Community Psychology for Applied Psychologists

Community Psychology for Applied Psychologists

Community Psychology for Applied Psychologists: Working Alongside Marginalised/Excluded/Disadvantaged Communities Facilitators: Dr Ho Law and Dr Glenn Williams With input from Community Psychology Section Committee members Agenda Speaker and delegate introductions Sessions: 1. Introduction to Community Psychology 2. Ecology, Prevention and Promotion 3. Community Psychology - Research and Action 4. Community and Organizational Change 5. Applying these Principles and Practices in your Work Profile of Expertise/Experience: Dr Ho Law PhD CPsychol CSci FCMI MSCP(Accred) AFBPsS FRSM

Email: [email protected] Founding Committee Member of Community Psychology Section (Honorary Treasurer) Registered Psychologist, Chartered Psychologist, Chartered Scientist, a Fellow of the Royal Society of Medicine, an international practitioner in coaching psychology and psychotherapy. Chair (2010) of the British Psychological Societys (BPS) Special Group in Coaching Psychology.

Chair (2013-14) BPS Psychotherapy Section President, Empsy Network. Or: [email protected] Founder Director, International Society for Coaching Psychology Senior Lecturer, Programme Leader in Coaching Psychology, University of East London (UEL), UK.

Visiting professor, Lisbon University, Portugal. Visiting psychologist, School of Nursing, Hong Kong Sanatorium & Hospital (HKSH). Current research: Compassion in healthcare practice. Achievement awards: Local Promoters for Cultural Diversity Project (2003), the Positive Image (2004), the first Student Led Teaching Award (UEL 2013) - Best Supervisor. Profile of Expertise/Experience:

Dr Glenn Williams Received PhD in Psychology in 2003 Studied organisational change, personality, well-being and stress. Has worked in the NHS as a researcher from 1995 to 2001. Has delivered Psychology teaching since 2001 to nursing/other health professionals and to psychology students Author of 90+ books, book chapters, journal articles, conference papers, and commissioned reports. Heavily involved with Community Psychology research and practice

developments in the UK and abroad Committee member of the BPS Community Psychology Section since 2010. Member of the Society for Community Research and Action. Member of the European Community Psychology Association. External Examiner for BA (Hons.) Counselling and Psychology in Community Settings (Leeds Met University Regional Network). 4 Delegate introductions & Group Work Delegates divide into groups of 4 or 5.

Introduce briefly to each other their name and what they do. Discuss amongst yourself and agree on one example of the work from the group as the most representative application of psychology in communities. Ground rules participants are requested to: 1. Understand the question. 2. Use your groups chosen examples to illustrate the understanding of the questions in the later exercises. 3. Ensure understanding of the others viewpoints during the discussion. 4. Use common sense everyday experience. 5. Use imagination to step into the examples under debate. 6. Refrain from book citing.

7. A volunteer to take note to summarise the key points and report back to the plenary Community Psychology for Applied Psychologists: Session 1: Introducing Community Psychology with Dr Glenn Williams and Dr Ho Law Introduction to Community Psychology - Overview What is community psychology? Origins of community psychology Core values of community psychology What do community psychologists

do? What is Community Psychology? Its primary focus is on understanding, and working with, people in their wider social context beyond seeing them purely as individuals Acknowledges role of systems that exist around people relating to place, history, and culture that affect peoples well-being and behaviour It uses a multi-layered focus (Nelson & Prilleltensky, 2010) with analysis of: micro-systems (e.g. a family or social network), meso-systems (i.e. links between micro-systems such as between home and school or relationships between work and home) and macro-systems (e.g. social norms, economic systems and policies). Origins of Community Psychology (CP) in UK #1

Relatively new as an organised discipline in UK Psychology One of the forerunners was from Europe: Marie Jahoda and colleagues studied an unemployed community, Marienthal, Austria in 1930s. Their conclusion = negative impacts best understood at the community, rather than the individual, level (Jahoda,1983) Jahoda was responsible for an important pioneering psychological study of a community in Wales. Jahoda became 1st woman professor at Sussex University and founded a version of Social Psychology closely related to community psychology. Origins of Community Psychology (CP) in UK #2 Fast forward a few decades Roots of CP was in applied social psychology, mental health work, and clinical psychology.

