Charlotte Capri | University of Cape Town (original) (raw)

Papers by Charlotte Capri

By submitting this dissertation, I declare that the entirety of the work contained therein is my ... more By submitting this dissertation, I declare that the entirety of the work contained therein is my own original work, that I am the sole author thereof (save to the extent explicitly otherwise stated), that the reproduction and publication thereof by Stellenbosch University will not infringe any third party rights (save to the extent explicitly otherwise stated), and that I have not previously in its entirety or in part submitted it for obtaining any qualification.

Capri, C.H. (2022) in Grischow, J. D., & Mfoafo-M’Carthy, M. (Eds.). (2022). Disability Rights and Inclusiveness in Africa: The Convention on the Rights of Persons with Disabilities, challenges and change. Boydell & Brewer. https://doi.org/10.2307/j.ctv29mvsnx, 2022

South Africa is often hailed for its progressive Constitution, which includes a Bill of Rights as... more South Africa is often hailed for its progressive Constitution, which includes a Bill of Rights as its second chapter, and for the development of an advanced body of human rights jurisprudence by its Constitutional Court (Republic of South Africa [RSA], 1996). It was among the earliest States to sign the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) and its Optional Protocol, on 30 March 2007, followed by ratification. Despite this encouraging start, South Africa’s dualist legal system is yet to incorporate the Convention into domestic law. By implication, the capacity of adults with intellectual disabilities (ID) to make decisions with legal consequences (i.e. their legal capacity) is still regulated by common law.

BMC Health Services Research, 2019

Background: Low-and middle-income countries often lack the fiscal, infrastructural and human reso... more Background: Low-and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice guidelines based on research findings from high-income countries. While the context of health organizations is increasingly recognized as an important consideration when such guidelines are implemented, there is a paucity of studies that have considered local contexts of resource-scarcity against recommended clinical guidelines.

Journal of Social and Political Psychology, 2018

Participating in social activism implies responsibility for its exchange and creation. We focus o... more Participating in social activism implies responsibility for its exchange and creation. We focus on Intellectual Disability (ID) as an advocacy site for individuals who are dependent on assistance with activities of daily life, and attend to the process of taking care during social justice projects. Our paper responds to current South African social justice controversies perpetrated against people who may be unable to independently mobilize against increasingly othering-even deadly-socio-political conditions. Underpinned by relational Ethics of Care, voluntary-assisted-advocacy can be a psychologically relational, intersubjective, and societal project that strives for ID citizenship-making and social justice. This paper draws on numerous interviews and a number of ethnographic observations in exploration of ID care. Empirical material was subjected to thematic content analysis, and participant quotes bring our argument to life. Relationships among people with Intellectual Disability (PWID) and non-ID assistant-advocates are asymmetrical. We can either uphold dominant non-ID voices, or transform socio-political ruling relations that maintain dependence on conditions of power and inequality. Our contributions to the advocacy we co-create today will shape the activism we will depend on in the future. We consider relational voluntary-assisted-advocacy as a psychological and ethical resource for sustainable, mutually satisfying social change.

Enabling and disabling socio-political thinking and decisions impact on resources for caring abou... more Enabling and disabling socio-political thinking and decisions impact on resources for caring about intellectual impairment and can create two things: policy environments in which enabling services will be delivered and spaces that will include or exclude the participation of people with intellectual impairment as active citizens. To achieve citizenship with the rights and obligations this entails, we all require socio-political resources; but how often have we asked people with intellectual impairment what they need in order to live as full members of society? Intellectual impairment citizenship begins with respect for specific requests and needs, effective engagement with individual experiences and opinions, and recognition of a truer knowledge and expertise. Including intellectually impaired individuals as experts in research and policy formulation increases the likelihood that policies will more accurately reflect their social conditions and have greater impact on their daily lives. It remains our task to facilitate conditions and opportunities in which expert voices on intellectual impairment can be raised. In relational and intersubjective socio-political and research spaces, experiences of impairment are no longer bestowed upon but voiced by people who live with intellectual impairment in a disabling world—in other words, the real experts.

