Advocacy for Service Users and Carers in Community Learning Disability Team Meetings When Service Users and Carers Are Absent

  • Cordet SmartEmail author
  • Holly ReedEmail author
Part of the The Language of Mental Health book series (TLMH)


Many MDT team meetings occur where service users and their carers are absent. Service user views therefore need careful representation. Advocacy for service users is often undertaken by someone designated as an advocate. In an MDT meeting, there is no designated single advocate. Each clinician has a professional duty to advocate for service users. We examined how clinicians did this in MDT meetings. Elongated advocacy sequences occurred when there was a barrier to service access. Barriers originated from: the MDT, external services, or the service users family or social network. Advocacy was achieved through storytelling. This was punctuated with persuasive conversational devices: use of personal emotional responses, direct and indirect reported speech, re-enactments and contrast structures. Implications for advocating for service users are discussed.


  1. Booth, T., & Booth, W. (1996). Sounds of silence: Narrative research with inarticulate subjects. Disability and Society, 11(1), 55–69.CrossRefGoogle Scholar
  2. Campagna, K. D. (2013). Who will be the patient advocate on a multidisciplinary team? Hospital Pharmacy, 48(2), 90–92. Scholar
  3. Gluyas, H. (2015). Patient-centred care: Improving healthcare outcomes. Nursing Standard, 30(4), 50–57.CrossRefGoogle Scholar
  4. Griffiths, L., & Hughes, D. (1994). “Innocent parties” and “disheartening” experiences: Natural rhetoric’s in neuro-rehabilitation admissions conferences. Qualitative Health Research, 4(4), 385–410.CrossRefGoogle Scholar
  5. Hansson, E., Ekman, I., Swedberg, K., Wolf, A., Dudas, K., Ehlers, L., & Olsson, L. (2015). Person-centred care for patients with chronic heart failure—A cost-utility analysis. European Journal of Cardiovascular Nursing. Scholar
  6. Haugh, M. (2010). Jocular mockery, (dis)affiliation, and face. Journal of Pragmatics, 42, 2106–2119.CrossRefGoogle Scholar
  7. Henry, L., & Gudjonsson, G. (1999). Eye-witness memory and suggestibility in children with mental retardation. American Journal of Mental Retardation, 104(6), 491–508.CrossRefGoogle Scholar
  8. Hepburn, A., & Potter, J. (2007). Crying receipts: Time, empathy, and institutional practice. Research on Language and Social Interaction, 40(1), 89–116. Scholar
  9. Holt, E. (2017). Indirect reported speech in storytelling: Its position. Design, and Uses, Research on Language and Social Interaction, 50(2), 171–187. Scholar
  10. Jefferson, G. (1984). Transcript notation. In J. M. Atkinson & J. Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp. ix–xvi). Cambridge: Cambridge University Press.Google Scholar
  11. Mandelbaum, J. (2013). Storytelling in conversation. In J. Sidnell & T. Stivers (Eds.), Handbook of conversation analysis (pp. 492–508). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  12. McGrath, P., Holewa, H., & McGrath, Z. (2006). Nursing advocacy in an Australian multidisciplinary context: Findings on medico-centrism. Scandinavian Journal of Caring Science, 20(4), 394–402.CrossRefGoogle Scholar
  13. Pilnick, A., Clegg, J., Murphy, E., & Almack, K. (2010). Questioning the answer: Questioning style, choice and self-determination in interactions with young people with intellectual disabilities. Sociology of Health and Illness, 32(3), 415–436.CrossRefGoogle Scholar
  14. Sklar, M., Aarons, G., O’Connell, M., Davidson, L., & Groessl, E. (2015). Mental health recovery in the patient-centered medical home. American Journal of Public Health, 105(9), 1926–1934.CrossRefGoogle Scholar
  15. Stone, S. (2008). A retrospective evaluation of the impact of the Planetree patient-centered model of care on inpatient quality outcomes. Health Environments Research and Design Journal, 1(4), 55–69.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.School of PsychologyUniversity of PlymouthPlymouthUK

Personalised recommendations