Transcript Critical Health Psychology Needs Psychopolitical Validity

Transformative
Participatory Action
Research in Community
Psychology
Isaac Prilleltensky
[email protected]
www.education.miami.edu/isaac
Outline
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Community psychology: Where we are and
where we are going
Well-Being, Oppression, and Liberation
Psychopolitical Validity
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Epistemic
Transformational
Transformative Participatory Action Research
Examples of TPAR
Discussion
Community Psychology: Where We Are
and Where We’re Going
Dimension
Where We Are
Where We’re
Going
Explanatory
framework
Ecological
(person, micro,
meso, macro, but
macro is in the
background),
focus on
risk/protective
factors,
contextualized
but depoliticized
Oppression,
liberation, wellbeing (multilevel, ecological
analysis),
contextualized
and politicized
Community Psychology: Where We Are
and Where We’re Going
Dimension
Where We Are
Where We’re
Going
Place of values
and ethics
Value-laden (the
influence of
multiple values is
noted), increased
attention to
ethics at the
community level
Value-driven,
social ethics
(primacy of value
of social justice)
Community Psychology: Where We Are
and Where We’re Going
Dimension
Where We Are
Where We’re
Going
Research
Communitybased, primarily
positivist,
relatively minor
emphasis on
constructivism
Critical
constructivist
and postpositivist,
participatory,
action-oriented,
and communitybased
Community Psychology: Where We Are
and Where We’re Going
Dimension
Where We Are
Where We’re
Going
Focus of
intervention
Focus on
competence and
strengths,
prevention of
problems in
living for
populations
Focus on
liberation and
well-being for
individuals,
organizations,
and societies
Community Psychology: Where We Are
and Where We’re Going
Dimension
Where We Are
Where We’re
Going
Relationship
between
disadvantaged
community
members and CP
professional
Collaborative
model with
multiple
community
stakeholders
Accompaniment,
solidarity
between
professionals and
disadvantaged
community
members in their
struggle for
liberation and
well-being
through praxis
Critical Community Psychology
Carolyn Kagan and Mark Burton’s definition of community psychology
captures well what we mean by critical community psychology:
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Community psychology offers a framework for working with those
marginalized by the social system that leads to self-aware social
change with an emphasis on value-based participatory work and the
forging of alliances. It is a way of working that is pragmatic and
reflexive, whilst not wedded to any particular orthodoxy of method.
As such community psychology is one alternative to the dominant
individualistic psychology typically taught and practiced in the higher
income countries. It is community psychology because it emphasizes a
level of analysis and intervention other than the individual and their
immediate interpersonal context. It is community psychology because
it is nevertheless concerned with how people feel, think, experience,
and act as they work together, resisting oppression and struggling to
create a better world. (Burton et al., 2007; 219)
Critical Community Psychology
For us, critical community psychology is:
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Ecological in nature, recognizing the need to
concentrate simultaneously on individuals,
relationships, and communities
Value-driven
Guided by the central value of social justice
Praxis-oriented in its efforts to overcome social
injustice through social action in partnership
with disadvantaged people
Critical Community Psychology
Ecological
Spheres
Well being
Values
Oppression and
Social Justice
Praxis
Individual
Absence of
disorder
Health
Unequal
distribution of
health problems
and exposure to
risk
Health promotion
and prevention
Selfdetermination
and participation
Disempowerment
and internalized
oppression
Consciousness
raising
Positive
subjective well
being
Voice, choice and
control
Perceptions of
control, self
efficacy and
mastery
Citizen
participation
Empowerment
Transformation
of settings
Critical Community Psychology
Ecological
Spheres
Well being
Values
Oppression and
Social Justice
Praxis
Relational
Positive social
relations
Caring and
compassion
Social exclusion
Informal supports
Positive identity
Diversity
Racism, sexism,
heterosexism,
ableism, and
classism
Celebration of
strengths and
diversity
Pride
Transformation
of settings
Elimination of
stigma
Confronting
racism, sexism,
heterosexism,
ableism and
classism
Critical Community Psychology
Ecological
Spheres
Well being
Values
Oppression and
Social Justice
Praxis
Collective
Accessible social
programs
Support for
community
structures
Barriers to
resources
Advocacy for
universal services
Low social
capital
Community
capacity building
Extreme
economic
inequality
Social change
Social capital and
sense of
community
Elimination of
poverty
Distributive
justice
Investment in
human and
community
economic
development
Psychopolitical Validity
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Psychopolitical validity derives from the
consideration of power dynamics in
psychological and political domains of health.
