Using explanatory models in the care of a person with intellectual disabilities
| Published date | 10 May 2013 |
| Pages | 152-160 |
| DOI | https://doi.org/10.1108/20441281311320738 |
| Date | 10 May 2013 |
| Author | Francis Inwang,Colin Hemmings,Cindy Hvid |
| Subject Matter | Education,Health & social care |
Using explanatory models in the care
of a person with intellectual disabilities
Francis Inwang, Colin Hemmings and Cindy Hvid
Abstract
Purpose – Thiscase study seeksto explore the differences between carer and professional perspectives
in the assessment and treatment of a young man with intellectual disabilities, autism and mental health
problems.
Design/methodology/approach – The opinions and perspectives of psychiatrists involved in the care
and treatment of ‘‘S’’ and ‘ ‘S’’’s mother about the aetiology, course, treatment and prognosis of ‘‘S’’’s
condition, are explored using ‘‘explanatory models’’.
Findings – This paper shows the similarities and the differences of opinions and perspectives about the
mental health care of a person with intellectual disabilities.
Originality/value – It shows how the explicit comparison of notions about a person’s condition,
assessment and treatment may help all involved to work together for the common ground of achieving
the best outcomes for service users.
Keywords Explanatory models, Carers, Alternative therapies, Complementary therapies, Health care
Paper type Case study
Introduction
This case report is written jointly by psychiatrists and the mother of a person with intellectual
disabilities called S. He is a 19-year-old man with mild intellectual disabilities and episodic
impairment of behaviour who has been diagnosed with autism and psychosis. This report
will explore the similarities and the differences of opinions and perspectives about the
mental health care of S between the psychiatrists involved and S’s mother. It draws on the
theory of ‘‘explanatory models’’ which are the ‘ ‘notions that patients, families and
practitioners have about a specific illness episode’’ (Kleinman, 1988).
The doctor’s view
S is an only child and was a normal weight baby. There was a reported history of possible
schizophrenia on the paternal side of the family although this is disputed by his mother. There
were no problems with the pregnancy and no evidence of foetal abnormality. S was apparently
‘‘blue at birth’’ but he did not need any resuscitation or special care. There were no feeding
problems and he did not vomit or cry excessively.There was no evidence of any delay for S in
achieving his early developmental milestones. His mother reports that he was walking by
14 months and constructing sentences by the age of 3. He experienced one febrile convulsion
following his second birthday. He was investigated by a neurologistfor episodes of possible
absence seizures but no underlying pathology was found. Concerns about S were raised
about his reaction to changes when he started nursery at the age of three and a half. S also
developed strong specific interests at this time, for example in dinosaurs, pipes and door
hinges. At school, he was described as ‘ ‘unusual’’ socially and behaviourally. S continued
to make developmental progress until the age of 7. He was attending a mainstream
PAGE 152
j
ADVANCES IN MENTALHEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 7 NO. 3 2013, pp. 152-160, QEmerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/20441281311320738
Francis Inwang is based at
the Kent and Medway NHS
& Social Care Partnership
Trust, Maidstone, UK.
Colin Hemmings is based at
the South London and
Maudsley NHS Foundation
Trust, London, UK.
Cindy Hvid is the mother
and carer of ‘‘S’’,
London, UK.
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