3. 3
ORGANISING COMMITTEE
Richard Coles
Sandra Costa
Gemma Dixon
Susannah Goh
Kelly Hanna
Ka e Sewell
Sharon Watson
SCIENTIFIC COMMITTEE
Richard Coles, School of Architecture and Design, Birmingham City University, UK
Jo Berry-Firth, School of Visual communica on, Birmingham City University, UK
Anne Boultwood, School of Fashion and Tex les, Birmingham City University, UK
David Cox, School of Health, Birmingham City University, UK
Chris na Ergler, Department of Geography, University of Otago, New Zealand
Ronaldo Gabriel, LaB2Health, Dep of Sport Science, Exercise and Health, University of Trás-os-Montes & Alto Douro, Portugal
Susannah Goh, Ins tute for Health and Quality of Life, Birmingham City University, UK
Zoe Millman, Faculty of Business, Law and Social Sciences, Birmingham City University, UK
Barry Percy-Smith, Centre for Applied Childhood Youth and Family Research, University of Huddersfield, UK
David Prytherch, School of Fine Art, Birmingham City University, UK
Cathy Treadaway, Centre for Applied Research in Inclusive Arts and Design, Cardiff School of Art and Design, Cardiff Metropolitan
University, UK
REVIEWERS
Jo Berry
Anne Boultwood,
Richard Coles
Sandra Costa
Greg Dunn
Ronaldo Gabriel
Susannah Goh
Sian Hindle
Gail Kenning
Isabel Mar nho da Silva
Frederico Meireles
Lara Andrea Mendes
Zoe Kathleen Millman
Maria Helena Moreira
Anastasia Nikologianni
Barry Percy-Smith
David Prytherch
Silvia Schaeffer
Jacqueline Taylor
Cathy Treadaway
Sharon Watson
4. 4
CONTENTS
FOREWORD......................................................................................................................................................... 7
WELCOME .......................................................................................................................................................... 8
KEYNOTE SPEAKERS............................................................................................................................................ 9
Karen Creavin
Engaging communi es in wellbeing...................................................................................................................... 10
Kalevi Korpela
Natural se ngs and favourite places in the vicinity promote well-being............................................................. 11
Fiona Bannon
Of possibili es, poten al and co-crea on: Dancing routes to desired iden ty .................................................... 14
Claire Freeman
Well-being across the age range: The role of everyday nature encounters ......................................................... 16
Adrian Sutherland
Robert Sharl
Future Wellness: Healthcare and Well-being in a Changing World....................................................................... 19
CHILDREN’S WELL BEING ................................................................................................................................... 20
Teen Sex ng and Well-being - A Review of Qualita ve Literature ....................................................................... 21
The value of rela onal pedagogy and professional love to early childhood interven on and child/family well
being for children with complex disabili es.......................................................................................................... 24
An explora on of an asset-based approach to the management of diabetes in young people: a qualita ve
par cipatory approach.......................................................................................................................................... 28
What is a child a aining from dance classes beyond physical competences?...................................................... 32
Dissonant Technologies: Health Professionals’ Impressions of Adolescents’ Interac ons with Medical
Technologies for Managing Type 1 Diabetes......................................................................................................... 36
From playgrounds to playrooms: spaces of childhood in modern architecture.................................................... 40
Interac ve Storytelling Workshop ........................................................................................................................ 45
Ways to well-being for children............................................................................................................................. 46
Workshop on collabora on and co-produc on for improving well-being ............................................................ 51
NATURE BASED SOLUTIONS TOWARDS WELL BEING ....................................................................................... 55
Community gardens and healthy place making. Case studies from Birmingham and the West Midlands, UK..... 56
“Significant Walks” : Visualising Well-Being, Ar cula ons of the Data and Experience of Chronic Low Back
Pain........................................................................................................................................................................ 64
Understanding the power of the “solo”................................................................................................................ 68
Exploring Past and Present Pa ent Accounts of the role of Gardens in Mental Wellbeing .................................. 72
Dancing in and with Nature .................................................................................................................................. 75
Pathways to nature: towards an experien al landscape for demen a care environments.................................. 76
Design for Demen a: Crea ng demen a friendly environments in residen al aged care facili es (RACFs) in
Australia through the integrated use of landscape elements ............................................................................... 79
Wellbeing by Design: From Gardens to Green Infrastructure ............................................................................... 82
A case study to explore smellscape in open spaces around railway sta ons from the well-being perspec ve.... 86
THE CONTEXT OF THE MEDICAL HUMANITIES .................................................................................................. 90
“Feeling right” in the hospital: guidelines for architectural design of rela onship spaces................................... 91
5. 5
Designing for demen a: Interior Design as a tool to enhance well-being among pa ents and caregivers .......... 95
An inves ga on into risky health behaviours within adult cys c fibrosis pa ents .............................................. 99
Improving the sense of wellbeing for dependent older people living in supported housing................................ 103
The wellbeing of people with younger onset demen a in aged-care facili es..................................................... 107
Presenta on: How live music, storytelling & contemporary / integrated dance performance increases the well-
being of hospital pa ents, out-pa ents, staff & family members......................................................................... 111
Communica on aids for medical personnel and foreign-language pa ents and their rela ons in paediatric
care........................................................................................................................................................................ 112
Liminal Hospital Spaces; Corridors to Well-Being?................................................................................................ 115
Psychologically-Suppor ve Design S muli [PSDS] To Promote Wellness through healthcare spa al design........ 118
Promo ng well-being: restoring the garden, restoring ourselves......................................................................... 123
Designing for wellbeing in late stage demen a .................................................................................................... 127
Life Echo – The Future Of Memory or (how personal trauma of cancer can become an idea that can become a
commercially successful business) ....................................................................................................................... 131
MENTORING FOR WELL BEING .......................................................................................................................... 132
From Product to Process: Reframing design research methods to support well-being in the demen a care
environment.......................................................................................................................................................... 133
Promo ng a culture of health and well-being amongst pre-professional dancers in training.............................. 137
Young Lesbian and Bisexual Women’s Experiences of Health and Well-being: A Mixed-methods Peer Research
Study ..................................................................................................................................................................... 141
Mental well-being and caring in Japan.................................................................................................................. 145
Developing a Personal Art of Living Toolkit: a medical humani es case study ..................................................... 148
Choral Singing As An Empowerment Tool For People With Longterm Health Condi ons .................................... 152
On Empathy: Orienta ons and Conversa ons for the Aspiring Architect............................................................. 155
From Individual to Global Well-Being: Designing an Undergraduate Public Health and Wellness Course
Curriculum............................................................................................................................................................. 159
The impact of e-coaching ques on framing upon emo ons in self-reflec on, self-efficacy and subjec ve well
being ..................................................................................................................................................................... 162
VISIONING AND FUTURE THINKING OF WELL BEING SCENARIOS.................................................................... 168
The Legal Protec on of the Well-Being of Future Genera ons............................................................................. 169
MakeSpace for Men: How can the therapeu c use of tex le cra
processes help achieve posi ve mental wellbeing for men?................................................................................ 173
Co-crea ng Wellbeing: The WarmNeighbourhoods® AroundMe™ Experience.................................................... 177
The Happiness Pulse – A Measure of Individual Wellbeing at a City Scale: Development and Valida on............ 182
Building Wellbeing Together: Exploring Strategies for Wellbeing Network Development.................................... 187
Enabling wilderness: crea ng the opportunity for disabled tramping within New Zealand’s Na onal Parks....... 190
The Aerie: An innova ve way for wellbeing restora on in an open-plan workspace........................................... 193
RECORDING, REPRESENTING AND EVALUATING THE POSITIVE EXPERIENCE .................................................. 197
Childhood cogni ve ability buffers the impact of social disadvantage on wellbeing in midlife............................ 198
TOWARDS A MEASURE OF KINDNESS: An Explora on of a Neglected Interpersonal Trait ................................... 202
Alone Together, the Social Life of Benches: how filmmaking can help to tell detailed and nuanced stories about
encounters, exclusion and wellbeing in outdoor spaces....................................................................................... 207
“What did the doctor say?” Picture sheets as visual aids for communica ng informa on to pa ents during
medical consulta ons ........................................................................................................................................... 211
BLOCK PRINTING AS A MODEL OF ENGAGEMENT ................................................................................................ 216
Printmaking as a Model of Engagement (Block Print Interven on 60 minute workshop)................................................222
Making the invisible visible –communica on and the ‘mem…or…y’ series - connec ng through visual arts
7. 7
FOREWORD
WELL-BEING 2016: CO-CREATING PATHWAYS TO WELL-BEING
In 2011 we ini ated a series of interna onal conferences that explored the mul -dimensions of well-being. Several things prompted
our decision- being situated in a design faculty we were enthusias c about exploring the unique contribu on that the arts and
humani es disciplines offer, while comprehensive research of local community interac on and engagement with green spaces had
resulted in, what we then termed, ‘social criteria for green spaces’ later to morph into well-being parameters. This and other work
made us realise that there was a need to bring different disciplines together, academics and prac oners, to discuss and debate the
concept of well-being through different lenses with the aim of understanding the concept of wellbeing, defined and demonstrated
by the reality of everyday engagement and in doing so to develop be er theore cal understanding of the systems that might be
opera ng.
The idea was well received and con nues to be equally relevant and urgent now as it was in 2011 with Well-being 2016 being the
third conference in the series.
