Participatory Action Research (PAR) is becoming widely recognised as a credible alternative to more conventional ‘design frames’ (Thomas, 2013, p.132) within academia and beyond (see Kindon et al, 2010; Klocker, 2012). Nevertheless, some postgraduates and academic supervisors still shy away from the design due to the potential tensions it can be seen to cause PHD study (Klocker, 2012). In order to prove to myself that this is an appropriate choice of design for my PhD project, I use this paper to explore some of the possible tensions that may arise, as well as consider the practicalities of delivering PAR in the field, and what it might look like in reality. I intend to do this by focusing on one of the main principles of PAR, “participation”, to see how this informs a PAR approach and may apply in practice. The purpose of the paper is for me to start to consider the potential challenges and benefits faced using PAR within a PhD framework, as well as to ensure a participatory approach is fully embraced throughout the research process.
Before diving into the realms of PAR though, the reader needs to understand the type of research I am about to embark on and the questions I intend to ask. Therefore, I spend the following section summarising the research, putting it into context using some relevant literature.
The aim of my research is to explore the hidden and misrepresented struggles and solutions of social lives in distress. What I mean by this is that there are people in the United Kingdom today struggling to maintain a healthy social life, struggling with the act of socialising, struggling to maintain positive relationships with others, and struggling to feel connected. More often than not these struggles are framed as psychological in nature stemming from mental health difficulties, the social problems being seen as symptoms of distress rather than problems in their own right. I believe more research needs to take place to find out why these struggles occur and whether we should be using a more integrated and balanced psychosocial approach to distress than has previously been used, whereby ‘notions that are conventionally distinguished – “individual” and “society” being the main ones – are instead thought together, as intimately connected or possibly even the same thing’ (Frosh, 2003, p.1547 in Redman, 2016, p.73). To comprehend and achieve a more balanced psychosocial approach, social health and difficulties should be acknowledged and considered on the same scale as mental health. As Johnson (2017) admits, though, although most people are more or less accepting of the fact that mental health is intertwined with the social, the social is still the poor relative in terms of research and evidence in comparison to the psychological (Johnson, 2017, pp. 245- 246). I hope my research helps to change this by focusing on social health, a less familiar but still an important aspect of health. So what actually is social health?
· Social Health
Alongside physical and mental health, The World Health organisation sees social health as an integral pillar to the health of the individual and society as a whole (2016). Brock Chrisholm coined the term in 1948, he wrote “we have responsibility for social health, for being able to live in peace and contributing to the welfare of other people. The social responsibility of the individual has never been recognised before on such a wide international basis” (1948, pp.364 – 368). The definition of social health is broad and ‘incorporates elements of personality, sociability, and social skills, and it also in part reflects the norms of the society in which the individual finds himself (McDowell, 2006, p.150). The concept of social health generally focuses on social activities, social wellbeing, social network quality, interpersonal communication, social support, and social role participation and satisfaction (Castel et al., 2008 cited in Carlson et al., 2009, p. 454) and can be described on two levels. Firstly, on a micro level: ‘that dimension of an individual’s wellbeing that concerns how he gets along with people, how other people react to him, and how he interacts with social institutions and societal mores’ (Russell, 1973, p.75 cited in McDowell, 2006, p.150). Secondly, on a macro level, a society is socially healthy when ‘there is equal opportunity for all and access by all to the goods and services essential to full functioning as a citizen’ (Russell, 1973, p.75 cited in McDowell, 2006, p.150). How a person functions in relation to their sociocultural context is ‘an important aspect of one’s overall social health, referring to an individual’s ability to function in community, social and occupational domains’ (Cornblatt et al. 2007 cited in Carlson et al., 2009, p.454) and there is a whole host of literature suggesting levels of social health and functioning have a direct correlation to mental health and illness (see Carlson et al., 2009, p. 455). Similarly, social connectedness is an aspect of social health causing distress. If a person experiences negative social relationships, low connectedness is more likely to manifest, whereby a person feels more ‘interpersonally distant from other people and from the world at large. They often see themselves as outsiders, feel misunderstood by others, have difficulty relating with the social world and are uncomfortable in social situations (Lee et al., 2001, p. 310).
