Eating Disorders in the Workplace

by Jaclyn Siegel, University of Western Ontario.

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Eating disorders are among the most common mental illnesses in women (Hudson, Hirpi, Pope, & Kessler, 2012; Mangweth-Matzek & Hoek, 2017) and have the highest mortality rate of any psychiatric condition (Arcelus, Mitchell, Wales, & Nielsen, 2011). There are three primary eating disorders outlined in the current version of the diagnostic and statistical manual (DSM-5). First, anorexia nervosa is characterised by preoccupation with food, weight, and body shape, as well as caloric restriction. Due to chronic low energy intake, those with anorexia can sometimes have noticeably thin bodies, but this is not always the case. Second, bulimia nervosa, on the other hand, is also associated with the same cognitive obsessions but is hallmarked by binge eating and purging. Purging includes any behaviours performed as compensatory mechanisms for perceived over-consumption, such as vomiting, laxative abuse, or exercise. Bingeing refers to feeling out of control while eating large quantities of food, usually in a short amount of time. Third, binge eating disorder is a condition comprised of binge eating, but not compensatory behaviors. Those with binge eating disorder, however, often experience extremely high levels of shame and guilt and can sometimes, but not always, have a higher weight status as the result of increased caloric intake (American Psychiatric Association, 2013).

Women with eating disorders endure cognitive, physical, and psychosocial impairment as a result of the conditions (Bohn, 2008; Mehler, Birmingham, Crow, & Jahraus, 2010; Polivy, 1996). For many, these symptoms begin during adolescence, and some receive treatment during the teen and early adult years (Favaro, Caregaro, Tenconi, Bosello, & Santonastaso, 2009). However, eating disorders are notoriously difficult to treat. Even the most effective and efficacious interventions have high relapse rates, and the number of women who achieve a state of permanent recovery is very low. As such, some researchers consider eating disorders to be chronic conditions whereby afflicted individuals vacillate between periods of symptom relapse and remission throughout their lives (Fairburn, Cooper & Cooper, 1986; Herzog et al., 1999; Russell, Szumkler, Dare, & Eisler, 1991). Additionally, the financial burden of both initial psychological intervention, as well as prolonged maintenance and monitoring, can serve as a barrier to full recovery for women with these conditions (Samnaliev, Noh, Sonneville, & Austin, 2014). However, while women with eating disorders are severely impacted by their conditions, they often are still able to engage in social relationships, schooling, and, notably, work.

In the United States, individuals with diagnosed eating disorders are protected from workplace discrimination and are entitled to reasonable accommodations through the Americans with Disabilities Act (Americans with Disabilities Act, 1990). Research suggests that employment can have myriad benefits for individuals with disabilities, (Fleming, Fairweather, & Leahy, 2013; Rubin, Chan, & Thomas, 2003), but the nature of workplace life may complicate the relation between work and well-being for women with eating disorders. Specifically, stress and stigma are frequently experienced and difficult to avoid at work, and both the experience of stress and perceiving stigma have been shown to exacerbate eating disorder symptomology and even predict relapse (Griffiths, Mond, Murray & Touyz, 2015; Grilo et al., 2012). Given that a large portion of adult life is spent at work (Waldo, 1999) and the relatively high prevalence of eating disorders in adult women, the intersection of working life and symptom management is of great importance. However, there is extremely little work done that examines the repercussions of managing an eating disorder (or any other clinical mental health condition, for that matter) in the workplace.

‘…there is extremely little work done that examines the repercussions of managing an eating disorder (or any other clinical mental health condition, for that matter) in the workplace.’

In order to examine this critical gap, it was necessary to let women tell their own stories of the ways in which their eating disorders had interacted and interfered with workplace life. I interviewed seventy women who had been diagnosed with either anorexia, bulimia, or binge eating disorder and had managed their conditions at work. Participants were encouraged to share as much as they felt comfortable and were free to discuss stories from different jobs and various periods in their recovery journeys. My co-author, Katina Sawyer, and I developed a theoretical model of the way in which individual characteristics of our participants uniquely predicted different stigma, stress, and identity management strategies for the complex navigations and negotiations of workplace life. We additionally identified the specific organisational and interpersonal stressors faced by women at work, which served a moderating role in women’s selection of specific management strategies. We then examined the organisational and personal outcomes of engaging in these various techniques. This work was presented at both the annual conference for the Society of Industrial and Organizational Psychologists in Orlando, FL in April of 2017 as well as the International Conference on Eating Disorders in April of 2018. This work is still being finalised, but, broadly, these were the findings:

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Certain demographic characteristics of the women in our sample appeared to predict the types of management strategies in which they engaged at work. Specifically, disease type, recovery progress, perceived visibility of the disease, and attitudes toward stigma all had a unique influence on the ways women engaged in the workplace. However, regardless of individual characteristics, workplace stressors were largely the same for all of the women in our sample.

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Some were labeled as organisational stressors, or global aspects of work life that contributed to the stress and stigma experienced by participants. Notably, food-centric work events such as the lunch hour, office parties in which food was present, happy hours and events outside of work, and business meetings over meals presented unique challenges for women with eating disorders.

Additionally, health-focused workplaces that featured wellness competitions that prioritised weight loss or dieting, or had health propaganda in the office such as scales and posters, also proved problematic. Scheduling conflicts were also challenging for these women, and some specific occupations appeared to be more stressful for participants than others. Interpersonal stressors included coworker insensitivity, specifically diet talk and general trivialization of mental health at work, as well as leader intolerance with the condition.

Individual characteristics seemed to be influenced by these workplace stressors, and the combination of these two factors affected how women with eating disorders managed stigma, stress, and their identities in the workplace. Participants in our study often felt torn with regard to whether or not, when, how, and with whom to disclose aspects of their condition at work. As such, they disclosed differentially, often only doing so when their once-invisible identity took on visible characteristics. Additionally, many chose to avoid workplace stressors (organisational and interpersonal) entirely or engage in mindfulness strategies to manage them. Many chose to engage in recovery-centric behaviours, but others chose to prioritise professionalism over recovery. These strategies appeared to be differentially selected depending on individual characteristics.

Techniques varied in effectiveness for these women and resulted in differential organisational and personal outcomes. The affected organisational outcomes included work performance, job attitudes, and organisational commitment. Impacted personal outcomes included eating disorder symptoms, social connectedness, and emotional distress. Specifically, women who were able to effectively balance the stress of work as well as their recoveries felt incentivised to maintain their recovery efforts for the sake of enjoying the benefits of their careers, as well as the authentic social relationships they were able to establish at work.

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Conversely, those who felt overwhelmed by the stressors of work life sometimes returned to disordered eating symptoms as coping mechanisms. These personal outcomes seemed to predict a prolonged course of the condition and sometimes even relapse for these women. For some, the general work environment of diet culture, deadlines, and emotional sterility was too triggering, and a few of the participants in the study revealed that they had left the workforce entirely for the sake of their health. Others, however, found ways to navigate work life that were conducive to both occupational success and recovery.

Overall, our research suggests that women with eating disorders are willing and able to make important contributions to and flourish within the workforce, but only when stress and stigma are well-managed. In order to make employment more enjoyable and healthy for women with eating disorders, workplaces must be conscious of the ways in which the culture of the organisation is may hinder proper eating disorder maintenance and recovery, specifically by reconsidering organisational health incentives and monitoring the way that diet culture, weight stigma, and mental health trivialisation are perpetuated in the workplace. Women recovering from eating disorders are engaged in a prolonged healing process and must feel safe, comfortable, and supported in order to properly manage the symptoms of their conditions. Leaders can help women with eating disorders by being tolerant of lingering symptomology and generously granting accommodations to women with these diagnoses. Offices in general can work with individuals with eating disorders to ensure that food-centric work events are comfortable and enjoyable for them, perhaps by ensuring that there is at least one “safe food” for them at the event. Coworkers can best support women in the office with eating disorders by monitoring and minimising their language surrounding food, bodies, and eating and by making the person with the condition feel welcome by inviting her to social events, even if she rejects these invitations initially.

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Women with eating disorders should consider working with therapists  to specifically learn how to successfully navigate workplace stressors. Though our work identified disclosure, recovery-centric behaviours, and mindfulness as particularly effective stress, stigma, and identity management strategies, we understand that what works for some may not work for others, depending on their level of comfort. Additionally, we encourage women with eating disorders to familiarise themselves with their rights as per the Americans with Disabilities Act. A list of reasonable accommodations can be found at: https://askjan.org/media/downloads/EatingDisACSeries.pdf. We are hopeful that this study will lay the framework for future research on managing mental health conditions in the workplace and help organisations, clinicians, and women with eating disorders find effective ways to flourish in both their recoveries and their careers.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C.: American Psychiatric Association.

Americans with Disabilities Act of 1990, Pub. L. No. 101-336, 104 Stat. 328 (1990)

Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Archives of General Psychiatry, 68, 724-731. doi:10.1001/archgenpsychiatry.2011.74

Bohn, K., Doll, H. A., Cooper, Z., O’Connor, M., Palmer, R. L., & Fairburn, C. G. (2008). The measurement of impairment due to eating disorder pathology. Behaviour Research and Therapy, 46, 1105-1100. doi:10.1016/j.brat.2008.06.012.