African Journal of Disability, 2018

Background: Intellectual disability (ID) is the most prevalent disability in the world. People wi... more Background: Intellectual disability (ID) is the most prevalent disability in the world. People with intellectual disability (PWID) frequently experience extreme violations of numerous human rights. Despite greater prevalence in South Africa than in high-income countries, most
ID research currently comes from the Global North. This leaves us with few contextually sensitive studies to draw from to advance inclusive citizenship.
Objectives: Our scoping review aims to investigate pertinent ID rights issues in South Africa, synthesise quantitative and qualitative studies, and provide a synopsis of available evidence on which to base future work. We aim to clarify key concepts, address gaps in the literature
and identify opportunities for further research.
Method: We followed strict eligibility criteria. Medical subject heading terms were entered into seven databases. Seven reviewers worked independently, two per paper. Quantitative and qualitative data extraction forms were designed. We followed Preferred Reporting Items for
Systematic Review and Meta-Analysis (PRISMA) guidelines and registered a protocol. An inductive approach enabled a thematic analysis of selected studies.
Results: By following PRISMA guidelines, 82 studies were assessed for eligibility of which 59 were included. Ten sub-themes were integrated into four main themes: the right not to be discriminated against, the right to psychological and bodily integrity, the right to accommodating services and challenges to rights implementation.
Conclusion: People with intellectual disability face compound difficulties when trying to assert their constitutionally entitled rights. This ongoing project requires serious commitment and action. Statutory obligations to nurture every South African’s human rights naturally extend to PWID and their supporters who forge ahead in a disabling environment.

Esidimeni means 'place of dignity'. It now signifies the disaster in which people continue to die... more Esidimeni means 'place of dignity'. It now signifies the disaster in which people continue to die (140 at last count) and go missing after being transferred from Life Esidimeni into the care of non-governmental organisations (NGOs). [1-3] Esidimeni is not only a medical maladministration scandal. It is a story about the sociopolitical abuse of people who only matter once they die. Patients are not dead because they were mentally ill or simply medically mismanaged. They died because we are careless. We do not care enough to be clear about the difference between people with mental or psychiatric illness and people with intellectual disability (PWID) (no longer called mentally retarded). Countless Esidimenis are currently happening to people who are still alive. The extent of neglectful and abusive care will again only come to light once they also die of starvation, dehydration, cold and infection. Abominable as the crisis is, it is our (current) high-water mark of an ongoing silent catastrophe, which implies that abuse of the living matters less, if at all, than being neglected to death. It also comments on our nation. We profess to know about discrimination and resultant inequality, yet the PWID at the centre of the Esidimeni tragedy are of the single most disenfranchised and oppressed groups in our society.

European Journal of Psychotherapy & Counselling

Purpose: This paper aims to show how an intersubjective view on disablist discourse and practice ... more Purpose: This paper aims to show how an intersubjective view on disablist discourse and practice might craft an egalitarian space from which expert voices on living and working with intellectual impairment could emerge, and attempts to further bridge psychoanalytic and disability studies. Method: The paper shares the view on dispelling the notion that intellectually impaired individuals cannot benefit from psychoanalytic psychotherapy, and speaks to the slow progression of research on intellectual disability psychotherapies. It supports disability researchers' emphasis on moving studies from a third-person reporting style toward counter-hegemonic texts, and explores a way of forefronting impaired individuals' expertise. Results: The discussion shows how subjectivities of both psychotherapist and intellectually impaired patient can intersect – thereby raising previously subdued voices to enable social action for the expression of dissatisfaction, equal (moral) rights, individuality and freedom from disablist practices. Conclusion: Intersubjective work could offer a new way of understanding psychotherapy and research with intellectually disabled individuals differing in degree and manner of impairment; address effects of subaltern voice, marginalisation, disempowerment and defense by equalising therapist–patient power (im)balances; and by virtue of its scientific literature base, provide a contextual clinical account of disability psychotherapy and research as anti-discriminatory political and social processes. ä Implications for Rehabilitation Psychoanalytic intersubjectivity implies that there can be no analytic neutrality unaffected by the therapist's subjectivity, and that ongoing experiences of one's subjectivity are deeply influenced by the subjectivities of those with whom one is interacting. Cautious and thoroughly considered self-disclosure on the part of the therapist in experiencing the patient becomes a permissible therapeutic intervention. In intersubjective research texts, the experience of disability can ultimately be voiced by the real experts living with intellectual impairment in an often disabling world.