· The Social Hub
Wanting somewhere safe to go to practise my social skills amongst others who struggled similarly, I originally set up a monthly meeting where people could plan and organise activities to enable them to practise their social skills by engaging in simple social and cultural activities in their local community amongst others who struggled in similar ways. This was supposed to provide a platform to build social confidence and a sense of a healthy and fulfilling social life. Now adopted by the Starfish Group (a partnership of organisations that work together in the third sector to deliver mental health services in Staffordshire and the North East), the Social Hub model has gone onto develop dramatically over the past 3 years into an integrated psychosocial service addressing both social health and mental health difficulties. By combining opportunities for people to access social support, engage in meaningful activity and provide opportunities for development into peer mentor and volunteer roles, people can gain skills, qualifications, and friendships that help them resolve their life problems, change their lives and social contexts for the better and move forward in life. As the founder member of the Social Hub and the regional manager of the project, the model and service seems the most fitting place to locate my research, having unlimited access to people struggling with both mental health and social health difficulties. Being a researcher obviously throws up many ethical dilemmas considering my positions of power within the service as founder and manager, and I am aware of this tension, which I explore later.
· Research Questions
Taking into account the brief description of the psychosocial perspective, social health, and the social hub model above, I have devised the following research questions:
1. What are the hidden and misrepresented struggles associated to social health? How and why are they hidden and misrepresented as symptoms and experiences of mental illness and what are the benefits of recognising the struggles in their own right, as well as within a more equitable psychosocial framework?
2. What is the collaboratively constructed meaning of ‘social health’, taking into consideration the meanings of the following: ‘culture’, ‘context’, ‘sociocultural context’, ‘social distress’, ‘social life’, ‘a culture of social health’? Work up a typology.
3. How is social health, and more specifically, sociocultural context, transformed through interaction with the Social Hub model and how does this affect experiences of psychosocial distress?
Now the reader has an idea of the research topic and questions posed I would like to spend the remainder of the paper exploring participatory action research to consider how such a design operates within a PhD framework and how participation as a process may work in reality.
PAR Research Design- A Participatory Epistemology and Ontology
Before even embarking on an exploration of participatory action research, it is important to get to grips with the epistemological and ontological orientations of the approach. In contrast to traditional research designs which “assume knowledge to reside in the formal institutions of academia and policy and often presuppose an objective reality that can be measured, analysed and predicted by suitably qualified individuals…Participatory Action Researchers recognise the existence of a plurality of knowledges in a variety of institutions and locations” (Kindon et al., 2007, p.9). Due to this counter-hegemonic approach to knowledge production (Kindon et al., 2007, p.9), PAR is becoming a ‘growing family of approaches and methods to enable local people to share, enhance, and analyse their knowledge of life and conditions, to plan and to act’ (Gujit and Kisadha, 1994, p. 171 cited in Gibbon, 2002, p. 546). More specifically, it recognises “those who have been most systematically excluded, oppressed or denied carry specifically revealing wisdom about the history, structure, consequences and the fracture points in unjust social arrangements” (Fine, forthcoming in Kindon et al., 2007, p. 9) and this is why I have chosen this ‘design frame’ (Thomas, 2013). Research, for me, must be collaborative, democratic and action orientated. I see no point in engaging in research that limits the transformation of individual’s and the community contexts in which I am situated. I am drawn to a participatory epistemology because it ‘represents a challenge to scientific positivism and seeks to practise the radical, suggesting that it is not enough to understand the world, but that one has to change it for the better’ (Kindon, Pain and Kesby, 2010, p.13). PAR is “closely related to standpoint methodologies in the sense that the researchers may, in fact, be studying themselves, or at least others in a similar situation” (Smith, 1990 in Morrow and Brown, 1994, p.257). Brookfield and Holst state there are four distinct principles to participatory epistemology and ontology:
1) Metaphysically speaking reality is interconnected: nothing exists or can be understood in isolation;
2) In research terms objective and subjective aspects of reality need to be considered (Freire, 1974);
3) The objective and subjective are understood as always being dialectically related;
4) Reality is interrelated and in a constant state of motion and change driven by internal contradictions (2011, p. 184).
