3.2 Explain how an individual’s perception of power imbalance may contribute to their distress

This guide will help you answer 3.2 Explain how an individual’s perception of power imbalance may contribute to their distress.

A power imbalance happens when one person holds much more influence, control, or authority over another. In health and social care, this often takes place between care workers and the people who need support. The worker usually has some control—deciding on care plans, routines, or how information is shared.

When an individual feels that others hold all the decisions, they can become distressed. Distress refers to emotional suffering and mental disruption. This might show up as anxiety, frustration, sadness, or a loss of confidence.

Each person’s view of the power imbalance affects how they feel. Even if the worker does not mean harm, the individual’s perception shapes their experience. You need to understand what “perception” means here: it is how someone sees or interprets a situation, not just the facts.

Even small differences in how people feel about control can matter greatly.

Causes of Perceived Power Imbalance

People feel a power gap in many ways:

• Decisions being made for them
• Not being listened to or believed
• Lack of privacy
• Having their choices limited
• Inconsistent or confusing rules
• Being spoken down to or ignored

A person’s previous experiences can shape how they see authority and care workers. If someone faced harm or neglect before, they may be much more sensitive. They may see control, even where the worker intends to help.

Cultural, linguistic, and social backgrounds can also play a part. Some groups, for example, may feel less able to question authority.

How Perception Shapes Emotional Response

When someone believes that a worker or service has more influence than them, and that their own voice is ignored, distress is likely. This can happen when:

• Their preferences are not considered;
• Information is kept from them;
• Changes are made without their input.

They may feel trapped or powerless. These feelings can feed into higher levels of stress, sadness, or anger. If someone cannot see a way to regain some control, distress can last for a long time. Trust in the service or worker may erode.

The Emotional Impact of Powerlessness

Experiencing or even sensing a power imbalance can make a person:

• Feel worthless or invisible
• Become anxious about asking questions
• Doubt their choices and wishes
• Lose motivation to take part in their care
• Feel isolated
• Suffer emotional or psychological harm

Distress can also show as physical symptoms, such as headaches, difficulty eating, or sleep problems. The body and mind are closely linked.

Some people may respond by withdrawing from contact. Others might display anger or challenge staff.

Case Examples: Perception in Action

To make sense of this, let’s look at a couple of everyday examples.

Example 1: Decisions about Meals

Janet, an older adult in supported living, wants to eat breakfast later than the home’s schedule allows. Staff insist on a strict timetable. Janet is not asked for her view.

Even though staff believe they are being efficient, Janet feels her wishes do not matter. She grows frustrated and upset, feeling like a “number” instead of a person.

Example 2: Medical Treatment

Ali, a young adult with learning difficulties, needs an operation. He wants to be part of the decision-making but staff talk above him and only speak to his family. Ali feels ignored and scared, convinced that his views do not count.

He becomes withdrawn and stops co-operating with care, showing clear signs of distress.

Why Perception Matters More Than Intention

An individual may feel powerless regardless of the worker’s good intentions. What matters most is the person’s own interpretation or perception. Staff might think they are acting kindly, but if the person feels excluded or controlled, distress can follow.

This is why seeing issues through the person’s eyes is so important. Good communication and active listening can prevent misunderstandings. Always find out how the person feels—in their own words.

Communication and Its Role

Poor communication often causes a sense of power imbalance. For example:

• Talking in jargon the person doesn’t understand
• Not allowing questions or discussion
• Not explaining the reasons for decisions
• Ignoring feedback or complaints

On the other hand, clear and respectful communication can reduce distress:

• Use open questions
• Ask about preferences
• Explain options and risks
• Be patient, and give time to decide
• Show empathy

Small steps like using the person’s name or checking they understand can help greatly.

