life, I talked
to a professional and they said because of my learning difficulties they knew a
counsellor (p.513)
This also highlights a fair experience of DVA interventions through the absence of
discrimination (Thompson 2019).
Another positive experience articulated in the Walter- Brice, Cox et al study involved a social
worker offering to advocate on the behalf of a participant to the police regarding their
experience of re-victimisation.
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The social worker said shall I ring the police up, she rung them up, she helped me out,
cause they [police] help me now, they did a really good job (p.513).
However, most of the participants Walter-Brice et al. (2012) engaged with experienced
hurdles in seeking help, and were disappointed by the responses they received from
services following disclosure of DVA (Walter-Brice, Cox et al. 2012). Whilst in their
relationships many of the women engaged in the research activities across many of the
extracted papers stated that they had disclosed their experiences of DVA to a professional
person. However, many of the participants reported inappropriate or unhelpful responses.
Woodlock and Harris (2022) draws attention to literature that highlights that women with
disabilities are one of the groups most at risk of arrest and misidentification as primary
aggressors, by police, during DVA callouts.
In addition to this Walter-Brice, Cox et al. (2012) highlights that when women with learning
disabilities seek help from services to leave their abusive partners, it was either denied or
inappropriate to their needs. These experiences were also reflected in the research
conducted by McCarthy, Hunt et al. (2017). McCarthy, Hunt et al. (2017) found that when
people with learning disabilities asked for help, they felt as though no one was there to help
them. Women with learning disabilities often felt aggrieved by unhelpful responses. Their
experiences elicited both feelings of anger and frustration directed towards services and the
internalisation of their inappropriate responses (Walter-Brice, Cox et al. 2012). Women felt
that they had been treated unfairly by the services they expected would help them and were
left feeling responsible for the abuse they experienced (Walter-Brice, Cox et al. 2012). This
type of injustice was a common experience in Walter-Brice, Cox et al. (2012) and can be
linked to unfairness as a lack of accountability (Hester, Williamson et al. 2023). Women were
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angered by the attitudes of services that appeared to protect the rights of perpetrators. One
participant who engaged in the research conducted by Walter-Brice, Cox et al (2012) asked
Why should I move he should move it’s always the woman if she gets abused who has
to go, it’s not our fault we’re abused but we seem to feel guilt (p.511).
McCarthy (2017b) summarises that the responses from DVA services are often not good
enough. Despite police, doctors, nurses, health visitors, social workers and support workers
all being aware of some of the participants experiences of DVA, arrests, charges,
prosecutions, and convictions were uncommon (McCarthy 2017b). This procedural
unfairness may contribute to a feeling of immunity from repercussions amongst
perpetrators (McCarthy 2017b).
Some women with learning disabilities interpreted the lack of help available to them as
being due to financial restrictions placed upon DVA services (McCarthy, Hunt et al. 2017).
This was also reflected in the paper by Walter-Brice, Cox et al (2012). In this paper one
participant felt as the they weren’t receiving the support they needed because they only
had low support needs, and that funding was only available to people with high support
needs because of cuts to budgets. McCarthy, Hunt et al. (2017) states that cuts to services
inevitably hinder support responses to women with learning disabilities who report DVA.
Robb and McCarthy (2022) state that there is a need for sufficient funding for local
authorities to undertake community and early preventative interventions that includes
resources to reduce isolation, promote engagement and promote wellbeing. Funding should
also be used to train frontline staff engaged with people with learning disabilities to
recognise the indicators of DVA. This should be happening routinely (McCarthy 2019).
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When services are designed to meet the support needs of people with learning disabilities
who have experienced DVA their outcomes improve. Cavalier (2019) outlines the process
undertaken to create an easy access version of a programme for survivors of DVA which is
already run throughout the UK. Women with learning disabilities who engaged with both
the original and easy access version of the intervention reported that after engaging with
the easy access version they were better able to identify abuse and had more information
about where to go for help. However after engaging with the easy access versions women
also reported feeling less confident (Cavalier 2019).
3.4.5. Theme 5 Unfairness and injustice
Whilst this theme did not reach the 50% threshold for inclusion it has been explored due to
its relevance to the thesis. Two of the extracted papers explicitly discussed experiences
around unfairness and injustice, these were Walter- Brice, Cox et al (2012) and McCarthy
(2019).