Fairburn, C., Cooper, Z., & Cooper, P. (1986). The clinical features and maintenance of bulimia nervosa. The British Journal of Psychiatry, 144, 238-246. doi:10.1002/oby.20301

Fleming, A. R., Fairweather, J. S., & Leahy, M. J. (2013). Quality of life as a potential rehabilitation service outcome. Rehabilitation Counseling Bulletin, 57, 9-22. doi:10.1177/0034355213485992

Favaro, A., Caregaro, L., Tenconi, E., Bosello, R., & Santonastaso, P. (2009). Time trends in age at onset of anorexia nervosa and bulimia nervosa. Journal of Clinical Psychiatry, 70, 1715-1721. doi:10.4088/JCP.09m05176blu

Griffiths, S. B., Mond, J. M., Murray, S. B., & Touyz, S. (2015). The prevalence and adverse associations of stigmatization in people with eating disorders. International Journal of Eating Disorders, 48, 767-774. doi:10.1002/eat.22353

Grilo, C., Pagano, M., Robert, S., Markowitz, J., Ansell, E… Skodol, A. (2012). Stressful life events predict eating disorder relapse following remission: Six-year prospective outcomes. International Journal of Eating Disorders, 45, 185-192.

Herzog, D., Dorer, J., Keel, P., Selwyn, S., Ekeblad, E., Flores, A., … Keller, M. (1999). Recovery and relapse in anorexia and bulimia nervosa: A 7.5-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 829-837. doi:10.1080/21662630.2016.1202125

Hudson, J., Hirpi, E., Pope, H., & Kessler, R. (2012). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 72, 164. doi:10.1016/j.biopsych.2006.03.040

Mangweth-Matzek, B. & Hoek, H. W. (2017). Epidemiology and treatment of eating disorders in men and women of middle and older age. Current Opinions in Psychiatry, 30, 446-451. doi:10.1097/YCO.0000000000000356

Mehler, P. S., Birmingham, L. C., Crow, S. J., & Jahraus, J. P. (2010). Medical complications of eating disorders. In C. M. Grilo & J. E. Mitchell (Eds.), The treatment of eating disorders: A clinical handbook (pp. 66-80). New York, NY, US: Guilford Press.

Polivy, J. (1996). Psychological consequences of food restriction. Journal of the American Dietetic Association, 96, 589-592. doi:10.1016/S0002-8223(96)00161-7.

Russell, G., Szmukler, G., Dare, C., & Eisler, I. (1991). An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44, 1047-1056. doi:10.1001/archpsyc.1987.01800240021004

Samnaliev, M., Noh, H. L., Sonneville, K. R., & Austin, S. B. (2015). The economic burden of eating disorders and related mental health comorbidities: An exploratory analysis using the U.S. Medical Expenditures Panel Survey. Preventative Medicine Reports, 2, 32-34.

Waldo, C. R. (1999). Working in a majority context: A structural model of heterosexism as minority stress in the workplace. Journal of Counseling Psychology, 46, 218-232. doi:10.1037/0022-0167.46.2.218

 

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Working with the people whose lives you research

Making co-production a reality: ExpertAge

 

peer facilitators

Two of Age NI’s peer facilitators

by Annie Melaugh McAteer and Marian Cinnamond

Background

In recent years there has been a strong emphasis on ‘service user involvement’ and co-production in research. There are many possible benefits: better quality research, innovation and broad dissemination channels to name a few. Having experience of co-production, through working with volunteer peer facilitators, I have experienced these benefits. In addition, the approach has helped me grow as a researcher and changed my approach to identifying questions and interpreting findings through the inclusion of older people in the research.

At Age NI we strive to put older people at the heart of everything we do, and as a result, we feel our approach to research should be no different. Different levels of co-production exist and we have found that involvement of older people, from conceptualisation to dissemination, is key in producing high quality, informed work.

This article outlines a model of co-production that we know works well for us (and of which we are very proud). We use this model to help shape and develop services and policy and it ensures the views of older people are heard. As a researcher I get a lot out of this approach, not least the opportunity to find out what really matters to older people.  Our peer facilitators also get a lot out of this experience,

‘As a peer facilitator I had the privilege of people telling me about experiences that had sometimes been very difficult for them and may have had a negative impact on their confidence and self esteem. I had known some people I interviewed for a long time and others not at all, but I was given insight into their lives which I would not have otherwise have had. This was an enriching and humbling experience for me. (peer facilitator feedback)

 

Older people are experts by experience

We are all getting older. Individually of course, but also as a population.1 And I think we should celebrate this and all doors it opens to new opportunities in later life. An important part of this is that people are given the opportunity to age well and enjoy later life. Older people face a range of barriers which can impact on ageing well including access to quality health and social care, access to information about the help they are entitled to, ageist attitudes and discrimination. It is these areas we most want to understand through our research. More recently we have been working to understand what makes a ‘good life’ for older people and how they understand the term ‘frailty’. Older people are their own experts, with lived experiences of what works and what does not and, as all researchers know, experts are the best place to start.

 

ExpertAge

The older people involved in developing our research are enthusiastic and dedicated volunteers. Their passion and insight helps us ensure our research is accurate and reflective of older people in Northern Ireland.

Co-production takes place through our ExpertAge team; a group of peer facilitators, supported by an Engagement Manager, who support our research in various ways. Those involved receive bespoke training around facilitation and data collection. The model is based on the understanding that people are more comfortable talking to peers than to professionals,

‘Many of us have a tendency to feel less judged or dismissed by people to whom we feel similar, or perhaps be better understood.’ (Feedback from peer facilitation)

Peer facilitators provide feedback on research approaches in terms of understanding and relevance. This helps us ensure we are getting to the core of the issue and doing it in a way that is accessible for older people. They provide insight into developing research within an ethical framework – for example, will asking this question cause distress, and if so, is it necessary or what would mitigate distress? They help us recruit participants, ensuring older people from a range of backgrounds are included, especially those who might belong to lesser heard groups; those who are isolated for example.

One of the most valuable aspects of peer facilitator involvement is their role in data collection. They support older people to complete questionnaires, and carry out one-to-one interviews. These peer to peer conversations allow for a more in-depth exploration of the areas being addressed, and our peer facilitators are able to take the time to spend with people, to do this at their own pace,

‘the interview was quite long, so we stopped for tea and cake in the middle, to give the person a rest’ (peer facilitator feedback)

We know that older people want to be heard, and that being listened to is an essential part of feeling involved and valued. Using co-production and supporting co-researchers, allows us to do this in a meaningful way.

Finally, our peer facilitators support dissemination of results. They provide feedback from their perspective about the data collection, they provide input into preliminary discussions around results and they participate as co-presenters in events to launch findings. Marian, a peer facilitator, co-wrote this post with me.

For me, co-production starts before the project and continues on afterwards. Co-researchers are part of the research team and the project benefits from their inclusion.  As a researcher I should support them, ensure they receive adequate training, brief and debrief them and build relationships. This all takes time, but in seeing the quality of the work delivered, I know it is worth it. And it isn’t just my view; over the last year we have worked with a local council and Public Health Agency using this model. To end, I would encourage others to adopt such an approach and put those impacted by research at its heart.

https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/july2017

2 For an example of work the peer facilitators have been involved in see here

About Annie, Marian and Age NI:

Annie has a psychology background, graduating from her PhD at Queen’s University, Belfast in 2017. She currently works in the voluntary sector in Northern Ireland as Impact and Evaluation Manager at Age NI. Her research interests are in wellbeing, understanding the needs of older people and service evaluation. She is an advocate of co-production and includes older people in the development of her current work.

Marian Cinnamond: Marian is an Age NI peer facilitator and has been involved in several projects, supporting older people in Northern Ireland to share their views.

Age NI’s vision is a world where everyone can love later life. We provide a range of services to help support older people across Northern Ireland; Advice and Advocacy service provides support and information for older people; Wellbeing Services seek to improve the lives of older people, empowering them to live the lives they want and our Care Services provide care for those who need it. Our policy and influencing activities ensure that policy decisions made today support more older people in Northern Ireland to love later life. We also support sub regional older people’s networks and offer a wide range of volunteer roles. To find out more about Age NI you can see our website: http://www.ageuk.org.uk/northern-ireland

The Power of Resilience in Children Exposed to Adversities

by Dr. Niki Nearchou, Assistant Professor at the School of Psychology, University College Dublin.

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Photo: pexels.com

 Mairy grew up living with her mother and stepdad, who used to drink and beat her mother every other day. Now she runs her own business and has two children. She feels that being a child was really hard but now all the wounds are healed .1

 Eva was born in December 1942 at a labour camp in Czechoslovakia, and was almost 2 when she arrived in Auschwitz. Now she lives in Munich, Germany, and works as a psychotherapist .2

 Alex was physically abused and neglected for years until the social services intervene and remove him from his family. Now, after graduating from college, he has his first job, lives on his own and thinks it’s time to propose to his girlfriend .1

These children are just a few examples of those who, despite being exposed during their childhood to remarkably adverse circumstances, managed to bounce back, cope with negative consequences and even thrive. This positive coping and adaptation despite experiencing distressful situations or traumatic life events is well known as resilience.

