Challenging Behaviour. MSC Dissertation

University of Portsmouth
PORTSMOUTH
Hants
UNITED KINGDOM
PO1 2UP
This Dissertation
Mitchell, Alexandra (2013) Challenging Behaviour: An
investigation into the social construction o la!els and
stereot"#es and the relationshi# !et$een this and
institutional a!use% &Dissertation'
(as !een retrieved ro) the
*niversit" o +orts)outh,s -esearch -e#ositor":
htt#:..e#rints%#ort%ac%u/
To contact the -esearch -e#ositor" Manager e)ail:
#arade0#ort%ac%u/

Challenging Behaviour:
An investigation into the social
construction of labels and stereotypes and
the relationship between this and
institutional abuse
288936: Alexandra Mitchell
The University of Portsmouth
MSc Social Work Dissertation
May 2013
Word Count: 8,785

288936 MSc Dissertation
1

Acknowledgments

I would like to thank my Mum and Dad who have been a continual source of support,
guidance and encouragement, throughout the MSc and in all aspects of my life.
I would also like to share my thanks and gratitude with Dr. Kieron Hatton without whom this
dissertation would still be an idea. His supervision and knowledge throughout the course of
this piece has been consistently inspiring and I am grateful for all of his support, patience and
direction.
Lastly I would like to thank my MSc colleagues who have reassured, listened, helped and
laughed with me throughout the two years.

2

Authors Declaration

I hereby declare that, except where indicated by the proper use of citations and references,
that this is an original piece of work.

Signed:

Dated: .

3

Abstract

The aim of this dissertation is to critically analyse the relationship between socially
constructed labels and stereotypes, specifically challenging behaviour, and instances of
institutional abuse. Although there is a plethora of research in the field of institutional abuse
there is very little about the perpetrators and the effects of personal, cultural and structural
influences on the de-humanisation of service users in institutional settings. This author has
aimed to deconstruct issues of stereotyping and labelling, group mentality and collective
abuse, power and moral disengagement to gain a greater understanding of cases such as
Winterbourne View.
Further to this the author has created her own models of the Processes of De-humanisation
and Processes of Humanising and has gone on to propose a new system in which service
users are able to exercise their agency and power in equal partnership with practitioners.
4

Contents
Table of Figures ...................................................................................................................................... 5
Chapter One ............................................................................................................................................ 6
Introduction ......................................................................................................................................... 6
Research Aims and Objectives ........................................................................................................... 8
Research questions .............................................................................................................................. 8
Chapter Two.......................................................................................................................................... 10
Methodology ..................................................................................................................................... 10
Inclusion and exclusion criteria .................................................................................................... 10
Coding ........................................................................................................................................... 11
Search strategy .............................................................................................................................. 11
Data Collection and analysis ......................................................................................................... 12
Theoretical framework ...................................................................................................................... 13
Stantons Genocide Model (2008, p.285) ..................................................................................... 13
Thompsons Processes of Oppression (2011, pp. 90-92) .............................................................. 14
Chapter Three: Literature review .......................................................................................................... 17
Staff attributions and the social construction of challenging behaviour, stereotypes and labels ... 17
The Milgram Effect (1963, cited by Franzoi, 2006, p.340): Group mentality, conformity and
collective abuse ................................................................................................................................. 20
Victim and oppressor characterisation: playing the role ............................................................... 21
Leadership and power: Top down abuse ........................................................................................... 22
The relationship between evil acts and evil character (Calder, 2003): Moral disengagement .. 23
Power ............................................................................................................................................ 25
Chapter Four: The Future: Recommendations and Conclusions .......................................................... 27
Beginning to Humanise: Processes of de-humanisation and humanisation ...................................... 27
Model: Processes of De-humanisation (Mitchell, 2013) ............................................................... 27
Model: Processes of Humanising (Mitchell, 2013) ....................................................................... 29
Results, the future and recommendations: Giving voice to the service user ..................................... 31
Conclusions and moving forward ..................................................................................................... 33
References: .................................................................................................................................... 36
Bibliography: ................................................................................................................................ 43
Appendices: ................................................................................................................................... 45

5

Table of Figures

FIGURE 1: EARLY STAGES OF GENOCIDE (STANTON, 2008, P.285) ............................................ 13

FIGURE 2: RELATIONSHIP BETWEEN GENOCIDE MODEL AND PROCESSES OF OPPRESSION .......... 15

FIGURE 3: PROCESSES OF DE-HUMANISATION MODEL (MITCHELL, 2013) ................................. 27

FIGURE 4: PROCESSES OF HUMANISATION (MITCHELL, 2013) .................................................. 29

6

Chapter One
Introduction
In recent years there have been numerous reported instances of whistleblowing and
undercover investigative pieces surrounding allegations of abuse within institutional
settings. Contrary to media representation of such cases, these are still relatively
uncommon (Gallagher, 2000, p.795) and whilst the focus has so often been the sexual abuse
of children, there is a broader issue of abuse within a wide variety of settings and sectors
(Gallagher, 2000, p.785). Indeed, a recent case, which came to National attention in May
2011 was that of Winterbourne View: a residential care home providing support for adults
with learning disabilities, complex needs and challenging behaviour, including those liable to
be detained under the Mental Health Act 1983 (Care Quality Commission (CQC) report :
Review of Compliance, 2011, p.2). This case exploded in to the media as a result of a BBC
Panorama undercover investigation and detailed systematic abuse of vulnerable patients,
with challenging behaviour, by staff members.
Of interest to this researcher is the workers abandonment of ethics and morals and why
seemingly ordinary people would subject those most vulnerable to abuse when they should
have the capacity to recognise this as wrong. In the case of Winterbourne View staff
members utilised techniques and processes put in place by the organisation to safely restrain
clients to inflict pain. The restraint techniques used to subdue patients were used wrongly,
inappropriately, and to excess and in a manner that would cause humiliation, distress and
agony. Pitt (2011) reports that one incident involved staff restraining a patient with a pillow
case over their mouth to stop them spitting for 20 minutes whilst another patient was
restrained under a duvet for 15 minutes.
This researcher proposes that this abandonment of ethics is not an innate character flaw or
evil within these practitioners/support staff and therefore must be a result of factors within
the institution resulting in a gradual decline of treatment which in its beginnings could
manifest itself as an excessive use of power, for example, but culminate in torment, abuse and
maltreatment.
For this to transpire a process must have occurred, with a multitude of catalysts and factors,
which lead these ordinary workers to commit such abusive and unthinkable acts. If this is
7

the case then there must be environmental, cultural, organisational or psychological
influences within this situation which provide a nurturing environment for this abuse.
To analyse and discuss this theory the author will be concerned with the concept of labelling,
in particular challenging behaviour and the relationship between this and the de-humanising
of these service users. To do so several themes will be utilised which highlight potential
influences leading to institutional abuse of those with challenging behaviour. These will
include, staff attributions and the social construction of stereotypes and labels, group
mentality/collective abuse, leadership and power and the future of practice/giving back a
voice to the service user.
In the initial phases of this piece the author carried out research in to the notion that there
could be a decline in morality and that there could be a process or series of cause and
effects that led to these behaviours. On carrying out this research the author noticed that there
were commonalities and overlaps between the factors of institutional abuse and the process of
state organised genocide. Whilst this seems almost inconceivable and is an extreme example,
of interest to this researcher are the early stages (pre-genocide) or the processes of labelling
and stereotyping and the degenerative nature of these which lead to de-humanisation.
Stanton (1998, cited by Stanton, 2008, p. 285), proposes an eight staged process of genocide
illustrating this gradual and subtle decline; however, of relevance to this piece are the first
three stages which highlight some significant correlations with this authors hypothesis of
institutional abuse. This will be discussed, in detail, in the theoretical framework section of
this piece as it has informed and been the foundation for the research.
The final stage of the genocide model, suggested by Stanton (1998, cited by Stanton, 2008,
p.285), is also of interest; denial stage: blame is often placed on the victims and an attempt is
often made to cover up the atrocity. To a certain extent, this can also be witnessed within
cases of institutional abuse, in which there is a perception that institutions attempt to protect
their own, shift blame and brush incidents under the carpet.