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The main objective of psychopolitical validity
is to infuse in critical health psychology an
awareness of the role of power in wellness,
oppression, and liberation at the personal,
relational, and collective domains.
Psychopolitical validity
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In order to attain psychopolitical validity,
investigations and interventions would have to
meet certain criteria. These criteria have to do
with the extent to which research and action
incorporate lessons about psychological and
political power.
Psychopolitical Validity I: Epistemic
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This type of validity is achieved by the
systematic account of the role of power in
political and psychological dynamics affecting
phenomena of interest
Such account needs to consider the role of
power in the psychology and politics of
wellness, oppression and liberation, at the
personal, relational, and collective domains.
Psychopolitical Validity I: Epistemic
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Guidelines for epistemic psychopolitical
validity are presented in Table 1.
Table 1
Guidelines for Epistemic Psychopolitical Validity in Critical Community Psychology
Concerns
Domains
Collective
Relational
Personal
Wellness
Accounts for role of political and
economic power in economic
prosperity and in creation of
institutions that promote equality
and public health
Studies the role of power in creating
and sustaining egalitarian
relationships, social cohesion, social
support, respect for diversity and
democratic participation in
communities, groups, and families
Studies role of
psychological and political
power in achieving selfdetermination,
empowerment, health,
personal growth, meaning
and spirituality
Oppression
Explores role of globalization,
colonization and exploitation in
illness and suffering of nations and
communities
Examines the role of political and
psychological power in exclusion
and discrimination based on class,
gender, age, race, education and
ability.
Studies conditions leading to lack of
support, horizontal violence and
fragmentation within oppressed
groups
Studies role of
powerlessness in learned
helplessness, hopelessness,
self-deprecation,
internalized oppression,
shame, physical and mental
health problems and
addictions
Liberation
Deconstructs ideological norms
that lead to acquiescence and
studies effective psychopolitical
factors in resistance to norms that
cause illness
Studies acts of solidarity and
compassion with others who suffer
from oppression and illness
Examines sources of health,
strength, resilience,
solidarity and development
of activism and leadership
Psychopolitical Validity II:
Transformational
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Transformational validity derives from the
potential of our actions to promote personal,
relational, and collective wellness by reducing
power inequalities and increasing political
action
Table 2
Guidelines for Transformational Psychopolitical Validity
Concerns
Domains
Collective
Relational
Personal
Well-being
Contributes to institutions that
support health, emancipation,
human development, peace,
protection of environment, and
social justice
Contributes to power
equalization in relationships and
communities. Enriches
awareness of subjective and
psychological forces preventing
solidarity. Builds trust,
connection and participation in
groups that support social
cohesion, health and social
justice
Supports personal empowerment,
health, sociopolitical development,
leadership training and solidarity.
Contributes to personal and social
responsibility and awareness of
subjective forces preventing
commitment to justice and personal
depowerment when in position of
privilege
Oppression
Opposes economic colonialism
and denial of cultural rights.
Decries and resists role of own
reference group or nation in
oppression of others and
deterioration of health in other
groups
Contributes to struggle against
in-group and out-group
domination and discrimination,
sexism and norms of violence.
Builds awareness of own
prejudice and participation in
horizontal violence
Helps to prevent acting out of own
oppression on others. Builds
awareness of internalized oppression
and role of dominant ideology in
victim-blaming. Contributes to
personal depowerment of people in
position of privilege
Liberation
Supports networks of resistance
and social change movements that
pursue health and wellness.
Contributes to structural
depowerment of privileged people
Supports resistance against
objectification of others.
Develops processes of mutual
accountability
Helps to resists complacency and
collusion with exploitative and
illness producing system.