When I was starting to delve into the resilience literature as part of preparing my doctoral research proposal, I was stunned by how amazing children such as Alex or Eva, despite experiencing life events that no child should be ever exposed to, faced the risk and developed really well. I must admit, it crossed my mind that maybe there is something special about these children to make them fight and overcome such stressors in their lives. It seems that the notion of gifted and charismatic children dealing with risks was very existent in the resilience milieu, using at the time terms like invincible or invulnerable children.  In 1975, Pines wrote one of the earliest articles on resilience titled  “In praise of Invulnerables” for APA Monitor, while the next year (March 1976), The Washington Post published an article titled “Trouble’s a Bubble to Some Kids”, a headline implying that some children can burst out of their risk bubble and have happy, normal lives.

As I was unravelling the trajectory of resilience research, I realised that resilience in battered children is far more common than I had initially thought. Among the numerous exceptional scholars that have enriched resilience literature through the years, I was irresistibly attracted by Ann Masten’s work: “What began as a quest to understand the extraordinary revealed the power of the ordinary” 3. This powerful sentence summarizes the essence of resilience, and at the same time infuses hope. I strongly believe that this statement reflects the contemporary conceptualisation of resilience, which is defined as ‘a dynamic process that incorporates adaptation within the context of exposure to adversities.’4 Any discussion on resilience presupposes that the two following conditions are met: firstly, exposure to any kind of risk and secondly, effectively coping with any negative outcomes.

 

‘Participants who, while growing up, were supported by adults outside their family circle, continued their education and established a good relationship with a partner, developed to become competent and caring adults.’

 

The Kauai project followed a cohort of babies born on the Hawaiian island of Kauai in 1955, until they reached their mid 30’s. This ground-breaking study showed that certain clusters of factors operated protectively against adversities, such as parental psychopathology and poverty, and eventually promoted resilience. Participants who, while growing up, were supported by adults outside their family circle, continued their education and established a good relationship with a partner, developed to become competent and caring adults .The list of protective factors is long, and as research evidence suggests, is differentiated according to the type of risk. For example, while family support has been consistently reported as a protective factor for children and adolescents living in areas of armed-conflict,6 one significant adult member of their broader community network, was the agent that helped children cope with abuse.7

Nevertheless, there is a general agreement on three areas of protective factors, identified in individual characteristics (e.g. self-esteem, empathy, optimism), in the home environment (supportive and warm familial context) and in the social environment (school, work, community) 8. The severity of exposure to a traumatic event can be critical, no matter the presence of positive supports, and unfortunately some individuals will not bounce back.

Resilience has been extensively studied in relation to childhood maltreatment, resulting in a rich literature that constantly feeds the design of significant interventions in order to face trauma. Physical, emotional and sexual abuse, and neglect, are the four forms of childhood maltreatment inducing severe consequences on children’s welfare and development. Emotional (sometimes referred to as psychological) abuse has been reported as the most serious form of childhood maltreatment, and the most difficult to detect because usually it leaves no visible marks and can be more easily concealed.9

 

‘Positive teacher-student interactions have a substantial impact on children’s well-being’

 

When considering childhood maltreatment, we tend to plausibly think that family is usually involved, because by definition the term refers to an act of commission or omission (in the case of neglect) imposed by a caregiver. As a child grows up, school becomes the context in which he or she spends a significant amount of their time. Hence, it is not a surprise that school becomes the most important social environment after the family environment to influence emotional, cognitive and social aspects in children’s course of development. Positive teacher-student interactions have a substantial impact on children’s well-being, whereas negative relationships may have adverse outcomes. Although many educators tend to establish good, constructive relationships with their students using effective communication channels, research suggests that this is not always the case. Some studies report that specific teachers’ negative behaviours towards students, identified as Emotional Abuse by Teachers, may have negative psychological and somatic consequences on school-aged children 10.

Being increasingly involved with resilience readings, I could not but ask myself: If teachers’ negative behaviours have adverse consequences on students, are there perhaps some factors to counteract these consequences, diminish their effects and promote resilience? This was one of the questions upon which I based my doctoral research goals, i.e. to explore the role of a number of factors that promote resilience in school-aged children (9 to 12 years) exposed to incidents of emotional abuse by teachers. I was about to dive into totally unchartered territory, given that there is much research on protective factors associated with maltreated children within the family context, but none existing within the school context. The main pillar of my research was the hypothesis that since resilience is so well documented and evident for every form of child maltreatment, then somehow it should be linked to the research questions I sought to answer. Indeed, the findings revealed children that reported incidents of emotional abuse by teachers tend to present more behavioural difficulties when compared to children with no similar experiences. Self-confidence, a warm family environment and good relationships with peers were the factors that had a positive impact on behavioural adjustment in children that had experiences of emotional abuse by teachers.

The implications of these findings in the educational context are critical, suggesting that negative student-teacher interactions may result in unfavourable outcomes on children’s well-being. The key message is the power of the ordinary, reflected in this case upon the interactive power of friendships, of good parenting practices, and of enhancing self-confidence in young children. Are there maybe other individual and environmental factors that can promote resilience in children with negative schooling experiences? This question remains to be explored by future resilience studies.

 

 

  1. These are cases of individuals I worked with during my professional practice as a counselor. The names are not real, the details have been altered and the individuals consented in using some part of their de-identified stories in this article.

  1. Retrieved from https://www.theguardian.com/world/2015/jan/26/tales-from-auschwitz-survivor-stories

  1. Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American psychologist, (p.235), 56(3), 227-238.

  1. Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work.Child development,71(3), 543-562.

  1. Werner, E. E. (1993). Risk, resilience, and recovery: Perspectives from the Kauai Longitudinal Study.Development and psychopathology,5(04), 503-515.

  1. Tol, W. A., Song, S. and Jordans, M. J. D. (2013), Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries. J Child Psychol Psychiatry, 54, 445–460.

  1. Flores, E., Rogosch, F. A., & Cicchetti, D. (2005). Predictors of resilience in maltreated and nonmaltreated latino children. Developmental Psychology, 41(2), 338-351.

  1. Zolkoski, S. M., & Bullock, L. M. (2012). Resilience in children and youth: A review.Children and youth services review,34(12), 2295-2303.

  1. Glaser, D. (2011). How to deal with emotional abuse and neglect—Further development of a conceptual framework (FRAMEA).Child abuse & neglect,35(10), 866-875.

  1. McEachern, A. G., Aluede, O., & Kenny, M. C. (2008). Emotional abuse in the classroom: Implications and interventions for counselors.Journal of Counseling and Development: JCD,86(1), 3.

  1. Nearchou, F. (2018). Resilience following emotional abuse by teachers: insights from a cross-sectional study with Greek students. Resilience-themed issue of Child Abuse & Neglect, 78, 96-106. https://doi.org/10.1016/j.chiabu.2017.10.012

 

Tackling the ethical approval process

Forms over function: Ethics, ethnography and the NHS

by Carol Robinson

At times last year I forgot that I was doing a PhD. It’s not that I was having a wild time as a student. No, by 9am every day I turned up to the office my department has kindly provided, settled down at my desk and worked solidly until some point after 5pm. Some of that time I’d be keeping on top of email, or attending departmental meetings, but mostly, I was working. Twitter doesn’t distract me, I had an organised weekly list of things to do that I worked through, and things were progressing nicely, thank you.

So why did I forget that I was working towards a PhD? Because for most of that time everything I did was aimed at getting ethical approval for my research. So it was almost a shock to look up and remember that wasn’t really my goal. My goal is to do the PhD research, to contribute to human knowledge and understanding, and to do it in a way that improves people’s lives. For a while however, compiling what became 91 pages of ethics forms plus supporting documents and all the bureaucracy that goes with that completely eclipsed the research.

I always knew I’d need to get ethical approval for my work. What I didn’t appreciate was how time-consuming, frustrating and complicated this would be. I used to listen to other people’s stories of wrestling with UK’s Integrated Research Application System, or with the NHS Health Research Authority’s byzantine processes and think either that they were exaggerating for effect or that perhaps their project wasn’t, well, good enough. I’d had approval from the prison service for England and Wales for two previous research projects; how hard could it be? I now apologise whole-heartedly that these thoughts even crossed my mind.

I did make life harder for myself by wanting to research dying prisoners, thus requiring both health service and prison service approval, as well as that of my University. The prison service process was fairly straightforward and familiar. The real trouble was with the NHS processes, and with the relationship between the three bodies. What kept me going for several weeks, as I tried to untangle the mass of acronyms and synonyms involved, was the thought that I was gaining useful experience. At the end of all this, I thought, I’ll be able to put on my CV that I understand the process, know how to fill in the form and could liaise with a health Research Ethics Committee. Not true. The process is so capricious that all such an entry in my CV would prove is that I once had the mental fortitude to see an application through to its conclusion.

Although my colleagues will tell you I sighed out loud quite a bit, I did make it through the time when an overnight update to the IRAS website hived my answers off into two separate forms, one of which I couldn’t see. I didn’t scream when I discovered just before submission that this should be changed back to one form. I stayed cheerful as my participant information sheet, carefully written to suit people not that keen on reading, expanded to yet another page with all the extra information I was asked to include. I only muttered a modest amount when asked to add the (to the participants) totally meaningless IRAS reference number to it. I maintained my outward equilibrium whilst I confirmed I would not be doing things I’d never thought of (wearing clerical dress was my favourite such request, closely followed by audio-recording outside of interviews). But I confess my heart did sink when someone I was relying on to understand what should happen next said this would be a learning process for them too.