Krebs (1998, cited by Dale & Alpert, 2008, p.64) discussed the abuse within catholic
institutions and detailed that the Pope John Paul II, attempted to protect the church and also
shifted blame and responsibility on to society and the mysterious presence of evil in the
world.
8

This sense of moral disengagement, in essence, forms part of the foundation of this
dissertation and the author attempts to establish if there is a relationship between this,
institutional abuse and the social construction of labels and stereotypes. Underpinning this
notion is the idea that attitude is disseminated by an exploiting class for the purpose of
stigmatising some group as inferior so that the exploitation of the group itself may be
justified (Cox, 1970, cited by Miles, 2000, p.128).

Research Aims and Objectives

The aim of this dissertation is, as the title suggests, to gain a greater understanding of the
relationship between the social construction of labels and stereotypes, in particular the label
of challenging behaviour, and the perpetration of institutional abuse. However, the author
also aims to challenge the behaviour of those perpetrating abuse and discuss the future of
practise to make recommendations with regards to the creation of a system that enables and
empowers service users to exercise their power and become active agents in their care.
To meet these aims and objectives the researcher will be utilising the following themes and
examining;
Staff attributions and the social construction of challenging behaviour, stereotypes
and labels
The Milgram (1963, cited by Franzoi, 2006, p.340) effect; group conformity,
collective abuse and victim/oppressor roles.
Leadership and power; top down abuse, power and moral disengagement.
The Future: Giving voice, recommendations and Conclusions
Research questions
Due to stereotyping and labelling of challenging behaviour are service users deemed
to be un-worthy of being treated with compassion and dignity and could this correlate
with the three early stages of the genocide model in a similar process of de-
humanisation?
Would these individuals have abused if they had not been around other abusers? Have
they simply conformed to the culture which fails to value the service user and
facilitates the negative treatment of the clients?
9

Is the abuse a manifestation of the leadership and managerial values and actions of the
setting? Is this a matter of top down cause and effect leading to a moral
disengagement due to following orders?
Is there a cultural assimilation due to the cyclical resistance of power?
Is there a way of creating a system which allows the service users voice to be heard
as a participant in their own care with agency, then, aiding in the elimination of such
abuse?

10

Chapter Two
Methodology
All ethical issues have been taken in to consideration (appendix 1)
As the literature review reveals there is a multitude of research within this field that discusses
and analyses instances of institutional abuse and the various thematic topics that the author
has chosen however there seems to be very little relating to the perpetrators of such abuse, the
social psychological research and linking this to character shifts, moral disengagement,
stereotyping and power systems. Thus, this research is fairly innovative and this meant that
the themes were vital to constructing a holistic approach to answer/discuss the research
questions.
Inclusion and exclusion criteria

For the purpose of this research dissertation the researcher has utilised exclusion and
inclusion criteria to keep the search for literature and the main dissertation focused (Aveyard,
2010, p.73). The inclusion and exclusion criteria, found within appendix 2, have meant that
the author focused only on appropriate research; according to era, source, subject and
applicability. Research written before 1995 will only be utilised in its classical form for the
purpose of background and historical information. There was also an exclusion of research
focused on state organised genocide as it is not directly applicable to institutional settings;
however this has formed the foundation for thematic discussions and is the basis of the
theoretical framework. The author will also exclude research from outside of the U.K when
discussing the future and recommendations as this will ensure that the findings and
recommendations could be more applicable to the U.K social work system.
The literature review will be concentrated on secondary research from journals, news articles,
Government reports, published texts and information released by the social work bodies (e.g.
Care Quality Commission). In particular there will be a use of the interim report from the
Department of Health [DOH] with regards to Winterbourne View and the subsequent Final
Report produced in December 2012.

11

Coding

The aforementioned themes were selected using a coding process by way of evaluating the
given literature in this topic area and selecting commonalities. This revealed the most integral
factors in order that the researcher could cover these and critique and analyse them with the
aim of answering or discussing the research questions.
Search strategy

To find appropriate literature numerous sources have been employed and searched and these
include those listed within appendix 3.
The search strategy began by using key terms to search electronic databases (as in appendix
4). The initial key terms were selected using the concepts which were derived from primary
literature searches around the topic area, such as de-humanisation, stereotypes and
institutional abuse. From this preliminary searching the author was able to review a range
of literature and, using the exclusion and inclusion criteria, remove those that were
inappropriate as well as develop more specific search terms such as staff attributions,
banality of evil and moral disengagement. This technique drew a saturation of literature
in a multitude of fields and therefore it was deemed essential to link these keywords together
appropriately (appendix 4).
In carrying out these searches, synonyms were also considered as well as plurals and
abbreviations where applicable. The search altered quite considerably throughout, for
example, as new terms were discovered.
Whilst the author accepts that the exclusion of grey material may limit and create a bias
within the study, it is not suitable, within this limited time frame, to search for grey
literature (Aveyard, 2010, p.73). However, this may be considered if a piece is deemed to be
relevant, reliable and necessary, for example a policy in light of the Winterbourne View
Investigation.
Further to this, the literature was hand searched in order to find citations and other relevant
literature. Author searching was also a valuable tool, particularly with regards to the
12

theoretical framework and classical research as authors such as Foucault, Goffman, and
Thompson are firmly rooted within the fields of research that the author analysed.

Data Collection and analysis

Collection of data, interpretation of relevance and applicability, analysis and categorisation
was carried out by the researcher. After applying and utilising the techniques above source
literature, it was categorised in to relevant groups, in accordance with the research themes. In
some cases cross overs between themes can be identified within one piece of literature and
therefore an open classification system was applied to allow for research papers to be placed
in multiple categories, for example the social construction of stereotypes has a strong link
with power and the allocation of power.

13

1) Classification
2) Symbolisation
3) De-humanisation

Theoretical framework
Stantons Genocide Model (2008, p.285)

The foundation for this piece is Stantons (2008, p.285) Genocide Model, and whilst
genocide is not the subject for this dissertation, the three early stages of genocide, represented
below, formed the theoretical framework.

The first stage, classification, is the process of classifying a group as them amongst those
that are us and is the formation of a fracture in societal groups.
The second, symbolisation is the process of applying a symbol or name to a classification
group (e.g. psychos or gypos).
The third of Stantons stages of genocide is the process of groups or a group beginning to de-
humanise the classification group by likening them to outsiders, unworthy of dignity or
equality.
It is the authors view that a correlation can be seen between this and instances of institutional
abuse and that this progression could be relevant in assessing how professionals could
perpetrate this and morally disengage from their actions in order to do so. There are also vast
correlations with this and Thompsons (2011) theories of discrimination and oppression.
Figure 1: Early stages of genocide (Stanton, 2008, p.285)
14

Thompsons Processes of Oppression (2011, pp. 90-92)

The second strand of the theoretical framework incorporates the theories of oppression
(Thompson, 2011, p.90-92) and Thompsons (2011, p.25) PCS model which recognises the
complex nature of how inequalities, oppression and discrimination operate within society.
The model identifies three interconnected levels that reinforce this process, these are: the
personal, cultural and structural (Thompson, 2011, p. 22).
Personal level (P) relates to our thoughts, feeling and actions and has a significant impact on
inequality and oppression. At times our views are based on stereotypes which can be either
explicit or implicit (Thompson, 2011, p.25). However, it is necessary to understand that the
individual must be viewed holistically and cannot be separated from the cultural context they
are bound within (p.26).
Cultural (C) relates to the wider cultural context and this can include community, education,
religious belief, language which in itself can marginalise and oppress but can also include
and bind people (p.27). We do not necessarily know that we are part of this and Berger and
Luckmann (1967, cited by Thompson, 2011, p.27) describe this as taken for grantedness of
interaction. This describes how we become so absorbed by our culture, assumptions and
beliefs, subconsciously, allowing us to feel part of something and understand our place
within our context. However, this can breed discrimination as it means we can fail to see
others differences, judge them as inferior due to difference and cause us to symbolise and
discriminate.
The cultural level is embedded within the structural level (S) of society or macro-level which
is the controls of social order (e.g. politics, class) and of significance here is the structural
influences at play within these institutions (p.29).