McCarthy (2019) explored injustice in relation to women with learning disabilities
engagement with services responding to DVA and the removal of their children by children’s
social services. McCarthy reported that many of the women felt a deep sense of injustice
and many simply did not understand the processes which had led to their child’s removal.
For two women, this sense of injustice and confusion led to violent resistance (McCarthy
2019). In addition to this many of the women experienced limited support both when their
children were at home with them and after they had been removed. On occasions where
they offered help by services, the women experienced the support as inadequate (McCarthy
2019). This raises several questions around the ability of professionals to meet the support
needs of mothers with learning disabilities who are experiencing DVA. There appears to be a
lack of appropriate and accessible person-centred support, advice, and information. This
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highlights how the experiences of injustice in relation to contact with DVA services can be
related to procedural unfairness and the presence of discrimination.
Walter-Brice, Cox et al. (2012) found that women with learning disabilities often felt
aggrieved by the responses they received from DVA services. For example, women were
angered by the attitudes of services that appeared to protect the rights of perpetrators over
their own. This was compounded by a lack of understanding amongst some professionals
regarding what DVA is and how its experienced by women with learning disabilities. For one
woman this lack of professional understanding and inability to empathise made her feel
“worthless again” (p.511). This is another example of how injustice can be experience as a
lack of accountability, as discussed in chapter 2. In addition to this some of the women’s
determination and resolve to leave an abusive relationship was hampered by the inability of
services to offer the right help and support (Walter-Brice, Cox et al. 2012). As a result, some
of the women interviewed by Walter-Brice, Cox et al (2012) had no alternative but to
remain at home, living with the perpetrators. This had a negative impact on their mental
health. This was often compounded by the removal of their children as DVA escalated.
Walter-Brice, Cox et al. (2012) state that attempts to fight against the removal of their
children would, at times. be interpreted by professionals as symptoms of postnatal
depression. As a result of this the experience of depression was not acknowledged as a
symptom of the DVA (Walter-Brice, Cox et al. 2012). Instead, depression and any need for
medication was associated with ‘baby blues’ (p.512). Walter-Brice, Cox et al. (2012) cite the
work of Ussher (1991) to make the argument that the misdiagnosis of the symptoms of DVA
positions women with learning disabilities in a psychiatric discourse and creates a perceived
sickness within that needs to be cured. Walter-Brice, Cox et al. (2012) argue that women
with learning disabilities are seen as learning disabled first, and not as women who are
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statistically highly likely to experience DVA within intimate partner relationships. They
conclude by stating that "it is only when women with learning disabilities are truly
recognised throughout society as women that they can begin to be acknowledged as
vulnerable to the exposure and experience of DVA within intimate partner relationships
(p.515).
3.5. Chapter summary, The Research Question, and the Research
Aims
The review of the literature has supported me to establish the academic context for which
the thesis sits. However, despite procedures put in place to conduct and evidence an
extensive search of the available literature, it is improbable that I have been able to locate
every relevant publication. However, I am satisfied that I have met my responsibility to
design and execute a search that yields relevant literature that is both trustworthy and of
significance to the interests of the thesis.
The identification of the themes inherent in the literature has implications for research with
people with learning disabilities in relation to their experiences of fairness when engaging
with DVA interventions. The literature review highlights that women with learning
disabilities often experience marginalisation and isolation throughout the life-course and
this can contribute to increased vulnerability to experiences of DVA. Experiences of fairness
and unfairness were linked to motherhood and DVA interventions. Motherhood and DVA
interventions have been explored through the lenses of fairness as accountability,
procedural fairness, and fairness as the absence of discrimination.
The literature review has highlighted that the link between learning disabilities and the
experiences of fairness in relation to DVA interventions is under-researched and there is a
need for qualitative research to explore this.
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Based on these considerations the aim of the thesis has been identified as the examination
of how people with learning disabilities (the thesis participants consist of one man and six
women) experience fairness and/or unfairness when engaged with services responding to
DVA. The following research question was adopted:
How do people with learning disabilities experience fairness and/or unfairness when
engaged with services responding to domestic violence and abuse?
The following aims have also been developed and adopted:
1. Critically explore what fairness and unfairness means to people with learning
disabilities.
