Professional/client Relationships: Creating a 'Working Alliance' with People with Learning Difficulties

People labelled as mentally handicapped are perhaps the last amongst the various client groups to be considered as autonomous individuals with a say in their own destinies. There is growing pressure on professionals in all fields to relinquish power and control and recognise the inherent problems of attitudes and practices which promote rather than reduce dependency in clients. Even where client groups are recognised as independent and effective members of society, there are strong resistances to this changing professional role. Where severe learning difficulties are involved, the resistances do not arise just from clinging to older, more comfortable attitudes and practices, but also from a genuine uncertainty about how to proceed. The principle of normalisation does not seem to translate easily into new modes of professional/client interaction.

This paper sets professional/client relationships in their immediate historical context and considers how interpretations of normalisation seem to confirm rather than conflict with established professional assumptions. Some approaches are suggested which may help in structuring and supporting a process of change from dependency-inducing relationships to a 'working alliance'.