Chapter 7

An Overview of Community Psychology Interventions

Chapter Aims

The goals of this chapter are for you to learn about: (a) the community psychologist as an agent of social change, (b) the differences between ameliorative and transformative interventions, and (c) different settings for community psychology interventions.

We provide an overview of community psychology interventions in this chapter. We begin with a discussion of the community psychologist as an agent of social change, emphasizing the interconnections of the personal, political, and professional dimensions of community psychology. Next we examine the differences between ameliorative and transformative interventions. We argue that community psychology has focused primarily on amelioration to the neglect of transformation. Finally, we consider different settings for community psychology interventions. The core concepts and framework that we introduce in this chapter serve as a foundation for the remaining chapters in this section, in which we go into more depth about interventions at the social (Chapter 8), organizational, community (Chapter 9), small group and individual (Chapter 10) levels of analysis.

THE COMMUNITY PSYCHOLOGIST AS AN AGENT OF SOCIAL CHANGE: CONNECTING THE PERSONAL, POLITICAL, AND PROFESSIONAL

In this section, we discuss the role of the community psychologist as an agent of social change. However clear we are as community psychologists about our values, the world of action is one that is very messy and rife with conflicts and ethical dilemmas. When we try to change the status quo, we inevitably run up against many obstacles and much resistance. Creating social change is a struggle. Our values are constantly challenged in the intervention work that we do. Sometimes we experience value conflicts and have to decide which values are most important in a particular context. At other times, we have to choose between many different ways of implementing our values.

The Making of a Community Psychologist

We believe that being a community psychologist is a question of identity, a definition of who we are and who we want to be. Each community psychologist is a whole person. As whole people, our personal, political, and professional selves are intertwined. Through consciousness-raising about social issues and analysis of power dynamics, community psychologists come to connect the personal and the political parts of their identity, as feminists have asserted for some time. One cannot be a community psychologist in one=s public life at work and then go home to one=s private life and Aturn off@ the values that inform one=s work as a community psychologist. Rather the personal and political, the private and public, and the professional and citizen parts of the community psychologist come together through a journey of personal growth, empowerment, and political awareness.

Moreover, each community psychologist has a unique personal journey that brought her or him to the field. As Ira Goldenberg (1978) observed some time ago:

ASocial interventionists are not born, they are made. . . The making of a social interventionist . . . can best be understood in terms of a process through which certain classes of events become the experiential ground for subsequent social actions which, if not defined as >deviant,= are acknowledged to fall outside the mainstream of expected or anticipated behavior. The process itself, which rarely smooth or predictable, is punctuated by specific circumstances which are no less social salient that they personally significant.@ (Goldenberg, 1978, pp. 29 & 34)

Goldenberg (1978) goes on to note that while there are seldom dramatic, life changing events in the biographies of social interventionists, each person experiences some critical event or events that push her or him along the road to community psychology and social intervention. He then relates several critical events in his life that shaped him into a social interventionist. Training in community psychology is a process of socialization into the identity of a community psychologist. Students in training are provided with the analytical tools to make sense of critical incidents in their lives and current field placements in community settings. Personal reflection in the context of group support facilitates the making of a community psychologist.

Like Goldenberg (1978) and others (e. g., Sloan, 2000), we believe that community psychologists need to be reflexively aware of their values, experiences, and power, and to relate their personal biographies. Our values and social analysis are not fixed entities, but rather constantly emerging perspectives on both where we are at currently and where we want to be. Reflexivity is an important antidote to arrogance and dogma, believing that we have the right answer. The point is that personal, political, and professional growth are ongoing processes, not end states.

Reflexivity is necessary to unpack personal privilege (see Chapter 21). Striving to understand personal privilege and developing accountability mechanisms to oppressed groups are ways to reveal blind spots and promote further growth. An example that illustrates this point is male privilege. The two of us, Geoff and Isaac, grew up in sexist, patriarchal societies, in which many privileges were and are bestowed upon us, simply by virtue of our gender. While we believe that we have come a long way, 25 years ago the two of us were undoubtedly quite blind to many of the issues faced by women in society and in our own field of community psychology (Bond & Mulvey, 2000). It is painful to come to an awakening that you have been guilty of sexist thoughts and acts and of colluding with social systems that were and are oppressive to women. This is why consciousness-raising and reflexivity need to be ongoing processes for community psychologists.