The twin themes of co-crea on and understanding the pathways that exist in pursuing or underpinning the achievement of well-
being form the focus of Well-being 2016. Here we seek to answer a range of ques ons about nego a ng and naviga ng the
experiences that underpin the achievement of well-being. How posi ve encounters are or might be embedded in our everyday
contacts with the environment where we live, learn, play or work; how individuals are supported in ways that enables them to
take control of their personal well-being; what cons tutes a pathway; how are the impacts expressed or captured, the techniques
involved, the use of electronic media, verbalisa on and narra ves or through ar s c endeavour, design, making and the cra s, the
unique role of the prac oner and the growing relevance of the medical humani es approach?
Delegate response has been excellent, the diversity of papers is impressive and the quality of the material offered is, I believe, of the
highest standard yet, while prac oners have responded in offering a series of workshops in which you can explore at first hand the
poten al of an approach. In addi on we have five keynote speakers drawn from across the globe who present different perspec ves
and set the scene for the papers presented in a series of breakout sessions.
Accordingly, I invite you to ‘chill out’ over the two days, to expose yourself to situa ons and material that challenges your own
posi on and in doing so to raise the bar regarding our understanding of the well-being paradigm.
I look forward to engaging with as many as you as possible, in debate, though the social event planned and hopefully through follow
on ini a ves.
Welcome to Well-being 2016
Professor Richard Coles
School of Architecture and Design,
Birmingham City University
8. 8
WELCOME
Dear Well-being Friends,
I would like to welcome you to Well-being 2016 - our third global conference bringing together academics and prac oners to share
learning, research and prac ce.
As a university with a strong civic history, Birmingham City University wishes to con nue this tradi on of societal engagement and
impact, in the present and on into the future. This tradi on is not just a ma er of our ins tu on’s iden ty; rather it is something
that we live by in academic dialogue and social ac on with you- our collabora ve partners- to make a difference to the communi es
around us, wherever we are in the world.
Through the efforts of the Well-being 2016 Commi ee, all those who have offered to share their work in keynotes, presenta ons
and posters, and those who come to contribute to our many forthcoming discussions, I hope that you shall enjoy these truly
interna onal and cross-disciplinary exchanges.
Seeing so much input to our themes - Children’s Well-being; Medical Humani es; Recording, Represen ng and Evalua ng Posi ve
(Well-being) Experiences; Visioning and Future Thinking of Well-being Scenarios; Nature-Based Solu ons Towards Well-being; and
Mentoring for Well-being- from you, our guests, the Conference Commi ee and I have been struck by how much we will all be able
to take away and reflect upon. These themes are not just fascina ng areas of academic study, but they relate to our daily lives and
workaday contexts.
Enjoy the two days ahead of you and explore a li le of our friendly city where you can. Please think of this conference as the
con nua on or, for newcomers, the start of a partnership with Birmingham City University. We are a place of inter-organisa onal
collabora on. We are a cosmopolitan community- one where interna onal diversity is valued and, indeed, represented by our
students and staff. So, perhaps you can consider us and our campuses a ‘home away from home’ where ideas and dialogue can
flourish.
Kindest wishes and all the best for your wellbeing and learning
Susannah Goh
Director, Ins tute for Health and Quality of Life,
Birmingham City University
10. 10
KAREN CREAVIN
ENGAGING COMMUNITIES IN WELLBEING
Karen qualified from Lancaster University in 1990. A er a brief spell working in London in the publishing
industry, Karen returned to Lancaster to qualify with a CQSW/post graduate diploma in social policy. She
worked for 4 years as a proba on officer, specialising in working with sex offenders and domes c violence
perpetrators. She worked as an adop on and fostering social worker, and then worked in the homeless
field where she managed services for homeless young women. She won an organisa onal management
award for her work and during this me qualified with a Masters in Public Sector Management from
Birmingham University. She then went to the Audit Commission as a performance management specialist,
and then on to be Director of quality and performance for Birmingham and Solihull Connexions Service.
In 2005 she moved to work for Birmingham City Council, ini ally as senior manager for the deprived
Ladywood Cons tuency. While there, in conjunc on with a colleague from the Heart of Birmingham
PCT, she set up the award winning pilot Gym for Free. This later rolled out as a city wide ‘be ac ve’
programme. Karen was asked to project manage the city wide scheme on behalf of partners across the
city. The scheme went live on 1st
September 2009 and has now won na onal and interna onal awards
and acclaim.
Karen is now Head of Wellbeing services at Birmingham. She oversees na onally acclaimed projects
within the service such as Ac ve Parks, Big Birmingham Bikes, and Ac ve Streets. She works with the
LGA on member training sessions, and is a regular speaker at conferences and training sessions on the
links between health, wellbeing and sport. Karen is a magistrate and chair of governors at a local school.
A keen runner and cyclist, with a passion for equality and communi es, Karen established and chaired
Kings Heath Running Club, chaired Birmingham LGBT Pride, established Birmingham LGBT organisa on
(which now has England’s first Wellbeing centre open in Birmingham), and now works as a volunteer in
her local community where she lives. Karen has two lovely children.
Karen is speaking about: Engaging communi es in wellbeing.
11. 11
KALEVI KORPELA
NATURAL SETTINGS AND FAVOURITE PLACES IN THE VICINITY PROMOTE
WELL BEING
In this presenta on, I will look at the rela onship between environment and well-being from 1) a
determinis c, bo om-up perspec ve describing restora ve environments studies and from 2) a top-
down, person-oriented, self-regula on perspec ve describing favourite place studies. I also introduce 3)
the idea of awareness-enhancing tasks to affect how a person perceives and interacts with environments.
Take-home messages are in bold.
Restora ve environments studies
Experimental, epidemiological and interven on studies have provided a consistent body of evidence on
the restora ve effects of natural se ngs. Among healthy popula ons even short exposure to natural
environments and “green exercise” can reduce mental fa gue and psychological and physiological stress
and improve well-being more than exposure to built urban environments (Barton & Pre y 2010; Bratman
et al. 2012; Har g et al., 2014). Complemen ng the idea of the restora ve effects of nature, some studies
have suggested that exposure to the natural world also has re/vitalizing effects. By defini on, vitality
includes posi ve feelings of aliveness and vigor that are more energized than feelings of restora on or
relaxa on (Ryan et al., 2010).
Li le is known about the different types of greenspace that might affect restora ve and vitality
experiences. In our experimental study, we inves gated the feelings of both restora on and vitality in
two different kinds of natural environments (Tyrväinen et al., 2014). Seventy-seven healthy middle-aged
par cipants (92% female) visited three different types of urban areas (in a randomized order) a er their
working days: a built-up city centre, an urban park, and urban woodland located in Helsinki, Finland.
The visits consisted of 15 minutes of sedentary viewing, and 30 minutes of walking. The results showed
that both exposure to an urban park and extensively managed urban woodland increased feelings
of restora on, vitality, and posi ve mood (cf. favourite place studies underneath). These feelings
decreased in a built urban se ng.
In proposing mechanisms for this poten al for stress reduc on, the main focus to date has been on
bo om-up, perceptual proper es of natural environments, such as their visuo-spa al proper es
(Ratcliffe et al., 2016; Ulrich, 1983) or experien al quali es of human-environment interac on (Kaplan
& Kaplan, 1989). Moreover, physiological changes associated with visits to nature may partly be due to
reduced exposure to air pollu on and noise which affect cardiovascular systems rapidly. There is a dearth
of studies on this. In a subsample of thirty-six adult female volunteers of our nature visit experiment
in Helsinki, we monitored levels of respirable ambient par cles and environmental noise. The results
showed that visits to urban green environments were associated with beneficial short-term changes
in blood pressure, heart rate and heart rate variability with only par al contribu on from reduced air
pollu on and noise exposure.
To bring these environment psychological results in connec on with work and organiza onal psychology
and to inves gate recovery from work stress within the working day, we conducted two (spring & fall)
randomized controlled trials (RCT) in an ongoing research project (de Bloom, Kinnunen & Korpela, 2014).
153 knowledge workers engaged for 15 minutes daily in different lunch break ac vi es for ten days.
Par cipants were assigned to a 1) park walking, 2) relaxa on exercises and 3) control group. During
the interven on, both interven on groups reported less tension a er lunch breaks than before. Vitality
increased and fa gue decreased most markedly immediately a er the break in both interven on groups.
In the fall RCT, levels of relaxa on, detachment, and enjoyment of the break increased notably compared
with baseline in the park walking group. The relaxa on group experienced an increase in relaxa on.
Overall, the most consistent posi ve recovery experiences were reported in the park walking group.
No differences were observed in cor sol awakening response (CARi) or cor sol decline during the day
(CDD). Blood pressure decreased significantly in the a ernoon at work. This decrease was the largest in
the park walk group. Park walks and relaxa on exercises during lunch breaks - both ac vi es poten ally
easy to learn and implement in an organiza onal se ng - enhanced knowledge workers’ recovery
from work, but the effects were weak, rela vely short-lived and dependent on the season.
Favourite place studies
In experimental studies described above, the study se ngs are selected by the researchers not by the
respondents themselves. In our studies on favourite places, we have proposed that visits to a close-
to-home favourite place are one of the “windows” (= units of analysis) through which well-being and
restora ve experiences can be frui ully studied in an everyday context. Thus, they reflect person’s
Kalevi Korpela is a professor
of psychology with a
specializa on on environment
and well-being. His research
is focused on the restora ve
and well-being effects of
the use of natural and built
environments. In par cular,
he has studied environmental
self-regula on, i.e., the
use of favourite places and
natural se ngs for emo on-,
stress-, and self-regula on.
