Analysis of the community psychology field

“The Swampscott conference in 1965 highlighted a growing need for psychologists to be political activists and agents of social change – this conference is considered the birthplace of community psychology” (Barry, 2008). The ultimate aim of community psychology is to enhance the quality of life through collaborative research and action. Community psychology consists of three dominant perspectives – namely, the ecological perspective, the social constructionist perspective and the critical perspective. Community psychologists use these perspectives to structure research and formulate interventions. Community psychology focuses much attention on health and creating interventions to alleviate health concerns. Health, is not just physical well being, but is a state of complete physical and social well being and not merely the absence of disease or infirmity” (Petee & Asch, 1949)

As the discussions progresses, the three perspectives will be explored in detail, the case study Deadly Cells: The struggle of HIV positive prisoners will then be utilized to contextualise the three perspectives in formulating HIV/AIDS health interventions within prisons. Before we dive into the complexities that underlie these interventions it is important to have an accurate understanding of the three perspectives that are considered to be the foundation of community psychology interventions.

Urie Bronfrenbrenner was the first to propose the ecological model based on a nested level of analysis. Bronfrenbrenner asserted that the individual does not exist as a static entity but is at the core of various levels of analysis that are all in constant interaction with each other – thus an individuals behaviour does not exist in a vacuum and is influenced by the environment. The levels of influence include: the microsystem (refers to interpersonal relations), the mesosystem (refers to interaction among the systems that the individual is involved in), the exosystem (this involves the larger social system) and the macrosystem (refers to cultural and religious beliefs). “James Kelly evolved Bronfenbrenner’s theory by shifting the focus from the individual and the levels of analysis to develop an understanding of how human communities function” (Kelly, 1966, p. 537). Kelly highlighted four important principles that govern the behavior of individuals in different contexts. The four principles are as follows: adaptation (individuals need to adapt to the demands of change); succession (acknowledges the history (values, culture etc.) of a context – history helps understand the present); cycling of resources (this is the identification and utilization of the resources available within a context – the central aim being, to focus on the strengths of the particular context and its constituents) and interdependence (change is directly proportional to the other systems, thus change in one part of the system may cause negative or positive effects in other parts of the system). The ecological perspective helps stress that systems are not static entities, thus effective interventions can only be achieved by adopting a holistic stance.

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“Social constructionism are sociological theories of knowledge that consider how social phenomena or objects of consciousness develop in social contexts” (Daniel, 1998, p. 126).Therefore, our world has been constructed, through social interactions within our environment Social constructionism has many underlying principles that help accurately understand this theoretical paradigm.

Social constructionism is anti-naturalism, which according to Bruner states that: “It is culture not biology that shapes the human mind that gives meaning to action by situating its underlying intentional states in an interpretive system” (Gergen, 1999, p. 27).This point illustrates that there is a danger involved if we treat individuals and societies as mere objects, to probe and study (as in biology), agency and interaction need to be considered. Secondly, is the use of language. Language is not just a means of communication, but a complex tool of symbolic representation that we utilize to construct our social reality, to define roles, formulate traditions and develop unique systems of representation.

Closely tied to language is the third principle of ‘meaning’. Food is food because we have socially constructed it as an edible substance within our culture – we gave it meaning (e.g.: the stomach of the sheep is a delicacy in Indian culture, however in Western culture it may be incomprehensible to eat). Fourth is power, power is closely tied to the notion of discourse (“Refers to how people operationalize language within a culture” (Freedman & Combs, 1996).The various discourses of a particular culture dominate the culture, and knowledge of such discourses create a sense of power. Power and discourse is utilized to normalize individuals within a culture. Each and every culture contains a grand narrative which can be defined as the dominant, overarching ideology that exists within a culture. Grand narratives are sustained and constructed through the use of guiding metaphors, which refers to the selective use of language to actualize our realities. The fifth principle is that there is no single truth. This can be illustrated by the speech entitled ‘The Danger of a single story’, delivered by famous Nigerian author Chimamande Adichie. In her speech Adichie speaks of her childhood and the books that she read which were chiefly British and American. These books influenced her overall view of the world to such an extent that when she began writing (at 7 years old), all her characters were predominantly white and lived in their white world. It is important to note that she developed a single story of the world devoid of her African heritage. Her unilateral views were confirmed when she entered university and her American roommate was awestruck, that she, a Nigerian girl could speak fluent English. As her roommates view of Africa was nothing but poverty and war – a single story of Africa. Coupled with the ‘single story’ notion is the issue of power. “Power is the ability not just to tell a story of another person, but to make it the definitive story of that person” (Adichie, 2002). It is evident that a single story robs all the colour of any painting. “The consequence of a single story is it robs people of dignity and emphasizes how we are different than how we are similar” (Adichie, 2002). The above illustration illuminates the notion that there are multiple sides to any story ,however what may be the most important side is the underlying dynamics that are absent from sight. From the above discussion on social constructionism it is clear that this perspective by no means objectifies reality, but subjectifies experiences, interactions and social construction within a particular context.

“Critical psychology can be understood as a metadiscipline that urges the discipline of psychology to critically evaluate its moral and political implications” (Painter & Terre Blanche, 2006, p. 215) Critical psychology places importance on challenging the dominant values of mainstream psychology. Critical psychology points out that the roles of professionals (e.g. politicians, psychologists etc.) are not value free roles and the values of professionals need consideration. Therefore, it is evident that critical psychology poses a much needed criticism of mainstream psychology. Critical psychology and mainstream psychology differ in the following aspects: Traditional psychology attributes problems to particular individuals and their contribution to the emergence of a problem ,conversely critical psychology identifies a problem within a particular system and the existing power differentials, secondly, mainstream psychology emphasizes individualism and capitalist values, critical psychology challenges this view, asserting that this view stunts the search for self-actualization and the final aspect is power. Power according to mainstream psychology is attained through professional training and knowledge, however critical psychology asserts that power should be shared and not exist within individuals. Critical psychology highlights that power can either empower or marginalize individuals and all interventions do not benefit all individuals. Thus from the above discussion it is clear that critical psychology is a coupling of the previous two perspectives with ultimate goal of freedom and empowerment.