They go onto suggest that if reality is always changing then so too is knowledge, which means people engaging in research need to explore the relationship between objective and subjective ways of perceiving reality in order to understand how this “process manifests itself in their lives” (Freire, 1974 in Brookfield and Holst, 2011, p. 184). In addition, through being involved in the research they are then able to challenge who has the fundamental right to create knowledge, by “actively promotes[ing] the legitimacy of the knowledge of the oppressed, while at the same time critiquing the assumption of the unearned legitimacy of knowledge produced by powerful groups and institutions” (Heaney, 1993, in Brookfield and Holst, 2011, p. 185). Therefore, participatory research uses an “ontology that suggests humans are dynamic agents capable of reflexivity and self-change and an epistemology that accommodates the reflexive capacities of human beings within the research process” (Kindon et al., 2010, p. 13).
Levels of Participation
At the heart of participatory research then, is participation (obviously), as I have mentioned above. But what does that mean in reality? Although Freire, founder of the PAR approach suggests that the participatory research process must involve participants as co-investigators (Brookfield and Holst, 2011, p. 177), others highlight the importance of recognising varying levels of participation. For example, “various authors have attempted to identify different models and levels of participation, frequently arguing that collective action and self-mobilisation by participants demonstrate successful PAR (Kindon et al., 2007, p. 15). Some academics suggest best practice might be to limit the amount of co-researchers involved in a PAR project (Phillmore, 2017) due to the amount of support and supervision co-researchers may need and how this subsequently impacts on the delivery time and resources of the research project as well as on the researcher themselves. However, I am more inclined to adopt a inclusionary position where ALL participants take part as co-researchers with varying roles, duties and responsibilities, as to me this is part of the appeal of PAR:- that all participants are researchers to varying degrees dependant on their interests, motivation, skill and capability - some investigating their own lives and contributing to group discussions and tasks, with others engaging in extra group activities such as interviewing, transcribing, analysing and report writing. If I were to invite some participants to co-research and others not, I believe this would be a form of exclusion on my part and a way of exerting my power on others, as well as adhering to the establishments ethos of who is and is not able to lead research. I believe all participants should be equal in terms of the status of being a co-researcher- if they are happy to do so. To me, participants and co-researchers are the same thing in the PAR approach. How much they participate in researching about their own life and others is completely dependent on each individual. All participants will be supported thoroughly throughout the study with regular group and one-to-one meetings and supervisions. I know from experience of working in a highly participatory manner for the last 12years that activities, even research activities, have the potential to be facilitated in ways which allow for and promote participation in its most rounded sense. Negotiating with participants on issues such as session and project time frames, resources used and adequate levels of support, all provide opportunities to be involved in the research process whilst, at the same time, protecting the participants (and myself) from being overwhelmed and overworked. As a manager I am familiar with delegating tasks and there may be other participants within the group also familiar, willing and appreciative of the opportunity to gain extra responsibility in a supervisory or supportive capacity. There may be others who would simply like to monitor the duration of a session to keep the group on track or to be in charge of sourcing materials for the project. Consequently, levels of co-researching should be discussed with each individual participant and based on their skills, experiences, interests and choices. Although, delegation presumes I have the authority to exert this power in the first place which may not be the case once out in the field, I foresee facilitation and delegation as responsibilities I cannot waver as the welfare of the participants, whether classed as co-researchers or not, is my responsibility and I need to continue to monitor this throughout the study. In addition, delegating appropriate responsibilities to participants helps them to feel comfortable, valued and included in the research process which may then lead onto retention and even greater levels of participation and responsibility in terms of being a co-researcher, as their confidence and skillset grows.
Participation and PhD Study
One of the tensions usually highlighted about doing PAR within a PhD is the level of participation of participants and of the researcher and how much co-researchers should be allowed to infiltrate the process, especially in relation to writing the research proposal, collecting and analysing the data and even writing the thesis. Usually with more conventional research ‘there is a beginning and a vision of an end point, but [with PAR] the researcher has no idea of how the research will unfold. A PAR process is not linear and is therefore difficult to report on in a conventional way’ (Gibbon, 2002, p.555). This means that writing a thorough account of what I plan to do in the form of a research proposal proves particularly difficult when using a PAR design. As part of being a postgraduate student, I am expected to produce a comprehensive research proposal planning every aspect of the research process before it takes place. This means that the crucial initial stages of the research process lack co-researchers input and this can cause, once out in the field interacting and responding to participants’ opinions and ideas and moving forward as co-researchers together, that the research process is most likely to change quite dramatically, even more so than how it might do within a conventional PhD context. PAR normally asks participants to choose the agenda, but in this case, the topic and research questions are already set, due to the independent construction of the research proposal. Dean warns that ‘when the agenda is already set people’s sense of apathy regarding public life is reaffirmed rather than challenged’ (2008 cited in Clements et al., 2008, p.15) therefore, the setting of the agenda may affect the recruitment process as people may feel like the research does not relate to them and their lives. Therefore, in order to promote participation, I need to explain the research to people so they can see how it relates to their life and explain that their contribution and involvement in the research and future development of the agenda is valuable and needed to transform the mental health arena, which I hope appeals and encourages people to become involved and participate.