15

Figure 2: Relationship between genocide model and processes of oppression

In the above diagram the author illustrates the comparisons that have been made between
Stanton and Thompsons work.
Sterotyping is described by Thompson as a rigid typification (2011, p.92) which is
resistant to change not dissuaded by logic or evidence and often unduly negative
affecting our perceptions and actions. The author makes the comparison above to the first
stage of Stantons model (2008) as in a similar way, stereotyping and classification are
presented as the beginning of a process and are, similarly, the rigid fracturing of society in
to classified groups or stereotypical clusters.
Thompson goes on to theorise that the next stage in this process is discrimination (p.90)
which he presents as the process of applying labels and symbols to groups. Theoretically, this
parallels Stantons symbolisation stage, however, unlike this genocide model, Thompson
points to discrimination being a process with various methods of application including
marginalisation and stigmatisation, which interact together but also exclusively to reinforce
and act as a vehicle for oppression.
Oppression, Thompson surmises (2011, p.90), is the outcome of this set of discriminatory
processes that can take a multitude of forms such as racism or sexism. Much like de-
humanisation, this is the end result of a subtle progression that is not simply a matter of
personal prejudice but a manifestation of cultural, personal and structural influences that
develop as they are re-enforced.
1) Stereotyping(Thompson, 2011, p. 92)
(Personal) Classification
2) Discrimination (Thompson, 2011, p.90)
(Cultural) Symbolisation
3) Oppression (Thompson, 2011, p. 90)
(Structural) De-humanisation
16

This theoretical framework has informed the authors own models which seek to illustrate the
processes of de-humanisation and create a new model of humanising both of which are
presented in chapter 4.

17

Chapter Three: Literature review

Staff attributions and the social construction of challenging behaviour, stereotypes
and labels
Social constructivism is the notion that our actions, language and even laws and motives are
governed not by the world or observation but are created and based on our interactions,
bound in the historic and cultural context in which they sit. In this sense the way in which we
behave is a creation of our social processes in our day to day life (Burr, 1995, p.4). In relation
to this piece the author is interested in the social construction of stereotypes and labels,
particularly the label challenging behaviour and the potential impact of this, in terms of
institutional abuse. The researcher proposes that it is possible that the actions of perpetrators
are a result of de-valuing attitudes towards service users that pre-exist either within the
structural context of the specific institution or within society. This, in turn, becomes a
common, socially constructed attitude at ground level and therefore re-enforces, facilitates
and disseminates to create a degenerative cycle which nurtures this perception and forms a
culture of oppression. The researcher here is also concerned with the formulation of the
character of the service user as a victim and the impact of this on the conduct of staff,
therefore victim and oppressor roles will also be discussed.
Social constructionism, particularly the branch of anti-essentialism- in promoting the idea
that our knowledge and actions are formed through our social interactions-discounts that
there is any internal, biological or psychological principles within each human being that
makes him/her who they are (Burr, 1995, p.5). In particular, it is necessary to return to the
notion that individuals have agency. Kekes (1998, 217) states that actions are autonomous
if their agents (a) choose to perform them, (b) their choices are unforced, (c) they understand
the significance of their choices and actions. Somewhat contradictorily he goes on to state
that autonomous actions do not require their agents to have consciously gone through and
articulated these steps. This idea seems to propose that agents are those that chose,
without pressure, to perpetrate an action for which they fully understand the consequences
but without consciousness. Interestingly, the author of this dissertation wishes to suggest that
the perpetrators of institutional abuse are agents with autonomy, but whose choices are
18

shaped by socially constructed labels and stereotypes of the service user. An example of this
is staff attributions, which are the underlying assumptions that staff make about the causes
of challenging behaviour and can be crucial in shaping their responses (McKenzie, Paxton,
Loads, Kwaitek, McGregor and Sharp, 2004, p.16).
The term challenging behaviour in itself is one that has been debated furiously within
literature in recent years and a definitive definition is unlikely, however, as the purpose of
this dissertation is not to do so Emersons definition will be applied; Culturally abnormal
behaviour(s) of such intensity, frequency or duration that the physical safety of the person or
others is likely to be placed in serious jeopardy (Emerson, 2001, p.3). The term itself
functions as an umbrella phrase which encompasses a broad class of unusual behaviours
shown by people with severe intellectual disabilities (Emerson, 2001, p.3) and is used to
classify and categorise the exhibited actions of those who may, for example, have mental
health issues or learning disabilities (e.g. aggression, self-harm). Of interest here are the
ramifications of this label in terms of institutional abuse. When the final report by the DOH
(2012) was written, there were around 3,400 individuals in NHS-funded inpatient facilities;
(p.11) many entered Winterbourne as informal patients but were later detained under Mental
Health legislation, but why (p.13)? If there was an escalation in their challenging behaviour
which resulted in their detention, why?
Emerson (2001) in his key text, Challenging Behaviour, describes how this can only be
properly understood if it is viewed as a social construct; that is that behaviour can only be
labelled as challenging when it is defined by certain factors (2001, p.7):
Social rules and guidelines which provide a frame of reference for what is
appropriate within certain settings, circumstances or situations.
the interpretations and beliefs of those who apply the label and their understanding of
the roots of the behaviour (staff attributions)
the capacity of the person exhibiting the behaviour to be able to provide an
appropriate account of the cause or reason for it
The structure and/or management of the service which seeks to deal with the
behaviour.
In essence the context in which behaviour is presented and defined is key and attributions of
appropriate behaviour alter depending on this. This can lead to ascribing social roles and can
19

serve to empower and disempower the individual equally. It is important to recognise that
when attempting to analyse perpetrators actions, as Thompson suggests (2011, p.26), they
must be viewed holistically and cultural and structural contexts and expectations must also be
considered. Burr (1995, p.8) defines knowledge as something that people do not have
and it is this theory, based in social constructionism, that informs the authors rationale for
research; it is knowledge of the service user that pre-determines the actions of the abuser
and so it is this knowledge, typification (Thompson, 2011, p. 91) and subsequent
classification (Stanton, 2008, p. 285) that must be understood, from formation to
perpetration of abuse.
Of course, for classification to occur there must be pre-formed ideas about those with
challenging behaviour that allow for this process of classification to take place. It is this
authors theory that this is rooted in inequality, typification and pre-existing social
expectations about how members of social groups should act, think and behave (Thompson,
2011, p.24). It is therefore logical to firstly deconstruct the social construction of typification
and the relationship between this and the theoretical framework.
When making a comparison between Stantons model of genocide (2008, p.285) and
Thompsons processes of oppression, the author proposes that typification (Thompson,
2011, p. 91) forms the beginning of this process as it is frame of reference we utilise to
understand the world around us, processing information and assigning categories to make
sense of observations and interactions. This involves establishing what is typical of a
particular class of things, events, people or phenomena A typification is a form of yardstick
by which we make sense of some of the complexities of the social world (Thompson, 2011,
p.91).
In this way, we use a framework of assumptions to form a model of expectations which is
applied in order that one does not need to start afresh with every observation, interaction or
situation. Dewey (1929, p. 247) states that generalized facts, when they are taken to be
individual events complete in themselves, lead to a picture of the universe in which
occurrences are exactly like one another. There is repetition but no development.
Analytically, the author perceives that Dewey is outlining in this early, philosophical text, the
complexity of understanding and he seems to be outlining how we use generalised facts to
make sense of what is in front of us, be it a person, object, scenario or action, but how we
must seek further information to adapt our model of what is known in order to further
20

develop our understanding. As Deweys (1929) text is titled, our Quest for Certainty
determines that as humans we will always seek and desire further knowledge, building on
what is already known, to make sense of the world around us. However, If these typifications
or models of understanding become rigid (Thompson, 2011, p.92) (e.g. all nurses should be
female) they begin to form stereotypes and start to become a vehicle or breeding ground for
oppression and de-humanisation, manifesting in a culture of negative/abusive treatment.