2. Describe how people with learning disabilities experience fairness and unfairness
within the context of services triggered by DVA.
3. Develop an understanding of how people with learning disabilities want to be
supported by services responding to DVA.
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Chapter 4: Methodology
This chapter explores how the study’s methodological foundations and chosen method
supported me to answer the research question and meet the identified aims of my research.
I start this chapter by outlining my epistemological stance and ontological position. I then
summarise the chosen methodology and discuss the rationale for selecting this approach in
relation to its theoretical underpinnings and considerations made towards other
approaches. I then discuss the importance of reflexivity and how it offers transparency
regarding the impact of my own personal and professional experiences upon the research
process, and how I experience and interpret the world around me. This chapter also outlines
my recruitment protocol in relation to participants for both interviews and the advisory
group. I also explain the advice the advisory group gave in relation to the design of the
research materials. I continue outlining how I conducted the interviews and the process
used for data analysis. Ethical considerations will be explored, both as they arise and in a
dedicated section of the chapter. I will also discuss how I mitigated the impact of covid 19
on the research design, as well as its impact upon wider ethical considerations.
4.1. Qualitative research design
The dual purpose of this research is to establish whether people with learning disabilities
experience fairness and/or unfairness when engaged with services responding to DVA, and
to gain an in-depth understanding of how this is experienced. The subjective and personal
orientation inherent within qualitative methodology is fundamental to the explorations of
the lived experiences of social phenomena. To consider how the participants see the world,
and how they make meaning and sense of their ideas and experiences (Bryman and Becker
2012, Savin-Baden and Howell Major 2013) I opted to use a qualitative research design. This
enabled me to explore participants thoughts, feelings, perceptions, understandings, and
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reflections to gain an insight into how they make sense of, and understand, their
experiences of fairness within the specific context of my research.
Carter and Little (2007) outline a three-stage roadmap for conducting qualitative research in
the social sciences. I have used this roadmap to support me to:
1. explore my epistemological stance,
2. explain my chosen methodology, and
3. justify the method used.
4.1.1. Ontology
Ontology is a philosophical term that addresses questions pertinent to the nature of reality
(Savin-Baden and Howell Major 2013). There are two main ontological positions: realism
and idealism. Realism suggests that there is an objective external and knowable reality that
exists independent of human experience. On the other hand, idealism suggests that reality
is subjective and constructed by individuals and groups (Savin-Baden and Howell Major
2013). Meaning is thus what research participants assign to their lives. My own view of the
nature of reality aligns with idealism. These beliefs have been influenced by my educational
background, including reading both sociology and social work at university, as well as
professional experiences in social work, adult social care, and strategy and policy
development.
4.1.2. Epistemology
Epistemology is the philosophical theory and study of knowledge and is concerned with its
possibilities, nature, sources, and limitations (King, Horrocks et al. 2019). Moon and
Blackman (2017) add that epistemology is concerned with all aspects of the validity, scope,
and methods of acquiring knowledge, such as what constitutes a knowledge claim; how can
knowledge be acquired or produced; and how the extent of its transferability can be
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assessed. Epistemology is important because it influences how researchers frame their
research in their attempts to discover knowledge (Moon and Blackman 2017). When
establishing an epistemological position it is particularly important to question what we can
know and what we might want to know as well as the role of the researcher in the research
(King, Horrocks et al. 2019).
Researchers who adhere to positivism take the philosophical position that seeks to produce
objective understandings of the world that can be generalised beyond the immediate
research setting (King, Horrocks et al. 2019). Within this epistemological positioning the
researcher and the world are seen as separate, with the world existing regardless of the
researcher’s presence (Bryman and Becker 2012). Most quantitative research can be seen as
taking a positivist approach (King, Horrocks et al. 2019). One of the underlying tenants of
quantitative research is a philosophical belief that our world is relatively stable and uniform,
such that we can measure and understand it as well as make broad generalisations about it
(Mertler 2019). Positivist quantitative research relies on the collection and analysis of
numerical data to describe, explain, predict, or control variables and phenomena of interest
(Gay, Mills et al. 2009). It was my assessment that the aims of my research could not be fully
achieved within a quantitative positivist paradigm. This thesis does not look to control
variables, predict the outcome of data collection, nor make broad generalisations about the
findings. Further to this I am firmly of the view that the researcher cannot separate
themselves from the research process, a point we pick up later in the chapter.