Being a reasonable person, I did appreciate that part of the difficulty was that I was having to fit getting approval for sociological research into a process intended for clinical trials. The mismatch only seems to be partly recognised by the bodies responsible. So, whilst there’s a protocol template to complete aimed at qualitative research, I still had to say I wasn’t using ionising radiation or using human tissue samples. And whilst there are ways to amend the project once it’s been approved, there’s no appreciation that good sociological research is often iterative. Instead, there’s the assumption that you will know all possible scenarios in advance. With this comes an assumed relationship to the research participants; they are to be the subjects, not the co-creators of research knowledge. There is no scope for an understanding of ethical research that deviates from a generic (clinical) ideal, and consequently, the best of a discipline’s specific characteristics and of its newer research methodologies can be lost. I say newer, but in practice even my well established chosen ethnographic methodologies sit uncomfortably with the process of getting ethical approval from a health research authority.

There was a tendency in the guidelines provided to use language in unexpected ways. Have you ever had that experience of all the words making sense individually, but being incomprehensible when put together? I found myself trying to draft emails to effectively ask “so if ‘host organisation’ doesn’t mean ‘the organisation hosting the research’, what does it mean?” I struggled, along with my supervisors, and it turned out, the ethics committee staff, to understand what the REC had wanted when it asked whether I had an ‘honorary contract’. Later on, the REC asked if the scientific validity of the study has been confirmed independently of the academic supervisors, giving as an example of how this might be achieved “a University PhD review process”. None of us, not my academic supervisors, not the university ‘sponsor’ that I’d discovered along the way was also needed, knew what this meant. We were stumped, and resorted to gently approaching a professor elsewhere to see if they could provide such an independent scientific review, and quickly. In the end, this was not needed –all that was meant was would the University’s ethics committee be looking at it. Yes, of course.

There were funny moments too. Having had my application reviewed by a Research Ethics Committee that met in Essex, I then discovered how similarly I pronounce ‘Ethics’ and ‘Essex’, on the phone, to a poor, kindly person trying to understand which ethics committee had looked at it. Eventually, I said, “the one that met in Chelmsford” and we moved on. Having three ethics committees look at your work is not fun. As things are, it’s inevitable for research such as this, but unsurprisingly their expectations are not always compatible. The prison service doesn’t want any contact details for external people, such as academic supervisors, included on Participant Information Sheets; the NHS expects this. The University wants email addresses only; prisoners don’t have email. The NHS REC regarded the notices that prison governors would issue to let prisoners and staff know about the research as ‘posters’ that the REC should scrutinise, so needed the final text agreeing before I could get their approval – 6 months in advance of the governor issuing the text. Prison governors are incredibly busy people, so I am indebted to them for having calmly accepted this.

There is, outwardly, plenty of advice available on NHS websites. Much of it is out of date, hard to find, or impossible to understand. There are flow charts describing a parallel world, ‘start here’ guides buried beyond discovery, and directories that are out of date. Lovely, kind and supportive staff within the NHS R&D offices or working with RECs do their best, but if your project is unusual, there are things they can’t be expected to know, such as that there’s a limited number of Health RECs who will look at prison applications, until it’s nearly too late.

I’m not alone in this. In my struggle to understand the process, I came across numerous articles by academics similarly venting their frustrations, including one that fairly calmly reflecting on the problems, before revealing that their own project had spent the entire initial research budget trying to get permissions for research. Wiser people before me have also found that processes designed for quantitative-based medical interventions and clinical trials cannot adjust to the needs of qualitative research. And yet not much seems to have changed. My gripes may seem small, but behind them is a bigger issue, that of the imbalance of power between researchers and research ethics committees and the lack of accountability of the people, some experts, some lay people, appointed to make such important decisions.

So now I have all the ethical approvals I need, 10 months after I first starting filling in the forms, I’m remembering fondly why I’m here. It comes in flashes; the possibility of time to open that new book I’ve been eyeing up, something on the news that reminds me of the relevance of my research interests, a chance conversation with a colleague. Best of all was a recent conversation with a senior manager at one of the prisons I’ll be visiting for fieldwork. We’d not spoken before, but within minutes she’d reminded me why I’m doing this, why it matters that I’ve survived through all these hurdles. Out there are people who are doing their best in tough circumstances, and good quality research may just be able to help them. I’m looking forward to getting on with it.

Not anonymous enough? Research data and issues of anonymity.

by Carol Robinson, doctoral researcher, University of York.

CR1

Recently, I settled down to enjoy an article by one of my favourite academic writers. It was everything I’d hoped it would be: well written, thought provoking and interesting. It took a new approach to its subject and had a campaigning edge that I sympathised with.  And then, towards the end of it, I realised that I knew one of the people who had participated in the study being reported. Not that I knew them in terms of recognising a type, but that I actually knew them. My first response was one of disappointment. I want my academic heroes to be flawless. My next thought was along the lines of ‘will anyone else know them?’ followed quickly by the question ‘does it matter?’

A quick search on-line resulted in a Wikipedia page that confirmed other people would be able to identify the participant if they wished. The academic had not revealed their interviewee’s age or location, but from the context it was clear that they were referring to a member of a small group and once more specific information was given, anyone with a curious mind and an internet connection could produce a name. From my knowledge of the individual, further details in the article then confirmed what I had found.  Anyone else would be able to identify them, even if they lacked my certainty.

So, does it matter? The article probably won’t be widely read, even in academia, and it’s therefore doubtful that anyone else will do the searching to put a name to this participant. It’s possible the participant wouldn’t mind if they were named, although the author gave no indication that they’d consented to this. The encounter that was described didn’t include anything particularly controversial or personally revealing. If they read it, the person might not like some of the ways they were portrayed but there was no obvious information that could be used against them. But shouldn’t the participant have been assured of anonymity regardless?

Anonymity is one of the things I have to think about in my own research, which is around deaths in prison, two subjects with particular sensitivities. It is one of the hallmarks of ethical conduct, together with confidentiality and informed consent, necessary not least because twentieth century history has too many examples of exploitation and damage occurring in the name of ‘research’. Anonymization arguably has a value in its own right.  Attempting anonymization, even if we secretly admit we may fail, is a way of preserving the idea of academic integrity, of seeking to avoid the exploitation of other people’s generosity that would taint our work. It is evidence of academic vigour. This links back to my initial disappointment that an experienced academic had made a mistake. If the anonymization was ineffectual, were there other aspects of this article that were in some way dubious?

Demonstrating that we have followed the conventions of academic research, whether by correctly referencing our sources or by using recognised methodologies, is part of staking our claim to be academics. It shows a respect for the traditions of our particular discipline, and in the case of techniques such as anonymization, establishes our research as ethically valid. And if ethical validity is lost, it is arguable that other forms of credibility are lost too.

Research ethics committees usually insist on anonymity and confidentiality for people participating in any research, especially vulnerable participants, as a way of protecting them. It is assumed that some harm or loss may befall an individual if their identity is known, if the stories and experiences they share and which become the researcher’s data are in some way linked backed to them as a person living in the real world, beyond the study report or academic article. Sometimes, as in my own research, this is associated with taboo subjects or criminal activity, where there may be very real consequences if anonymity is not maintained.

In seeking ethical approval for research involving prisoners, deemed to be vulnerable because of their incarcerated status, I am encouraged to think through how I will record and store my data in a way that protects their identity. The specific threat is rarely stated. Although it may be poor practice, is failing to anonymise a person really putting them at risk of harm? In many cases, there is perhaps no direct link between a possible failure to anonymise effectively and a harmful consequence for the participant; the information revealed has to have the potential to be used in a way that would confer harm. However, there is often a simple presumption that all people participating in research should be protected, which ignores the question of whether harm is likely to follow from identification.

In all aspects of our lives, most of us share personal information continually.  We willingly offer up personal information all the time, giving our names, addresses and even bank account details to near strangers, trusting without evidence that they will be used for the purpose we intend. We share our views in conversations that can be overhead by others and via on-line discussions with unknown interlocutors. We post pictures on social media, link them to others without their consent, and live surrounded by cameras. Why do we persist in thinking we can anonymise research participants?

Researchers may use pseudonyms, but often a participant’s gender, age, nationality, race or class are pertinent to the research and so cannot be hidden. We can limit access to some findings, but that poses its own ethical dilemmas. And when the research needs to focus on participants from a small group, as in the case of the article I was reading, anonymization becomes so much harder to achieve.

I have experienced this in my own research. Last year, I interviewed uniformed prison staff with experience of working with terminally ill prisoners, in a prison where there were few female officers. The interviews gave really useful insights into the work prison officers perform with dying prisoners but I was painfully aware that the female interviewees may be identifiable by other staff in the prison, despite my best efforts at anonymization, simply because they belonged to such a small group. Even with a wider pool of participants, in a tight-knit world such as a prison anonymization is hard to maintain. Surely we should not abandon useful research because it involves a small group or close-knit communities?