Excluding intellectually impaired individuals from participating in research based on the argumen... more Excluding intellectually impaired individuals from participating in research based on the argument of limited capacity can be unethical and a human rights violation. As co-constructors of studies that may affect them directly, adults living with intellectual impairment need not be excluded as co-researchers. By virtue of their expertise on the topic, their voice may stand in public and scientific service on disability matters.

Child and Adolescent Social Work Journal

Objective South African child sexual abuse workers active in low-income communities bear witness ... more Objective South African child sexual abuse workers active in low-income communities bear witness to stories of sexual and physical abuse, neglect, pervasive deprivation, and violence. North American, British, and European workers’ emotional experiences have been captured in the literature, and a gap remains to be filled by those of their South African colleagues. This research aims to focus on the emotional experiences of social workers who engage therapeutically with sexually abused children in the Helderberg basin of the Western Cape, and resonate in some way with readers working in situations of poverty and trauma in other parts of the world.

Method This study employed an explorative inductive research method, and followed a critical realist and contextual constructionist approach. Multiple-case study data collection took place by means of semi-structured interviews with social workers who engage therapeutically with sexually abused children. Data were examined by means of thematic analysis, and psychoanalytic theory was employed to analyse defences that surfaced during interviews.

Results There were similarities in emotional experiences between South African participants and their abovementioned counterparts. The research also identified salient features of working with child sexual abuse in South Africa. The emotional experiences of doing such work, coupled with participants’ ways of managing sexually abused children’s material, gave rise to possible vicarious traumatisation symptoms and allowed for a psychoanalytic understanding to be put forward. The research also reports on useful measures that might enable individuals to continue interventions.

Conclusion To enable ongoing effective therapeutic engagement, social workers should have access to opportunities for acknowledging countertransferences and processing dynamic material defended against. The research contributes to knowledge of working in South Africa by exploring the emotional experiences of those who help sexually abused children daily, and by investigating the psychological impact prolonged therapeutic engagement has on workers active in Western Cape low-income communities.

Aim: Migrating nursing labour inadvertently reinforces South Africa’s care drain, contributes to ... more Aim: Migrating nursing labour inadvertently reinforces South Africa’s care drain, contributes to a global care crisis, and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.
Method: An exploratory descriptive-interpretivist method investigated nurses’ experiences of psychiatric intellectual disability work. 16 free association narrative interviews were collected in 2013. Thematic analysis allowed findings to emerge from the data.
Results: Findings reflect a number of themes: ‘relational interaction’, ‘care burden’, ‘system fatigue’, ‘infantilising dynamic of care’, and ‘resources for coping’.
Conclusion: System fatigue contributes more to negative experiences of providing care than direct patient work, and nurses experience more relational reciprocity from patients than from institutional management. Organisations should meet nurses’ needs for burnout prevention, afford them impact in implementing institutional controls, and engage in a non-exploitative and non-exclusionary way.

This paper comments on infantilisation by attending to South African adult Intellectual Disabilit... more This paper comments on infantilisation by attending to South African adult Intellectual Disability (ID) care through an Ethics of Care lens. Data were gathered from three sources within two specialist ID care sites – from 10 adult residents, 16 nurses, and 3 wards. Deeply embedded in care practices is the disabling of adults with intellectual impairment when referred to as ‘children’. These practices fall short of Tronto and Kittay’s caring societies ethic. Care exchanges generate relational and intersubjective spaces, and infantilising care dynamics require urgent attention if we wish to change ways in which ID is viewed and responded to.