His research interests also
include place a achment and
the role of nature exposure in
recovery from work stress.
https://www.researchgate.net/
profile/Kalevi_Korpela and
http://www.favoriteplace.info/
Korpela_Kalevi.htm
12. 12
a variety of natural spaces (including recrea on / exercise
se ngs) near the housing block, not any specific type of
green space, which is important when providing restora on
possibili es for a maximally large propor on of the popula on.
Favourite urban places may provide nearly equally strong
restora ve experiences as favourite built green spaces (parks)
which is a somewhat contradictory result to several experimental
studies comparing natural and urban places (selected by the
experimenter).
Thus, future applied and theore cal developments should take
note that the superior restora veness of natural places may not
hold for all types of places in everyday life where people select
from familiar urban and natural places according to their own
preferences and emo onal a achments. An interes ng tool
for combining informa on about people’s favourite places to
planning is the “so GIS” method (Kahila & Ky ä, 2009). It is an
internet tool for par cipatory mapping with the goal of iden fying
the rela onship between environmental factors, local, place-
based experiences and everyday behavior.
For counselling purposes, we have tenta vely proposed
“favourite place prescrip ons” as an analogy to “exercise
prescrip ons” in primary healthcare. In health counselling,
people could be advised to seek out and visit a favourite place
or several favourite places from their everyday surroundings
including both natural and built environment. By diver ng the
focus of counselling and discussion away from physical exercise
per se, these prescrip ons might serve as an indirect method of
increasing physical ac vity and well-being in popula on groups
who are inac ve and insensi ve to exercise prescrip ons or
health educa on. Moreover, the prescrip ons might work
as a method for raising the popula on’s awareness of the
environment and its quality.
Awareness-enhancing tasks along walking trails
Currently, it is not reliably known whether deliberate tasks
intended to focus a person’s a en on on the features of the
natural surroundings and to enhance mood and relaxa on can
affect restora on and thereby decrease stress. Relying en rely on
design-basedsolu ons(planningorconservingnaturalse ngsfor
physical ac vity) can be problema c in a rapidly urbanizing world.
An alterna ve to design is to manipulate how a person perceives
and interacts with the exis ng environments. Furthermore,
awareness-enhancing tasks may allow uninteres ng or less
ideal environments to be experienced in stress-allevia ng ways
and help people to be physically ac ve.
To date, the engagement-based approach has been used in only
two studies (Duvall 2011, 2013). The results showed that using
awareness-enhancing tasks (e.g. Focus on your senses or Take on
a new job or role – imagine you are an ar st looking for beauty)
for outdoor walks in a 2-week interven on increased sa sfac on
and a en onal func oning and decreased feelings of frustra on.
There was no difference in the me spent walking between the
experimental and control groups.
We developed a 6 km forest trail with 7 signposts in the “Health
from the Forest” project 2008-2010 (h p://www.favoriteplace.
info/Korpela_Kalevi.htm). The tasks printed on the signpost aim
to 1) induce relaxa on, 2) improve mood, 3) induce cogni ve
reflec on, 4) induce a en onal restora on, 5) enhance the
search for a favorite place or spot which can be 6) socially shared.
In a self-report user survey (N=167) of the Finnish trail with
tasks, 69% of the par cipants reported that they were calmer,
more alert and more away from everyday worries than before
walking. 73% of the visitors were very or quite sa sfied with the
needs and mo va ons and preferences in their ongoing self-
regula on.
Favourite place studies refer to inves ga ons where the
par cipants typically describe the use and meaning of their real-
life favourite (important, liked, valued) places in their everyday
surroundings. In adult samples from different countries (Finland,
the USA, Ireland, Senegal, Estonia), natural se ngs, such as
parks, beaches or forests have cons tuted 50%-60% of favourite
places (Korpela & Har g, 1996; Newell, 1997, Sommer, 1990).
19%-29% have been home-related (residen al area) places, the
rest being various urban places such as cafes, libraries or streets.
Cross-sec onal self-report studies have shown that favourite
neighbourhood places provide stress-allevia ng experiences
and that people visit these places for the regula on of their
self-experience and feelings (Jorgensen et al., 2007; Korpela &
Ylén, 2007). The meanings a ached to favourite places reveal the
importance of individual, top-down factors such as memories and
personal interpreta ons. For example, memories of the past and
familiarity have figured in previous studies on favourite places;
threats to self-esteem and the coherence of self-experience
are included in the reasons to visit a favourite place (Korpela,
1992); and self-referencing appears to be more characteris c
of favourite place experiences than fascina ng environmental
proper es (Korpela & Har g, 1996; Korpela et al., 2001).
Also restora ve outcomes, i.e., relaxa on, the allevia on of
nega ve feelings, increase in posi ve feelings, forge ng worries,
clearing random thoughts, recovering a en onal focus, and
facing ma ers on one’s mind have characterized visits to natural
favourite places in par cular. Accordingly, people with some
health complaints, compared with those with few complaints,
choose more likely natural favorite places in the vicinity and
benefit more from their visits to these places in emo onal terms
(Korpela & Ylén, 2007).
Favourite place choices are not a random and momentary,
whimsical choice affected by the measurement methodology
itself (survey or interviews) but seem to have temporal stability
at least over a 10-month period (Korpela et al., 2009). People use
and visit these places deliberately, o en over extended periods
of me. There is some indica on of a dose-response-rela onship
between me spent in favourite places and well-being: A field
experiment showed that the group visi ng favourite places
every day for five days experienced significantly stronger daily
restora ve experiences than the not-visi ng and control groups
(Korpela & Ylén, 2009).
Inoneofoursurveystudies,wecomparedrestora veexperiences
in different types of residen al favourite places including green,
waterside and urban areas (Korpela et al., 2010). Restora ve
experiences in favourite exercise and ac vity outdoor areas,
waterside environments, and extensively managed natural
se ngs (mainly urban woodlands) were equally strong and
somewhat stronger than in favourite places in urban se ngs
or built green spaces (mostly parks) even a er controlling for
nine situa onal, personality, and demographic determinants.
These were the length of stay in the favourite place, frequency
of visi ng, nature orientedness, nature being important as such
before 16 yrs. of age, nature hobbies, upli s derived from social
rela ons, hassles/worries related to money, hassles/worries with
work, and sa sfac on with life.
As the restora ve experiences in the three types of natural areas
did not significantly differ from each other, it can be concluded
that it may be the total amount, or rather, the existence of
13. 13
Medicine, 36, 435-438.
Korpela, K., Ylén, M., Tyrväinen, L. & Silvennoinen, H. (2009).
Stability of self-reported favourite places and place a achment
over a 10-month period. Journal of Environmental psychology,
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Korpela, K., Ylén, M., Tyrväinen, L. & Silvennoinen, H. (2010).
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Ryan, R. M., Weinstein, N., Bernstein, J., Brown, K. W., Mistre a,
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Sommer, B. (1990). Favorite places of Estonian adolescents.
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Tyrväinen, L., Ojala, A., Korpela, K., Lanki, T., Tsunetsugu, Y., &
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trail they walked. An ongoing experimental study inves gates the
effec veness of the tasks in comparison with no-task walks on
the trail.
If restora on from stress is enhanced with psychological tasks
along nature-trails, such interven ons could be carried out on a
larger scale to benefit public health promo on in the a empts
of reducing the accumula on of stress cost-effec vely.
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Behavior, 45, 303-322.
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a se ng for housing-apprecia on and fear and the contribu on
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14. 14
FIONA BANNON
OF POSSIBILITIES, POTENTIAL AND CO CREATION: DANCING ROUTES TO
DESIRED IDENTITY
By way of introduc on what is perhaps most per nent to men on and underscores the key elements
of this discussion is the idea of access to experiences of arts. Here I acknowledge desire, of wan ng to
live an affec ve and examined life and of apprecia on for the ways that our complex interrela ons play
significant roles in how we learn to think, to relate and to correspond to our surroundings and the others
with whom we experience.
With this web as a basis for discussion my inten on is to explore ideas that revolve around our capaci es
to engage with varied circumstances where we each may find ways to facilitate posi vity, sa sfac on and
fulfillment; experiences that arguably evolve as counter proposi ons to vulnerability, dispossession or an
o en felt sense of lack of self-worth.
How can we live and prosper in ways that espouse the ethical poten als of generosity, care and well-
being?
How might we avoid fulfilling the cri que made by Wolfgang Iser in his paradoxical observa on that,
‘human beings have … become unavailable to themselves; [that] we are but do not know what it is to
be’ (2000 155-6)?
In order to contextualize the discussion my inten on is to draw on experiences from my own work both
as a community dance prac oner and more recently as an academic. In order to do this I begin by
looking back to an earlier me in my career when I worked for The Clwyd Dance Project, then based at
Theatr Clwyd in North Wales. One of the dance programmes we hosted was for a group of teenagers
who spent two, three some mes four nights a week dancing as part of Clwyd Youth Dance (CYDs). It is
the legacy of some of their lived experiences in terms of sustainability and well-being brought up to date
through rela on with more recent project examples that provides the basis of this discussion.