The Milgram Effect (1963, cited by Franzoi, 2006, p.340): Group mentality, conformity
and collective abuse

In such cases as Winterbourne view there was a sense that these individuals had become a
collective, systematically abusing the service users within their care, in an almost pack like
fashion. A multitude of research in this field suggests that this loss of the individual can
create a significant alteration of character and morality. Waller (2002, p.30) reflects on work
by numerous theorists and suggests that the blending of individuals in to a group creates a
common mind set and dispels individual differences in an almost primitive fashion. He goes
on to propose that groups are less troubled, therefore, by the emotions of those outside of the
collective, and become selfish and callous (p.31). As a result, individual capacities for
goodness, altruism and morality are typically subverted to the brutal character of the group
(Waller, 2002, p.31). At Winterbourne View, it appeared that staff were forming alliances
and the perception of this author is that there was a mirroring of behaviour: abuse, such as the
taunting of a male with learning difficulties who was exhibiting challenging behaviours,
such as stereotyped mannerisms (Emerson, 2001, p.3), was replicated by four different staff
members on separate occasions. Waller (2002, p.35) adds weight to this argument as he
suggests that a group setting will only magnify and amplify traits within the individual, in
essence causing them to act in a way they would not have acted otherwise.
Self-categorisation theory (Turner, 1987, cited by Wood, Moir & James, 2008, p.570),being
able to categorise oneself as a participant in a group or collective, allows a person to form a
social identity, ultimately leading to the formation of group-mentality and the normalisation
of abusive in-group behaviours. In Wood et al. study of gang-related prisoner activity, it was
discovered that collective misconduct may weaken moral standards (p.577) and the authors
21

related this to a study by Bandura (1999, cited by Wood et al., 2008, p. 577) in which it was
stated that when everyone is responsible, no one really feels responsible. Although this
study yielded results which indicate that collective mentality informs a lack of responsibility
for ones own actions, as seen within Winterbourne View, the targeted population for this
research was just 10% of one prison and thus cannot be generalised. It is also challenging to
apply this to the practitioner perpetration of abuse as the circumstances are vastly different;
particularly relevant is the fact that prisoners are caged within their institution and have the
pressure of role choice and hierarchical struggle. In the case of the staff at Winterbourne,
there was no fear of becoming a victim and thus, no pressure to choose to be a perpetrator.
Victim and oppressor characterisation: playing the role
Language alone can be incredibly powerful in assigning stereotypes and roles to all members
of society. Language is not only a system of communication but also a vehicle for power
(Thompson, 2003, p.70); from gender roles such as homemaker to the negative stereotypes
of lunatic and the more positive differently abled, roles are continually assigned to all
areas of society. The very notion of labelling creates a myriad of issues as without the
designated roles there would be an inability to ascertain the needs or differences of people,
however, roles can create imbalances of power, inequality and oppression. In this instance,
social constructionist theory would not seek to to make claims about who are real victims
but would study victimisation as an interpretive process (Harris, 2006, p.226).
Whilst Harris claim is one of great interest to this research paper, to critique it would be to
highlight the danger of over simplifying the concept of victimisation and the risk of
suggesting that inequality itself is only a social construction with no other influencing
factors contributing to this huge and ubiquitous issue.
Labels and the assigning of roles can, to some degree, inform our own self; without an
identifiable trait, character or distinctiveness to make a comparison with, the human being
would be unable to characterise itself or understand its place within society. Hicks (2006, p.
502), in a discussion about stereotyping, articulates this concept; to create our individuality
and self-identification we cling to the aspects of ourselves such as gender, race, culture
which categorise us. It is all too easy to assume that labels are a way of forming judgments
of others, however, the labels often work in reverse, serving those that label themselves
normal with a frame of reference with which to measure this. The mentally ill not only
22

specify troubled selves, but they also inform the untroubled, in turn, that they are not
(Gubrium & Holstein, 2001, p. 11). Foucault (1979, cited by Gubrium & Holstein, 2001, p.
13) also alludes to this and states that if we do not work with recognisable identities our
claims to selfhood will be treated as nonsense.
In particular, when looking at the formation of role with regards to assumed social identity,
Goffman (1990, p. 12) describes a process by which a category is assigned to an individual
on first appearance; if the individual then appears to deviate from this category in a way that
is deemed to be abnormal or negative he is reduced in our minds from a whole and usual
person to a tainted, discounted one. Of relevance here is the proposition that on their own,
negative attributes of the individual are not in fact an issue or a cause of stigma or
discrimination, it is only if these attributes are interpreted as not fitting with the individuals
typification that they become a pre-cursor for stigma. This proposition is not without flaws
however as it suggests that stigma is a result of an individual behaving outside of their
category norm when in reality stigma occurs widely and often as a result of unwarranted and
unfounded dislike for a particular group. As if in response to this critique, Goffman (1990,
p.14) goes on to highlight that there are important attributes that almost everywhere in our
society are discrediting.
Leadership and power: Top down abuse
Hinrichs et. al. (2012, p. 62) propose that unethical behaviour by those who hold power can
be augmented throughout an organisation through compliance and that the willingness of
persons in follower positions to obey an unethical leader has important ethical implications
for organisations and society (Browning, 1992, cited by Hinrichs et. al. 2012, p.62). These
social psychological researchers believe that followers disengage from their own corruptive
or abusive behaviour by using their follower status as a justification for their actions.
Certainly within the case of Winterbourne view there appeared to be a ring leader and the
author proposes that the negative and oppressive attitudes of leadership could have,
transferred to those around him and signalled the beginnings of moral disengagement and
abuse. Freudian theory could also be applied in this instance as Waller (2002,p.31) describes;
the individuals conscience or superego begins to falter and is transferred to the leader of
the group, in turn the individual no longer acts in accordance with his/her internal morals
and instead follows the leaders.
23

The relationship between evil acts and evil character (Calder, 2003): Moral
disengagement

It is often perceived that those with an innately evil character perpetrate evil acts or behave
immorally, however, it is those ordinary in nature that commit acts of institutional abuse
that interest this author. Hannah Arendt (1994), one of the most notable political theorists in
the field of power, describes a Nazi responsible for the organisation of the Holocaust as
terrifyingly normal (p.276). This philosophy is most famously represented by the phrase
coined by Arendt herself: the banality of evil (p.252). This is not intended to trivialise such
atrocities as genocide but represents the theorists view that this man was not a monster
(p.55) but someone who relinquished his autonomy to make moral choices and simply did
his duty (p.135) thereby morally disengaging from his actions. This theory can be illustrated
by examples of the occurrences within Winterbourne View as, on the 1
st
June 2011, the BBC
news reported that onepatientwas seen being verbally abused and doused with cold
water while fully clothed, as a punishment. During this incident there were four to five staff
members present, some just observing, others were participating.
By May 2011 fifteen staff at Winterbourne View had been suspended from duty (Care
Quality Commission (CQC): Review of Compliance, July 2011, p. 3) as a result of the
aforementioned BBC Panorama undercover investigation. It is almost inconceivable to
imagine that these individuals were innately bad; this, by way of elimination, points to the
concept that something occurred within Winterbourne View that facilitated a shift in morality
and an abandonment of social work values. Kekes (1998, p.216) presents an opposing
argument raising a concern that there is an unwillingness amongst us to accept the
reflexivity of evil, in a sense, that we fail to acknowledge that bad deeds reflect on the
agent and presume that other variables must have been influential for this atrocity to occur.
The author of this dissertation presents a combined argument: that these were agents who
perpetrated abuse, but, that these agents were acting according to socially constructed
ascriptions/norms at play within the organisation and agent.
For this to occur, there must be a block or barrier which allowed them to perpetrate acts of
abuse without their morality or conscience preventing it and this is termed as moral
disengagement: the selective suspension of the internal self-regulatory standards people
24