Books by Charlotte Capri

By submitting this dissertation, I declare that the entirety of the work contained therein is my ... more By submitting this dissertation, I declare that the entirety of the work contained therein is my own original work, that I am the sole author thereof (save to the extent explicitly otherwise stated), that the reproduction and publication thereof by Stellenbosch University will not infringe any third party rights (save to the extent explicitly otherwise stated), and that I have not previously in its entirety or in part submitted it for obtaining any qualification.

Capri, C.H. (2022) in Grischow, J. D., & Mfoafo-M’Carthy, M. (Eds.). (2022). Disability Rights and Inclusiveness in Africa: The Convention on the Rights of Persons with Disabilities, challenges and change. Boydell & Brewer. https://doi.org/10.2307/j.ctv29mvsnx, 2022

South Africa is often hailed for its progressive Constitution, which includes a Bill of Rights as... more South Africa is often hailed for its progressive Constitution, which includes a Bill of Rights as its second chapter, and for the development of an advanced body of human rights jurisprudence by its Constitutional Court (Republic of South Africa [RSA], 1996). It was among the earliest States to sign the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) and its Optional Protocol, on 30 March 2007, followed by ratification. Despite this encouraging start, South Africa’s dualist legal system is yet to incorporate the Convention into domestic law. By implication, the capacity of adults with intellectual disabilities (ID) to make decisions with legal consequences (i.e. their legal capacity) is still regulated by common law.

BMC Health Services Research, 2019

Background: Low-and middle-income countries often lack the fiscal, infrastructural and human reso... more Background: Low-and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice guidelines based on research findings from high-income countries. While the context of health organizations is increasingly recognized as an important consideration when such guidelines are implemented, there is a paucity of studies that have considered local contexts of resource-scarcity against recommended clinical guidelines.

Journal of Social and Political Psychology, 2018

Participating in social activism implies responsibility for its exchange and creation. We focus o... more Participating in social activism implies responsibility for its exchange and creation. We focus on Intellectual Disability (ID) as an advocacy site for individuals who are dependent on assistance with activities of daily life, and attend to the process of taking care during social justice projects. Our paper responds to current South African social justice controversies perpetrated against people who may be unable to independently mobilize against increasingly othering-even deadly-socio-political conditions. Underpinned by relational Ethics of Care, voluntary-assisted-advocacy can be a psychologically relational, intersubjective, and societal project that strives for ID citizenship-making and social justice. This paper draws on numerous interviews and a number of ethnographic observations in exploration of ID care. Empirical material was subjected to thematic content analysis, and participant quotes bring our argument to life. Relationships among people with Intellectual Disability (PWID) and non-ID assistant-advocates are asymmetrical. We can either uphold dominant non-ID voices, or transform socio-political ruling relations that maintain dependence on conditions of power and inequality. Our contributions to the advocacy we co-create today will shape the activism we will depend on in the future. We consider relational voluntary-assisted-advocacy as a psychological and ethical resource for sustainable, mutually satisfying social change.

Enabling and disabling socio-political thinking and decisions impact on resources for caring abou... more Enabling and disabling socio-political thinking and decisions impact on resources for caring about intellectual impairment and can create two things: policy environments in which enabling services will be delivered and spaces that will include or exclude the participation of people with intellectual impairment as active citizens. To achieve citizenship with the rights and obligations this entails, we all require socio-political resources; but how often have we asked people with intellectual impairment what they need in order to live as full members of society? Intellectual impairment citizenship begins with respect for specific requests and needs, effective engagement with individual experiences and opinions, and recognition of a truer knowledge and expertise. Including intellectually impaired individuals as experts in research and policy formulation increases the likelihood that policies will more accurately reflect their social conditions and have greater impact on their daily lives. It remains our task to facilitate conditions and opportunities in which expert voices on intellectual impairment can be raised. In relational and intersubjective socio-political and research spaces, experiences of impairment are no longer bestowed upon but voiced by people who live with intellectual impairment in a disabling world—in other words, the real experts.