At the me I was a recent graduate of the Laban Centre for Movement and Dance then based in New
Cross, London. The Centre was, and is in its current embodiment Trinity-Laban a Conservatoire for
dance training. At that me,1986 it had recently started a post-graduate training programme for Dance
Animateurs under the guidance of Peter Brinson, MBE. The programme had come to frui on because of
his work with Ballet for All, a na onal project that sought to disseminate access to movement training,
performance and educa on for all. In the Animateur training what became clear was that we each
needed to be able to meet a brief that incorporated choreography and crea vity whilst also addressing
the socio-cultural impact of arts experience through passion and convic on in poli cs. The aim was to
foster representa on for the communi es we were part of in terms of enabling their ‘voices’ to be heard
in rela on to access to educa on and broader community provisions. Our brief then and from what I
see in the work by colleagues working in ‘People Dancing: The Founda on for Community Dance’ now,
remains the same. To work as advocates for the arts, calling for access and experience of the arts to be
part of our social rights. Whilst being aware of the seeming cultural disregard for the social relevance of
arts and movement in people’s lives, we knew it needed to be different. However, if we throw a glance
towards what we see happening in 2016, we can recognise the same disregard for the arts as the p of
an iceberg in terms of the dilu on of societal values. So, what I aim to discuss is what at the me was an
all encompassing experience, where there was opportunity to ar culate the poli cal, social and ethical
fortunes of coming to understand more of what it is to be sen ent beings, observing and hearing the
views of younger genera ons as they themselves tussled with their dancing selves, their emerging points
of view and their a tudes to being part of a sustaining shared community.
Looking back what I see is the opera on of an affec ve ethics of existence, one that offered possibility
and poten al, to follow the arguments of Gorgio Agamben (1993) in his discussions of the coming
community.
Together we found out about,
…. being moved with others, working in contexts and forging solu ons,
…. Apprecia ng, uncertainty and prac cing, ‘becoming human’.
In the complex rela onships: between what is embodied, felt, thought and shared, what I found was
dancing as a self-actualising discipline. The work set in terms of more current prac ces was more akin
to ‘well-being’. In it I can see the folds of transi on in terms of iden ty, formulated through reflexive
Fiona Bannon is an academic
based at the University of
Leeds where she lecturers in
Dance and Performance. As
the Chair of DanceHE, http://
dancehe.org.uk, Fiona leads
the representative body for
dance studies in the UK and
is acting Chair of the World
Dance Alliance-Europe.
Recent areas of research
include exploration of ethics-
of-collaboration drawing on
aesthetic experience through
body-based arts. Fiona is
a founding member of the
performance collective,
Architects of the Invisible
a group that explores
experimental choreography
and social interaction.
15. 15
narra ons. This is something that usefully reverberates in the
words of sociologist Steph Lawler when she reminds us that,
‘iden es are produced through the autobiographical work in
which all of us engage every day’ (2014, p.26). The importance
of weaving interac ons between our sensory experiences, the
environments in which we live and work and our fluctua ng
cri calabili esareevermorerelevant. Ifwecannotgivea en on
to the complex pa erns of our interac ons then we might expect
only a narrowing of experience and a diminishing of any sense of
fulfilling our aspira ons.
In my current work I increasingly frame experiences as being
drawn from an everyday aesthe c life-world. What I have come
to prize is the values inherent in engaging with a enriching palate
of experience during the forma ve parts of one’s life, wherein
one’s self-iden ty can perhaps be more easily characterized for
what we are; moving-thinking-beings. What I offer is a glimpse
of the possibili es of living well as an idea of flourishing, where
one’s life-world can con nuously weave, blend, expand and
accommodate the possibili es of the uncertain and of change.
What we might appreciate from this in turn is ourselves as
vibrant human ‘becomings’, as opposed to the sta c no on of
human beings, with awareness of the benefits found by inves ng
in joint ac vity, where we might come to recognise the wealth of
opportunity to be revealed in social co-existence, in co-crea ve
ac on.
Bibliography
Agamben, G. 1993. The Coming Community (Theory Out of
Bounds). Trans Michael Hardt. University of Minnesota Press.
Minneapolis.
Iser, W. 2000. The Range of Interpreta on. New York: Columbia
University Press.
Lawler, S. 2014. Iden ty. Cambridge: Polity Press.
16. 16
CLAIRE FREEMAN
WELL BEING ACROSS THE AGE RANGE: THE ROLE OF EVERYDAY NATURE
ENCOUNTERS
Well-being and environment
Well-being is a growing theme in nature studies, usually from the perspec ve that lack of contact
impacts nega vely on both physical and mental wellbeing. The rela onship between well-being and
mental health is encompassed in the term biophilia defined as “the innately emo onal affilia on of
human beings to other living organisms….” (Wilson, 1993. p. 31). Kellert further dissects the biophilia
no on and asserts that the “human need for nature is linked not just to the material exploita on of the
environment but also to the influence of the natural world on our emo onal, cogni ve, aesthe c and
even spiritual development…” (1993, p.42). At the other end of the nature spectrum, Louv coined the
term “nature deficit disorder’ to describe what he sees as a set of health disorders derived from lack of
contact arguing: “By weighing the consequences of the disorder, we can also become more aware of
how blessed our children can be- biologically, cogni vely, and spiritually- through posi ve connec on to
nature” (Louv. 2008, p.36). In this paper we focus on how this connec vity can be achieved across the
ages in places close to home.
People-nature nexus in an urbanising world
In our studies our concern has been to examine the nature-people nexus, in a series of studies in
which everyday nature emerges as a commonplace but vital determinant of well-being. It challenges
the special-rare and ecological disciplinary focus dominant in the biological sciences. While we accept
and find accord with the no ons of Wilson and Ecopsychologists regarding the posi ve contribu on
that nature provides for people’s well-being, our a en on is on how those posi ve a ributes can be
realised. We argue that the places where and the ways in which these a ributes are realised within the
urban environment are as yet poorly understood despite their central importance in understanding how
nature connec ons can be met in an urbanising world. It is impera ve that we not just understand the
more formally recognised connec ons that occur through environmental educa on or planned visits
to nature sites rather the incidental and everyday connec ons that occur in familiar places. It is these
connec ons we argue that children, older people and those limited in their ability to access more distant
places that should also be the focus of research and greenspace prac ce.
A mul disciplinary approach
Our approach is to work in mul disciplinary research teams. The research transcends disciplinary
boundaries being placed as it is at the people-nature interface where both inevitably impact on and
transform the other in ways both posi ve and nega ve. Specialist biological knowledge allows for
analysis of the biological constructs of available biodiversity, the individual species, biological complexes
and their rela onships; for example the presence or absence of na ve plant species in rela on to
invertebrate popula ons. Social science understanding of human-nature interrela onships for example
how societal constraints determine which green spaces children can access and what ac vi es they
can perform there. The third element is input from planning and the land use professions into poten al
processes and prac ces for transferring this understanding into prac cal greenspace outcomes in places
where people live, as in the design of outdoor spaces in shared accommoda on developments for older
people.
Figure 1 and 2 - Birdfeeders and strawberries in the garden connect people to natural processes
Claire Freeman is Professor in
the Department of Geography,
University of Otago, New
Zealand where she mainly
teaches in the Master of
Planning Programme. Her
interests are in environmental
planning including; sustainable
communities, planning for
children and young people
and planning with nature.
Claire’s talk will look the
relationships between
environment and well-being,
specifically New Zealand city
children’s connection with
nature, people’s connections
to nature through their
gardens and how relationships
with nature change as people
age.
17. 17
environment differ in their therapeu c value. Our study seeks to
iden fy which natural elements older people value and explore
to see how ageing impacts on older adults’ ability to benefit from
the health benefits of exposure to and engagement with nature?
In this we examine older people s ll living in family homes and
those who have downsized. Ini al findings suggest that as people
re re some find they have more me for nature, ge ng out and
about but also as health declines the ability to access wider nature
also declines through inability to drive or walk, or dependence on
bus routes. The garden and green immediately adjacent to the
house can then take on much greater importance. It is not only
direct connect with nature that ma ers but being able to see
nature, views of nature, birds, bees, trees through household
windows is a connec on that is especially valued.
Children and nature: Lack of contact with nature for children
has been associated with a range of health dis-benefits, excess
weight, stress and anxiety, hyperac vity, depression that Louv
sees as indica ve of ‘Nature deficit disorder” (Louv, 2005). We
wanted to find out from children themselves whether they felt
connected to nature and to explore how they connect to nature
in their everyday lives. Certainly our study children did experience
constraints on their independent mobility; few had freedom
to go wherever they wanted or to play in the most biodiverse
places; bush, woodlands, streams and beaches. However,
children did nonetheless develop connec ons to nature in their
everyday lives and made good use of the nature opportuni es in
the spaces available to them even if they could only access their
gardens. We detected li le evidence that children themselves
felt disconnected from nature and they did no ce nature in their
everyday places. Children from lower socio-economic groups did
tend to have access to less biodiverse areas, mainly because their
gardens were less biodiverse sites, although other biodiverse
sites were s ll present.