have that prevent them from committing inhumane or reprehensible acts (Bandura, 1999b,
cited by Hinrichs, Wang, Hinrichs & Romero, 2012, p. 63). It is this authors opinion that this
is a result of socially constructed labels and stereotypes which influence the ability of the
agents to be able to switch off moral self-sanctions, leading to de-humanisation (Bandura
et. al, 1999, cited by Wood et al., 2009, p.577).
In an experiment by Bandura, Underwood and Fromson (1975, cited by Zimbardo, 2004, p.
31) it was revealed how effortlessly a group of ordinary people could be encouraged to act
aggressively based on de-humanising labels. In this study the group were asked to deliver
electric shocks of varying intensities to a group of students. Three conditions were set up and
participants were lead to deliberately over-hear the researcher describe the group as either
nice, animals or no label: the group in the animals condition delivered the highest level of
shocks; Zimbardo (2004, p. 32) describes this as a shift from good to evil behaviour
accomplished by knocking down control processes, blocking them, minimising them or re-
orientating them. Lang (2010, p.227) furthers this debate by theorising that to remove the
sense that one is breaking their moral code it is necessary to sever any ties of
identification with the victim. In short, to perpetrate acts that harm others against our
morality, we must not identify the victim as like ourselves. We believe the person with a
stigma is not quite human (Goffman, 1990, p.15) and with this in mind, begin to practise
based upon this conjecture.
Hicks (2006, p.501) applied this notion to a model coined the Pyramid of Hate. In this
model he explains how acts of bias (e.g. labels: comparable to classification/stereotyping)
can lead to acts of prejudice (e.g. ridicule: comparable to discrimination, de-humanisation)
and therefore, he states that de-humanisation can come about as a result of stereotyping and
discussing feelings with like-minded friends (p.501). This hierarchical pyramid
disseminates; after de-humanisation, acts of discrimination (e.g. harassment and social
exclusion) take place and these lead to acts of violence such as abuse. Hicks (2006, p. 501)
places discrimination hierarchically above de-humanisation within this process, contrary to
the notions set out within the theoretical framework of this piece. However, in the case of
Winterbourne View it could appear that this pyramid shares overlaps with the events that
took place as acts of bias such as the application of labels, led to ridicule, torment and abuse
and ultimately discrimination in the form of lack of advocacy, lack of positive
activity/interaction/support, exclusion and non-participation. In this instance then,
25

discrimination is seen to be at the wider structural level (Thompson, 2011, p.29) by way of
the formation of organisational culture, attitude and exclusionary practice.
From a critical angle, Moller and Deci (2009, p.41) present the idea that when people are
controlled or feel restricted, such as within institutions, they begin to feel de-humanised and
therefore behave in a less civilised or disruptive way. The author of this research does not
wish to propose that the victims in institutional abuse encourage or promote the abuse
perpetrated against them. However, it is possible that this behaviour increases the victims
risk of abuse, due to power dynamics shifting in an effort to control or manage this
behaviour.
Power
Empowerment is frequently referred to throughout policy and literature alike and is widely
recognised as a method of best practice, working with service users in order that are enabled
to participate in decision making, full citizenship and equality. However, this does not
necessarily transcend from policy to ground level. The foundation of working with service
users in an inclusive and participatory way means shifting the power from power over
(dominance) to power with (inclusive, partnership) (Thompson, 2007, p.63) and as Hatton
(2013) suggests this requires the recognition of the agency of these individuals.
Thompson (2007, p. 60) discusses this in relation to power dynamics and states that;
Power is not something that people can possess in a physical, tangible way. It is to a
large extent, about dispositions, institutionalised patterns, relationships and structures
and, in order to appreciate the complexities of power and empowerment, we have to
look at matters in a much more sophisticated way than just seeing empowerment as
giving away power
Donald and Rattansi (1992, cited by Thompson, 2011, p. 30) described this important
relationship in terms of racism and stated it is not individual beliefs and prejudices about
race that are the main problem what matters are the structures of power, the institutions
and the social practices that produce racial oppression and discriminatory outcomes. The
Winterbourne View final report by the DOH (2012, p.21) states that service users were not
listened to, had very limited access to advocacy (p.15), had little opportunity to air
complaints and that those that did were not heard (p.15). This indicates that the dynamics of
power within this institution were disparate and non-inclusive. It is the authors view that
26

within institutional settings, challenging behaviour could be perpetuated as an exercise of
power, then re-enforced by staff who apply methods of restraint, control and punishment.
Arnsteins (1969, cited by Hatton, 2009, p. 91) Ladder of participation illustrates eight
levels of participation, from manipulation to full citizen control; this setting could be
indicative of the therapy stage which is categorised as non-participation and is considered
as symptomatic of the people that hold the power (the professional or practitioner) having the
sustained influence over decision making, seeking to cure those who seek power (Hatton,
2009, p.91).
Foucault states (1980, p. 96) that power is not just about A asserting power over B, who is
lower in status, but power is both ascending and descending and can be exercised in a
multitude of ways. As an individual acts, subconsciously and consciously, within frameworks
ascribed by cultural and personal experiences and expectations (as previously discussed) it is
integral to note that these ascriptions will differ in the confines of an institution. In the wider
community one is more able to exercise of power at will, however, within Winterbourne the
service users were restricted and their identities disjointed, resulting in resistance and
exercise of power through disengagement and/or becoming volatile. In a reactionary way, the
staff became more aggressive and oppressive, using the challenging behaviour as a
justification. This parallels Lukes (2005, p.30) work as he states that A exercises power over
B, when A affects B in a manner contrary to Bs interests and goes on to suggest that power
is asserted by shifting As interest, then creating a course of action to suit it, in turn justifying
it (p.37). In this instance then, the staff shifted the service users interest through using
punitive abuse as a consequence to challenging behaviour, they then re-enforced this model
of action verbally with threats, in turn justifying the abuse when this was applied.
This highlights how labelling behaviours as challenging could result in a disparity in power,
punitive action and a degenerative cycle of abuse.

27

Chapter Four: The Future: Recommendations and Conclusions
Beginning to Humanise: Processes of de-humanisation and humanisation

Model: Processes of De-humanisation (Mitchell, 2013)

Figure 3: Processes of de-humanisation model (Mitchell, 2013)

Model: Processes of De-Humanisation: Explained

The model that this author has created is an illustration of the proposed factors that connect
and interact within society and these institutions, simultaneously and exclusively, to re-
enforce and act as a vehicle of oppression and de-humanisation. As has already been stated,
Cultural Level:
Social construction of
classification and symbolisation
stereotyping and discrimination
Personal level:
Moral disengagement
De-humanisation
oppression
Structural Level:
Oppression
Personal Level:
Classification, symbolisation,
de-humanisation and oppression
28

the author theorises that the structures within these institutions are a nurturing ground for this
cruel and intolerable abuse and that this is due to a degenerative cycle.
The model seeks to collate these ideas and act as an illustrative tool to bring clarity to this
theory. As can be seen, the model is a combination of the three early stages of genocide and
Thompsons (2011, p.25) P.C.S model as well as the processes of oppression as theorised by
Thompson within his literature.
The model shows how the social construction of labels and symbols based on stereotypical
and discriminatory ideas about a group or groups can feed in to our personal thoughts and
feelings to create oppressive and de-humanising practice. The first, right hand, personal level
shows the process of moral disengagement brought about by subjection to cultural level
symbolisation and classification; in this case the culture of the institution. These
discriminatory values disseminate and become a breeding ground for further classification
and symbolisation at a personal level, and re-enforce de-humanisation and oppression at a
cultural level and structural level.
This author proposes therefore that active change needs to take place in order to begin to
interrupt this cycle and reverse it; thus, a further model has been proposed below.

