Research Project ‘Discovery Awareness’

'The use of Discovery Awareness in Intellectual Disability Services: Examining a European approach to challenging behaviour in a UK setting'


Approaches to challenging behaviour which promise solutions may be more attractive to service providers and policy makers. The strength of reflexive approaches like DA is that they may provoke lasting change by supporting staff to make their own discoveries about the patient and could be a valuable approach to challenging behaviour.


Between 5 and 15 % of people with ID demonstrate challenging behaviours. Staff reactions can be counter-productive causing a cycle of reinforcement.  Challenging behaviour interventions often focuson altering specific behaviours but may not focus on interactional aspects of care.

Whilst the immediate efficacy of behavioural interventions has been demonstrated, they can have negligible long term effects. Staff reflection on interaction can improve relational aspects of care and have  positive effects on challenging behaviour. This paper explores how Discovery Awareness(DA), an interactional method, may be used to engender staff reflexivity in order to stimulate interaction and lower challenging behaviour.


This paper examines common approaches to challenging behaviour and uses DA as a point of contrast. DA is a method created by Jacques Heijkoop utilizing video analysis to stimulate new ways of reflecting upon interaction.

This paper focused on the way in which staff spontaneously begin talking as if: they were narrating what the patient was thinking in DA sessions.

'Although reported speech and constructed dialogue have been well researched, there has been significantly less investigation in conversation analytic literature of how interactants voice a non-present person’s internal monologue , and the actions this may accomplish. This paper explores this phenomenon in staff interactions during an intervention called Discovery Awareness (DA). DA aims to support staff who work with people with intellectual disabilities and challenging behaviour through video analysis of the person; the objective is to become more attuned to the patient and to try to see the world from their point of view. This research has found that this interactional context leads to the recurring use of ‘imagined constructed inner dialogue’ whereby the staff narrate using a first person pronoun what the patient may be thinking in a particular part of the video clip. This paper argues that the use of ´imagined constructed dialogu´e allows participants in DA session to engage in complex interactional work which builds vivid descriptions of the patient they are seeking to understand better. The participants use this form to make assessments , empathise with the patient, evidence their points and summarize the gist of what others say. In sum, it is an extremely versatile way of enacting a variety of complex epistemic and empathic actions.'

'Imagined constructed dialogue' It means talking from the point of view of someone else, but as the kind of thing they may say, but the kind of thing they may be thinking. Generally, it is characterised by using personal pronouns, in the present tense, and representing the speakers interpretation/understanding of what another person is thinking or feeling at a particular point. Whilst it shares these commonalities, it is used to serve a variety of different functions in DA sessions (acting as evidence for points being made, as a way to represent different ways an interaction could have gone, to disagree with someone else in an easier format, or to summarise what another person has said by using/adopting the voice of the person). I argue what all of these actions have in common is that they put the person's voice at the centre of the interaction, and are therefore empathetic turns at talk, as they present, and represent to others, the persons inner thoughts (as they interpret them). What makes this striking is that it seems to be a natural consequence of the DA sessions that I saw.