Indeed, should we even try to anonymise our research participants? Most of the time I would say yes, but there are times when far from protecting our participants, doing so actually risks inflicting a harm.  As researchers, we promise anonymity to ethics committee on behalf of other people, who may not wish for it. Very often, participants may have offered to help the researcher because they too care about the issue that is driving the research and want to have an impact on the situation. They may want to have their voices heard, and by extension, themselves credited. When we anonymise them, we keep their voices, but hide their faces. For vulnerable participants in particular, this is potentially a misuse of power. It is a way for the researcher to exert their positional power and claim control. Nicely anonymised, our participants may not even be able to spot themselves in our final reports and presentations. They can’t see how they are represented, and so they can’t hold us to account. There are ways round this, involving them in the production of the final report, but in my discipline at least, few researchers seem to opt for these approaches.

Lastly, I found myself thinking ‘what does one do if one spots that an academic has not sufficiently anonymised their data?’. It is not easy to be certain what responsibility we have when we spot something problematic with someone else’s work. In the case of the article I read, the peer reviewers had been content with the text, the editorial board satisfied and the article is now published. The damage, if there were any, is done and in an age of on-line journal access, probably un-doable.

I asked colleagues, and was struck by two responses in particular, widely divergent but both from science faculties. One, coming from a discipline where the professional accountability of practitioners is paramount, felt strongly that I should contact either the author directly to alert them to the problem, or the journal anonymously to suggest they review their procedures. From another department, a colleague suggested I keep quiet, and not draw attention to the problem or myself. For them, raising the matter with the author would only make things worse. Each response of course reflected the culture and values of the particular academic disciple. In some academic disciplines, where the use of human participants is rare, the question of the quality of participant anonymization may rarely come up. But for many disciplines, including my own, where the involvement of human participants is so often essential to a research project, this is an issue that can occur at any time. Do we as academics have a collective responsibility to revisit anonymization?

 

Emotion Rules in Feminist Book Reviews: An Inroad to Improving Feminist Relationships

By: Lisa Kalayji

WAB 2Swimming through the endless tidal wave of demoralising political think pieces and scholarly jibber-jabber in my mostly academic Twitter feed, I came upon an account called ‘ShitMyReviewersSay’, which features the cruelly scathing comments that anonymous peer reviewers write about the hopefully-to-be-published academic journal articles of their colleagues. The account’s handle? @YourPaperSucks.

Its purpose, other than to give us an opportunity to chuckle at what, under different circumstances, makes us want to either cry or set a university building ablaze, is to highlight the absurd magnitude of the viciousness that peer reviewers will direct at their colleagues when given a chance to do so anonymously.

It’s cathartic to have a laugh at this sort of thing, but when it doesn’t come in the form of a satirical Twitter account, our reaction is a lot different. ‘What the hell?!’ we wonder incredulously. ‘Couldn’t you express your criticism in a less ruthless and petty way? What good does it do you to ruin someone’s day and treat their carefully nurtured brainchild of a paper like garbage?’

ShitMyReviewersSay reminded me of the book reviews in Trouble and Strife, the radical feminist magazine I’m doing my PhD research with.

Trouble and Strife published a fair number of book reviews – feminists write a lot of books! – and over the course of my research I’ve found that there’s a vast deal we can learn about a group of people, be they academics, radical feminists, or any other group, from the way they review each other’s writing.

My research is about emotion culture: the system of rules and social norms that prevail in a society or social group which affect how people feel emotionally and how they express those emotions. Book reviews contain a treasure trove of clues about the emotion culture of the social group that the reviews come from, but in order to see those clues, you need to know some of the things sociologists have learned over the last few decades about how emotions work.

Emotions are relational

As the term ‘relational’ suggests, emotions come up in relationships between people. Because psychology dominates the popular lexicon we use to talk about and make sense of emotions, we tend to think of emotions as states which exist inside of us, are linked to our neurochemistry and our personal histories, and are mostly governed by things like innate human needs for social bonding. All of those things are partially true, but what the sociological study of emotions has revealed is that emotions are actually relational.

Why we feel the way we do in any given situation is constituted by our relationships to the people and things around us and what we understand those things to be and mean.

There isn’t anything in our genetic code that makes us get annoyed when a friend we’re supposed to meet for lunch shows up half an hour late (though our biology is necessary for us to be able to experience feelings), and the feeling of annoyance isn’t something inside of us that emanates outward through the things we say or do (though we do express emotions in that way). We’re annoyed at someone (that’s the relation), and the reason for that annoyance is what we think the lateness signifies. We’re busy people! Don’t they think we have better things to do than sit around waiting? We have to be back at work soon – now we’re going to have to rush through lunch! Our awareness that our friend knows that it’s considered rude to keep someone waiting and that it’s an inconvenience to us is what makes us annoyed – their indifference to our needs and to the agreed conventions of how keeping a lunch date with someone works creates our feeling. Likewise, though, if we found out that they’d been delayed because a stranger attacked them on the street and nearly broke their jaw, our annoyance would quickly give way to concern – what their lateness showed about our relationship to them would have changed, and with it, our feelings about it.

Emotions are subject to rules

Much like there are social rules about how we’re supposed to behave in different sorts of situations, there are also rules about how we’re supposed to feel and how we’re supposed to express feelings. If an adult is audibly crying at, say, a fancy restaurant or a business meeting, that would seem inappropriate, and probably make everyone around them quite uncomfortable. If they were at a funeral, however, that would be considered normal and appropriate, and no one would be bothered.

Even if feelings aren’t expressed, there are rules about how we’re supposed to feel.

If, for example, you’re a bit off your game at work because your sister died last week and you’re in grief, and while not actually admonishing you for it, you get the sense that your boss is annoyed with you for not being your sharpest self right now, you might get upset or angry at them. When someone is in grief, we expect others to respond with compassion, even if that grief peripherally causes some inconvenience to others – it’s a violation of the social norms of compassion and empathy to get annoyed at someone for being grieved, even if the annoyance is mostly hidden and not openly expressed. The rules are also different depending on what the characteristics of the people involved are. If that person crying in the restaurant is an infant, while people might still not be pleased about the noise, it wouldn’t make them feel awkward and uncomfortable, because we consider it normal behaviour for babies to cry regardless of time or place.

These are all some general aspects of how emotions in social life work in ordinary social situations. What my research is about, though, is the specifically political dimension of emotions in social life.

Social norms about emotions are deeply political, even in most seemingly innocuous daily interactions like those I described above. Rules about who is allowed to feel or express what feelings towards whom divides along a lot more political lines than the differences between adults and children. Anger is generally considered more appropriate in men than in women (and in women is more likely to be characterised as histrionics or emotional instability), and vulnerability more appropriate in women than in men (with men’s abilities to be ‘proper’ men called into question if they cry, especially in public). Rules about emotions are also racialised – even very slight expressions of anger from black men are interpreted as very threatening because black men are culturally conceived of as inherently threatening, while much stronger expressions of anger from white men (or women) are regarded as less threatening and are more likely to be considered justified. Our prevailing cultural conceptions about what characteristics different kinds of people innately have give rise to specific, and often strictly socially enforced, rules about who can feel what and how their feelings can be expressed.

Emotions in feminist book reviews

Feminists do a lot of writing, and a lot about how emotions work in feminism can be learned from examining the books, magazines, pamphlets, manifestos, and websites they write. I’m researching radical feminism, a specific type of feminism (there are a lot of them) which emerged during the ‘second wave’ of the Women’s Liberation Movement in the late 1960s, and continues today. From 1983-2002, a radical feminist collective the UK published a magazine called Trouble and Strife, and a lot of radical feminist political thought from that period can be found there.

WAB 1Because feminist politics is so substantially borne out through reading and writing, one of the central strategies that feminists use to think through politics is by reading and debating one another’s writing. For that reason, unsurprisingly, Trouble and Strife published quite a few book reviews, wherein contributing authors to the magazine reviewed books authored by other feminists. By comparing these reviews, and the responses to them that readers communicated to the magazine through letters to the editors, we can see radical feminist emotional politics in action.

What I’ve found is that the emotion rules in radical feminism are different for relationships between radical feminists than they are when dealing with someone outside that political community. When dealing with fellow radical feminists, they’re more considerate of one another’s feelings, express their criticisms more hesitantly and gently, and are more appreciative of the aspects of the work that they agree with. On the rare occasion that someone breaks this rule and is harshly critical of someone within the radical feminist community, there’s a strong backlash, with others writing letters to the magazine to express strong objections to those criticisms having been published, and some questioning the political identity of the magazine as a whole in light of their decision to publish exacting reviews.

This will ring true for many feminists who currently engage in online activism, who are familiar with the more receptive audiences within their own political communities, and harsher (and sometimes outright vitriolic) criticism from feminists who have a fundamentally different set of political values.

This has profound implications for the future of feminism: if feminists who disagree on crucial political issues are more willing to upset one another, and less desirous of understanding where others are coming from, then we’re likely to see a continuation of the entrenched infighting that has plagued feminism for decades. I’m not suggesting here that we should return to the ‘happy sisterhood’ of yesteryear (which, as many feminists have pointed out, never actually existed). What I do want to highlight, though, is that if we want to understand why conflicts between feminists get so heated and can be so divisive, understanding the emotion rules which give shape to feminists’ relationships with each other is a crucial piece of the puzzle.

Once we become more aware of these rules and how our own feelings are shaped by them, we can act to change them, and while this won’t solve all of feminism’s problems, it can go a long way toward generating more fruitful dialogues between feminists who belong to different political communities.