Conclusion
Our studies suggest a number of findings emerge. Firstly, much
of the biodiversity and nature connec on research is looking
in the wrong place. It focuses on connec on in more pris ne
environments, woodlands and on one-off nature encounters,
whereas we would argue that it is the common, the immediate,
the home environment that is central to wellbeing. People value
and are resourceful in accessing nearby nature and par cularly
value nature that they have a sense of personal connec on to,
a climbing tree, their vegetable patch, a fruit tree, a tree where
birds gather or bushes where bees seek nectar or a tree or shrub
that has personal value, perhaps planted to commemorate an
Our approach
Inourresearchwehaveinves gatedeverydaynaturerela onships
through different but ul mately connected studies, the Dunedin
garden study, the natural neighbourhoods for city children study,
and our current study on nature and ageing. As the final study
is in process the results for that study discussed here are purely
indica ve, being based on ini al interviews. Here we summarise
some key findings on nature, well-being in everyday lives from
these studies but first some basic informa on about them.
See table below.
Emerging themes
Though the studies included different popula on groups, and
were located in different places and had different loca onal
focus, just the garden or a wider neighbourhood the focus was
similar how do par cipants perceive , use and value nature in
their daily lives. The following sec on iden fies some common
and emerging themes.
Dunedin garden study: In the Garden study the original aim was
to see if people could be mo vated to support na ve biodiversity
in their gardens. As some 36% of Dunedin is private garden
and gardens have been the focus of minimal research we were
interested to see what na ve biodiversity is present in gardens
and what people would be prepared to do to support na ve
biodiversity. In order to do this we needed to first understand
what mo vates people in their garden rela onships, no ng
that the sample contained a spectrum of householders from
dedicated gardeners to those with minimal interest. Several
themes emerged health, relaxa on and escape, ownership and
iden ty, caring or a duty of care, produc vity, social rela onships
and connec on to nature. Wellbeing was central to the garden
rela onship, both physical and mental or emo onal and
expressed in a myriad of ways from destressing a er work, a place
to talk to family, sharing produce and feeling that you are making
a difference to the world’s environment. The benefits for older
people were especially noted in terms of keeping fit and ac ve
and as a social catalyst. However, impaired health and inability
to garden was also a source of frustra on. It was these emerging
themes concerning this age group that led to the current older
adults study
Nature and Ageing: While the benefits of nature exposure and
connec on are clear earlier in life, we know li le about how
varia ons in the type of nature exposure can deliver well-being
outcomes in later life. It is possible that natural elements of the
Dunedin Garden Study Nature and ageing Natural neighbourhoods for city children
Field work date 2008-10 2016 2014
Sample size 55 households Ongoing (50 approx) 187 children
Loca on Dunedin Dunedin Auckland, Dunedin, Wellington
Character of par cipants Homeowners, different socio-economic
groups, more women (39) men (16), ten-
dency to be older and without children.
Living in family homes and downsized
homes, aged over 65, different socio-eco-
nomic and health status
Children aged 9-11, different ethnici es and
socio-economic groups
Interview loca on Home Home School
Methods Two Interviews one year apart
Photo exercise - 10 photos of garden
features par cipant valued
Detailed biological survey of the garden,
plants, invertebrates and birds
Interview
Computer-air photo and GIS exercise iden-
fying places respondent uses and places
they iden fy as having biodiversity values
within a 5 minute walk of their home
Biological survey of the garden and adjacent
nature sites used on an everyday basis.
Interview
Drawn neighbourhood maps
Computer-air photo and GIS exercise iden-
fying places children use and places they
iden fy as having biodiversity values
Biological survey of child’s home range area
18. 18
“My garden is an expression of me”: Exploring householders’
rela onships with their gardens, Journal of Environmental
Psychology, 32, 135-143. doi:10.1016/j.jenvp.2012.01.005
event or a cu ng that was given by a neighbour or rela ve.
Nature is important across the ages but seems especially so at
the opposite ends of the age spectrum, children and older people
and here the home and adjacent environment is vital. Planners
and land use managers need to recognise the importance
of the very local in people’s lives as it here the acquisi on of
health benefits can be most acutely supported or frustrated.
Understanding the everyday then enables researchers to help
policy makers, designers, planners and others understand what
people value, need and how to best include it, or at least not
exclude from everyday life. For in the everyday is joy and hope
and family and the people that make life good when done in a
se ng in which nature is present.
References
Wilson, E.O. 1993 Biophilia and the conserva on ethic, in Kellert,
S.R. and Wilson, E.O. (Eds) The Biophilia Hypothesis, Island Press,
Washington.31-41
Kellert, S.R. 1993 The biological basis for human values of nature.
in S. R. Kellert and E. O. Wilson (Eds). The Biophilia Hypothesis.
Island Press.
Louv, R. 2005. Last Child in the Woods: Saving our children from
nature-deficit disorder. Algonquin Books: Chapel Hill, NC.
More informa on on our studies is available in the following
publica ons:
Freeman, C. van Heezik, Y. Stein, A. Hand, K. (2015) Natural
Neighbourhoods for City Children, ISBN: 978-0-473-31872-7
report available as pdf from h p://www.otago.ac.nz/geography/
staff/academic/otago089591.html
van Heezik, Y. Dickinson, K.J.M. Freeman C, Porter, S. Wing,
J.Barra , B.I.P 2016. To what extent does vegeta on composi on
and structure influence beetle communi es and species richness
in private gardens in New Zealand? Landscape and Urban
Planning, 151, 79-88.
Hand, K.L., Freeman, C., Seddon, P.J., Stein, A., van Heezik, Y.,
2016. A novel method for fine-scale biodiversity assessment
and predic on across diverse urban landscapes reveals social
depriva on-related inequali es in private, not public spaces,
Landscape and Urban Planning. 151, 33-44.
Freeman,C.vanHeezik,Y.Stein,A.andHand,K.2016.Technological
inroads into understanding city children’s natural life-worlds,
Children’s Geographies, DOI: 10.1080/14733285.2015.1126552
Freeman, C. van Heezik, Y. Hand, K and Stein, A. 2015. Making
Ci es More Child- and Nature-Friendly: A Child-Focused Study
of Nature Connectedness in New Zealand Ci es, Children, Youth
and Environments, 25: 2, 176-207
Van Heezik, Y.M., Freeman, C. Porter, S., Dickinson, K.J.M.
2014. Na ve and exo c woody vegeta on communi es in
domes c gardens in rela on to social and environmental factors,
Ecology and Society, 19 (4): 17. [online] URL:h p://www.
ecologyandsociety.org/vol19/iss4/art17/
van Heezik, H. Freeman, C. Porter, S. Dickinson, K. 2013. Garden
size,householderknowledgeandsocio-economicstatusinfluence
plant and bird diversity at the scale of individual gardens,
Ecosystems. 16: 1442–1454, DOI:10.1007/s0021-013-9694-8
van Heezik, Y., Dickinson, K. J.M., Freeman, C. 2012. Closing the
gap: communica ng to change gardening prac ces in support of
na ve biodiversity in urban private gardens. Ecology and Society.
17(1) 34.h p:// doi.org/10.5751/ES-04712-170134
Freeman, C., Dickinson, K J.M., Porter, S., van Heezik, Y. 2012.
19. 19
ADRIAN SUTHERLAND
ROBERT SHARL
FUTURE WELLNESS: HEALTHCARE AND WELL BEING IN A CHANGING
WORLD
All across the world, healthcare is changing. Ageing popula ons are increasing demand. Improved—and
more personalised—treatments are turning once-terminal illnesses into chronic condi ons.
The increasing sophis ca on and power of personal digital devices such as smart phones and wearables,
and the reach of social media, are reinven ng how healthcare systems can engage with pa ents and
communi es. Individual ci zens are coming together as communi es to provide self-help and health
advocacy.
The popula on health pyramid is an effec ve tool for visualising the stra fica on of high, medium and
low risk pa ents. Typically used for case management and for demand planning, we’ll use the pyramid to
explore instead the changing needs of the different pa ent groups.
Exploring funding and economics, technology, digital monitoring and care, and pa ent-centred design
thinking approaches, we’ll consider both what happens today and what could happen in the future
though a holis c approach to healthcare, ci zen-engagement, and well-being.
Adrian Sutherland is a CSC
Healthcare Industry Strategist
with global experience
in healthcare trends and
technology implications,
and part of the global team
focusing on next generation
technology investments.
Adrian has led programs
in both the Insurance and
Healthcare sectors, working
for some of CSC’s highest
profile clients in UK, Europe &
Australia. He is also a Trustee
of Anorexia & Bulimia Care, a
national UK eating disorders
organisation. CSC is a global
provider of next-generation
technology solutions serving
public and private sector
healthcare clients in the
provider, payer and life
sciences markets.
Robert Sharl has worked
at the intersection of
design, technology, and
user experience since the
early 1990s. He founded
the digital consultancy
Futurilla, and co-developed
a Masters programme in
User Experience Design for
Visual Communication at
Birmingham City University.
He is currently collaborating
on mobile and wearable
applications with CSC’s
Global Healthcare team,
and developing a Research
& Development Lab for
emerging interdisciplinary
designers.
21. 21Children’s well-being
note that this type of research alone cannot establish causality
(Wolfe et al, 2014, p.7). Moreover, they lack the nuances of
personal experience and contextual details which qualita ve
inves ga ons can capture. As such this paper will review
qualita ve inves ga ons into the effect sex ng has on the well-
being of young people.
Method
A Google Scholar search was conducted using the following
search terms; adolescent sex ng, young people and sex ng,
teenagers and sex ng and qualita ve adolescent sex ng. Further
ar cles were iden fied for inclusion based on a manual search of
the bibliographies of systema c review papers iden fied through
the Google Scholar search.
