Book Review: The Reflective Journey

Dr Rebecca Fish, a researcher at Lancaster University, reviews The Reflective Journey: A Practitioner's Guide to the Low Arousal Approach by Professor Andrew McDonnell




I have been working as a researcher for people with learning disabilities and/or autism in forensic services since 1997. I have heard many tropes about ‘challenging behaviour’, as well as seeing dehumanizing and individualizing ways of referring to people. I know that ‘challenging behaviour’ can be reduced - and even eliminated - by recognizing the needs of the person and making accommodations for them. In light of the shocking exposures of abuse in residential services by BBC Panorama, it is clear that in some spaces there is a need for a more positive, human, and gentle culture of engaging with people.


All behaviours occur within a relational and circumstantial context. This book is described as ‘an honest framework for supporting people’ (9) to be used as a guide by anyone working with or caring for people who can become distressed and overwhelmed. McDonnell tells us that he named the book The Reflective Journey because it is so important to consider our own behaviour when supporting people in crisis. The book talks about people’s responses without Othering them, or using medicalized or pathologizing terminology. Whilst not downplaying the genuine struggles involved in the work of care, McDonnell offers real ways of relating to people that are successful and beneficial to all.


Each chapter requires the reader to consider and reflect on their own actions and responses as well as the person they are supporting. Notably, each chapter offers practical advice about good and effective behaviour management, along with examples and case studies that are all real-life experiences of McDonnell and his colleagues. There are manageable exercises and activities to appeal to different learning styles, and at the end of each chapter there are key learning questions for reflection.


There is an excellent section on trauma-informed practice (Chapter 3), that shows in practical terms how restrictive interventions work to re-traumatise people and should be avoided in any way possible. Empathy is covered in Chapter 4 in a way that requires the reader to re-examine their preconceptions, allowing us to consider the ‘double empathy’ theory. Chapters such as ‘Understanding fear’ (Chapter 5), and ‘Acceptance, forgiveness and understanding’ (Chapter 8) show us why distressed behaviours emerge, and how to understand them. Other chapters in Part 2 offer practical explanations of how to use the Low Arousal Approach. Each of the chapters brings home the awareness that responses are situation-specific, and that situations can be altered.


The book contains just enough academic background to be evidence-based, but this doesn’t distract from the powerful and pragmatic guidance within the book. This is true social model of disability stuff! I would recommend this book to all practitioners working closely with people with learning disabilities and/or autism, as well as social care / social work students, and family carers.



Dr Rebecca Fish,

Researcher at Lancaster University

February 2021


The Reflective Journey is available to buy exclusively from the Studio 3 Website, and is on sale now in paperback and eBook format!

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