This strategy can be extended to other social movements as well, and it has rarely been a matter of more urgency than it is right now for social movements to be able to prevent the breakdown of their political projects due to irreconcilable conflicts from within their communities. During the currently ongoing period of rapid and disorientating social and political change, understanding the emotion rules of social movements can help us to ensure that efforts to enact positive social change are successful, and examining the way we speak to, speak of, and write about one another is one tool we can use for making sense of our emotion cultures.

You can find all issues of Trouble and Strife on their website at troubleandstrife.org.

‘When you know better, you do better’: Tackling inequality in secondary schools

by Holly Foley, PhD candidate in Sociology at TCD, Project Co-ordinator at The Rising Tide Project and Junior Chambers Ireland ’10 Outstanding Young People’ 2017 nominee.

‘When you know better, you do better’ – Dr. Maya Angelou

 

Schools are the battleground where inequality can be eradicated and the students’ right to equality can be won. Society can judge its most vulnerable members with a very harsh eye. Nobody wishes to live in poverty, raise their children in poverty and be judged by their peers for the size of their TV, the food on their table and the clothes on their back. Let us imagine that we were all genuinely doing our best with the skills and knowledge that we had, however limited or however bountiful, but accepting that we were nonetheless doing our best. Maya Angelou bestowed many pearls of wisdom upon us, one of which resonates with me daily “When you know better, you do better”. It can be that simple. Schools bring our young people together to educate them; education in its many forms helps us do better.

There is a growing body of literature which explores the influence of school in the lives of young people. Now we know better, let us do better. Let our schools raise our young women and men up from their first steps on their educational journey until they march out the door, heads high armed with the knowledge and power to do better.  Sounds lofty? I am a realist, so let’s get practical. Our teachers must teach the curriculum, but in what environment, with what expectations and with how much awareness of “the hidden curriculum”?

Let us explore class inequality first. Research in an Irish context found that irrespective of social background and Leaving Cert grades, young people attending a school with a high concentration of working-class students were much less likely to go on to higher education than those who attended middle-class or socially mixed schools. In Ireland, students from middle-class schools were more likely than those from working-class schools to go on to some form of post-school education and training. It is not the bricks and mortar or the tables and chairs of the school that is creating such an obvious divide. Schools need to examine their culture.  Is everyone present because it is compulsory, or because they want to teach and learn and grow and do better? What is the belief system in the school? Do the teachers believe in their students? Do the students believe in themselves? Schools cannot control the messages students are getting in the media, in their neighbourhood or in their homes. They can, however, carefully craft the messages that students receive during their day of learning and they can encourage students to control how they receive positive and negative messages about themselves. What subjects are schools offering? Is the school offering a higher-level option to junior and senior cycle students? Schools which do not offer a European language and higher-level subjects to their students are sending a loaded, negative message to their students: these are not for you. Schools which do not offer and actively encourage students to study higher-level subjects are curbing the future life-chances of their students and need to hold themselves to a higher standard. What types of guidance does a school offer? Research tells us that working-class students and students from ethnic minorities are more heavily reliant on formal guidance in schools for making educational decisions. Does the school have a college-going culture? Are students exposed to different types of pathways? Visibility is crucial when planning post-school pathways. If a student does not know a certain career or profession exists, how can they pursue that pathway?  Simple answer: they cannot and so they do not. Instead they follow the familiar pathways that have been worn before them but, no more! Now they will know better and they will do better.

This leads us to the issue of gender inequality. Research suggests that male students achieve more success than female students in co-educational schools. Reasons for this include teachers calling on male students more frequently to answer questions, allow male students to speak over or ‘shout-down’ female students and dominate the discourse. Not only is this further reinforcing gender inequality in the classroom, but it internalises the power structure for females who carry this experience of subordination into higher education and the workplace. Are co-educational and single sex schools fighting gender bias in subject choice? There is a disservice being done to all students by not fostering a culture in which male and female students can actively engage in traditionally highly-gendered subjects.  If a school is not challenging gender bias in subject choices the message is clear to students from a very young age.  Students make distinctions between what is for them and not for them; thus, their pathways become gendered which is not in the best interests of the students, the school or wider society. Gender inequality damages everyone and stunts our growth as people and as a society.

I attended a single sex school, and I lament the wasted opportunities that a ‘better’ culture and a ‘better’ understanding of our agency in society could have created. There were approximately 700 young women in my school. Can you imagine the change 700 young women could make in the world if they were armed with the tools to tackle inequality in its various forms? Prescribed prose and poetry on the curriculum in my time did not speak to young working-class women and their place in the world, or the power they possess. Geography seemed a somewhat abstract subject, mountains, rivers,  and lakes unfamiliar from my own vantage point in a housing estate. And of course, the Leaving Certificate “points race”, a tall-tale of meritocracy, which in reality is run on a two-tier track and never the twain shall meet.

We do a disservice to our young students by not acknowledging the power to create change that they possess. One young person working in isolation to tackle inequality will undoubtedly face an unrelenting path. A school of 700 young people, hungry for more, has the power to create a tsunami of change in their community, to empower their peers to go forth and demand better. Schools must acknowledge their unique position in shaping these future agents of change. Over the course of a lifetime a school has daily access to young people, where they can empower them with the knowledge to create change, consistently reinforce these values and lift their aspirations to previously unimaginable heights.

Let us end on a reflection of the school as the ‘battleground’ where equality can be won. If a school makes it their mission to wage war on inequality, their students will carry this victory with them. Empowered and emboldened by this victory, students can assert their place in society and challenge inequality on a global stage with confidence and eloquence because these students will know better and these students will do better.

Austerity, women and health inequalities in the UK

by Amy Greer Murphy, Durham University

My PhD is part of a five year research project entitled ‘Local Health Inequalities in an Age of Austerity: The Stockton-on-Tees study’. It’s a mixed method case study exploring the localised impacts of austerity on health. My role is examining the experiences of women living in Stockton using qualitative research.

A few key terms

Austerity refers to attempts to reduce government deficits through spending cuts and sometimes tax increases. Across Europe, austerity was implemented in many countries, such as Greece and Ireland, as a precondition of receiving bailouts in the wake of the financial crisis of 2008. In the UK, a major restructuring of the public sector and welfare system has been undertaken since 2010.

Neoliberalism refers to the application of free market principles to public policy. It has been enacted in the UK since Thatcher’s Conservative government came to power in the 1980s and has comprised of deregulation (e.g. of the banking and financial system), privatisation (e.g. of bus and rail services) and, more recently, austerity (e.g. extensive welfare reforms).

‘Health inequalities’ refer to disparities in life expectancy and years of health life (‘mortality’ and ‘morbidity’) within and across nations. There is a gradient in all countries – those with more socio-economic resources also have better health (Marmot, 2010). In the UK, health inequalities are widening since austerity began. Schrecker and Bambra (2015) have referred to the process of widening health inequalities and liberalised economic and social policies as a ‘neoliberal epidemic’.

Austerity and inequality in the UK

The UK is a large country, and one of great social contrasts. The contrasts that are relevant to my research are related to inequality of opportunity, resources, health, and the government policies, political decisions and historical legacies that bring these about. The North East has experienced a huge restructuring of its’ social landscape in recent decades. Mining, heavy industry and manufacturing have all but ceased to operate there. The jobs that once provided decent incomes and rooted people to their communities, providing clear routes through the lifecourse and class allegiances, have slipped away. In their place are zero hour contracts in care homes and nurseries, seasonal work in factories and as agency staff providing security in shopping centres.

Through this research process I have tried to understand what neoliberalism and austerity feel like if you’re not on the winning side of them, focussing on gender and class. I’ve then tried to see the wider connection to globalised economies and deregulated financial markets.

Stockton-on-Tees

One of the ways austerity is affecting places and people differently is through health. In Stockton-on-Tees, the gap in life expectancy for men is the largest in all of England, at 17.3 years, and one of the widest for women, at 11.4 (Public Health England, 2015). If you are a man born in one of the wealthier, typically less urbanised parts of Stockton you can expect, on average, to live 17.3 years longer, and more of those years in good health, than a man born just a short walk away, in a more built-up and less well-off part of town. You are also at a higher risk of cardio-vascular disease, obesity, cancer, mental health issues, suicide, alcoholism, to be more socially isolated, have a worse paying, precarious job or no job at all, and to be at the mercy of an increasingly retrenched welfare state for your income and livelihood. The picture for women is similar, but different in crucial ways I will explore later.

This, of course, isn’t the picture for everyone in Stockton; I don’t want to paint a doomsday caricature (Benefits Street, the Channel 4 show, made a noble attempt at that in 2014 with their ‘poverty porn’ foray into life on Kingston Road). Stockton is steeped in a proud industrial legacy, is surrounded by beautiful dales and hills, has a vibrant town centre, and is home to thousands of people of all kinds who are creating thriving and enduring communities. Undeniably, however, government policy is making the lives of an increasing number of its residents tougher.

The research topic

Women face a distinct set of risks under austerity, as their lives, choices and opportunities often play out differently. This led me to develop my research project, to be carried out with mothers from across the borough. I wanted to understand what the experiences are of being a woman living in a place like Stockton – what can they tell us about other similar places that have experienced stark deindustrialisation and withdrawal of resources and traditional routes to employment and social stability? What does it feel like to live through welfare reform, as a mother, with enough money or very little, in an area with lots of different inequalities?