Contributes to struggle to recover
personal health and political identity
Transformative Research
Paradigm
Focus of Research
Transformative Research Paradigm
Analytic
Quantitative and/or qualitative methods are
used to analyze problems in participatory
research process
Main concern is epistemic psychopolitical
validity
Quantitative and/or qualitative methods
used to generate action and intervention in
participatory way
Main concern is transformative
psychopolitical validity
Activist/
Interventionist
Roots of Transformative
Research Paradigm
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Participatory Research
Action Research
Feminist Research
Anti-racist Research
Values and principles of transformative research
1.
Self-determination and participation (empowerment)
■ Research should be attuned to issues of power and promote the power of
disadvantaged people
■ Research begins with the experiences and concerns of disadvantaged people
■ Research process is democratized so as to maximize the participation of
disadvantaged people in all aspects of the research
■ Research uses qualitative methods that give voice to disadvantaged people
2.
Community and inclusion
■ Research strives to develop authentic and supportive relationships among researchers,
disadvantaged people and other stakeholders
■ Research should be directed towards the goal of building solidarity for social change
Values and principles of transformative research
3.
Social justice and accountability to oppressed groups
■ Research money should be distributed in a way that provides job and training
opportunities as co-researchers for members of disadvantaged groups
■ Research findings should be used for education and/or advocacy to create social
change
4.
Reflexivity
■ Research should use emergent (or flexible) research designs
■ Research should provide an educational component
■ Research should be demystified so that knowledge is accessible to all, not just
researchers
■ Research should involve all stakeholders in the interpretation of findings and
recommendations for change
Roles for Transformative Action
Researchers
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I VALUE IT
Inclusive Host
 Visionary
 Asset Seeker
 Listener
 Unique Solution Finder
 Evaluator
 Implementer
 Trendsetter
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Example 1: Miami SPEC project
Organizational conditions leading to transformative
practice: Findings from a multi-case study, action
research investigation
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University of Miami SPEC Team
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Isaac Prilleltensky
Ora Prilleltensky
Scot Evans
Adrine McKenzie
Debbie Nogueras
Randy Penfield
Corinne Huggins
Nick Mescia
What is transformative practice?
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In the context of community, educational,
health, and human service organizations, we
define transformative practice as consisting of
four principles
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Strengths
Prevention
Empowerment
Community change
DRAIN VS. SPEC APPROACHES
Drain Approach
 Deficits-based
 Reactive
 Alienating
 Individualistic
Problems
 Too little
 Too late
 Too costly
 Too unrealistic
7/16/2015
SPEC Approach
 Strengths-based
 Primary Prevention
 Empowerment
 Community change
Opportunity
 Built to last
 Starts early and saves $$$
 Creates civic engagement
 Builds social movement
Prilleltensky
27
Time and place of interventions
Collective
THIS IS WHERE WE NEED TO BE
Quadrant IV
Examples:
Food banks, shelters for homeless
people, charities, prison industrial
complex
Quadrant I
Examples:
Community development, affordable
housing policy, recreational
opportunities, high quality schools
and accessible health services
Reactive
Proactive
Quadrant II
Quadrant III
Examples:
Skill building, emotional literacy,
fitness programs, personal
improvement plans, resistance to
peer pressure in drug and alcohol
use
Examples:
Crisis work, therapy, medications,
symptom containment, case
management
Individual
THIS IS WHERE WE ARE
Focus and engagement in interventions
THIS IS WHERE WE NEED TO BE
Strength
Quadrant I
Quadrant IV
Examples:
Voice and choice in celebrating and
building competencies, recognition of
personal and collective resilience
Examples:
Just say no! You can do it!
Cheerleading approaches, Make nice
approaches
Detachment
Empowerment
Quadrant II
Quadrant III
Examples:
Voice and choice in deficit reduction
approaches, participation in
decisions how to treat affective
disorders or physical disorders
Examples:
Labeling and diagnosis,
“patienthood” and clienthood,”
citizens in passive role
Deficit
THIS IS WHERE WE ARE
Context of Investigation
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Action research with 5 community based
organizations (CBOs) to promote Strengths,
Prevention, Empowerment, Community Change
Three year study consisting of
1.
2.
3.
4.
5.
Training
Team work
Consultation
Professional development
Action research
Context of Investigation
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Organizations selected on basis of “readiness”
Organizations consist of
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Major local funder (MF)
Major provider of health services for poor (HS)
Organization that promotes early interventions (EI)
Local civic coalition (LC)
Local human service (HS)
Budgets range from $ 1 million to over $ 100
million
Personnel ranges from 15 to 700
Context of Investigation
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Intervention components
1.
