Transcript Document

Stories of people who have
attended a Lesbian, Gay, Bisexual,
& Trans (LGBT) support group in a
secure learning disability service
Dr Paul Withers, Clinical Psychologist
Head of Psychological Treatment Services
Calderstones Partnership NHS Foundation Trust
• LGBT people are at significantly greater risk of experiencing
psychological distress1 2
• Research indicates that experiences of discrimination and
difficulties with identity formation contribute to this distress3 4 5 6
• Support groups can help address these issues7 8
• People with learning disabilities are at increased risk of having
mental health problems and may be more likely to have negative
views of LGBT identities9 10 11
• Research relating to support groups for LGBT people who have a
learning disability is of limited quantity
The Avenue
Set up 5 years ago at instigation of service users
Meets monthly
Over 30 service users have attended (On Site population less than 200)
Activities include campaigning, socialising, events and
This research
• The research was undertaken at my request following discussion
with the group members
• Based in a secure service for people with learning disabilities
• Undertaken by the group attendees in collaboration with Liz
Tallentire, Trainee Clinical Psychologist
• For this group of people to be heard
• To increase understanding of the group’s role in members’ lives and
in their rehabilitation
• To inform development of this group and possibly others
Participatory approach, including consultation on design
Total of 18 co-researchers
Qualitative semi-structured interviews (9 co-researchers)
Written information (8 co-researchers)
Narrative analysis, including co-researcher contributions (4 coresearchers)
• The analysis included considering what co-researchers said (stage
1), then how they said it and why they said it (stage 2), similar to
dialogic/performance analysis12
• Ethical Issues
Results: the group story
Deciding to go to
the group:
identity and
coming out
Starting to
attend the group:
fear and namecalling
Developing pride
in who you are:
this changes your
Becoming able to
be yourself when
at the group
Wanting to help
others with their
sexuality: pride in
Wanting to carry
on the work
direction in life
Deciding to go to
the group: identity
and coming out
• Big decision
• coming out about having an LGBT identity
Decision influenced by:
• Support in the secure service
• Attitudes in the secure service
• Perceptions of others’ views
• Media
“it's coming out who you really are…that's
what it's done with me, I've come out who I
am” (Ashley).
“you feel more confident [at this service] to
come out and do that [go to a support
group]” (Casey)
“some staff have an issue with relationships”
• Fear of others’ reactions
• Name-calling experienced by nearly all coresearchers
• How name-calling was addressed was
important, one person stopped attending
due to name-calling
• “I was frightened the first time I went”
Starting to attend
the group: fear and
• “I stopped going because people ridiculed
me and were name-calling, saying things
like 'Faggot', 'Nonce' and 'you're in there
with all the other Nonces’ ”
• Welcomed
• Not judged
• Safe
From name-calling
Trust in other group members
• Support from staff facilitators
“you can dress up, be whoever you want to be [at
the group], where like you know in here you can't,
you just have to dress normal...cos of how other
people react” (Ashley)
Becoming able to
be yourself when
at the group
“I got used to it and it’s changed my life, I feel
more open with people when I talk to them. I
never used to be like that when I first went to the
group, but now since I've been going, people gave
me the support through it and everything and I
feel better for it now, I can go to the group
without any problems.” (Jamie)
Pride in identity
Able to be themselves outside the group
Positive emotional change
Talking about sexuality helped
“well I'm who I am, and I'm happy now, and like
all thanks to you lot [the group], … cos they
made me feel a lot better in myself, like I was
saying I was scared.” (Morgan)
Developing pride
in who you are:
this changes your
“Some people talk about what they are and
open up and it's more better when you open up
in a way, then people understand what you are
then they give you the support what you need,
it's quite interesting to know.” (Jamie)
Wanting to help
others with their
sexuality: pride in
Some people joined at this stage
Real sense of achievement
Raising self-esteem
Different ideas about what the group aims
should be, reflecting group’s multiple
“I've helped them ….and it's helped me to
achieve a new goal to do the same again … my
life goal… [This has made me] Really happy and
proud” (Alex)
“we had someone from Blackpool and she was
really fascinated by us, she said this is the first
group I've been to, that's been really positive…
so everyone had big heads on” (Robin)
• Goals when leaving the service
• Connection with the outside community
• Important for rehabilitation
“When I leave here, the tutors are hoping to help
me and support me …to run the same group...that
means taking responsibility, ownership…and it'll
show me how well I've moved on” (Alex)
Wanting to carry
on the work
direction in life
“My future's going to go further. I'm going to
move out of…[the service] and live …with
somebody who's same as me …and have a
relationship with that person, and say, look this is
where I've come from, this is where I’m staying, do
you fancy setting up a programme, a goal to go
and work with them [LGBT] people, or set one up
[support group] for us to get people involved to
talk about their sexuality.” (Jamie)
Importance of the group
• Identity development – a different identity?
• Reduced distress, following initial attendance
• Self-esteem
• Rehabilitation
May work by modelling behaviour, links with social learning theory13
Findings consistent with other research regarding LGBT support
groups7 8
Group story related to the dominant coming out narrative14 and Cass’s
(1984) model of sexual identity development15
The research had strengths and limitations
• Continued service investment in the group
• Similar groups could be considered by other services
• Staff training in supporting LGBT people and addressing related
Further research to:
• Measure difference in rehabilitation outcomes for those who
attend the group compared to those who do not
• Explore staff attitudes to service user relationships
• Explore how interaction with LGBT staff affects client identity
development and rehabilitation through modelling
• Use a participatory approach
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