The methods

The research design was informed by the work of Sociologists who have used their skills to bring to the academic and policy world narratives that are otherwise silenced – quite often the voices of women. Berverley Skeggs (1997), wrote about class and gender and respectability in an area of England not so far from Stockton, Ann Oakley (1979; 1993) spent years with mothers asking them what they thought about housework, women’s health and becoming a mother, and Arlie Hochschild (1989) delved into the lives of women trapped in the double- or triple-bind of work, caring for children and elderly relatives. The methods I used are similar to theirs, and ‘qualitative’, meaning they are designed to explore diverse social worlds and understand why certain groups of people or individuals make choices or live in certain ways, or why their lives are presented in a certain light. I had a methodology (system of methods) and sampling strategy (idea of why I wanted to contact, and why). Unlike some quantitative social research or scientific experiment, or the research wasn’t designed with representativeness or generalisability in mind.

I used ethnography, or participant observation; I spent 16 months at a women’s group where I gained friends and mentors and learned about being woman living on a low income in Stockton. I also interviewed 15 women, 14 of whom are mothers, from a wide variety of socio-economic backgrounds and from many different walks of life. I recruited participants through the local Sure Start centres, Twitter, Thrive, the anti-poverty charity I spent a lot of time at, and through snowball sampling (asking people I met if they could recommend someone, or pass on my details). I offered a voucher as a thank-you and recorded my interviews.

Some findings

Continuing austerity and the decline of opportunities: For respondents and their wider networks, there is a huge concern about the likely continuation of austerity and what that might mean for families and communities. We spoke about diminishing opportunity and prospects, the long-term decline of services, the quality and availability of housing and work in the area.

The desire to ‘just be a mam’: Respondents found their roles as mothers and carers increasingly devalued, with the expectation that caring work should be provided by the market and that they should seek formal work as a primary source of income. However, quality work is unavailable, childcare unaffordable, and an important source of identity formation, their role as carers and mothers, diminished under austerity.

Mental health: It became increasingly obvious as I spent more time in the field that the deterioration of participants’ mental health and sense of wellbeing was stark. Discussions of everyday struggles with depression, anxiety and serious bouts of post-natal depression were worryingly frequent. Furthermore, long-term physical health and chronic pain issues were part and parcel of life for many of the women I spent time with, symptoms of a lifetime of stress, poor quality housing and other inequalities (Mattheys et al. 2015).

Conclusion

Underpinning my research is the understanding that women, particularly mothers, face a set of distinct risks under austerity, through labour market changes, reliance on the welfare system and the public sector. They are employed in higher numbers in the public sector, and so more vulnerable to job losses there, and more likely to be underemployed or in low-paid work in ‘feminised’ sectors. They may also face maternity discrimination in their workplace, experience a large gender pay gap and are absent from the labour market for extended periods while they take care of young children. Women also make use of public sector services in high numbers, the very services being cut back during austerity. They rely on the welfare state for many reasons to a much larger extent than men. Welfare reforms like the benefit cap, bedroom tax and sanctions, closures of community centres and privatisation of Sure Starts and lone parent conditionality hit not just women in large numbers, but children and families too. This research is trying to illustrate how austerity is regressive and contributing to growing inequality, and how this group, like many all around the UK, are finding it a challenging time to live through.

References

  • Blyth, M. 2013. Austerity: the history of a dangerous idea. Oxford University Press, Oxford.
  • Hochschild, A. 1989. The Second Shift: working parents and the revolution at home. Viking Penguin, New York.
  • Konzelmann, S., 2014. The political economics of austerity. Cambridge Journal of Economics 38 (4) pp. 701–741.
  • Marmot, M., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., and Geddes, I. 2010. Fair society healthy lives. The Marmot review executive summary. The Marmot Review. UCL Institute of health equity, London.
  • Mattheys, K. Bambra, C. Kasim, A. Akhter, B. 2015. Inequalities in mental health and well-being in a time of austerity: Baseline findings from the Stockton-on-Tees cohort study. SSM -Population Health 2 Pp. 350–359.
  • Oakley, A. 1979. Becoming a mother. Martin Roberston and Company Ltd., Oxford.
  • Oakley, A. 1993. Essays on women, medicine and health. Edinburgh University Press, Edinburgh.
  • Public Health England, 2015. Stockton-on-Tees Health Profile 2015.
  • Robson, S., and Robinson., J., 2012. Findings and recommendations from interim case study: the impact of austerity measures upon women in the North East of England. The Women’s Resource Centre, London.
  • Rubery, J. and Rafferty, A. 2014. Gender, recession and austerity in the UK. In: Karamessini, M. and Rubery, J. 2014. Women and Austerity, the economic crisis and the future of gender equality. Routledge, Oxon. pp. 123-144.
  • Schrecker, T., and Bambra, C., 2015. How politics makes us sick: neoliberal epidemics. Palgrave Macmillan, London.
  • Skeggs, B., 1997. Formations of class and gender, Theory, Culture & Society. Sage Publications, London.

 

This IS ‘proper’ research: Taking on the social science vs. science debate

By: Rosie Smith 

“So why is your research necessary?”

“How do you get funding for research like this?”

These are just two of the many questions that I was asked recently whilst taking part in a competition for PhD researchers at my university. The competition was interdisciplinary and was aimed at showcasing doctoral research at the institution, whilst also providing early career researchers, like myself, a gateway into public engagement. Needless to say the competition was one of the many uncomfortable things I intend to do this year as part of my resolution to be a ‘yes’ woman and challenge myself more.

Finalists were made up of three researchers per faculty (social science, science, arts and humanities), and as a criminologist I quickly found myself gravitating towards the social sciences camp. It was a full day event in which we were judged on a multitude of criteria ranging from originality, impact, accessibility, interdisciplinary scope, and importance. I use the word ‘importance’ hesitantly, as it’s a term that causes particular anxiety when I consider my own research. My work explores the concept of ‘spectacular justice’ and the way the mass media makes the criminal justice system visible and public. I explore this concept by analysing how high profile criminal cases are represented in media archives from the 1800s to 2016.

 

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And whilst I thoroughly enjoy my research, I still often find it difficult to have confidence that my work is ‘important’, and necessary. In part this is because I am self-funding my research, and at times I find it difficult to have confidence in my work when understandings of ‘good’ research are so closely bound to notions of impact and attracting funding. But it is also in part because of situations like these, when I am forced to contemplate the debate around what constitutes ‘proper’ research.

When I was posed these questions, I admit, I was initially shocked and somewhat taken aback by the abruptness with which they were posed. But at the same time these questions draw on some of the existing anxieties I have as I begin the journey into academia. To me, these questions in some way breach the social conventions on conversation etiquette, not to mention conventions on what is and is not okay to ask a frazzled and distressed PhD student.

To the first, I was honest, and launched into the toils of juggling several part-time jobs alongside trying to develop the aura of a rounded and successful academic.

But it was the question “Why is your research necessary?” that caused me more concern. Looking around the room at the other contestants I began to question whether this question had been asked of the other finalists, in particular the natural, computer, and the physical scientists.

I was transported back to the long debates I had as an undergraduate with my ‘proper’ scientist friends. In these debates I would spend hours defending the position that social science is important and necessary, and that the two disciplines can exist in parallel.

I would passionately defend the position that the relationship between the two does not need to be one of comparison. Admittedly, my efforts to convert them were largely fruitless. And I was often left being endearingly mocked, only to be told that “but it’s not a real science though is it?” And unfortunately this is still a plight I am fighting as I embark through my PhD.

It is as if this debate is a matter of either or. You are either a social scientist or a scientist, with very little scope to dabble somewhere in the middle. This was only confirmed as the day progressed. I overheard the finalist next to me ask a gentleman, “Are you going to go to Rosie’s stand next?” To which the gentleman replied, “I don’t think so, I don’t like social science, I’m a more of a scientist”.

jlhk

Needless to say I tried my best to convince him of the merits of the dark underbelly of the social sciences, but was left wondering why I had to.

I cannot escape the importance of gender to this debate. Despite being interdisciplinary, the competition finalists were overwhelmingly female, with male colleagues only being represented by the science faculty.

Needless to say there are a large number of male social scientists who contribute greatly to the field, but historically the social sciences have been regarded as a ‘feminine’ discipline.

This is supported by statistics on the relationship between gender and higher education degree choices: in 2016, 17,075 men accepted university offers to study a social science subject in the UK, which amounts to just over half the figure for women which totalled at 30,860 (UCAS, 2016). And so I interpreted the questions “why is your research necessary?” and “how do you get funding for research like this?” not only as a judgment on the value of my research, but a value judgment more generally about the credibility of the social sciences as a predominantly female discipline. I couldn’t ignore the feeling that the feminization of the social sciences served as a double mechanism to justify the position of the sciences as superior.

At times I worry that as a social scientist, the rivalry that exists with science, whilst often only in jest or antics, has a direct impact on understandings of what constitutes ‘proper’ research.

And I question the appropriateness of using one set of criteria to judge and compare the value and ‘necessity’ of the two disciplines. In my opinion they are complimentary rather than contradictory fields. And we should be striving to broaden our understanding of what constitutes ‘proper’ research. Because although my research does not find a solution to world hunger or fight disease, it does have value- just in its own way.

