Emotional support and inclusion for blind and partially sighted people in the United Kingdom: the development of counselling for sight loss, a pluralistic practice model
This is a narrative account of a cohesive programme of research carried out between 2010 and 2016, which resulted in ten peer-reviewed, published papers that provide an empirical basis for my thesis. The impetus for this academic exploration was provided by my personal experience of acquired sight loss, where my medical and functional needs were prioritised but my emotional needs were overlooked. The first study I undertook confirmed that people experienced negative emotional effects attributable to acquired sight loss. Subsequent studies explored the experience of social exclusion in health and education for blind and partially sighted people. Difficulties were evident across the lifespan, starting with undiagnosed refractive errors in childhood, moving to perceptions of inclusion in high school and on to experiences of exclusion in health care and engagement with leisure activities in adulthood. These papers offer a context for understanding the social and emotional effects of sight loss. Two supporting papers examined how inclusion in healthcare might be increased through nurse education and how accessible games might aid inclusion in entertainment. The thesis as a whole focuses on the development of Counselling for Sight Loss, a pluralistic practice framework for responding holistically to the emotional effects of sight loss, which are compounded by social exclusion. My theoretical model explaining the transition from sight to blindness provided a theoretical context for the thesis, advocating that different people benefit from different types of emotional support at different times in their sight loss journey. This has implications for the nature and timing of emotional support offered to blind and partially sighted people. Counselling for Sight Loss is based around a menu of therapeutic tasks, identified from analysis of systematic case study data in which clients identified helpful aspects of their therapy. These tasks provide an empirical basis for working therapeutically with clients who have visual impairment and will act as a foundation for the development of training materials. The findings of my most recent study have highlighted the need for a national framework for the provision of emotional support services for blind and partially sighted people within the United Kingdom. Currently, emotional support and counselling services are being delivered by staff with varying degrees of relevant training, including those with none. My research has contributed to the development of quality standards and training, based on my Counselling for Sight Loss data, to benefit UK service delivery. Thus my thesis represents a systematic commitment to using research to generate real-world solutions to a real world problem: designing and delivering effective emotional support and counselling for adults with sight loss in the United Kingdom.
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