29

Model: Processes of Humanising (Mitchell, 2013)

Figure 4: Processes of Humanisation (Mitchell, 2013)

Model: Processes of Humanising: Explained

The above model is one that the author proposes to counteract the previous model of the
cyclical and degenerative process of de-humanisation. Above it is highlighted that an agent
or person with agency can positively reverse or begin to undo this cycle.
As practitioners, if we work anti-oppressively and in such a way that values and gives voice
to the service user this will have an impact on the way we collectively think and act. This
model is certainly not mutually exclusive to practitioners and also relates to the agent, as the
service user, who can challenge and exercise power equally. Many marginalised groups,
30

through personal and collective struggles, have challenged oppressive practices and
structures, for example Survivors Speak Out who fought for better mental health treatment.
The author wishes to suggest that the perpetrators of institutional abuse are agents with
autonomy, in accordance with the definition by Kekes (1998, p.217), whose interactions are
shaped by socially constructions of labels and stereotypes and that the service users are
agents who with a shift in culture and anti-discriminatory practice could exercise their power
and agency on equal grounding.
As shown in the above model, it is theorised that the agent can positively and dynamically
alter the process of de-humanisation by practising in a non-oppressive, inclusive way and
projecting constructive classifications and symbolisations. It is proposed that this would
propagate to the cultural level and begin to build positive social constructions based upon an
anti-oppressive and anti-discriminatory frame of reference and drive this to a structural level
norm; positively influencing policy, institutions and managerialism to work in a
humanising, anti-oppressive way. This process can also disseminate downwards from
structural to cultural and personal, in a cyclical course. Much like the previous model, these
favourable, cycles of practice can be a catalyst for change exclusively or simultaneously in a
gradual, progressive manner; and like a snowball effect will gather momentum and apply
pressure to all levels.

31

Results, the future and recommendations: Giving voice to the service user

The researcher proposes that to alter or intercept the occurrences of institutional abuse it is
necessary to give the service users back their voices in order that they can exercise their
power and recognise their ability and practitioners ability to exercise agency in doing so.
Hicks (2006, p. 502) highlights the need to rid people of self-perpetuating labels; if there is a
continual use of terms such as victim or oppressed then we contribute to the power of the
very construct.
By empowering people to have a voice and to support them to exercise power over their own
lives it is possible to encourage change at a personal level. For this reason if professionals
aim to empower and alter the way we collectively think and act on a personal and cultural
level, like a domino effect this could begin to challenge inequality and oppression at a higher
or structural level, (Thompson, 2011, p.219). In a disseminating fashion, contributing to
service users empowerment is a starting point for tackling discrimination and this involves
al individuals playing their part in collectively challenging the dominant discriminatory
culture and ideology (Thompson, 2006, p.30).

There are also issues to consider in relation to the setting and structure in itself, Krebs (1998,
cited by Dale & Alpert, 2008, p.64) discussed the abuse within the catholic institutions and
detailed that there was a need to start by examining the church structure. Indeed, McDonald
et al. (2011, p.146) discovered that the size of the residential home also played a significant
contribution with larger homes receiving higher levels of complaints. This alludes to the
importance of the environment and structure of the residential setting and the issues that this
may raise: Emerson (2001, p.25) notes that the prevalence of challenging behaviour is also
positively related to the level of restrictiveness in the persons residential placement. This
correlates with the authors previous theory that restriction and restraint increase challenging
behaviour, and fall in line with a resistance as an exercise of power. Critically however,
various studies (Emerson and Hatton, 1994, Larson and Yarkin, 1989, cited by Emerson
2001, p. 26) have found that challenging behaviour leads to institutionalisation and that the
same relationship is not found in reverse. Structure is both enabling and constraining, and it
32

is one of the specific tasks of social theory to study the conditions in the organisation of
social systems that govern the interconnections between the two (Cassells, 1993, p.122).
In a study by Goergen (2001, cited by McDonald et. al. 2011, p.147) nurses also raised a
concern over staff to patient ratios as contributing factors in abuse, however, the author must
highlight that this research was carried out in the U.S.A and therefore the care systems are
dissimilar. Irrespective of this, this factor could overlay with the U.K. and parallels the DOH
final report, which states that challenging behaviour lessens with the right support and
people with challenging behaviour benefit from personalised care, not large congregate
settings (p.19). It is integral to recognise the potential for the opposite outcome to occur as
in many cases the sheer number of professionals involved in service users lives may
decrease engagement, brand support as tokenistic and make it difficult to form a
relationship (Thompson, 2007, p.49). In fact, people with learning difficulties or challenging
behaviours often feel that their communicative life is weighted towards receiving help and
support, which can reinforce a sense of helplessness and power imbalance (Ferris-Taylor,
2007, p.329). Seys and Duker (1988, cited by Emerson, 2001, p.149) further this debate by
discussing how increasing staff to patient ratios does not necessarily translate in to an
increase in support, and Emerson (1992, cited by Emerson, 2001, p.149) also highlights that
in very highly staffed residential settings for people with challenging behaviour, the
majority of staff time is spent on activities not involving direct contact with users. McDonald,
Beaulieu, Harbinson, Hirst, Lowenstein, Podnieks and Wahl (2011, p.146) evaluate the
structural risk factors surrounding institutional abuse and propose that, as the author also
discussed earlier, there is correlations between staffing stress levels and abuse of patients.

In the report, mentioned earlier, by the CQC (2011, Review of Compliance, p.5) it was
highlighted that staff were not correctly or appropriately vetted, trained or supervised. If this
is critically analysed, this could be an indication that organisational malaise and low morale
as a result of lack of support and appropriate training had led to the formation of a dissatisfied
collective; Waller (2002, p.35) discusses the work of social psychologists McCauley and
Segal, who discovered that the formation of terrorist organisations came from a shared mind-
set or shared grievances.

33

Conclusions and moving forward

A report by the Voluntary Organisations Disability Group (VODG) in 2011, released as a
result of the Winterbourne View inquiry, demonstrates the need for a person-centred
approach to ensure quality at every level and then working hard to embed this culture
from the boardroom to the frontline (p.8). By doing so, the author suggests, vulnerable
individuals can be positively supported to fulfil their potential, in accordance with best
practice.
It is about promoting a culture and a way of working that actively challenges poor
practice and promotes compassionate care across the system (DOH, 2012, p.5). To promote
this change in culture and shift in practice the author proposes the implementation of the
methodology and theory of social pedagogy.
As Hamalainen explains, the basic idea of social pedagogy is to promote peoples social
functioning, inclusion, participation, social identity and social competence as members of
society (Hamalainen, 2003, cited by Hatton, 2009, p. 113)
Although the policy may be in place that residents are supported, and able to voice concerns
safely this is not reflected in practise and Thompson (2007, p.49) highlights how it can
become a matter of professionals making the right noises rather than genuinely involving
users of services in the implementation and evaluation of services and it is here that there
needs to be a move away from tokenism to application. Since the implementation of the NHS
Community Care Act in 1990 (SCIE, 2007, p.2; Beresford & Croft, 2004, p.61) moves have
been made to promote and encourage service user involvement within the care/social work
sector, however, questions about whether social work and social services are essentially
liberatory or confining empowering or disempowering remain as pertinent and contested
today as ever (Beresford & Croft, 2004, p. 55)
The British Association of social workers code of ethics (2012) illustrates, with phrases such
as social workers should respect peoples right to make their own choices (p.8), just how
ingrained the notion of service user voice is. Critically, however, there needs to be a
differentiation made between paying lip service to this and actually practising in such a way
that users gain real power needed to affect the outcome of the process (Arnstein, 1969,
cited by Hatton, 2009, p.91).
34