African Journal of Disability, 2018

Background: Intellectual disability (ID) is the most prevalent disability in the world. People wi... more Background: Intellectual disability (ID) is the most prevalent disability in the world. People with intellectual disability (PWID) frequently experience extreme violations of numerous human rights. Despite greater prevalence in South Africa than in high-income countries, most
ID research currently comes from the Global North. This leaves us with few contextually sensitive studies to draw from to advance inclusive citizenship.
Objectives: Our scoping review aims to investigate pertinent ID rights issues in South Africa, synthesise quantitative and qualitative studies, and provide a synopsis of available evidence on which to base future work. We aim to clarify key concepts, address gaps in the literature
and identify opportunities for further research.
Method: We followed strict eligibility criteria. Medical subject heading terms were entered into seven databases. Seven reviewers worked independently, two per paper. Quantitative and qualitative data extraction forms were designed. We followed Preferred Reporting Items for
Systematic Review and Meta-Analysis (PRISMA) guidelines and registered a protocol. An inductive approach enabled a thematic analysis of selected studies.
Results: By following PRISMA guidelines, 82 studies were assessed for eligibility of which 59 were included. Ten sub-themes were integrated into four main themes: the right not to be discriminated against, the right to psychological and bodily integrity, the right to accommodating services and challenges to rights implementation.
Conclusion: People with intellectual disability face compound difficulties when trying to assert their constitutionally entitled rights. This ongoing project requires serious commitment and action. Statutory obligations to nurture every South African’s human rights naturally extend to PWID and their supporters who forge ahead in a disabling environment.

Esidimeni means 'place of dignity'. It now signifies the disaster in which people continue to die... more Esidimeni means 'place of dignity'. It now signifies the disaster in which people continue to die (140 at last count) and go missing after being transferred from Life Esidimeni into the care of non-governmental organisations (NGOs). [1-3] Esidimeni is not only a medical maladministration scandal. It is a story about the sociopolitical abuse of people who only matter once they die. Patients are not dead because they were mentally ill or simply medically mismanaged. They died because we are careless. We do not care enough to be clear about the difference between people with mental or psychiatric illness and people with intellectual disability (PWID) (no longer called mentally retarded). Countless Esidimenis are currently happening to people who are still alive. The extent of neglectful and abusive care will again only come to light once they also die of starvation, dehydration, cold and infection. Abominable as the crisis is, it is our (current) high-water mark of an ongoing silent catastrophe, which implies that abuse of the living matters less, if at all, than being neglected to death. It also comments on our nation. We profess to know about discrimination and resultant inequality, yet the PWID at the centre of the Esidimeni tragedy are of the single most disenfranchised and oppressed groups in our society.

European Journal of Psychotherapy & Counselling

Purpose: This paper aims to show how an intersubjective view on disablist discourse and practice ... more Purpose: This paper aims to show how an intersubjective view on disablist discourse and practice might craft an egalitarian space from which expert voices on living and working with intellectual impairment could emerge, and attempts to further bridge psychoanalytic and disability studies. Method: The paper shares the view on dispelling the notion that intellectually impaired individuals cannot benefit from psychoanalytic psychotherapy, and speaks to the slow progression of research on intellectual disability psychotherapies. It supports disability researchers' emphasis on moving studies from a third-person reporting style toward counter-hegemonic texts, and explores a way of forefronting impaired individuals' expertise. Results: The discussion shows how subjectivities of both psychotherapist and intellectually impaired patient can intersect – thereby raising previously subdued voices to enable social action for the expression of dissatisfaction, equal (moral) rights, individuality and freedom from disablist practices. Conclusion: Intersubjective work could offer a new way of understanding psychotherapy and research with intellectually disabled individuals differing in degree and manner of impairment; address effects of subaltern voice, marginalisation, disempowerment and defense by equalising therapist–patient power (im)balances; and by virtue of its scientific literature base, provide a contextual clinical account of disability psychotherapy and research as anti-discriminatory political and social processes. ä Implications for Rehabilitation Psychoanalytic intersubjectivity implies that there can be no analytic neutrality unaffected by the therapist's subjectivity, and that ongoing experiences of one's subjectivity are deeply influenced by the subjectivities of those with whom one is interacting. Cautious and thoroughly considered self-disclosure on the part of the therapist in experiencing the patient becomes a permissible therapeutic intervention. In intersubjective research texts, the experience of disability can ultimately be voiced by the real experts living with intellectual impairment in an often disabling world.