Journal of Community and Applied Social Psychology launched in 1991 and co-edited by Orford. Textbook on Community Psychology produced in 1992. CP conferences held in the UK from the 1990s onwards. Strong tradition of critical psychology influencing CP. E.g. Prof. Ian Parker and Erica Burman. MMU integrates critical psychology and CP together as part of their undergraduate programmes. Growing links between health psychology and CP Michael Murray, David Marks and Carla Willig. For a fuller overview, see: Some Key People in UK Community Psychology Prof. Jim Orford Prof. Carolyn Kagan Prof. Jacqueline

Akhurst Some of the Initial Aims of the Section: To get a better understanding of the multiple factors (e.g. social, economic, political and environmental) that cause or perpetuate psychological problems in order for preventative strategies to be developed and put in place; To develop partnerships, where local knowledge of participants is valued as equal to expert knowledge, and professional skills are used collaboratively; To collect evidence of the impact of community-based interventions; To undertake forms of inclusive, participatory action research (and other more progressive research forms); To engage, and influence, policy makers. For progress on this, see Core Values of Community Psychology

Placing people in their social contexts Includes central concepts of: Power (Disempowerment..Empowerment) Social inclusion (Marginalisation..Inclusivity) Involves working collaboratively with others Uses a plurality of research & development methods (e.g. participatory action research) More critical community psychological approaches challenge the status quo 6 Rs Ethical Principles to guide Community Psychology Research and Practice 1. Rights 2. Respect 3. Recognition 4. Relationship 5. Representation 6. Responsibility

What do community psychologists do? They see social exclusion, marginalisation, powerlessness and oppression as having major impacts on health and well-being. Lack of power and oppression due to inequalities (e.g. rooted in social class, gender, sexual orientation and ethnicity) states of learned helplessness, conformity, self-blame and worthlessness downward spirals in well-being and ill-health (Prilleltensky, 2003). Community psychology research and interventions attempt to change these influences and systems. Community psychologists pursue social justice, liberation, and act as advocates for the marginalised and the oppressed. Examples of research = debt (Akhurst, 2011), gambling (e.g. Orford, 2010), climate change (e.g. Burton, 2009) disabilities (e.g. Kagan, et al., 1999) and physical and mental health (e.g. Lovell, et al., 2011). Questions For Discussion

What is community? What does community mean to you? Are you part of a community? If so, which ones? Are the communities that you belong to tied into a place/an ethnic group/a religion or something else? What made you part of that community? Did you get much of a choice? Community Psychology for Applied Psychologists: Session 2: Ecology, Prevention and Promotion with Dr Glenn Williams and Dr Ho Law Ecology, Prevention and Promotion

- Overview The Ecological Metaphor Prevention primary, secondary and tertiary approaches Promoting healthy lifestyles and choices Working together on a prevention/promotion project relevant to your work practice or research interests The Ecological Metaphor Interdependence (e.g. micro-, meso-, macro-levels) Cycling of Resources (e.g. having sustainable social support systems both formally and informally) Adaptation (e.g. coping with changes to the eco-system such as cuts to funding of essential services) Succession (e.g. having a long-term perspective evolutions to available

social systems and networks of support) Nelson & Prilleltensky (2010) Different Levels of Focus for Prevention Primary aims to reduce incidence of new cases of a disorder (i.e. the number of new cases in a specified population at a given time) Secondary aims to detect disorder and to give treatment at early stage. Ideally, the goal will be to reduce the prevalence of a disorder (i.e. number of active cases at a particular point in time) Tertiary aims to reduce the chances of disorder developing into disability/handicap From Orford (1992) Other Ways of Seeing Prevention Increasing levels of focus Bloom (1968),

