Framed: A Scoping Review of Photo-Elicitation in Interpretative Phenomenological Analysis and a Qualitative Study of Autistic Mothers Experiences after a Fabricated or Induced Illness investigation

Abstract

This thesis explores the methodological applications of combining Photo-elicitation interviewing (PEI) with Interpretative Phenomenological Analysis (IPA) and applies this methodological approach to the experiences of autistic mothers, a marginalised group, having undergone child protection (CP) investigations for Fabricated and Induced Illness (FII). Visual research tools like PEI have gained prevalence within qualitative health research, especially with groups whose experiences may have otherwise been missed by conventional research approaches. IPA, with an emphasis on meaning making from participants with first-hand experience of phenomena, has been increasingly employed alongside PEI, however lacked a mapping of the available literature on how these two approaches have been previously utilised. This thesis includes a scoping review which mapped 43 eligible studies using PEI-IPA which included peer-reviewed and grey literature. A narrative summary and semantic thematic analysis reported that PEI-IPA was reported by the extant literature to encourage participant led sense making for particularly sensitive and complex experiences, positing the possibility of its use in assisting with epistemic justice in research. Variance in the procedural and ethical navigations of using PEI-IPA suggested the potential for considering guidance for future researchers considering the use of PEI-IPA. This scoping review directly informed the methodological approach taken in second part of this thesis, the empirical paper, which used PEI-IPA to explore the lived experiences of autistic mothers having been subject to a child protection investigation for suspected Fabricated or Induces Illness (FII). Whilst extant and grey literature posited that autistic mothers are at a higher risk of suspicion for FII than neurotypical counterparts, their experiences are largely absent from extant research and policy making. In this empirical paper, eight autistic mothers took part in one-to-one remote interviews where up to five photos they had taken that represented to them a week in their life after their FII investigation were discussed. Transcripts analysed using IPA (Smith et al., 2009) uncovered three superordinate themes with a total of nine subordinate themes. The themes of “Once accused you are never exonerated”, “I forgot who I was” and “Strategies to Survive” interpreted how autistic mothers’ expressions of care were III misinterpreted by statutory services, resulting in a fracturing of what it meant for participants to be a good mother and requiring survival strategies beyond psychological therapy. For participants, survival demanded an accountability from the institutions that had harmed them, for a transparency in the professional narratives held about them and an opportunity to correct the record. These findings are argued to have direct clinical and policy implications in reflection that without systemic change, future efforts to safeguard families may risk a continuation of institutional harm against a marginalised population.