Hatton (2013) suggests that working in an inclusive and social pedagogical way allows
practitioners to find common ground with those we seek to enable and empower, and the
central concept is the idea of creativity. Practising in this dynamic and active way
involves transferring this power [power of the social workers] back into the hands of the
people (Langan & Lee, 1989, cited by Hatton, 2009, p. 76). At Winterbourne, the final
report by the DOH stated that there was a lack of any substantial evidence that people had
meaningful activity to do in the day and that access by outsiders to wards was restricted
(p.15). This constricting practice reflects in a lack of stimulation, creativity and activity and
subsequently heightens challenging behaviour.
As Thompson (2007, p.55) articulates, within new professionalism the discourse should
depart from the thread of the professional knows best, even when well intentioned, and the
relationship should be mutually powerful with the professional and service user bringing their
knowledge together to reach common goals. This social pedagogical approach is person-
centred and humanistic, and is the practice of working creatively alongside the service user
adopting the principles of working from the heart, empathising and listening, the hands,
completing tasks collaboratively and the head, being reflective and using theoretical
knowledge to work effectively (Petrie, 2011, p.8).
As Cavet and Sloper (2004, p.616 617) discuss, it is integral to create a listening culture
so that people feel able to express their views openly, are enabled to do so and believe that
they will be heard. This is relevant not only to their progression but also to their self-worth
and character as the most fundamental identity need is the need for recognition, the need to
have ones being appreciated and validated, or at least acknowledged, and taken into account,
by others (Bracher, 2006, p.7).
This forward thinking branch of social work theory aspires to balance the relationship
between professional and service user, encouraging participation but also involvement in all
aspects of the provision of services. Lorenz articulates the importance of the conditions when
trying to engage, involve or invite change, social learning and change can only occur
through open communication and with full participation of the client or learner not under
artificial conditions controlled by the social worker or the agency (Lorenz, 1994, cited by
Hatton, 2009, p.113). With this in mind, it is necessary to consider the approach and setting
of the interaction in order to ensure that the impact of artificial setting is reduced where
possible. The author proposes that this could be tackled by way of building positive
35

relationships through equal partnership and creativity. A further recommendation falls in line
with the DOH final report (2012) in to the occurrences of abuse at Winterbourne View:
The norm should always be that adults live in their own homes with the support
they need for independent living within a safe environment. (p.19)
Where someone is admitted to hospital the priority from the start should be
rehabilitation and returning home (p.19)
To conclude, this emphasis on prioritising the best interest of the individual, to continue to or
re-integrate back in to the community will promote and encourage independence, inclusion
and choice (DOH, 2012, p.19).
This shift in culture, as shown by the Processes of Humanisation model, needs to be
actioned at all levels and seen as more than just a policy or method of practice but must
come from practitioners themselves, working in an inclusive, creative and social pedagogical
partnership with the service user to encourage and promote empowerment, agency and
exercise of power. As Hersov (1992, cited by Hatton, 2009, p.77) states the first obstacle to
believing that people can begin to make real choices and decisions in their lives is our own
reluctance to acknowledge the possibility that they might be able to do so.
Encouragingly, most of those that were detained within Winterbourne View have since been
assisted in making these steps and the fact that they are now in social care supported
arrangements gives a strong indication of what is possible (DOH, 2012, p.17).

36

References:

Aveyard, H. (2007). Doing a Literature Review in Health and Social Care (2nd ed.).
Berkshire: McGraw- Hill.

Arendt, H. (1994). Eichmann in Jerusalem: A Report on the Banality of Evil. Middlesex:
Penguin Books.

Bracher, M. (2006). Radical pedagogy: identity, generativity, and social transformation.
Retrieved from The University of Portsmouth Library website:
http://site.ebrary.com/lib/portsmouth/Doc?id=10167433&ppg=91

Beresford, P., and Croft, S. (2004).Service users and practitioners reunited: the key
component for social work reform. British Journal of social work, 34, 53-68.

Burr, V. (1995). An Introduction to social constructionism. London: Routledge.

Calder, T. (2003). The Apparent Banality of Evil: The Relationship between Evil Acts and
Evil Character. Journal of Social and Philosophy, 34(3), 364- 376.

Care Quality Commission. (2011, July 18). CQC report on Winterbourne View confirms its
owners failed to protect people from abuse. Care Quality Commission. Retrieved
from http://www.cqc.org.uk/media/cqc-report-winterbourne-view-confirms-its-
owners-failed-protect-people-abuse

37

Care Quality Commission. (2011). Review of Compliance. Retrieved from CQC website:
http://www.cqc.org.uk/sites/default/files/media/documents/1-
116865865_castlebeck_care_teesdale_ltd_1-
138702193_winterbourne_view_roc_20110517_201107183026.pdf

Carey, M. (2009). The Social Work Dissertation. Berkshire: McGraw- Hill.

Cassell, P. (Ed.). (1993) The Giddens Reader. Basingstoke: Palgrave Macmillan

Cavet, J., & Sloper, P. (2004). The participation of children and young people in UK service
development. Child: Care, health and development, 3 (6), p.613-621.

Dale, K. A., Alpert, J.L. (2008). Hiding Behind the Cloth: Child Sexual Abuse and the
Catholic Church. Journal of Child Sexual Abuse. 16(3). 59-74. DOI:
10.1300/j070v16n03 04

Department of Health. (2012). Transforming care: A national response to Winterbourne View
Hospital. Department of Health Review: Final Report. London: TSO

Dewey, D. (1929). The quest for certainty. New York: Capricorn Books.

Emerson, E. (2001).Challenging behaviour: Analysis and intervention in people with
learning difficulties. Cambridge: University Press.

Ferris-Taylor, R. (2007). Communication. In B. Gates (Ed.), Learning disabilities: Towards
inclusion (5th Ed.) (pp. 325-357). London: Elsevier.
38

Foucault, M. (1980). Power/knowledge: Selected interviews and other writings 1972-1977.
New York: Vintage Books.

Four arrests after patient abuse caught on film. (2011). Retrieved from BBC News website:
http://www.bbc.co.uk/news/uk-13548222

Franzoi, S. (1996). Social Psychology (4th ed). New York: McGraw- Hill.

Gallagher, B. (2000). The Extent and Nature of Known Cases of Institutional Child Sexual
Abuse. British Journal of Social Work, 30(6). 795-817. DOI: 10.1093/bjsw/30.6.795

Goffman, E. (1990). Stigma: Notes on the management of spoiled identity. London: Penguin
Books.

Gubrium, J.F., & Holstein, J.A. (2001). Introduction: Trying times, troubled selves. In J.F.
Gubrium & J.A. Holstein (Eds.), Institutional selves: Troubled identities in a
postmodern world (pp. 1-20). Oxford: Oxford University Press.

Harris, S.R. (2006). Social constructionism and social inequality: An introduction to a special
issue of JCE. Journal of Contemporary Ethnography, 35(3), 223-235.

Hatton, K. (2009). New directions in social work practice. Exeter: Learning Matters.

39

Hicks, T. (2006). Humanizing the Other in Us and Them. Peace Review: A Journal of
Social Justice, 18(4). 499-506. DOI: 10.1080/10402650601030435

Hinrichs, K., Wang, L., Hinrichs, A., Romero, E. (2012). Moral Disengagement Through
Displacement of Responsibility: The Role of Leadership Beliefs. Journal of Applied
Social Psychology, 42(1). 62-80. DOI: 10.1111/j.1559-1816.2011.00869.x

Joint University Council. JUC Social Work Education Committee: Code of Ethics for Social
Work and Social Care Research. Retrieved from The University of Portsmouths
Victory website:
https://victory.port.ac.uk/webct/urw/lc5116011.tp0/cobaltMainFrame.dowebct

Kekes, J. (1998). The Reflexivity of Evil. Social philosophy and policy, 15. 216-232. DOI:
10.1017/s0265052500003137

Kenyon, P. (Writer), & Chapman, M. (Director). (2011). Undercover Care: The Abuse
Exposed. In M. Chapman (Producer), Panorama. London: BBC One.

Lang, J. (2010). Questioning Dehumanization: Intersubjective Dimensions of Violence in the
Nazi Concentration and Death Camps. Holocaust and Genocide Studies, 24(2), 225-
246. DOI: 10.1093/hgs/dcq026

Lukes, S. (2005). Power: A radical view (2nd ed.). Basingstoke: Palgrave Macmillan.

McDonald, L., Beaulieu, M., Harbison, J., Hirst, S., Lowenstein, A., Podnieks, E., Wahl, J.
(2011). Institutional Abuse of Older Adults: What We Know, What We Need to
40

Know. Journal of Elder Abuse & Neglect, 24. 138-160. DOI:
10.1080/08946566.2011.646512

McKenzie, K., Paxton, D., Loads, D., Kwaitek, E., McGregor, L., & Sharp, K. (2004). The
impact of nurse education on staff attributions in relation to challenging behaviour.
Learning Disability Practice, 7 (5), 16-20.