Training
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2.
Team work
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3.
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5.
Transformation teams meet biweekly
Consultation
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4.
Each organization sends reps to 18 person class
3 hours biweekly
Lecture, discussion, application
A researcher assigned to each organization
Weekly or biweekly consultations
Professional development
Action research
Research Design
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Action Goal of overall project: Promote SPEC practices in
organizations to improve community well-being
Research Goals of overall project:
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Data collection
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Assess whether organizations become more aligned with SPEC
principles as a result of interventions
If so, how
Quantitative and qualitative methods at baseline, year one, and
end of project
Goal of present study: Examine organizational conditions
leading to SPEC based on qualitative data gathered through
interviews, focus groups, and field notes with about 80
different participants in the five organizations
INTERVENTIONS TO PROMOTE SPEC
Training
T Team
Consultation
Action
Research
Professional
Development
ORGANIZATIONAL CONDITIONS
OUTCOME: SPEC IN THE COMMUNITY
Strength based
approaches
Preventive
approaches
Empowering
approaches
Community change
approaches
INTERVENTIONS TO PROMOTE SPEC
Training
T Team
Consultation
Action
Research
Professional
Development
ORGANIZATIONAL CONDITIONS
OUTCOME: SPEC IN THE COMMUNITY
Strength based
approaches
Preventive
approaches
Empowering
approaches
Community change
approaches
INTERVENTIONS TO PROMOTE SPEC
Training
T Team
Consultation
Action
Research
Professional
Development
ORGANIZATIONAL CONDITIONS
Climate
Resources
Support
Consciousness
OUTCOME: SPEC IN THE COMMUNITY
Strength based
approaches
Preventive
approaches
Empowering
approaches
Community change
approaches
Findings: Organizational Conditions
for Transformative Practice
Organizational Conditions for
Transformative Practice
Climate
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Effective
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Enabling structures; good communication; timely completion of tasks; efficiency;
accountability and follow-through, etc.
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Most of the organizations noted at least some deficiency in this domain, including
duplication of efforts; inconsistent policies; and bureaucracy
Reflective
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Learning opportunities; organizational learning; asking “big questions”; challenging old
notions; evaluating practice, etc.
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Organizations vary on this dimension, with some presenting as highly reflective and
others describing an environment where there is insufficient trust to challenge old
notions and practices. (“you ain’t gonna rock the boat.”)
Affirmative
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Climate of acceptance and appreciation; employee strengths are highlighted and utilized;
voice and choice; sense of control; team work and conviviality
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Distinction made between voice and choice in a number of organizations where
empowerment is espoused as an organizational value, but not always practiced well.
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In other organizations, staff empowerment is not even part of the organizational radar.
Resources
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Human
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Financial
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Adequate number of workers to meet demands; high skill level; capacity; dedication;
motivation; initiative
Largely described workers as caring, conscientious and committed to meeting the needs of
their constituents
Variable level of skill across organizations
Concern in some organizations that people are spread too thin due to a broad, overly
ambitious mission
Adequate financial resources to support positions; programs; etc.
A major barrier for most organizations in the current economic climate
Cuts in positions and lack of job security are a source of strain
For funding organizations, ongoing concern to make sure investments provide good return
Organizational
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Appropriate organizational structures to meet vision and mission; adequate time, space, etc.
Most organizations described as committed to vision and mission
Some noted that rapid and poorly communicated policy changes lead to inconsistent practices
and poor PR with other agencies
In one case, solicitation of input from “boots on the ground” was seen as a necessary condition
for improved buy-in to vision and mission
Support and Legitimacy
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Leadership for SPEC
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Board support and legitimacy for SPEC
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Leadership provides legitimacy and support to SPEC principles and practices; leader(s)“walk
the talk” in their support of the vision and mission of the organization
Organizations whose leaders are involved in all aspects of the SPEC training (class, T-Team,
etc.) experience greater legitimacy and support for SPEC practices and principles
Lower level of leaders involvement is associated with fewer SPEC practices
Board of Directors provides legitimacy and support to SPEC principles and practices ; board
members“ walk the talk” in their support of the vision and mission of the organization
Some describe difficulties in dealing with board members who come from a corporate
background and unfamiliar with nonprofit
Some board members advocate for special interest groups
Funder support for SPEC
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Funders provide legitimacy and support to SPEC principles and practices; funders “walk the
talk” in their support of the vision and mission of the organization
Some indication that funders may not always walk the talk, despite the theoretical support of
SPEC; some feel micromanaged by funders
Consciousness
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Justice
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Power
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Organization espouses a justice orientation; considers issues of fairness and justice in
understanding community problems and devising solutions
Large variation between organizations. For some, themes of “economic justice” and “social
justice” are espoused and central to the organizational mission. For others, justice is described
as enabling access to services, regardless of client background, legal status, etc.