This thesis will utilise a qualitative research design. The main concerns and preoccupations
of qualitative research include a focus on participants meanings and descriptions as well as
an emphasis on context, process and flexibility (Bryman and Becker 2012). It is these
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concerns and preoccupations that will enable me to answer my research question and meet
the research aims with sufficient depth. King, Horrocks et al. (2019) explains that what
counts as knowledge, and how that knowledge is generated and understood, carries
implications for the design and analysis of qualitative data. It is important to set out how I
think about the world and knowledge creation to provide transparency and justify the
research design. King, Horrocks et al. (2019) identifies four philosophical positions in
qualitative research, neo-positivism, limited realism, contextualism, and radical
constructionism.
4.1.3. Neo-Positivism
Neo-positivism assumes there is a single real world and the researchers role is to seek
objectivity and the avoidance of bias through a high degree of research standardisation
(King, Horrocks et al. 2019). The role of objectivity in neo-positivist research is problematic,
particularly for this thesis, given my own experiences and expertise in this area of study. As I
have already stated I do not believe that the researcher can be detached from the research
process as their experience informs and influences each part of the process. Further to this I
do not agree that there is one single real world, instead there are multiple individual worlds
constructed through a process of socialisation and experience, with each individual
experiencing phenomena in contextualised, intricate, and unique ways.
4.1.4. Limited realism
Limited realism is close to neo-positivism insofar as it shares a belief in reality that is
independent of our engagement with it, but it does not hold that we can know reality with
objective certainty (King, Horrocks et al. 2019). Limited realists seek to uncover contextually
contingent mechanisms by which the cause of specific phenomenon may be understood
(King, Horrocks et al. 2019). Limited realists privilege some interpretations of phenomena
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over that of others in search of the best possible explanations of processes and phenomena
(King, Horrocks et al. 2019). Thus, limited realists are not interested in the experience of a
phenomena from the perspective of individuals, but rather seek to explain the causes of a
particular phenomenon and how this can be understood. This thesis does not seek to
produce a consensus of reality that is independent of individual context, but instead seeks
to understand phenomena within its lived context from the perspective of the research
participants. This may take the form of shared experience and experiences that differ. For
me both the similarity and differences within the experience of phenomena are equally
important in providing a fully contextual understanding of experience.
4.1.5. Radical constructionism
Radical constructionism seeks critical understandings of how versions of reality are
constructed in specific settings, especially through language (King, Horrocks et al. 2019). For
radical constructionists’ language is not understood as representing reality but as discourse,
constructing a host of expectations and obligations that are constructed by social and
political institutions (Miller 1990). Discourse is an institutionalised way of speaking or
writing about reality that defines what can be intelligibly thought and said about the world
and what cannot (Miller 1990). Language therefore has the potential to construct particular
and different forms of reality (King, Horrocks et al. 2019). Meaning is thus not out there
waiting to be discovered, rather it is bought into being in the process of social exchange. As
such radical constructionists are not interested in experience as lived at all. Rather they are
interested in the positions people take and what they seek to achieve in doing so (King,
Horrocks et al. 2019). The central focus of my research is not on the position taken by the
participants during the interview process, nor what they seek to achieve in doing so. The
aim of my research is to explore the experiences of a phenomenon (fairness and unfairness),
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within a particular context (people with learning disabilities engaging with services due to
experiences of DVA). However, the positions taken by the participants and the
interpretation of why these positions are taken may form an interesting part of the process
of interpretation during the analysis of the data. This may subsequently be important in
understanding how and why a phenomena are experienced.
4.1.6. Contextualism
The tenants of neo-positivism, limited realism, and radical constructionism do not fully align
with my own philosophical underpinning regarding the nature of knowledge. My
philosophical alignment about the possibilities, nature, sources, and limitations of
knowledge are in alignment with the underpinnings of contextualism. This will now be
discussed in more depth.
Within a contextualist framework the perspectives of participants is grounded in their
actual descriptions of their experiences of a given phenomenon (Madill, Jordan et al. 2000).
Contextualist do not seek to re-articulate conventional understandings through consensus,
instead retaining truly novel perspectives where conventional understanding are often
valued (Madill, Jordan et al. 2000). At the centre of this is context. For contextualists
everyday life is set in a particular time, consisting of an innumerable number of factors,
relations, and activities, and is in a state of continuous change (King, Horrocks et al.