Miles, R. (2000). Apropos the idea of raceagain. In L. Back & J. Solomos (Eds.),
Theories of race and racism: A reader (pp. 125-143). Oxon: Routledge.

Moller, A., & Deci, E. (2009). Interpersonal control, dehumanization, and violence: A self-
determination theory perspective. Group Processes & Intergroup Relations, 13(1),
41-53. DOI: 10.1177/1368430209350318

Morton, A. (2005). On Evil. Oxon: Routledge.

Petrie, P. (2011). Communication Skills for working with Children and Young People. Jessica
Kingsley Publishers: London

Pitt, V. (2011, July 18). Castlebeck faces fines for 'misleading' CQC over alleged abuse.
Community Care. Retrieved from:
http://www.communitycare.co.uk/Articles/18/07/2011/117188/castlebeck-misled-cqc-
over-winterbourne-view-abuse.htm

41

SCIE. (2007, June, 22). Developing social care: the current position. Retrieved from:
http://www.scie.org.uk/publications/positionpapers/pp04/chapter4.pdf

Stanton, G. H. (2008). Building an anti-genocide regime. In S. Totten (Ed.), The Prevention
and Intervention of Genocide. Genocide: A Critical Bibliographic Review Volume 6.
(pp. 281- 293). London: Transaction Publishers.

Thompson, N. (2011). Promoting Equality: Working with Diversity and Difference (3rd ed).
Basingstoke: Palgrave Macmillan.

Thompson, N. (2007). Power and empowerment. Dorset: Russell House Publishing.

Thompson, N. (2006). Anti-Discriminatory Practice (4
th
ed.). Basingstoke: Palgrave
Macmillan.

Thompson, N. (2003). Promoting Equality Challenging Discrimination and Oppression (2
nd

ed.). Basingstoke: Palgrave Macmillan.

Triggle, N. (2012, March 30). Care Quality Commission has long way to go, says MPs. BBC
News. Retrieved from http://www.bbc.co.uk/news/health-17553901?

Voluntary Organisations Disability Group. (2011). Another Way: Transforming peoples lives
through good practice in adult social care. Retrieved from The Voluntary
Organisations Disability Group website:
http://www.vodg.org.uk/uploads/pdfs/Another_way_FINAL%281%29.pdf

42

Waller, J. (2002). Becoming Evil: How Ordinary People Commit Genocide and Mass
Killings. New York: Oxford University Press.

Wood, J., Moir, A., James, M. (2009). Prisoners gang- related activity: the importance of
bullying and moral disengagement. Psychology, Crime & Law, 15(6), 569-581. DOI:
10.1080/10683160802427786

Zimbardo, P. (2004). A Situationist Perspective on the Psychology of Evil. In A. G. Miller
(Ed.), The Social Psychology of Good and Evil (pp. 21-48). New York: Guilford
Press.

Zimbardo, P. (2007). The Lucifer Effect. London: Rider Books.

43

Bibliography:

Arendt, H. (1970). On Violence. London: The Penguin Press.

Bastian, B., Laham, S. M., Wilson, S., Haslam, N., & Koval, P. (2011). Blaming, praising,
and protecting our humanity: The implications of everyday dehumanization for
judgments of moral status. British Journal of Social Psychology, 50, 469-483. Doi:
10.1348/014466610X521383

Buzgova, R., & Ivanova, K. (2011). Violation of ethical principles in institutional care for
older people. Nursing Ethics, 18 (1), 64-78. Doi: 10.1177/0969733010385529

Foucault, M. (1988). Madness and civilization: A history of insanity in the age of reason.
New York: Vintage Books.

Goffman, E. (1991). Asylums: Essays on the social situation of mental patients and other
inmates. London: Penguin Books.

Herman, E. D. & Peterson, D. (2010). The politics of genocide. New York: Monthly Review
Press.

Herman, S. (1995). Triumph of the market: Essays on economics, politics and the media.
Boston: South End Press.

Midgley, M. (2006). Wickedness. London: Routledge.
44

Osofsky, M. J., Bandura, A., & Zimbardo, P. G. (2005). The role of moral disengagement in
the execution process. Law and Human Behaviour, 29 (4), 371-393. Doi:
10.10007/s10979-005-4930-1

Payne, H. & Littlechild, B. (eds.) (2000). Ethical practice and the abuse of power in social
responsibility: Leave no stone unturned. London: Jessica Kingsley Publishers.

45

Appendices:

APPENDIX 1: ETHICAL CONSIDERATIONS .................................................................................. 46

APPENDIX 2: INCLUSION AND EXCLUSION CRITERIA ................................................................. 47

APPENDIX 3: EXAMPLE DATABASES .......................................................................................... 48

APPENDIX 4: EXAMPLE KEYWORD SEARCH COMBINATIONS ...................................................... 49

46

Appendix 1: Ethical considerations

This dissertation makes use of secondary data from journals, text, Government reports and
other literature and for this reason full ethical approval, as with primary research, is not
applicable. This however, does not excuse the researcher from ethical deliberation as there
are still aspects that must be considered.
The secondary data will be collected using databases, library sources and internet sources
which do not require sign in and are openly available in the public domain. No primary data
will be collected and only published material will be accessed unless deemed appropriate or
ethical. An ethical checklist has been attached in appendix 5 to show that the author has paid
consideration to these considerations. This research is considered ethical in accordance with
the Joint University Councils code of ethics which states that social work and social care
researchers should seek to promote emancipatory research and work together with
disempowered groups, individuals and communities to devise, articulate and to achieve
research agendas that respect fundamental human rights and which aim towards social
justice. This study aims to promote the voice of the service users who needlessly suffer
institutional abuse with the objective of establishing suggestions for improvement to these
systems.
The main ethical issue that the author has encountered during the course of this proposal is
the need to remain unbiased and to consider all research in the field as relevant so as not to
pay undue attention to the pieces that give weight to the argument at hand. Aveyard (2010, p.
94) states that a literature review should resist the temptation merely to make a statement
and then to provide a reference that apparently reinforces this statement as this fails to
ascertain the quality and applicability of the research.

47

Appendix 2: Inclusion and exclusion criteria

Inclusion Exclusion
1995 onwards (unless classical research
appropriate)
Research based upon mass killing or genocide
unless for background or theoretical framework
Research concerned with
individuals/perpetrators (not political,
governmental, state concerned)
Research based upon institutions that are not
applicable: (e.g. church, childrens homes) unless
for background.
Only published research (text, journals,
news articles, published reports,
Government documents etc.)
Research not written in the English language
Only published research from reliable
secondary sources (databases such as
socINDEX or psycInfo)
Research from a subjective perspective: e.g. First
hand experiences of abuse.

48

Appendix 3: Example databases

SocINDEX Cover of journals: strengths: sociology, social
work
PsycInfo Covers literature in the psychological, social,
behavioural, and health sciences.
Social Care Online Published by SCIE: covering social care
information: including Government reports,
journals and websites
Taylor & Francis Online Covers academic journals published by
Routledge, Taylor and Francis, Informa Health
and Psychology Press
Cambridge Journals Online Covers academic journals: particularly in the
field of humanities, life sciences, psychology
and social sciences
Web of Knowledge Search interface allowing various databases to be
searched at once: including Web of Science and
Social Science Citation Index
49

Appendix 4: Example keyword search combinations

Power+insitutions Abuse+power
Power+organisations Moral disengagement+institutions
Institutions+abuse Challenging+behaviour
Social+construction Banality+evil+
Oppression+institutions Institutional+opression
Opression+abuse Language+power
Staff+attributions+ Structure+insitutions
Stereotypes+labels Power+labels
Oppression+labels Power+
Group+conformity Oppression+
Collective+abuse Social+construction+labels

Challenging Behaviour. MSC Dissertation

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Challenging Behaviour. MSC Dissertation

Transféré par

Droits d'auteur :

Formats disponibles

University of Portsmouth

Vous aimerez peut-être aussi