Excluding intellectually impaired individuals from participating in research based on the argumen... more Excluding intellectually impaired individuals from participating in research based on the argument of limited capacity can be unethical and a human rights violation. As co-constructors of studies that may affect them directly, adults living with intellectual impairment need not be excluded as co-researchers. By virtue of their expertise on the topic, their voice may stand in public and scientific service on disability matters.

Child and Adolescent Social Work Journal

Objective South African child sexual abuse workers active in low-income communities bear witness ... more Objective South African child sexual abuse workers active in low-income communities bear witness to stories of sexual and physical abuse, neglect, pervasive deprivation, and violence. North American, British, and European workers’ emotional experiences have been captured in the literature, and a gap remains to be filled by those of their South African colleagues. This research aims to focus on the emotional experiences of social workers who engage therapeutically with sexually abused children in the Helderberg basin of the Western Cape, and resonate in some way with readers working in situations of poverty and trauma in other parts of the world.

Method This study employed an explorative inductive research method, and followed a critical realist and contextual constructionist approach. Multiple-case study data collection took place by means of semi-structured interviews with social workers who engage therapeutically with sexually abused children. Data were examined by means of thematic analysis, and psychoanalytic theory was employed to analyse defences that surfaced during interviews.

Results There were similarities in emotional experiences between South African participants and their abovementioned counterparts. The research also identified salient features of working with child sexual abuse in South Africa. The emotional experiences of doing such work, coupled with participants’ ways of managing sexually abused children’s material, gave rise to possible vicarious traumatisation symptoms and allowed for a psychoanalytic understanding to be put forward. The research also reports on useful measures that might enable individuals to continue interventions.

Conclusion To enable ongoing effective therapeutic engagement, social workers should have access to opportunities for acknowledging countertransferences and processing dynamic material defended against. The research contributes to knowledge of working in South Africa by exploring the emotional experiences of those who help sexually abused children daily, and by investigating the psychological impact prolonged therapeutic engagement has on workers active in Western Cape low-income communities.

Aim: Migrating nursing labour inadvertently reinforces South Africa’s care drain, contributes to ... more Aim: Migrating nursing labour inadvertently reinforces South Africa’s care drain, contributes to a global care crisis, and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.
Method: An exploratory descriptive-interpretivist method investigated nurses’ experiences of psychiatric intellectual disability work. 16 free association narrative interviews were collected in 2013. Thematic analysis allowed findings to emerge from the data.
Results: Findings reflect a number of themes: ‘relational interaction’, ‘care burden’, ‘system fatigue’, ‘infantilising dynamic of care’, and ‘resources for coping’.
Conclusion: System fatigue contributes more to negative experiences of providing care than direct patient work, and nurses experience more relational reciprocity from patients than from institutional management. Organisations should meet nurses’ needs for burnout prevention, afford them impact in implementing institutional controls, and engage in a non-exploitative and non-exclusionary way.

This paper comments on infantilisation by attending to South African adult Intellectual Disabilit... more This paper comments on infantilisation by attending to South African adult Intellectual Disability (ID) care through an Ethics of Care lens. Data were gathered from three sources within two specialist ID care sites – from 10 adult residents, 16 nurses, and 3 wards. Deeply embedded in care practices is the disabling of adults with intellectual impairment when referred to as ‘children’. These practices fall short of Tronto and Kittay’s caring societies ethic. Care exchanges generate relational and intersubjective spaces, and infantilising care dynamics require urgent attention if we wish to change ways in which ID is viewed and responded to.