Heller (1984) Public Healthrelated (e.g. Robertson, 1986) Ecology (Bronfenbrenner, 1979) 1. Communitywide (focused on whole community) 1. Host (e.g. person infected) 1. Micro-level (e.g. family, workplace, school)

2. Milestone (those passing a developmental milestone 2. Agent (e.g. vehicle for transmitting disorder/disease) 2. Meso-level (e.g. interfaces between home and school, between home and work) 3. High-risk

3. Environment (e.g. noxious circumstances) 3. Macro-level (e.g. societal norms, legislation) Continued from Orford (1992) Why Primary Prevention Matters Primary Promotes healthy lifestyles Secondary Requires early diagnosis and treatment Does not need a condition to be

Relatively mechanistic and based diagnosed or understood to have an intervention for it (e.g. on biomedical model John Snows work on cholera Fits the linear model that prevention in London in 1854) underpins conventional health Based on an outcomes model care systems treats the person, not the Some interventions based on this disease approach may repair one part of Interventions typically involve the body but might still upset rest behavioural (e.g. exercise, diet) of the system or policy changes (e.g.

sanitation, pollution control) From Kaplan (2000) Focus Reference/s Compared with Cost/QALY Mammography Women aged 4049 Eddy, 1989; Salzmann et al. 1997 No

mammography Ranges from $150,000 to $240,000 PSA screening for men 60-70 yrs Krahn et al., 1994 No screening Screening causes reductions Daytime use of running lights in

automobiles Williams & Lancaster, 1995 No use of lights < $0 Tobacco restrictions for minors Graham et al., 1998 No restrictions < $1,000

Secondary Prevention Primary prevention Continued from Kaplan (2000) Promotion and Communicating the Message: Lessons from Research Messages should not be laden with statistics - be colourful and memorable The communicator needs to be expert, trustworthy and likeable Strong arguments to be put at beginning or end of communication

The message should have a clearly defined course of action From Daniel OKeefe (2002) For messages emphasising uptake of screening, suggestions of problems arising from no screening will be effective Audience receptivity to changing habits: Audience receptive - state only good points of message. Audience undecided - discuss both sides Promotion Issues to Consider

To whom is the message being promoted? Is this an effort at primary, secondary or tertiary prevention? What other elements of prevention are being tackled? Any of the following: Community-wide Milestone-based areas of focus (e.g. passing a life milestone) High-risk (e.g. those particularly at high risk) Micro-level (e.g. in a family or workplace) Meso-level (e.g. interactions between home and school micro-systems, or between home and work) Macro-level (e.g. prevailing attitudes and norms, current laws or policies) Group Work What risks to health and well-being can you identify for a target group relevant to your groups practice or research interests? What prevention strategies could you use to target

these risks? What promotion methods might work well for your target group, and why? Community Psychology for Applied Psychologists: Session 3: Community Psychology Research and Action with Dr Ho Law and Dr Glenn Williams Overview 3 main paradigms in community psychology research: Post-positivist Constructivist Transformative Examples of community psychology research

Designing research and action for your chosen target group group activity Three Paradigms for Community Research Outlined in Williams & Zlotowitz (2013): Positivist/Post-Positivist came from logical positivism with its emphasis on one external reality/truth Constructivist sees reality as being relatively shaped by peoples perceptions of their worlds and that there can be many truths (e.g. see post-modernist approaches to inquiry) Transformative developed from Marxist and critical theorist approaches to social phenomena; emphasis is on external reality that has been historically shaped by social, cultural, political, gendered, economic and ethno-racial factors. Based on assumption of inequalities being present and there being dominant/subordinate groups Focus of

research Post-Positivist Constructivist Transformative Analytic Mainly quant. Methods (surveys, epidemiological data, quasiexperiments, case-control, cohort studies) Mainly qual.

methods (grounded theory, discourse analysis, case studies) Quant./Qual. methods used. Highly participatory. Partners with those in a disempowered and marginalised community Activist/ Interventionist