Organization is highly aware of power issues in the community; sensitive to how differences in
power affect voice, choice and wellbeing; considers power issues when understanding
problems and devising solutions
Awareness and sensitivity to power issues in the community are at times inconsistent with
internal practices with employees.
Ecology
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Organization espouses an ecological orientation; considers personal, organization, and systemic
factors in understanding problems and devising solutions
A shared understanding that social and economic conditions are at the root of people’s
struggles does not always translate to more systemic organizational practices
Discussion
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Study begins to identify necessary and sufficient conditions for
transformative practice
Contribution to community psychology approaches to system
change: not just generic, but also specific conditions are
necessary to promote justice and social change (see special
issue AJCP on systems change June 2007, v. 39 ¾)
Contribution to organizational development: literature focuses
mainly on for profit and ameliorative not for profits. This
study aims to foster transformative practice in not for profits
and identifies consciousness as key condition (Chetkovich &
Kunreuther, 2006; Crutchfield & McLeod Grant, 2007)
Limitations, possibilities,
and next steps
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Great variation across organizations
More qualitative and quantitative data needed
Develop tool that can assess organizational profile
Refine methodology, initial pilot of conceptual framework
resonates with participants
Example 2: SPEC-YE
PAR with Youth
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SPEC-YE
- SPEC for youth
engagement in
African American
Neighborhood in Miami
- Youth participate in
running after school leadership program following
SPEC principles
- Youth engage in civic projects
Example 3: New SPECs Three-year action
research project in South East mid-size City
Island Center
John Snow Foundation
Nazaret
Center
MLK
Center
Healthy City
New SPECs Project
Center for Community Studies
Vanderbilt University
Vanderbilt New SPECs Team
Kimberly Bess, Patricia Conway
Scot Evans, Carrie Hanlin,
Diana McCown,
Bob Newbrough,
Doug Perkins,
Isaac Prilleltensky
Goals of New SPECs
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Apply community psychology principles to
organizational change for community well-being
Generate new practical knowledge for
organizations and the field
Develop practices in line with SPEC
Develop policies in line with SPEC
Institutionalize SPEC in the life of the
organization and the community
Principles of New SPECs
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Ownership by workers and community
members
Participation of workers and community
members
Power sharing
Home grown solutions
Practice and reflection
Action research
Structure of New SPECs
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Structures within organizations
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Structures across the project
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T-Team
Councils
Affiliation groups
Forums
Workshops
Task Forces
Coordinating Committee
Structures within our own Team
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Business meetings
Reflection meetings
Retreats
SPEC INTERNAL AND EXTERNAL
Child and
Family
Strengths
Prevention
Empowerment
Community
Change
Organizations Community
Summary of Outcomes for Nashville
New SPECs Project
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New mission statements
Research publications
Tools to measure SPEC
New policies at United Way
New outreach programs
More youth and client involvement
Assessment of projects in light of SPEC
More prevention efforts in organizations
Empowered counselors
Blending of therapy with social change
In every act, in every interaction, in every social action,
we hold each other accountable to promote
People’s dignity, safety, hope and growth
Relationships based on caring, compassion and respect
Societies based on justice, communion and equality
We are all better when these values are in balance
To put these values into action, we will:
Share our power
Be proactive and not just reactive
Transform the conditions that create problems for youth
Encourage youth and families to promote a caring community
Nurture visions that make the impossible, possible
We commit to uphold these values with
Youth and their Families
Our Employees
Our Organization
Our Community
This is a living document. We invite you to discuss it, to critique it, to live it