The psychological and emotional factors relating to self-injury for young people with complex needs
Lead Research Organisation:
University of Bristol
Department Name: Sch for Policy Studies
Abstract
Beverley's proposed research holds much potential for practice related work supporting young people with complex needs, but also as a contributing to the existing literature. Her work fits within the ESRC strategic priority area of mental health, in particular the ways in which social, psychological and environment factors influence and contribute to the self-injurious behaviour of young people with complex needs. Academically, her research is likely to contribute to the growing body of work that is situating self-injury by people with a learning disability into the mainstream discourse stress and distress, rather than it being ascribed to biological functions. This presents important guidance for interventions for young people who self-injure - potentially challenging the pharmacological and behavioural interventions that are currently often prescribed, and shifting the focus onto psychological support.
Organisations
People |
ORCID iD |
| Pauline Heslop (Primary Supervisor) | |
| Beverley Samways (Student) |
Publications
Samways B
(2022)
Professionals' attitudes towards people with intellectual disabilities who self-harm: A literature review.
in Journal of intellectual disabilities : JOID
Samways B
(2022)
Self-reported explanations for self-injury by people with intellectual disabilities: a systematic review of qualitative studies
in International Journal of Developmental Disabilities
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| ES/P000630/1 | 01/10/2017 | 30/09/2027 | |||
| 1925939 | Studentship | ES/P000630/1 | 01/10/2017 | 30/09/2025 | Beverley Samways |
| Title | A learning disability is not an emotional disability |
| Description | A video presenting my research produced for the Research Without Borders initiative. |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2021 |
| Impact | The video was used in the Research without Borders conference, added to my professional website and used as part of a lecture at the University of Bristol |
| URL | https://www.youtube.com/watch?v=S_3nrpD3j2k |
| Description | I completed a systematic review in September 2019 which examined professionals' perceptions of people who self-harm. It systematically reviewed the research evidence examining attitudes of professionals supporting people with and without learning disabilities who self-harm. It found thirty studies: four studies were conducted with professionals supporting people with learning disabilities, the other 27 studies were with professionals supporting people without learning disabilities. Attitudes were found to be largely sympathetic, but there was evidence of punitive and judgemental attitudes and a repeated concern raised across the sectors about inadequate training and support. Professionals supporting people with learning disabilities were found to have some attitudes that mirrored the behavioural and biological theories dominating theory and practice (that self-harm is the result of operant learning or associated with a biological condition or concern). However, they also tended to have a more relational approach, which was more reflective of the NICE (2013) recommendations. The review concluded with recommendations for adequate training for staff supporting people who self-harm; a NICE (2013) recommendation which is largely not being met. It also recommended better support and supervision for staff to increase resilience and equip them to sustain compassionate attitudes towards people who self-harm, with the appropriate resourcing to achieve this. It also concluded that professionals supporting people with learning disabilities who self-harm were found to have some differing attitudes, including a greater emphasis on relationship, recommending that these differences are worth exploring in future research. This systematic review was presented as a poster at the Seattle Club, 2019, a conference focusing on research into Child Development and Learning Difficulties, supported by UCL. I graduated with a MSc in Social Work Research with Distinction in December 2019. I was awarded a prize by Bristol's School of Social Policy for the best overall dissertation in the programme. This systematic review was successfully published in the Journal of Intellectual Disabilities in August 2021, entitled: Professionals' attitudes towards people with intellectual disabilities who self-harm: A literature review. A systematic review of self-reported explanations for self-injury by people with learning disabilities was also conducted in May 2020, forming the basis for the literature review of the PhD. It found that people with learning disabilities tended to talk about their own self-injury in relation to emotional factors. These were themed as: relief from overwhelming emotions; trauma and loss; and difficulty in articulating emotions. Overall, the review found a paucity of research asking people with learning disabilities about their own self-injury. However, the research available suggests that explanatory factors typically associated with those without learning disabilities should also be considered for those with intellectual disabilities. This has been submitted to the International Journal of Developmental Disabilities and is currently on it's second review. I have completed seven months of ethnographic data collection from July 2021 to February 2022 in a residential school for young people with severe learning disabilities and autism. I spent two days a week conducting participant observation with my three primary participants, each of whom had severe learning disabilities and autism and an established history of self-injury. I have gathered 180 hours of observational data, which captures the emotional experiences and expressions of the three participants. All three participants are non-verbal, so the data pays particular attention to non-verbal expression. The length of time in the field allowed me to learn the particular communication style and pattern of each participant, building rapport and understanding. The three participants demonstrated that they had a wide array of rich, nuanced emotional experiences. The data presented a picture of the participants' emotional lives as strongly influenced by their relationships (whether well-attuned or disconnected); current and past relationships, including experiences of separation, loss and bereavement, were significant to their emotional lives. In addition, the experiences of lost or compromised safety (relationally, psychologically or physically) provoked feelings of anxiety, stress, distress and anger; these emotions sometimes led to physical expressions of overwhelming emotion, including self-injury. Experiences of lost safety could be correlated to both experiences in the moment and associated stress or distress from past experiences. The research concludes with recommendations for policy, practice and research, stressing the importance of wedding trauma-informed approaches with the current dominant biobehavioural approaches. This allows for the consideration that previous adverse experiences and past relationships might also be factors in current presentations of distress, including self-injury. |