2019). To know differs from situation to situation and is local, provisional, and situation
dependent (Madill, Jordan et al. 2000), thus truth-conditions of knowledge claims vary with
the contexts in which those claims are made (Pynn 2016). This means that each participants
experiences are truly novel and is dependent upon the time, place, and space in which they
are experienced (Schwandt 2007). Each unique experience is also shaped by a person’s
protected characteristics, culture, socio-economic background, education, life experience,
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and traditions etc (Pynn 2016). Researchers can only come to know something about
participants through careful and sympathetic attention to how they care for various ‘things’,
how they are concerned or distressed by them, and ultimately how they are tied up and
involved with them. It is therefore important to interpret a participants experiences as a
person-in-context (Larkin, Watts et al. 2006).
The relationship between the researcher and participants is also essential to producing a
rich account of a person in context (King, Horrocks et al. 2019). It is not only the context of
the participant that is important to the creation of knowledge, but also the researcher’s
context and how that interacts with participants articulation of their experiences.
Contextualist approaches commonly put a strong emphasis on the importance of the
dynamics within the relationships between the interviewer and interviewee, and urge
researchers to pay close attention to these (King, Horrocks et al. 2019). For example the
empathy provided by a shared humanity and common cultural understanding can be an
important bridge between researcher and participant and a valuable analytic resource
(Madill, Jordan et al. 2000). However, context is not bound by just a set of interrelated
patterns in which people exists, it also refers to the social practice of asking questions about
meaning, identity, and speech etc (Schwandt 2007). The context of the interview, including
its time, place, and space, the skill of the researcher, and both the willingness and desire of
the participant to fully engage in the process also impacts upon knowledge creation.
Having set out my philosophical standpoint it is important to use these fundamental tenants
to inform which methodology I will employ during the research design, data collection and
data analysis. I have determined that interpretative phenomenological analysis adheres to
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my contextualist position (King, Horrocks et al. 2019) and as such this is the methodology I
will employ during the thesis.
4.2 Methodology
In this section I outline the theoretical underpinnings of my chosen methodology,
Interpretative Phenomenological Analysis (IPA), and its suitability to the thesis in relation to
the research question and aims, and the ontological and epistemological underpinnings of
the thesis discussed above. I then summarise the rationale for selecting IPA and outline
some limitations and how these were minimised. I finish this section by highlighting other
methodologies considered for use in the thesis, and why they were not chosen.
4.2.1. Interpretative Phenomenological Analysis
IPA first found prominence in health psychology. IPA is now employed in a wide range of
areas both within and beyond psychology, for example in health, education, management
and the humanities (Smith 2017). Researchers who adopt IPA are especially interested in
what happens when the everyday flow of lived experience takes on a particular significance
to people (Smith, Flowers et al. 2012). Simply put, the focus of IPA is the in-depth
exploration and interpretation of personal experience, with a particular focus on
understanding the participants point of view and how they make sense of their experiences
(Smith and Nizza 2021). The assumption behind this premise is that people are actively
engaged in the world and are constantly reflecting on their experiences to understand them
(Smith 2011, Smith, Flowers et al. 2012, Smith and Osborn 2015a, Smith and Osborn 2015b,
Smith 2017, Smith 2018).
My research aimed to capture the lived experience of fairness and unfairness amongst
people with learning disabilities, in their own terms, in relation to engagement with DVA
interventions. The role of research is not to determine the truth of what has happened but
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rather to understand what is meaningful for the participant. This was achieved by
interpreting what significance the participants attributed to their experiences through an in-
depth exploration of how they perceive, ascribe meaning to, and make sense of their
experiences. IPA consists of three theoretical stances, phenomenology, hermeneutics, and
ideography.
4.2.1.1. Phenomenology
Phenomenology is a philosophical approach to the study of experience (Smith, Flowers et al.