Focuses on programme evaluations, costeffectiveness, outcomes Also analyses programme data, archival information, minutes of meetings, observations, publicity material Defines problems and

intervenes in partnership with the disadvantaged community The Transformative Paradigm Ontology: Rooted in German critical theory, feminism, Marxism and strives for social justice and change. Proposes an external reality (like post-positivism). Unlike p-p, this reality is based on shared social histories where inequalities and misuse of power are salient. Epistemology: Inter-relationships between researcher and researched. The researcher is working in solidarity with the oppressed and marginalised. Important to acknowledge and reflect on this dynamic. Axiology: Has a moral and political stance underpinning the research. Has values of justice, respect for diversity, inclusivity, empowerment, and accountability to those being oppressed (6Rs). Methodology: Reflexive and critical. Uses participatory and actionoriented methods. Disadvantaged people are included in the setting for the research agenda and in the executing of the study and the

dissemination of findings and deciding what to do afterwards. An example: Stories of Hopes A narrative practice in wider communities Dr Ho Law & Naomi Mwasambili With input from: Valeria Sterzi & Jenny Gordon Aims of the project: 1. UEL Make It Global (MIG) project which aims to support 250 women-led, small and medium enterprises (SMEs) in London, to increase their confidence and awareness of the benefits to internationalise. 2. The scheme aims to: 1) increase peer coaching resources in Southwark;

2) get customer feedback; and 3) enable peer coaches to successfully carry out placements within their community. 3. The research aims to assess the effectiveness of a six-week community based peer coaching training scheme provided by Community Therapies and Training Service (CTTS) using narrative method. 4. The approach aims to help participants to improve their personal development, self-reflection and general functioning. Context: E C CTTS MIG W

A2 A1 W W D2 D1 T B Narrative approaches and practices

Meso - level psychological foundation Grounding experience Sequential framework Goal setting Well being Emotional Regulation Experience-based Social collaborative learning

Context Self definition Positive action Selfidentity Narrative techniques: Externalising Conversations (1:1) Re-membering/Re-Authoring (1:1) Outsider Witness Re-telling (1:1:n) Definitional ceremony (Community) Retellings of retellings. Working in Groups Instructions for observer/listener outsider witness Activity group

Listen Make note: Express -ion Image s Resonance s Katharsis Transport Case studies Identify: 1. The problem

2. The goal, hopes and dreams 3. How community psychology may help Group activity/Homework: Re-designing a community psychology research and action project for your target group (designing a new one if you wish) Identify: 1. The problem 2. The goal, hopes and dreams 3.

How will your intervention help Community Psychology for Applied Psychologists: Session 4: Developing Effective Organisational and Community Change with Dr Ho Law and Dr Glenn Williams Overview Resistance to change Using Appreciative Inquiry to effect change Steps for organisational/community change Considering strategies for organisational change in your groups by using your same target group from Sessions 2 & 3 Resistance May be Good for You

Foucault (1976) where there is power, there is resistance (p.95). The oppressed may be fighting for their rights through resistance. We need to distinguish between (a) the disempowered having their resources taken away through the change versus (b) the powerful having the status quo (and their status) being placed under threat through this change. Those with a vested interest in the status quo often mount an attack on the methodology [of a change or evaluation] because they do not like the challenging work that the group is doing. It is often easier to attack the method than to attack the sense making that the [collaborative] inquiry is doing (Burns, 2007; as cited by Kagan, et al., 2011). Case Study of How to Deal With Resistance Advocating for the leisure participation of people with learning difficulties: One of the local service managers was hostile to the project, arguing that slow, person-centred ways of working would lead to little change

and be a waste of public money. We invited him to join the management group of the project. Although his criticisms were still voiced, he could not stop his staff cooperating with a project of which he was part. He was also exposed to some of the exciting changes that were achieved. Within 3 years he had mainstreamed many of the ideas [of the project] and they became part of the serviceFar from continuing to resist, he ended up embracing the practices and had also brought a different set of skills and knowledge to the project (Kagan et al., 2011; p.289) Other Considerations about Change (Kagan, et al., 2011) It is effective when owned by those affected by the change. Change doesnt always happen straight away in the area where the intervention is focused. Work done by community psychologists to effect change is only one element of what is going on in an organisation at any one time. Many social patterns occurring at the same time in the same environment. People affected by the change may not have the perspective at the time to

be able to give effective feedback on the impact of the change. Community psychologists have a privileged position of being on the fringes and occasionally on the inside in helping to bring about the change. There is a tension, howeverStakeholders may be suspicious about whose interests are really being represented in helping to effect and evaluate the changes. Example of Effecting Individual Change: Feedforward Based on Appreciative Inquiry (AI) (Cooperrider & Srivasta, 1987) 3-phase appreciative interview: 1. 2. 3.