Now that a clear understanding of the three perspectives community psychologists utilize in formulating interventions has been developed, it will be used to contextualise the case study : ‘Deadly Cells: The struggle of HIV positive prisoners’

The article Deadly cells, illustrate the plight of HIV positive prisoners in a South African prison (Westville). The article states that infected inmates were denied access to anti-retroviral treatment (ARVs) – robbed of their human right of access to appropriate healthcare. The Department of Correction when notified of the issue responded by stating that prisoners need their identification documents (which they did not have) and that there was limited access to hospitals that would treat the prisoners. After much contention the matter reached the courts. Due to the harsh conditions (rape, unprotected sex, overcrowding, gang life etc.) in prisons, infection of the disease was exacerbated. In 2006, after much deliberation the government agreed to provide ARV treatment, however this conclusion does nothing to curb the problem of the rapid increase of HIV/AIDS victims in prisons.

The above case study will now be contextualised with the use of the three perspectives discussed earlier and interventions will be suggested to alleviate the problem.

A community psychologist working from an ecological perspective will define the prisoner’s perception of their environment, analyse the characteristics of the environment and then adopt a transactional analysis of how the perceptions and external characteristics interact to produce the problem – a holistic systemic view. The researcher will spend time at the prison in a participatory manner, engaging collaboratively with the prisoners to understand their problem on various levels. The ecological intervention will promote participation and instil the belief that the affected can indeed effect change. An example of an appropriate ecological intervention to alleviate the problem of HIV/AIDS at the Westville prison includes the following: first and foremost the prisoners need to be made aware of their rights and the laws that protect their health; this can be done by running education programs. The prison staff (officers, wardens etc.) need to play a proactive role in the prevention of rape, discrimination and the alleviation of gang fights in the prisons, this can be achieved through training programs for the staff. The issue of overcrowding within the prison needs to be referred to the authorities or community based organisations (CBOs) in order to create awareness and mass media attention. The prison authorities need to provide lubricants and condoms to prisoners – teaching them to be proactive. Pressure should be put on the Department of Health for ARVs and in-house HIV/AIDS care centres by creating media attention. Lastly, an external officer needs to monitor that the interventions are in place (by weekly visits). The above suggestions emphasise that the problem is not just a health issue and in order to alleviate the problem a holistic, nested stance needs to be adopted.

The social constructionist perspective differs from the ecological model as the values of the participants are central to the formation of an intervention. A researcher working from the social constructionist perspective will work closely with prisoners, in order to understand their subjective experiences, through qualitative methodologies. The researcher will search to uncover the prisoner’s discourses, utilisation of language and their grand narratives in relation to the causation and treatment of HIV/AIDS. Once a contextually specific view has been developed the researcher will begin to build a context specific intervention. An example of an intervention that may alleviate the problem at the Westville prison includes the following: A researcher may begin by conducting focus group interviews with the prisoners to gain an empathic understanding of the plight of the prisoners. Once a clear understanding of the problem (rape, overcrowding and the lack of proper healthcare) has been developed, the researcher will then collaboratively formulate possible solutions to the problem with the prisoners. Possible solutions may include: a prisoner awareness programme carried out by the prisoners, practicing safe sex, alleviating gang violence and rape through creating awareness and reporting incidences and by involving CBOs- thus taking responsibility for their own health. The lack of medical treatment can be alleviated by forming a campaign that emphasises the disabled healthcare rights of the prisoners, the ultimate aim being to gain media attention, ultimately government fulfilment of the laws that protect prisoners. The social constructionist view places importance on the value structure within a context, once these structures have been unwrapped, they can solve the problem by building new structures that are proactive – thus the answer may lie within discourses or narratives.

The critical perspective differs as it is an integration of the above two paradigms with the ultimate goal of freedom and empowerment. Critical psychology like social constructionism values the subjective experiences of the prisoners and therefore, can be considered to be value-driven. A key goal of critical psychology is to transform the problem and therefore, has political connotations. The aim of the researcher begins with a transformative stance, understanding the plight of the prisoners and to empower and liberate them to action, by enlightening them on the possible solutions. An example of an intervention to alleviate the problem at the Westville prison includes: “Participation Action Research (PAR) is a collaborative approach, with research aimed at social change, researcher and participants are partners and communication is central to successful intervention” (McTaggart, 1997). PAR is an activist approach. The prisoners could form a mass demonstration (protest) and form alliances with CBOs that can create awareness outside the prisons, thus jointly accessing media attention. Once attention is attained the CBOS can appeal to the relevant legal authorities and international organisations such as the United Nations and the World Health Organisation – ultimately this would push the government to act. Therefore, it can be seen that the critical approach emphasises transformation and activism.

From the above discussion it can be deduced that community psychology is a multidimensional field that employs the use of various perspectives namely, ecological (a holistic systemic view), social (value-driven, constructed reality) and the critical perspective (a critical, activist view). Each perspective sheds new theoretical light on the plight of the Westville prisoners all emphasising the need for stronger health systems, a need for coordination and cooperation between authorities, CBOs, prisoners and prison staff and a limited exercising of rights related to healthcare and laws protecting the well-being of prisoners. Therefore it can be concluded that community psychology with the utilization of the three perspectives can help the marginalized prisoners break free from the stigma that prisoners have dissolved their rights to healthcare.