Participation is not something that automatically happens in a research project. Encouraging people to take part is an integral and challenging part of the research strategy particularly when most of the potential participants are likely to have labels, identities and experiences embedded in psychological distress and illness. For such people, barriers and exclusions are common place which is why ‘participatory research…[must] make specific provision to engage and include groups facing particular oppression, disempowerment and exclusion (Beresford, 2007, p. 310). Beresford uses the work of Steel (2005), setting out a range of ways to ensure the inclusion of marginalised groups in research by:
· Offering time and resources to support their involvement;
· Providing choice about getting involved;
· Structuring research meetings to be inclusive;
· Providing advocacy;
· Reaching out proactively to marginalised groups; and
· Recognising the importance of language in ensuring inclusion, and developing appropriate language policy and practice (Beresford and Croft, 1993; Ward, 1997; Morris, 1998; Wilkinson, 2002 cited in Beresford, 2007, p. 311).
Participation and Time
‘PAR is often seen as time intensive (Macguire, 1993; Cameron, 2007; Moss, 2009 cited in Klocker, 2012, p.154) partly because of the time taken to build meaningful and trusting relationships with participants and also due to the iterative research cycle. Klocker says it is important to challenge this message because actually collaborating on research means there are more people to collect and analyse data. As Klocker admits “it was, quite simply, possible to interview a large number of people in a short timeframe because I was part of a team (2012, p. 154). However, she goes onto point out that it is important not to exploit or use others excessively in this process. Showing equal responsibility for the research is important to ensure all participants feel valued and fairly treated. In respect to my own situation, time spent building up relationships may not be as time consuming as many of the relationships have already been established through my role as manager of the Social Hub. Nevertheless, I am aware that my research role is different to my managerial role, so in fact, I may find it still takes time for people to trust in the way I work as a researcher as opposed to a paid member of staff.
Another separate but relevant way in which participation relates to time in comparison to more conventional styles of research, is that due to the action-oriented approach, change and impact starts to occur throughout the research, not only when the research is completed and disseminated. From working in the mental health field and understanding the relevance of my research topic, with financial cuts and a shift towards more social ways of working and thinking, I know changes need to happen NOW and a PAR research accommodates this urgency. Change ultimately starts on the ground with those people whose voices and actions matter the most- those using services and those who identify with mental health, illness, and distress labels. PAR allows this. It also takes the pressure off me as a postgraduate researcher being funded through my employer. Doing a six year part time PhD feels like it could take forever and I know the mental health field will not wait that long. I need to be writing about these trends now, as they happen. Otherwise, the project could be forced to move in different directions before I have had a chance to capture the important experiences going on now. A PAR approach captures the situation as it happens and provides opportunities for action if the group so decides, which means change can happen even whilst I’m still doing the research, which feels an exciting and privileged place to be.
I now recognise that PAR as a research design is easily compatible to PhD study, which alleviates some of the worries I had over my choice of design. Exploring participation, in particular, I now have a much better understanding of how I plan to approach my study, for example, having a clear distinction for all stakeholders of their position and participation within the research process. Preferring all participants to be classed as co-researchers, each individual’s needs, interests and motivations are then more easily suited to their chosen level of participation. In addition, promoting participation through practical, emotional and social support, participants feel valued and supported throughout the research process. By setting boundaries between my role as a postgraduate researcher and the role of co-researchers, I am able to retain a sense of what I have to do as a PhD student to obtain my qualification, at the same time, as allowing participants to take the lead on developing the research process, including aspects of the agenda.
In April 2018 I hope to be ready to embark on the fieldwork and look forward to putting my plans into practice, or, in reality and in line with a more collaborative PAR approach, having them ripped apart and reassembled in a collectively negotiated and democratic manner.
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