Get a narrative from the person on when s/he was at his or her best What were the conditions that brought out the best in that person? Look at the emotions experienced when reaching end of narrative To what degree do your plans for the immediate future take you closer to, or further away from, the conditions that allowed you to be at your best? Appreciative Inquiry (AI) as a Way Forward for Organisations (Robbins, 2003) Most Organisation Development approaches are problemcentred. Identifies a problem and aims to come up with solution. AI identifies unique qualities and strengths of an

organisation to build on to improve performance. Four-step AI process (large group meeting usually over 2-3 day period): 1. Discovery (what people think are the strengths of the organisation) 2. Dreaming (info from Discovery is used to envisage possible futures for the organisation) 3. Design (based on the articulation of the Dreaming stage, participants find a common vision for what the organisation will look like) 4. Destiny (discussion on how the organisation will fulfil this dream). Other Methods of Tracking Change: Stages of Change (Prochaska et al., 2008) Maintenance Preparation

Contemplation Precontemplation Action Steps for Organisational Change #1 (adapted from Nelson & Prilleltensky, 2010) Steps Aim People Tasks Who will do it?

When to do it? 1. Pre-cont. Create awareness Allies to the change Inform others Choose effective people Decide on

right time to sensitise 2. Contemp. Create need for change Allies and possible allies Look for specific problems and spread information

Credible Have time people in to create organisation momentum for change 3. Prep. Specific goals and areas to be changed Those with influence and credibility

Get data about problem and devise plan Internal or external consultants Have clear timetable for prep. phase Steps for Organisational Change #2 (adapted from Nelson & Prilleltensky, 2010) Steps

Aim People Tasks Who will do it? When to do it? Action Do the most effective interventions first

Everyone affected by the proposed change Many tasks linked to the changes Involve multiple agents of change Decide ahead of time on this. Too much time

lag will reduce credibility of change Maint. Put in place systems to sustain the change Everyone affected by the change Have As many activities to

people as institutionalise possible the change Have changesustaining activities at regular intervals Group Activity: Designing community-level or organisational change for your target group Effecting Change by Using your Groups Scenarios Have a think about your target group that you focused on in Sessions 2 and 3. Think about macro-, meso- and micro-level focused interventions that you could recommend. Now, aim to see if you can draw from the content of todays

session to bring about successful change. Who would you get involved in the change? How would you get the key stakeholders involved? Community Psychology for Applied Psychologists: Session 5: Incorporating Community Psychology Principles and Evaluative Practices in your Work with Dr Ho Law and Dr Glenn Williams Overview A case study of evaluation within a social enterprise and wider communities Evaluation at meso/macro level using multi-level modelling Considering strategies for evaluation in your groups by using your same target group from Session 4.

An evaluation model Qualitative quantitative Process Evaluation Input Process Output Outcome Impact Evaluation Evaluation methodology (Law, 2013) Responsive Evaluation qualitative method

Assumptions and the process: Robert Stake (1975) 1. Focus on issues that are important to stakeholders (not objectives or hypotheses). 2. Use the identified issues to drive the information (data) gathering process. 3. Regard human observers as the best instruments for the data collection. 4. Obtain information from diverse (different, independent and credible) sources. (Green & Abma, 2001) Responsive Evaluation qualitative method

Social Constructionism, - multiple realities constructed by social interactions context-bonded Pragmatic method let the design emerge from the ongoing process. Thus suitable for evaluating communitybased interventions e.g. using AI or action research may be embedded in other research methods such as ethnography or even quantitative method (as mixed design) for triangulation.