At the end of the day the judges seemed to recognise some of that value too. When the scores came in, I won! It was one of the proudest moments of my Phd so far, as a social scientist, as an early career researcher, and as a woman. This experience has taught me many lessons, but the most important is to take the victories, whether big or small, when they come around. Equally I aim to worry a little less about how much impact my research has, or how much funding I attract (or not) and concentrate on enjoying my PhD and remembering that whilst not earth-shattering, my research is still necessary. All research is proper research.

 

 

 

 

CHILD SOLDIERS: Where are the girls?

CHILD SOLDIERS: Where are the girls?  Kids, guns and the Patriarchy

By Marie Penicaut

Much has been written lately about African child soldiers.[1] We, in the West, are all familiar with the image of an eight or ten year old boy, holding an AK-47 too big for him, in a pseudo-military uniform, his eyes crying for help. We see him in newspapers and on television. We hear his horrifying story in documentaries, interviews, and sometimes self-written memoirs. Since Blood Diamond[2], we also see him in fiction films, poignant and stereotypical representations of these kids’ tragic lives that we too readily take for granted. And, as Nigerian author Chimamanda Ngozi Adichie wonderfully puts it in an inspiring TedTalk, “the problem with stereotypes is not that they are untrue, but that they are incomplete. They make the single story become the only story”.[3]

 

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The ‘typical’ child soldier

But where are the girls in all of that? Why don’t we see pictures of little girls carrying AK-47s? Why is there virtually no girl – not a single one – in Netflix’s critically acclaimed Beasts of No Nation[4], while many studies have proven that they constitute up to 40% of all child soldiers in some African contexts? Why are they so often completely ignored by academic literature, governments, international organisations and NGOs alike?

 

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Agu’s all-boys unit marching towards combat. Screenshot from Beasts of No Nation.

The answer should not come as a surprise. Once again, the Patriarchy strikes: society puts us in two clear-cut categories, where according to our biological sex – male or female[5] – we are expected to behave in a certain way. Girls will naturally be peaceful, pacifist, and passive; boys will be inherently violent, aggressive, and impulsive. Hence the common belief that on one side, ‘girls don’t fight’, while on the other, ‘boys will be boys’ – which inevitably leads to the idea that war is the realm of men, and of men uniquely.

No wonder, then, that girl child soldiers are invisible, even when confronted with evidence that 10 to 30% of child soldiers worldwide are female, and 30 to 40% in recent African conflicts.[6]

When – and if – mentioned, it is only as simple camp followers. As the ‘good little women’ they are, they cook, do the laundry and take care of the youngest. But in reality, many receive military training and fight just like the boys.[7] During the Mozambican War of Independence (1964-74), which opposed the Portuguese government and FREMILO (The Mozambique Liberation Front), the rebels had mixed and female-only military units where girls and young women fought for the liberation of their country.[8] War was an opportunity for them to escape their gender roles. They were treated just the same as men. But once the country became independent in 1975, it was not long before they were sent back to the kitchen, and the crucial role they played was progressively forgotten.

 

 

Johnny Mad Dog or the stereotypical child soldier narrative

We should not underestimate the power of the media and of pop-culture. They both represent and influence the way we make sense of the world. The first thing I did when I started researching child soldiering in Africa (for my master’s dissertation) was to try to find as many fiction films and documentaries on the topic I could. Before entering the more nuanced and detailed academic discussion, I wanted to have the exact same perception of the phenomenon as everyone else.

I was shocked when I watched Johnny Mad Dog[9], the ultraviolent and ultra-clichéd adaptation of the eponymous novel by Emmanuel Dongala[10]. It tells Johnny’s story, abducted at 9 by rebels, now 15, in yet another unnamed African country torn by a senseless conflict – the Western discourse on African child soldiers is also profoundly racist: most movies are entirely decontextualized, as if the story could take place anywhere on the continent, negating the vast diversity of its 54 countries and the complex reasons that lead to armed conflict.

In the book, there are two narrators: Johnny and Laokolé, a strong and smart girl, who manages her way through a world of violence and chaos. But Sauvaire completely silences her to put Johnny at the centre of the story. She becomes a character of secondary importance. Even worse: while in the book she cold-bloodedly plans to kill Johnny, and does it, as she knows he intends to rape and kill her, the film ends on her indecision whether to shoot at him in self-defence. Her originally strong agency is simply erased.

Dongala’s resistant discourse is violated and distorted to conform to the expectations of a public for which violence is the monopoly of males.

 

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Johnny Mad Dog’s last image: Laokolé pointing a gun towards Johnny, breathing heavily, undecided.

 

Girl soldiers, the “ultimate victim[s] in need of rescue”[11]

If you are active on social media, there is a good chance that you have heard of the Kony2012[12] phenomenon. The 30-minute video posted on YouTube by Invisible Children, an NGO built by three American missionaries, was created with the aim of fighting the child-soldiering the three “discovered” in Uganda. The viral video – which gained 100 million views in less than a week – sums up pretty well all the stereotypes on child combatants. It also illustrates the difference of treatment between girls and boys in the global discourse: “the girls are turned into sex slaves, and the boys into child soldiers”. Things are simple. Girls do all the chores and are sex slaves. Boys are forced to fight and to commit atrocities. Girls don’t fight and boys don’t get raped. Even more than their male counterparts, girls are voiceless victims in need of rescue by the West.

 

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Kony and his ‘army of children’. Source: Screenshot of Kony2012

Many girls and women are victims of sexual violence, especially in the climate of conflict and instability that has affected a number of African countries in the past decades. But stories of rape and abuse too often eclipse other stories of bravery, resilience and survival.

Even more than boys, girls are denied any agency, any voice; they are denied the possibility to speak out and tell their story as they experienced it and not as we want to hear it.

In some contexts, becoming a soldier can be empowering for them. They can gain power, a surrogate family where they had none, and escape their traditional gender roles.[13] Their experience is too often reduced to the sexual violence they may or may not have undergone. In virtually every documentary I have watched for my dissertation project, girls are interviewed uniquely to talk about their experience of sexual violence, and often asked to provide gruesome details to satisfy the journalist’s, and the public’s, morbid curiosity.

It is not the first and certainly not the last time that women have been misunderstood and misrepresented because of sexist stereotypes. But the tragedy lies in the consequences this has on the ground, for real girls that have served weeks, months, and sometimes years in militias. Because ‘girls don’t fight’, many demobilisation, disintegration and rehabilitation programmes[14] exclude them. Only 5% benefit from them.[15] And when they do, their special needs are rarely addressed: no female clothing in the aid packages, no tampons or pads, no reproductive healthcare, etc. Skills training and camp activities are often biased towards males – learning masonry, carpentry, mechanics etc.[16] When going back to civilian life, because they are labelled as sexual victims, they are affected by a stigma of sexual activity. Whether real or not, this stigma leads to social exclusion. Many girls hide their rebel lives from their family and community and decide not to register for demobilisation because they are too afraid of the consequences – of being seen as monsters, as dangerous rebels, as ‘bush wives’[17] that can no longer marry.

More than anything else, girl child soldiers are victims of the Patriarchy. In the West, which ignores and silences them; and in their own societies that stigmatise and exclude them both as rebels and as trespassers of their gender roles. The child soldier phenomenon is a complex one. Its gender dimension is only one aspect of the issue, but one that deserves much more attention than it gets now.

Movies like Beasts of No Nation, Blood Diamond and Johnny Mad Dog, with a large audience and good critiques, are missed opportunities to challenge a simplistic, essentialist and dangerous understanding of child soldiers.

They perpetuate many harmful ideas and are representative of the status quo on the place of women in war: none.  “Just as these films were made mostly by whites and thus show a white bias, so were they made mostly by men and show a male bias.”[18]

 

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[1] Understood as “any person below 18 years of age who is or who has been recruited or used by an armed force or armed group in any capacity, including but not limited to children, boys and girls, used a fighters, cooks, porters, messengers, spies, or for sexual purposes” (The Paris Principles, 2007).

[2] Blood Diamond, 2006. Directed by Edward Zwick.

[3] Available at: https://www.youtube.com/watch?v=D9Ihs241zeg.

[4] Beasts of No Nation, 2015. Directed by Cary J. Fukunaga.

[5] Many do not identify with these two categories.

[6] Denov, 2010, p. 13.

[7] Keairns, 2002, p. 13; Annan et al., 2009, p. 9.

[8] West, 2005.

[9] Johnny Mad Dog, 2008. Directed by Jean-Sébastien Sauvaire.

[10] Dongala, E. (2002) Johnny Chién Méchant. Paris: Le Serpent à Plumes.

[11] Macdonald, 2008, p. 136.

[12] Available at: https://www.youtube.com/watch?v=Y4MnpzG5Sqc.

[13] Valder, 2014, p. 44.

[14] UN-led child-specific programmes whose goal is to facilitate their return to civilian life. NGOs often intervene and collaborate at different steps of the process (UNDDR Resource Centre).

[15] Taylor-Jones, 2016, p. 185.

[16] Coutler, 2009, p. 64.

[17] Girls and women forced to ‘marry’ within the rebel group.

[18] Cameron, 1994, p. 188.