2012). It is not a unitary body of thought but instead has been developed and adapted by a
number of key individuals including Husserl (2012) (writing in the 1930s) and Heidegger
(1953). Although these contributors may vary in their ideas, they share a core concern with
thinking about what the experience of human beings is like (Smith, Flowers et al. 2012). In
simple terms, phenomenology can be defined as an approach to studying human experience
that seeks to describe the essence of a phenomenon by exploring it from the perspective of
those who have experienced it (Neubauer, Witkop et al. 2019). The goal of phenomenology
is to describe the meaning of this experience, both in terms of what was experienced and
how it was experienced (Neubauer, Witkop et al. 2019). Through an examination of
experience new meanings and appreciations can be developed to inform, or even re-orient,
how the participants, readers and researchers understand that experience (Neubauer,
Witkop et al. 2019).
Husserl has been identified as the founder of the phenomenological approach and his
conceptualisation can be understood as ‘transcendental/descriptive phenomenology’
(Neubauer, Witkop et al. 2019). For Husserl, phenomenology involves the careful
examination of human experience (Smith, Flowers et al. 2012). This involves focusing on
what is experienced in the consciousness of the individual. Consciousness is always directed
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at an object. Objects are conceptualised as the topic, thing, or state of affairs that is
experienced in the consciousness (Smith, Flowers et al. 2012). People are intrinsically
related to the objects they perceive in the lived world. Husserl conceptualises this as
‘intentionality’ (Smith, Flowers et al. 2012). Husserl was interested in discovering a means
through which individuals could accurately know their experience of objects in such a way
as to be able to identify its essential qualities (Smith, Flowers et al. 2012). To achieve this
Husserl argued that people should focus on the description of objects through their
experiences of thought, memory, imagination, or emotion (Neubauer, Witkop et al. 2019).
He also emphasised the importance of bracketing. Bracketing can be described as an
attempt to hold prior knowledge or belief about the phenomena under study in suspension
in order to perceive it through our experiences of thought, memory, imagination, and/or
emotion (LeVasseur 2003). Husserl argued that in order to achieve a deeper understanding
of objects we must ‘bracket’ our presuppositions and preconceptions of a given
phenomenon to concentrate on our perceptions of it (Smith, Flowers et al. 2012).
The ability to hold prior knowledge and belief in suspension has been contested. Heidegger,
a student of Husserl, re-evaluated the role of bracketing within the interpretation of
qualitative data. Heidegger contended that the researcher cannot not be completely
objective, separate, or value free when engaging with qualitative data as they bring their
fore-conceptions (prior experiences, assumptions, preconceptions) to their engagement
with the research process (Smith, Flowers et al. 2022). Heidegger championed the idea of
locating people, including the researcher, within their context (Smith, Flowers et al. 2022).
Contextual information can be considered on several levels including historical, situational,
cultural, and personal (Willig, 2013). Consequently, people make sense of the world from
the perspective of their realities and are thus not detached from their context (a world full
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of people, objects, language and culture) (Smith, Flowers et al. 2012). Heidegger concluded
that researchers cannot fully suspend prior assumptions, knowledge, experience, and
preconceptions during the research process (Dowling and Cooney 2012). This is consistent
with my contextualist position insofar as the researchers influence is not treated as a source
of bias threatening to undermine the validity and reliability of results, rather the
researcher’s subjectivity is very much a part of the research context (Larkin, Watts et al.
2006, King, Horrocks et al. 2019). To conclude, I do not think that bracketing is something
that can be achieved in the thesis as my own situational and experiential viewpoints will
impact upon my decision making throughout the research process. It is thus important to
engage in reflexive thinking.
Pietkiewicz and Smith (2014) explain that part of the IPA process is the documentation of
the researcher’s sense making. This is documented in the reflexivity statement (see
appendix 1), researcher diary entries (see appendix 2 and 3), the data analysis, and the
findings. When conducting research reflexive awareness is required to lay bare the
researchers influence on the research process (Smith, Flowers et al. 2012).
Much like the participants of the research, the researcher cannot remain value free or
separate from their own embedded historical, cultural, political, and social contexts which
have impacted upon their experiences, thoughts, feelings, motivations, and drives
(Neubauer, Witkop et al. 2019). Instead, the researcher’s past experiences and knowledge
are valuable guides to the research and how it is carried out. It is the researcher’s education
and knowledge base that lead them to consider a phenomenon or experience in need of
investigation (Neubauer, Witkop et al. 2019). Within IPA, researcher influence is not treated
as a source of bias threatening to undermine the validity and reliability of results, rather the
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researcher’s subjectivity is very much a part of the research context (King, Horrocks et al.