Users are free to decide whether the results are transferable to different contexts, as the subject-object relation is blurred (Abma, 2005). (Green & Abma, 2001) Impact evaluation quantitative design INTERVENTION PRE INTERVENTION POST CONTROL PRE CONTROL POST

Research question: What is the effect/impact of an intervention? Input/process/output - e.g. coaching/mentoring/counselling/ training Outcome - e.g. performance/ wellbeing Measurement e.g. scores. Questionnaire UIF SAQ: Measure personal, social, cultural and professional competence Recovery-Stress SAQ: Questionnaire (Kellmann & Kallus, 2001) Measure your general stress level (not clinical but social well being). Uif: CSC SRQ Competence

I Personal (Self) II Social (other) III Cultural (cross culture organisation and individuals) IV Professional Competence Awareness Self Awareness Empathy

Enlightenment Reflective Practice Management Self Regulation Social Skills Champion Continues Professional Development within supervision framework

Evaluation of Coaching Psychology Pedagogy preliminary results (1) Evaluation of Coaching Psychology Pedagogy preliminary results (2) Example of Multi-Level Modelling: A Three-Level Hierarchy Community 1 Programme 1 Individual 1

Individual i Community 2 Programme 2 Individual i Programme 1 Individual 1 Individual i Community 3

Programme 2 Individual i Programme 1 Individual 1 Individual i Programme 2 Individual i Benefits of Multi-Level Models (MLMs)

Homogeneity of regression slopes Model the variability in regression slopes Assumption of independence You can model the relationships between cases (Regression for repeated observations) Missing Data MLMs can cope with missing data Field, A. (2009). Discovering statistics using SPSS (3rd ed.) London: Sage. Group Activity: Designing an evaluation at community or organizational level for your target group Use the same Groups Scenarios Have a think about your target group that you focused on in Session 4.

Think about macro-, meso- and micro-level focused interventions that you could recommend. How would you evaluate the effectiveness of the changes that you have got planned? Now, aim to see if you can draw from the content of todays session to bring about successful embedding of the evaluation. Summary Questions, Discussion, workshop evaluation & Feedback Annex 1: Examples of Community Research #1 - Constructivist Research Boydell et al. (2000) qualitative study of 29 homeless people in Toronto, Canada. Used symbolic interactionism to see how sense of self and the homeless

persons social context interacted. Main finding the homeless persons in this study were motivated to maintain a retrospective, positive sense of self. The current sense of self was commonly affected by perceptions of: Stigma Isolation Shame Feeling inferior to others I felt disgusted with myself, you know, that I messed up. I felt bad, you know, like I was nobody (p.31) Aim of this study was not to generalise to all homeless persons but to understand their phenomenologies and the constructions of their realities.

Full article via: Annex 1: Examples of Community Research #2 Transformative Research Paradis (2009) A little room of hope: Feminist participatory action research with homeless women. PhD thesis. University of Toronto. April 2005 >50 women who were experiencing poverty, homelessness and isolation attended a workshop on human rights at a drop-in centre in Toronto. 15 months later, these women had attended weekly workshops on social and economic rights, methods of reacting to and resisting homelessness. They gave testimony to their experiences and their group sent a representative to the United Nations Committee on Economic, Social and Cultural Rights. Conclusion: homelessness is not only a material state, but more importantly a social process of disenfranchisement enacted through relations of harm, threat, control, surveillance, precarity and dehumanization (p. ii). Project acted at multiple levels including at the macro level.

Annex 1: More Examples of Community Psychology at Work #3 The Joshua Project: devotes a lot of time and effort to supporting some of the most marginalised community members who are often ignored/rejected by mainstream health, educational and other agencies: Artworks Creative: Works collaboratively with people at street level in their communities a great deal of positive change is effected: UCL research group looks at processes and outcomes of various forms of psychological helping and support see: http :// Prof. Jim Orfords work using community psychology to influence social policy relating to gambling:

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