| Exploitation Route | The overall goal of the PhD project. Background: For the past 50 years of research, the overall approach to self-harm has been that if a person has learning disabilities and self-harms, it is called 'self-injurious behaviour' and typically treated as a function of the person's disability or a learnt behaviour. If a person does not have learning disabilities and self-harms, it is typically considered to be rooted in emotional distress, trauma or adverse past experiences. These factors are not typically considered for people with learning disabilities. The goal of this project is to produce research that examines the emotional factors for self-harm for people with (severe) learning disabilities, building on the small amount of research in this area. The goal is to influence policy and practice, and particularly influence the way people with learning disabilities who self-harm are thought about and supported. To this end, I have begun a small business which seeks to offer support, training and advice to schools and organisations supporting young people with complex learning disabilities who self-injure. (See spin-outs for more details). |
| Sectors | Communities and Social Services/Policy,Education,Healthcare,Government, Democracy and Justice |
| Description | The findings have heavily influenced the founding of a company Unique Connections. Please see Spin Outs section for further details. |
| Sector | Education |
| Impact Types | Policy & public services |
| Company Name | UNIQUE CONNECTIONS CONSULTANCY LIMITED |
| Description | Unique Connections exists to improve the lives of children and adults with learning disabilities, autism and other disabilities who self-injure. We specialise in consultancy, training and advice regarding self-injury (self-injurious behaviour), but also offer support with wider issues including trauma-informed approaches, understanding autism and emotional well-being. This company is built upon the PhD research findings, which indicates that past experiences and attending overwhelming emotions need to be considered within the support of people with severe learning disabilities who self-injure. This is not currently common practice, so the company exists to provide evidence-based training and advice with the overarching goal of influencing the UK policy and practice over ten years. |
| Year Established | 2022 |
| Impact | This is company is in it's infancy, so is still establishing early clients. However, we opened the Belong conference as Keynote speaker in Coventry. We were also awarded the runner's up prize from University of Bristol's New Enterprise Competition, which included a £5000 grant. We have had the opportunity to deliver training at a number of schools and colleges are currently building the client base. |
| Website | https://www.uniqueconnections.org.uk/ |
| Description | Emotion and SIB: Exploring the emotional experiences of young people with learning disabilities who self-injure. |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Schools |
| Results and Impact | NASS conference is the national conference for the Network of 300+ schools, colleges and residential schools from the non-maintained, special needs sector. I was able to present the findings of my research, applying it to organisational work. Those attending were typically headteachers or heads of care from large non-maintained special schools, so the presentation reached out the policy-makers from the sector. I was subsequently invited to train for two days at a large special school in the North East of England. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Exploring the emotional factors relating to self-harm |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | To share findings about the emotional factors relating to self-harm amongst young people with severe learning disabilities with professional networks. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://senmagazine.co.uk/content/care/mental-health/15290/exploring-the-emotional-factors-relating-... |
| Description | Finalist in a university-wide competition to translate my research for the general public. Three Minute Thesis |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | I presented my thesis in three minutes. This was broadcast across the university and wider. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.youtube.com/watch?v=qPGauFWOVr0&t=3s |
| Description | Presentation to the Suicide and Self Harm (SASH) research interest group at University of Bristol's Medical School |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | I presented a small section of my findings entitled: Nonspeaking narratives of young people with severe learning disabilities who self-injure. This was to researchers with a specialism in this area. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Self-reported explanations for self-harm by people with intellectual disabilities: a systematic review of qualitative studies. |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Postgraduate students |
| Results and Impact | I presented at the online conference: Disability Research: Doing Research and Publishing Papers in Pandemic Times. This was run by the journal Scandinavian Journal of Disability Research. I presented the results of the systematic review conducted in May 2020, entitled: Self-reported explanations for self-harm by people with intellectual disabilities: a systematic review of qualitative studies. This was followed by question and answer session, which sparked some debate about the paucity of research involving those with learning disabilities in research. |
| Year(s) Of Engagement Activity | 2021 |