Removing Barriers Helps Restore Balance

Simple changes can break down the feeling of a gap in power:

• Give people as many choices as possible
• Involve them in every part of planning or decision-making
• Respect their privacy, dignity, and opinions
• Repeat information if they do not understand at first
• Let people know how to speak up if unhappy

Encourage feedback and do not take criticism personally. Some people need extra time or support to express their views, especially if past experiences made them afraid.

Effects on Mental Health and Wellbeing

Distress linked to power imbalance can have lasting results. It may increase the risk of:

• Depression
• Low self-esteem
• Anxiety disorders
• Social withdrawal
• Reluctance to seek help in future

Distress might even affect long-term health. If a person stops engaging with their care, their condition could worsen.

Effects on Relationships

Staff who ignore individual preferences may damage relationships. Loss of trust is common. A person may:

• Refuse care from certain workers
• Limit what they share or report
• Rely more on family or friends
• Feel unsupported or alone

Relationships built on respect can lessen distress, even if the person still needs assistance.

The Benefits of Empowerment

Empowerment means giving people as much control over their lives as possible. If the person feels listened to, informed, and respected, distress often falls.

Empowerment includes:

• Explaining choices in plain language
• Supporting people to express their wishes
• Helping people to make decisions
• Providing advocates for those who need extra support

Even when not all choices can be granted, explaining reasons clearly shows respect.

Legal and Ethical Duties

Workers must follow laws and codes that protect people’s rights, such as the Human Rights Act 1998 and the Mental Capacity Act 2005. These state that people must be given:

• Respect
• The right to be involved in decisions about their care
• Support to communicate
• Choices wherever possible

Failing to uphold these rights increases distress and may break the law.

Signs of Distress Linked to Perceived Power Imbalance

You may notice distress in the following ways:

• Verbal complaints about care or feeling unheard
• Mood changes or withdrawal
• Increase in physical symptoms with no clear cause
• Disengagement from activities or therapy
• Signs of fear or lack of trust

Spotting these early and responding quickly can help rebuild balance.

How Workers Can Reduce the Impact

Here are ways staff can help:

• Listen carefully, and show understanding
• Encourage participation in every aspect of care
• Speak in a way the person understands
• Respect all wishes, even small ones
• Offer reassurance and advocacy where needed
• Reflect honestly—ask, “How would I feel in their place?”

Recording and acting on feedback makes a difference.

The Importance of Professional Reflection

Stopping to reflect is vital. Ask yourself:

• Did I listen fully?
• Did I give enough choices?
• Was I open about risks and benefits?
• What more could I do to reduce distress?

Training and supervision can help staff spot when unconscious actions create a sense of powerlessness.

Barriers That Make Things Worse

Some systems or attitudes can make the problem worse. Watch for:

• Strict routines that override personal choice
• Limited staffing that reduces time for each person
• Cultural norms that do not value the person’s voice
• Language barriers

Regular review can reduce these barriers.

Working with Families and Advocates

Family members and advocates can support individuals to speak out. They help bridge gaps and offer reassurance. Staff should work in partnership with them. Always check that the person wants involvement from others, to respect privacy.

Training for Staff

Ongoing training on communication, rights, and inclusion helps reduce distress caused by perceived power gaps. It’s important to keep up to date with best practices.

Training should cover:

• Active listening
• Person-centred care
• Rights and advocacy
• Recognising signs of distress

This keeps every worker alert to the causes and effects of power imbalance.

Final Thoughts

The way someone perceives a power imbalance shapes their likelihood of feeling distress. If a person senses that their wishes are less important, or that staff make decisions without them, emotional harm can follow. Distress is not only about obvious bullying or control, but even the smallest slights or restrictions.

Your actions, words, and attitudes all affect how others see their place and worth. Even with the best intentions, failing to share information or seek input can create harm. Taking time to listen, explain, and involve each person makes a real difference.

Every person deserves respect, dignity, and involvement in decisions about their life. By focusing on what makes people feel in control, you lessen distress and build true trust. Always work to see life through the eyes of the person you support—small changes can improve wellbeing and recovery from distress linked to feeling powerless.