2019). That is to say that the researchers’ beliefs and attitudes are an integral part of the
research process. Researchers are assumed to have a position which affects the nature of
the observations and the interpretations that they make (Bukamal 2022). Because of the
importance of the nature of the relationship between the researcher and participants, the
researcher’s background, including class, gender, ethnicity, sexuality, age, ideas,
commitments and national identity, need to be made explicit (Bukamal 2022). Further to
this, ethical and inclusive approaches to research should reflect on power differentials and
researcher positionality, and the impact this may have on the collection, interpretation, and
representation of data (van der Heijden, Harries et al. 2019).
It is my belief that researchers should openly acknowledge their preconceptions and reflect
on how their subjectivity formulates part of the process. Researchers should also explore
their engagement with data in terms of the interaction between something that is old (fore-
structures) and something which is new (the data itself) (Smith, Flowers et al. 2022). It is
thus important to understand what participants narratives brings to us, and what we bring
to participants narratives (Smith, Flowers et al. 2022). This is something I have done
throughout the research process and evidenced through my reflexive statement and
research diary.
Husserl’s phenomenology fits with my contextualist approach as it both highlights that
knowledge is context bound and that knowledge production is influenced by participants
personal understandings, researchers’ interpretations, and the cultural context in which
both understandings are embedded.
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4.2.1.2. Hermeneutics
IPA is an interpretative approach and is therefore informed by hermeneutics, the theory of
interpretation (Smith, Flowers et al. 2012). Hermeneutics was initially developed for the
interpretation of biblical texts but the focus has gradually been extended (Smith, Flowers et
al. 2012).
Central to Heidegger’s conceptualisation of hermeneutics is the ‘dual quality of appearance’
(Smith, Flowers et al. 2012). For Heidegger ‘things’ in our world have both visible and
concealed meanings. Our fore conception (prior experiences, assumptions, preconceptions)
are present in the process of interpretation as we often look upon any new stimulus in light
of our fore conceptions (Smith, Flowers et al. 2012). Fore conceptions are always present;
however they are not always visible (Smith, Flowers et al. 2012). Therefore, although our
fore-conceptions enable understanding, Heidegger argued that they can also be a barrier to
the interpretative process where our focus should be on allowing the object of concern to
show itself, as it is (Smith, Flowers et al. 2012), and not how it is being interpreted.
Gadamer argued that understanding and interpretation are bound together and that
interpretation is always an evolving process, thus a definitive interpretation of a phenomena
is likely never possible (Laverty 2003). Gadamer adopted the belief that the primary aim of
interpretation is to attempt to understand the content of text and not to understand its
author (Laverty 2003). Schleirmacher (1998) disagreed with Gadamer and argued that an
understanding of the author is a central consideration of the interpretation of text. He
proposed that interpreting text involves two distinct levels: the grammatical (objective
textual meaning) and the psychological (subjective individuality of the author) (Yilmaz 2012).
Schleiermacher conceptualised these levels as parts of a hermeneutic circle (Yilmaz 2012).
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The hermeneutic circle is concerned with the dynamic relationship between the part and
the whole at a series of levels (Smith, Flowers et al. 2022). In essence, to understand any
given part, you must look at the whole; to understand the whole you must look at the parts
(p.22). This operates at a number of levels; such as the single word in relation to the
sentence, to the single episode of someone’s life in relation to their complete life (Smith,
Flowers et al. 2022). When applied to the research process the continual movement
between the parts and the whole may involve; moving from words, sentences, and
paragraphs (parts) to an entire transcript (whole), and the movement between researcher
and participant (parts) in working together to form an experiential account (whole)
(Montague, Phillips et al. 2020).
The movement between researcher and participant to form an experiential account is
further explored through the double hermeneutic. During the double hermeneutic the
researcher is trying to make sense of the participant who is trying to make sense of their
experience of the phenomena of interest (Smith, Flowers et al. 2022). In summary, when
providing an account of an experience, the participant is interpreting their actual lived
experience for the researcher. The researcher then tries to interpret the participants
interpretation (Smith, Flowers et al. 2012). There is thus a dual role for the researcher as
they become both like and unlike the participant. In one sense the researcher is like the
participant, a person drawing on everyday human resources in order to make sense of the
world. On the other hand, the researcher is not the participant as they can only access the
participants experience through their own, experientially informed lens (Smith, Flowers et
al. 2012). This double hermeneutic highlights how the researcher can never really step
outside their own position when conducting research.
