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Well-being 2016 book of proceedings

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Well-being 2016 book of proceedings

  1. 1. 2 PEER REVIEWED BOOK OF PROCEEDINGS Well-Being 2016: The third interna onal conference exploring the mul -dimensions of well-being CO-CREATING PATHWAYS TO WELL-BEING BIRMINGHAM CITY UNIVERSITY, BIRMINGHAM, UK 5-6 September 2016 COPYRIGHT Every scien fic paper published in these Book of Proceedings was peer reviewed. All explana ons, data, results, etc. contained in this book have been made by authors to their best knowledge and were true and accurate at the me of publica on. Neither the publisher, the editors, nor the authors can accept any legal responsibility or liability for any errors and omissions that may be made. © All rights reserved. No part of these proceedings may be reproduced by any means, electronic or mechanical, including photocopying, recording, or by any informa on storage and retrieval system, without permission in wri ng from the publisher. © Copyright©2016 by the authors Edited by Richard Coles, Sandra Costa & Sharon Watson, School of Architecture and Design Birmingham City University, 2016 Administra ve support Kelly Hanna & Gemma Dixon Ins tute of Health and Quality of Life, Birmingham City University Produced by Birmingham City University ISBN 978-1-904839-87-3
  2. 2. 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
  3. 3. 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
  4. 4. 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
  5. 5. 6 prac ce.................................................................................................................................................................. 226 “What’s going on during tex le making encounters?” ......................................................................................... 231 Good Vibra ons: How mentorship can deepen university learning and how dance can begin to answer the primary social and psychological needs of people living with demen a .............................................................. 236 POSTERS.............................................................................................................................................................. 239
  6. 6. 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
  7. 7. 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
  8. 8. 9 KEYNOTE SPEAKERS
  9. 9. 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.
  10. 10. 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
  11. 11. 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
  12. 12. 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, 29, 95-100. Korpela, K., Ylén, M., Tyrväinen, L. & Silvennoinen, H. (2010). Favorite green, waterside and urban environments, restora ve experiences and perceived health in Finland. Health Promo on Interna onal, 25, 200-209. Newell, P. B. (1997). A cross-cultural examina on of favourite places. Environment & Behavior, 29, 495-514. Ratcliffe, E., Gatersleben, B., & Sowden, P. (2016). Associa ons with bird sounds: How do they relate to perceived restora ve poten al? Journal of Environmental Psychology, 47, 136-144. Ryan, R. M., Weinstein, N., Bernstein, J., Brown, K. W., Mistre a, L., & Gagné, M. (2010). Vitalizing effects of being outdoors and in nature. Journal of Environmental Psychology, 30, 159-168. Sommer, B. (1990). Favorite places of Estonian adolescents. Children’s Environmental Quarterly, 7, 32-36. Tyrväinen, L., Ojala, A., Korpela, K., Lanki, T., Tsunetsugu, Y., & Kagawa, T. (2014). The influence of urban green environments on stress relief measures: A field experiment. Journal of Environmental Psychology, 38, 1-9. Ulrich, R. S. (1983). Aesthe c and affec ve response to natural environment. In I. Altman & J. F. Wohlwill (Eds.), Human behavior and environment: Advances in theory and research (Vol. 6, pp. 85-125). New York: Plenum Press. 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. References Barton J. & Pre y J. (2010). What is the best dose of nature and green exercise for improving mental health? A mul -study analysis. Environmental Science and Technology, 44, 3947-3955. Bratman, G. N., Hamilton, J. P., & Daily, G. C. (2012). The impacts of nature experience on human cogni ve func on and mental health. Annals of the New York Academy of Sciences, 1249, 118- 136. Brown, G. & Ky ä, M. (2014). Key issues and research priori es for public par cipa on GIS (PPGIS): A synthesis based on empirical research. Applied Geography, 46, 122- 136. De Bloom, J., Kinnunen, U., & Korpela, K. (2014). Exposure to nature versus relaxa on during lunch breaks and recovery from work: Development and design of an interven on study to improve workers´ health, well-being, work performance and crea vity. BMC Public Health 14, 488. Duvall, J. (2011). Enhancing the benefits of outdoor walking with cogni ve engagement strategies. Journal of Environmental Psychology, 31, 27-35. Duvall, J. (2013). Using engagement-based strategies to alter percep ons of the walking environment. Environment & Behavior, 45, 303-322. Har g, T., Mitchell, R., de Vries, S., & Frumkin, H. (2014). Nature and health. Annual Review of Public Health, 35(1), 207-228. Jorgensen, A., Hitchmough, J., & Dunne , N. (2007). Woodland as a se ng for housing-apprecia on and fear and the contribu on to residen al sa sfac on and place iden ty in Warrington New Town, UK. Landscape and Urban Planning, 79, 273-287. Kahila, M. & Ky ä, M. (2009). So GIS as a bridge-builder in collabora ve urban planning. In Geertman, S, & S llwell, J. (Eds.) Planning Support Systems Best Prac ce and New Methods, GeoJournal Library, Vol. 95, pp. 389-411. Springer. Kaplan, R., & Kaplan, S. (1989). The experience of nature: A psychological perspec ve. Cambridge: Cambridge University Press. Korpela, K. (1992). Adolescents’ favourite places and environmental self-regula on. Journal of Environmental Psychology, 12, 249-258. Korpela K. & Har g, T. (1996). Restora ve quali es of favorite places. Journal of Environmental Psychology, 16, 221-233. Korpela, K. M., Har g, T., Kaiser, F., Fuhrer, U., (2001). Restora ve experience and self-regula on in favourite places. Environment & Behavior, 33, 572-589. Korpela, K. & Ylén, M. (2007). Perceived health is associated with visi ng natural favourite places in the vicinity. Health & Place, 13, 138-151. Korpela, K. & Ylén, M. (2009). Effec veness of favorite place prescrip ons - A field experiment. American Journal of Preven ve
  13. 13. 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.
  14. 14. 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.
  15. 15. 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.
  16. 16. 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
  17. 17. 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.
  18. 18. 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.
  19. 19. THEME 1. CHILDREN’S WELL BEING
  20. 20. 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
  21. 21. 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.
  22. 22. 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
  23. 23. 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.
  24. 24. 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.

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