Ar cles met the criteria for inclusion in the review if they either
fully or partly u lised qualita ve methods. Given the small body
of qualita ve teen-sex ng research published to date, papers
sampling young adults up to the age of 24 were also included. In
total nine papers were included.
Review
The qualita ve literature review revealed that the wellbeing
outcomes associated with Teen Sex ng (TS) can be split into four
broad categories. The first two can be considered posi ve effects
on well-being and these are; (1) Pleasure and amusement and
(2) safe relief of sexual frustra on. Whilst the final categories;
(3) reputa onal damage and (4) feeling threatened, reflect
nega ve effects on well-being. Categories will be split further
into subcategories for greater depth of discussion.
1.Pleasure and Amusement
Pleasure and amusement is frequently revealed as an outcome
when young people are given the opportunity to discuss their
experience of sex ng. Findings from 15 to 18-year-olds by
Lippman and Campbell (2014) indicated that far from being a
nega ve experience a majority of the par cipants felt that sex ng
was “no big deal” (p.378). Most of the responses indicated a
sense of enjoyment was gained by engaging in sex ng and that
more o en than not the images were shared within roman c
rela onships. Another finding from Lippman and Campbell’s
(2014) inves ga on was that younger par cipants found the
actual images humorous. This suggests that younger teenagers
do not necessarily view the images for sexual arousal, a phase
which Lippman and Campbell (2014) referred to as “Pre-Sex ng”
(p.380). Burke ‘s (2015) research with University students also
found that self-produced sexually explicit images can be a source
of humour within friendship groups. Interes ngly, Burke (2015)
also found that when sexual images are shared within a roman c
context, sex ng is governed by an “unspoken rule” (p.854) that
the images are not a declara on of sexual intent, but simply a
way to have fun and flirt. Burke (2015) also reported that
females might share such images with other female friends as a
way gaining feedback on their physical appearance.
Findings from this first sec on challenge the no on that when
young people engage in sex ng they do so purely for sexual
arousal. That is, younger par cipants might sext because they
find the images humorous, whilst young adults might sext
because they gain enjoyment from the process of crea ng the
images or see it as a joke. What is clear however is that sex ng
can take a variety of forms and does not occur exclusively within
roman c or sexual rela onships.
2.Safe alterna ve to sex and relief of sexual frustra on
Sex ng as a safe means of communica on.
TEEN SEXTING AND WELL BEING A REVIEW
OF QUALITATIVE LITERATURE
Andrea Anastassiou
Birmingham City University, United Kingdom
andrea.anastassiou@mail.bcu.ac.uk
Abstract
The term “sex ng” refers to the sending and receiving of
sexually explicit imagery via some form of virtual messaging.
Though sex ng is by no means restricted to young people, it is
the par cipa on of young people and the effect it has on their
well-being which has led to widespread concern from parents,
educators and the media alike. Ringrose et al (2012) argued that
this “media panic” exists in response to a predominantly adult
discourse with li le input from the teenagers who engage in
sex ng. As such this paper will review the small but emerging field
of qualita ve research into teen-sex ng (TS) in order to iden fy
the effect sex ng has on the well-being of young people. Findings
from this review indicate that, many young people viewed sex ng
as “fun” (Lippman and Campbell, 2014), and amusing (Burke ,
2015). Moreover, sex ng can be part of a sexual-experimenta on
phase for teens who are not ready to engage in physical sexual
ac vity (Lenhart, 2009). Nega ve effects on well-being including
reputa onal damage are also discussed. It is concluded that
researchers must con nue to use crea ve, par cipatory methods
with young people to further explore the well-being effects of
this complex form of communica on.
Keywords: Teenagers, Sex ng, Communica on, Technology,
Gender
Introduc on
“Which is epidemic—sex ng, or worrying about it?” – (Bialik,
2009).
The role that mobile phones play in the lives and well-being of
young people has long been the target of controversy (Dimonte
& Ricchiuto, 2006). Nega ve behaviours associated with young
people and mobile phone use include; increased access to
pornography (Rothman et al, 2015), mobile phone addic on
(Walsh, White & Young, 2008) and cyberbullying (Smith et al,
2008). One such behaviour which has received much a en on
from law makers, researchers and the media alike is sex ng,
defined as “sexually explicit content communicated via text
messages, smart phones, or visual and web 2.0 ac vi es such as
social networking sites” (Ringrose et al, 2012, p. 9).
Given that sex ng o en involves the self-produc on of
pornographic images, comparisons have been made between the
effect of adolescent sex ng and the nega ve effects of adolescent
exposure to pornography (Stanley et al, 2016), which include an
increased tolerance to unwanted sexual behaviours (Bonino,
Ciairano, Rabaglie and Ca elino, 2006) and perpetra on of
sexual harassment (Brown & L’Engle, 2009). TS has further been
linked to nega ve well-being outcomes such as depression (Dake
et al, 2012) and low self-esteem (Sorbring et al, 2014). Indeed,
a review by Doring (2014) revealed that 79% of papers on TS
associated it with nega ve well-being outcomes.
Whilst such quan ta ve inves ga ons have contributed greatly
to the discourse on sex ng and teen well-being it is important to
22. 22 Children’s well-being
Escalated Sex ng and Gender
One consistent finding from the literature is that it is o en
girls who fall vic m to escalated sex ng. Ringrose et al (2012)
described how young girls can be tagged with the reputa on
of being a “sket” (p.43) once images are shared. Notably their
focus groups and interviews revealed that it was not only the
boys that saw them this way, fellow females also par cipated
in the name-calling and judgemental behaviour. Moreover, in a
Cross-European inves ga on, Stanley et al (2016) found that the
gendered nature of the reputa onal damage was par cularly
apparent in more tradi onally religious communi es.
One explana on for the gendered aspect to escalated sex ng
emerged from focus groups with 16-25-year-olds from Australia
(Yeung et al, 2014). One par cipant reflected that whilst boys can
exposethemselves“foralaugh”(p.336),girlswillo enexperience
humilia on if their bodies are exposed because society a aches
a greater s gma and more embarrassment to the exposure of
the female body (Yeung et al, 2014, p.336). Further findings
from this inves ga on indicated that the shame associated
with sexually explicit images of females make them more likely
to be circulated because the images are more controversial and
therefore become a greater commodity. This in turn causes more
reputa onal damage for the girl in ques on. Moreover, as well
as managing the effects of reputa onal damage young girls are
likely to blame themselves for having caused the situa on in the
first place by crea ng the images, whilst a ribu ng li le blame to
the person who circulated the photo (Burke , 2015 & Ringrose,
Gill, Harvey and Livingstone, 2015). This is echoed by Hasinoff
(2012) who noted that vic m blaming is a common aspect of the
TS narra ve.
These findings indicate that if a young girl has an explicit image
of herself forwarded on to an unintended audience she will likely
face judgement from male and female peers alike, as well as
blaming herself. In the instance that she belongs to a religious
community and/or the original image was sent within a casual
rela onship the nega ve outcomes might be intensified. This
suggests that whilst there are examples of escalated sex ng
effec ng males and taking place in a non-sexual context (Burke
et al, 2015, p.852), young girls are much more likely to experience
to nega ve effects of sex ng.
4.Feeling threatened
In the UK sex ng is illegal under the age of 18 (Sexual Offences
Act 2003), however sex ng can also be deemed a crime under
the Malicious Communica ons Act of 1988. Context for this has
been provided by qualita ve literature, for example findings by
Manning (2013, p.2511) indicated that for some young people
receiving an unwanted sext can feel like an “assault” because the
sexual content feels forced upon them. Bond (2010, p.597) noted
that the content of a sext remains unknown un l the message is
opened, thus managing risk is a challenge for young people when
they engage in this type of behaviour. Moreover, par cipants in
Burke ’s (2015) inves ga on referred to feeling “uncomfortable
and threatened” (p.850) a er receiving sexts from people they
had met online. Burke (2015) noted that these feelings were
not only caused by the sexual content but also the context of
having never met the sender.
Conclusions
A common conclusion of papers exploring young people and
sex ng is that qualita ve inves ga ons are of immense value to
the discourse but remain scarce (Cooper, 2016; Burke , 2015;
Ringrose et al 2012; Walker, Sanci and Temple Smith, 2012), the
small body of literature available for this review supports this
Findings frequently revealed that sex ng can be part of a safe
experimental phase for teenagers who are not sexually ac ve
(Burek , 2015; Lippman and Campbell, 2014; Yeung et al 2014;
Lenhart, 2012). Moreover, focus group findings by Yeung et al
(2014)alignedsex ngwiththeconceptofthe“Cyberself”(p.338).
The Cyber Self is a persona that can be u lised online in which the
technology user behaves differently when communica ng via the
internet than they would when communica ng with others face-
to-face. This modified persona is the effect of the barrier which
technology creates, leading boys to feel safe when reques ng
sexual images from girls and girls to when feel safe producing and
sending the images (Yeung et al, 2012, p.338) because the online
environment creates the percep on of privacy.
Sex ng as a relief for sexual frustra on
With older teenagers and young adult samples sex ng has been
iden fied as a relief for sexual frustra on when they cannot have
sex (Stanley et al, 2016). Importantly, Coggin and Crawford (2011)
reported that the ques ons used in qualita ve inves ga ons
can some mes shape how sex ng is discussed. They noted
that par cipants emphasised the nega ve outcomes of sex ng
when speaking about sex ng on the behalf of other people, but
stressed the posi ve elements of sex ng, such as relieving sexual
frustra on when discussing their own experiences. Sex ng has
also been described as an alterna ve to sex whereby the risk of
pregnancy does not exist (Stanley et al, 2016).