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It is important to note that PhD researchers do not work in a vacuum and thus collaboration
through supervision creates multiple hermeneutics which interact and change the
interpretative process (Montague, Phillips et al. 2020). This is of particular significance for
students who move through several formal and informal processes that scrutinise their
work, including their findings. Whilst Montague, Phillips et al. (2020) specifically explore
their experiences of conducting IPA with teams of researchers, I would equally apply their
principles to the thesis in light of the interactions I have had with academic colleagues
through supervision and Annual Progress Monitoring throughout the years. These
supportive mechanisms, and the multiple hermeneutics involved, feed into the hermeneutic
circle through negotiation, reflection, and discussion. These processes support the
construction of a richer analysis and discussion (Montague, Phillips et al. 2020). This
collaborative approach provides checks and balances through which an analytic consensus
can be reached, providing a richer interpretation that goes beyond description.
It is clear that the meaning of participants narratives in IPA can be made at several different
levels, and this shifts throughout the analytical process. Each level of understanding and the
changes in the depth of understanding is related to one another. These evolving
understandings inform the part-whole coherence of the thesis (Montague, Phillips et al.
2020). For example, the researcher’s initial interpretations of a transcribed interview are
impacted upon by their own preconceptions, expertise, experiences, and emotional
responses to the text. Any initial interpretative understandings of the data may change or
be reinforced during subsequent interviews and interactions with participants, through
interactions with supervisors and APM chairs, and/or engagement with literature etc. In
short data analysis is revisited throughout the research process, due to the iterative nature
of IPA, with the evolving understanding of the whole being informed by access to more
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informative parts (Smith 2007). Put simply each stage of analysis can lead to the revision of
prior interpretative decisions (Smith and Nizza 2021). This often involves a process of
moving back and forth into the exploratory notes and clustering, facilitating interpretations
at a number of different levels, all of which relate to one another (Smith and Nizza 2021).
It is important to note that a final interpretation of the research data using IPA may never
be reached as the hermeneutic circle could theoretically go on forever (Smith 2007). Further
to this the double hermeneutic reiterates IPAs compatibility with contextualism and the
centrality of reflexivity within the research process.
4.2.1.3. Idiography
IPA is an approach to qualitative research with an idiographic focus, which means that it
aims to offer insight into how a given person, in a given context, makes sense of a
given phenomenon (Smith, Flowers et al. 2012). Research with an idiographic focus differs
to nomothetic research as it does not seek to make generalisable and overarching claims
regarding human behaviour (Smith, Flowers et al. 2012, McLeod 2019).
The fundamental principle behind the idiographic approach is to explore every single
participants narrative individually, valuing their experiences on their own merits before
moving to a general cross-case analysis to explore the convergences and divergences
between them (Tuffour 2017). Further to this extracts from each participants transcripts are
directly quoted in the research to ensure the participants have a presence and do not get
lost in generalised statements (Smith 2017).
The principles underpinning ideography resonate with the aims of the thesis. The thesis
does not aim to capture a universal essence of the experience of fairness or DVA. The thesis
seeks to understand the personal perceptions and individual experiences of fairness and
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unfairness of participants with learning disabilities who have experienced professional
intervention related to DVA. Whilst IPA is experientially focused, it does not claim to
examine experience removed from the participant’s and researchers’ sense-making (Gil-
Rodriguez 2022). This is consistent with section 4.2.1.2 on hermeneutics. As a result I sought
to get experience close, as opposed to experience far (Gil-Rodriguez 2022).
The experiences that will be presented are specifically applicable to the participants who
have agreed to be a part of my research. Their experiences will contribute to
understandings of the phenomena of study, add to any existing knowledge, and create new
knowledge, but will not be generalisable, in the traditional sense, to wider populations. It is
important to note that any immediate claims from the analysis are therefore bounded by
the group studied (Smith and Nizza 2021). Any extension of these claims can be considered
through theoretical generalisability.
Theoretical generalisability is the mechanism through which researchers can assess whether
their findings t