Taken together, these findings suggest that despite the concern
which surrounds TS, teenagers might be sex ng because they
see it as a safe way of developing and maintaining their roman c
rela onships. This is both due to the perceived safety of sex ng
pla orms and also a way of avoiding the risks associated with
having sex. This interes ngly seems to mirror how the media
frames adult sex ng as a healthy way to communicate sexual
desire despite failing to acknowledge that it might have similar
benefits for young people (Hasinoff, 2012, p.7).
3.Reputa onal Damage
The sharing of sexts beyond the intended audience is considered
by many to be the biggest risk associated with TS (Yeung et al,
2014), Colenbrander (2014) referred to this phenomenon as
“escalated sex ng”. A tragic incident discussed in a paper by
Chalfen (2009) in which an 18-year-old girl hangs herself a er
her ex-boyfriend circulated sexually explicit photos of her is an
extreme example of the harm that can result from escalated
sex ng.
Bond (2010, p.595) discussed two situa ons in which an image
might be circulated; the first occurs when an image originally
created for private use within a roman c rela onship loses its
private status once that rela onship breaks down. The second
scenario is the result of images being sent to the wrong recipient
by mistake. Yeung et al (2014) noted that the scenario in which the
image is shared can affect how the image circulator is seen. For
example, their sample of 16-25-year-olds deemed the circula ng
of images which were made within a roman c rela onship as
objec onable, whilst images that were generated within a non-
commi ed rela onship can be circulated with less judgement.
Whatever the cause, the well-being outcomes for the individual
showninthephotooncetheimagesaresharedareo ennega ve.
Lippman and Campbell (2012) and Crawford and Groggin (2011)
both cited reputa onal damage and embarrassment as the most
frequent outcomes of escalated sex ng. Furthermore, Burke
(2015) noted that whilst escalated sex ng was not a frequent
occurrence in her inves ga on, when it did occur the vic ms
found themselves doub ng who they could trust.
23. 23Children’s well-being
Life Project; 2009.
Lippman, J.R. and Campbell, S.W., 2014. Damned if you do,
damned if you don’t… if you’re a girl: Rela onal and norma ve
contexts of adolescent sex ng in the united states. Journal of
Children and Media, 8(4), pp.371-386
MaliciousCommunica onAct1988,(c.27)London:TheSta onery
Office.
Manning,J.,2013.DoingIt|Interpre veTheorizingintheSeduc ve
World of Sexuality and Interpersonal Communica on: Ge ng
Guerilla with Studies of Sex ng and Purity Rings. Interna onal
Journal of Communica on, 7, pp. 2507–2520
Ringrose, J., Gill, R., Livingstone, S. and Harvey, L., 2012. A
qualita ve study of children, young people and’sex ng’: a report
prepared for the NSPCC.
Ringrose, J., Harvey, L., Gill, R. and Livingstone, S., 2013. Teen
girls, sexual double standards and ‘sex ng’: Gendered value in
digital image exchange. Feminist Theory, 14(3), pp.305-323.
Rothman,E.F.,Kaczmarsky,C.,Burke,N.,Jansen,E.andBaughman,
A., 2015. “Without Porn… I Wouldn’t Know Half the Things I Know
Now”: A Qualita ve Study of Pornography Use Among a Sample
of Urban, Low-Income, Black and Hispanic Youth. The Journal of
Sex Research, 52(7), pp.736-746.
Sexual Offences Act 2003 (c.42) London: The Sta onery Office.
Smith, P.K., Mahdavi, J., Carvalho, M., Fisher, S., Russell, S.
and Tippe , N., 2008. Cyberbullying: Its nature and impact
in secondary school pupils. Journal of child psychology and
psychiatry, 49(4), pp.376-385.
Sorbring, E., Skoog, T. and Bohlin, M., 2014. Adolescent girls’
and boys’ well-being in rela on to online and offline sexual
and roman c ac vity. Cyberpsychology: Journal of Psychosocial
Research on Cyberspace, 8(1).
Stanley, N., Barter, C., Wood, M., Aghtaie, N., Larkins, C., Lanau, A.
and Överlien, C., 2016. Pornography, Sexual Coercion and Abuse
and Sex ng in Young People’s In mate Rela onships a European
Study. Journal of interpersonal violence, pp. 1–26
Walsh, S.P., White, K.M. and Young, R.M., 2008. Over-connected?
A qualita ve explora on of the rela onship between Australian
youth and their mobile phones. Journal of adolescence, 31(1),
pp.77-92.
Wolfe, S.E., Marcum, C.D., Higgins, G.E. and Ricke s, M.L., 2014.
Rou ne Cell Phone Ac vity and Exposure to Sext Messages
Extending the Generality of Rou ne Ac vity Theory and Exploring
the E ology of a Risky Teenage Behaviour. Crime & Delinquency,
pp. 1–31
Yeung, T.H., Horyniak, D.R., Vella, A.M., Hellard, M.E. and
Lim, M.S., 2014. Prevalence, correlates and a tudes towards
sex ng among young people in Melbourne, Australia. Sexual
health, 11(4), pp.332-340.
no on. What is clear from the exis ng literature however, is
that the effect of sex ng on the well-being of young people is
difficult to quan fy into a binary posi ve or nega ve outcome.
Gender, culture, age, and rela onships can all alter how both
senders and receivers are effected by par cipa ng in sex ng and
this challenges the tradi onal no on that sex ng is exclusively
bad for the well-being of young people. Moreover, if some teens
experience posi ve outcomes as a result of sex ng, abs nence
programs might not be effec ve interven ons. An alterna ve
direc on for future research could be to iden fy the factors
which cause sex ng to go wrong and then educate young people
in how to avoid these factors as a form of interven on. Given the
complex nature of TS it is not only important for these qualita ve
inves ga ons to con nue but also for researchers to pursue
crea ve methods of capturing what sex ng means to young
people and how it effects their lives.
References
Bialik C., 2009. Which is epidemic—sex ng or worrying about
it? The Wall Street Journal, 8 April. Available at: h p://www.wsj.
com/ar cles/SB123913888769898347. [Accessed 7 June 2016].
Bond, E., 2010. The mobile phone= bike shed? Children, sex and
mobile phones. New Media & Society, pp.587–604
Bonino, S., Ciairano, S., Rabaglie , E. and Ca elino, E., 2006.
Use of pornography and self-reported engagement in sexual
violence among adolescents. European Journal of Developmental
Psychology, 3(3), pp.265-288.
Brown, J.D. and L’Engle, K.L., 2009. X-rated sexual a tudes and
behaviours associated with US early adolescents’ exposure to
sexually explicit media. Communica on Research, 36(1), pp.129-
151.
Burke , M., 2015. Sex (t) Talk: A Qualita ve Analysis of
Young Adults’ Nego a ons of the Pleasures and Perils of
Sex ng. Sexuality & Culture,19(4), pp.835-863.
Chalfen, R., 2009. ‘It’s only a picture’: sex ng, ‘smu y’ snapshots
and felony charges 1. Visual Studies, 24(3), pp.258-268.
Colenbrander, A.A., 2016. Always a step ahead: the process of
handling escalated sex ng: An explanatory study of interven on
and preven on actors and measures handling escalated sex ng.
M.Sc. Thesis. University of Twente
Cooper, K., Quayle, E., Jonsson, L. and Svedin, C.G., 2016.
Adolescents and self-taken sexual images: A review of the
literature. Computers in Human Behaviour, 55, pp.706-716.
Dake, J.A., Price, J.H., Maziarz, L. and Ward, B., 2012. Prevalence
and correlates of sex ng behaviour in adolescents. American
Journal of Sexuality Educa on, 7(1), pp.1-15.
Dimonte, M. and Ricchiuto, G., 2006. Mobile phone and young
people. A survey pilot study to explore the controversial aspects
of a new social phenomenon. Minerva pediatrica, 58(4), pp.357-
363.
Döring, N., 2014. Consensual sex ng among adolescents:
Risk preven on through abs nence educa on or safer
sex ng. Cyberpsychology, 8(1), pp.1-18.
Goggin, G. and Crawford, K., 2010. Moveable types: Youth and the
emergence of mobile social media in Australia. Media Asia, 37(4),
p.224.
Hasinoff, A.A., 2012. Sex ng as media produc on: Rethinking
social media and sexuality. New Media & Society, 1-17.h p://
dx.doi.org/10.1177/1461444812459171.
Lenhart, A., 2011. Teens and Sex ng. Pew Internet and American
24. 24 Children’s well-being
Currently in England the rights of young children (aged birth to
five) with developmental delays and disabili es are embodied
within The Children and Families Act (Department for Educa on/
Department for Business, Innova on and Skills/Department
for Work and Pensions/Department of Health and Ministry of
Jus ce, 2014) and the Special Educa onal Needs (SEN) Code of
Prac ce (DfE/Department Of Health, 2015). In theory under the
Act, parents of children with severe and complex needs and who
have an Educa on, Care and Health Plan (ECH) can choose how
and where their child is supported in terms of mainstream or
special educa on.
Whether children a end specialist school se ngs, mainstream
or combined se ngs, their interven on runs the risk of being
de-contextualised as families do not generally par cipate in their
therapy and educa on interven ons alongside them, except
in the case of home-based services such as Portage or play
therapy which are o en delivered in isola on from other therapy
services and have the poten al to isolate parents in the home.
Communica on and co-ordina on between therapy services can
o en be distant and disjointed (Blackburn, 2014). This view is
supported by Robertson and Messenger (2010) and Lamb (2009)
who argue that the most significant challenges for England in
delivering EI provision for children with disabili es have been:
• Maintaining effec ve communica on with all par es
involved;
• Developing a clear understanding of roles and responsibili es
between professionals
• and families;
• Maintaining a high level of professional specialism;
• Developing trust between families and professionals and
inter-professionally;
• Focusing on outcomes;
• Empowering parents and families.
The emo onal and prac cal considera ons of raising a child with
a developmental delay or disability are discussed in Carpenter
et al (2015). However it is important to acknowledge the
range of emo ons experienced by parents (from joy to grief,
denial and shock) which are largely con ngent upon their own
emo onal resilience and well being and resources (including
family/community support), the nature and degree of disability
experienced by their child and how obvious or ‘hidden’ the
disability is, tolerance and acceptance by community and
cultures they live in and financial and prac cal support provided
by EI services.
Aims and objec ves of this project
Taking this into account, the objec ve of this project was to
visit the Champion Centre in New Zealand (NZ) to learn about
their rela onship-based EI services for children with complex
needs. The aim was to interview professionals, observe their
interac ons with children, talk to families and gather informa on
about the work undertaken at the Centre that could be translated
to a UK context to work with children with complex needs. The
objec ve was to capture effec ve and best prac ce within an
interdisciplinary context that could be mutually beneficial for
all stakeholders concerned with children with complex needs,
their development and overall well being. Research ques ons
included:
• What are the views, understandings and reported prac ces
of professionals working within a rela onship-based early
interven on service with children who have complex needs?
THE VALUE OF RELATIONAL PEDAGOGY AND
PROFESSIONAL LOVE TO EARLY CHILDHOOD
INTERVENTION AND CHILD/FAMILY WELL
BEING FOR CHILDREN WITH COMPLEX
DISABILITIES
Dr. Carolyn Blackburn
Senior Research Fellow, Centre for the Study of Prac ce and
Culture in Educa on. Faculty of Health, Educa on and Life
Sciences, Birmingham City University
Carolyn.blackburn@bcu.ac.uk
Abstract
Thispaperdiscussesthekeycharacteris csofarela onship-based
early interven on service for children with complex disabili es
in New Zealand. Nine parents and twenty interdisciplinary
professionals were interviewed and nine children observed.
Key findings were the interac on between rela onal pedagogy,
professional love and child and family well being. Parents
appreciated the knowledgeable, well-trained professionals who
invested me in ge ng to know (and love) children and families
and family prac ces, worked together in harmony and valued
the contribu on that parents made to their child’s progress and
achievement. Professionals described the key characteris cs
of the service in terms of the range of therapies offered by
the service, the focus on a strengths-based and family focused
approach, play-based assessments, acceptance and value of
family prac ces (including responsiveness to Maori and bi-
culturalism), appropriate and respec ul places to meet and greet
families and work with children, and recruitment and reten on of
humble professionals who iden fied with the ethos of the model.
Observable social processes and structures within the delivery
of the model include respec ul professional interac ons and
rela onships with children and families, integrated professional
working, effec ve and mely communica on between
professionals and families, pedagogy of listening, wai ng and
personalisa on, engaged families and ac vely par cipa ng
children. A collabora ve and co-construc onist approach to child
and family well being was illuminated in the findings. This paper
discusses the above in light of current policy on early interven on.
Keywords: Rela onal pedagogy; professional love; well being;
complex disabili es; complex needs; integrated working; families;
ecological approach
Introduc on
The many benefits of early interven on (EI) for children, families,
and communi es where adequate resources are available have
been well documented (see Guralnick, 2005; Heckman, 2006).
EI programmes can prevent risk factors from exer ng nega ve
influences on children’s development (Field, 2010; Marmot,
2010; Munro, 2011; Allen, 2011). For children with intellectual
disabili es, EI can not only minimise intellectual delay, but
other secondary complica ons as well (Guralnick and Alber ni,
2006). Given the wide variability in the nature and quality of EI
programmes interna onally, Pre s (2006) argues for a common
set of principles to guide them. These would include but not
be limited to inclusion, child and family-centred ac vi es and
empowerment.
25. 25Children’s well-being
• Love of working with families rather than working solely with
children.
Key characteris cs of the Champion Centre
In describing the most important characteris cs of the Champion
Centre, all parents men oned the social support available to
families and the benefits of the integrated approach taken by
professionals to scaffold children’s learning and development.
Here it’s all interlinked, since she started coming here
she’s just come so far in her development. One person
will say oh she needs help with this and another will say
oh I can help with that and they piece it all together.
One parent compared the integrated approach of the Champion
Centre to her previous experience with another EI service, which
she reported as being quite disjointed. She wondered whether
her child would have made the significant progress that she has if
she had con nued with that service.
Six parents appreciated the way in which the interven ons
supported family life and noted the importance of professionals
acknowledging how hard parents worked at home to support
their children as well as the importance of consistent regular
visits to the Centre:
I love the fact that you come once a week and all the
therapists see her and work with her and then they all
meet and discuss her and everyone knows everything
about her.
Four parents men oned the value of well-trained knowledgeable
professionals employed at the Centre who know their child well
and understand their needs, whilst three parents appreciated the
fact that professionals were non-judgemental about their child
and family rou nes/prac ces. Two parents stated that when their
child was a ending the Middle Years Programme they found it
more difficult to determine and iden fy their child’s progress
than was the case for the Baby Programme and Transi on to
School programme. One parent each men oned the benefit
of the play-based approach where children were not rushed to
reach developmental milestones, the frequency of the therapy
sessions and the compassion and love offered by professionals to
parents and children:
The care that extends beyond their subject ma er, so just
being supported emo onally and many mes cha ng to
the staff, you would leave in tears, but I needed that.
One (past) parent described the media ng role of staff in helping
parents to “navigate” both medical issues and paren ng and
child behaviour concerns and another stated that her husband
was delaying a work promo on as it involved moving to another
District. She said they felt so strongly that their child was
benefi ng from their son’s par cipa on at the Champion Centre
that this was more important than increased wealth or career
prospects.
All parents reported that once they had selected the Champion
Centre as their preferred EI provider, their place and enrolment
was confirmed almost immediately and not longer than two
or three weeks. All parents also reported that they were fully
involved in their child’s learning and development at the
Champion Centre and valued this aspect of the service.
In describing the key characteris cs of the Champion Centre,
all professionals noted the importance of an interdisciplinary
• What are the views and percep ons of parents/families who
use the service?
• What are the observed prac ces of professionals and key
physical and social resources in a rela onship-based EI
service for children with complex needs?
Background to the Champion Centre
The Champion Centre in Christchurch, NZ is one of four EI services
in Canterbury for children aged birth to six with severe and
complex delays and disabili es. The Centre provides rela onship-
based EI services on a centre-based integrated therapy approach
that values children’s strengths and family prac ces. The
programme is offered to children from birth to school age who
have significant delays in at least two areas of development.
Children who a end the Centre have a wide range of special
needs. These include developmental challenges as a result of
Down syndrome and other gene c disorders, cerebral palsy,
extreme prematurity, epilepsy, developmental dyspraxia, au sm
and brain injury. Five principles underpin the service, these are
that the service is rela onal, family-centred, strengths-based,
ecological and reflec ve. Details of the service can be found here
h p://www.championcentre.org.nz/
Methods and ethical considera ons
Data collec on methods included observa ons of nine children at
the Centre during their interven on sessions and interviews with
their parents. A past parent whose child had previously a ended
the Champion Centre was also interviewed. This ar cle focuses
on parents and professional percep ons of key characteris cs of
the model from interviews.
Key characteris cs of rela onship-based EI services
Parents iden fied a number of key characteris cs that they
valued in a rela onship-based EI service. Five parents men oned
the importance of experienced, knowledgeable professionals
who teach parents to teach their children. Four of these parents
recognised that this helped to prepare their child for school. Four
parents each stressed the significance of professional support for
the rela onship between parents and children in showing parents
how to relate and play with their child, as well as professionals
knowing the child/family well enough to do this. Three parents
stated how useful it was to have the support of other parents
who were experiencing the same challenges and difficul es. Two
parents appreciated professional recogni on of their contribu on
to their child’s ongoing progress and one parent stressed the
value of feeling that “you’re not doing it alone.”
Essen al components in rela onship-based EI services suggested
by professionals were extremely varied. All five interviewee
groups talked about the importance of understanding the
family’s journey both prior to and during their rela onship with
an EI service. It was described as “crucial” that parents should
only have to relate their child’s early experiences to professionals
once and this should occur within their own ‘safe space’, usually
the home se ng. Also suggested by three professionals was
the need to respect families and other professionals’, honesty
and empathy. Suggested by one professional each was the
importance of:
• Working with parents to enhance their ability to support
their child and helping them to learn to love their child.
• Removing “roadblocks” to parent/child rela onships so that
children with disabili es can experience joy.
• Acknowledgement and respect for diverse family structures/
processes and interac ons.