Finally, we want to note that connecting the personal and political comes through our relationships with others. It is important to build a support network and sense of community and to have places where we can be nurtured, sustained, and challenged in our growth as community psychologists. Community psychologists need a peer group of like-minded people from psychology, other academic disciplines, and the community, who are committed to social justice and social change. As feminist writers have pointed out (Surrey, 1991), the growth and empowerment process is relational in nature.

Can I Make a Living Disrupting the Status Quo?:

Community Psychologists as Insiders and Outsiders

If community psychology is more of a social movement than a profession (Rappaport, 1981), we must ask how community psychologists are going to make a living. Who is going to hire and pay community psychologists to disrupt the status quo? Not surprisingly, community psychologists find employment based on their professional credentials rather than their values or political beliefs. Most often doctoral-level community psychologists are hired to work in university, research, or government policy settings, and masters-level and doctoral-level community psychologists work in a variety of human service settings, including health, education, mental health, child welfare and children=s mental health, counselling, etc. While these settings may hire community psychologists, they will nevertheless resist efforts by community psychologists and others to change the status quo. In a previous publication, we identified some ways in which community psychologists working as insiders in a variety of these settings can challenge the status quo and strive to shift the paradigm of practice (Prilleltensky & Nelson, 2002). Program managers, teachers/professors, and researchers can work within their organizations to promote social change. There are always dangers and concerns about Arocking the boat,@ but many settings provide at least some latitude for change.

We also believe that there are other settings that might be more congruent with the community psychologist as a social change agent. Seldom do we see or hear about community psychologists working in labour unions, international non-government organizations (NGOs) that focus on social justice issues, and social movement organizations, but we believe that these social change organizations are ripe for partnerships with community psychology trainees and graduates (Prilleltensky & Nelson, 1997). Community psychology training programs could pursue partnerships with these more non-traditional settings to promote more of a social change orientation.

Community psychologists can also work outside the system for social change. Community psychologists who work independently or for one setting can be hired to work as external evaluator, consultant, or researcher, for another setting. In these outsider roles, community psychologists can often have considerable influence in working for social change. As well, there are situations in which community psychologists are not invited by a setting but work as unsolicited interventionists. In other words, the community psychologist approaches a setting or community to partner on some project or intervention. Finally, community psychologists can work in their private lives as outside change agents. As citizens, community psychologists can join and participate in a variety of social change organizations and activities.

The Community Psychologist as a Professional

While community psychologists work collaboratively with community groups and de-emphasize the Aexpert@ role, community psychologists are trained professionals who have a set of core competencies. These competencies include: (a) values, social ethics, and the ability to think critically, (b) knowledge of community psychology theory, research, and action, and (c) a variety of community psychology skills (Murray, Nelson, Poland, Matycka-Tyndale, Ferris, Lavoie, Cameron, & Prkachin, 2001).

The knowledge and skill base of community psychology is rooted in values, social ethics, and critical thinking. It is the values of community psychology that frame community interventions. Critical thinking encompasses the ability to:

C identify the often hidden assumptions that underlie community intervention,

C examine how arguments are constructed and based on different paradigmatic assumptions,

C analyze the role of power in community interventions,

C reflect on how one=s social position, including race, gender, and social class, affects the construction of different intervention approaches (Murray et al., 2001).

Community psychologists must also have a broad base of knowledge related to community intervention. An understanding of community psychology intervention theory and intervention theories from other disciplines is essential. This includes knowledge about critical, ecological analyses of social problems and theory related to prevention, social change, alternative settings, citizen participation, community and organization development, and social policy. Community psychologists must also have knowledge about different intervention strategies, from macro social to small group, and research regarding their effectiveness.

Finally, it is not enough to be knowledgeable about community intervention. Community psychologists must also have applied intervention skills. Julnes, Pang, Takemoto-Chock, Speidel, and Tharp (1987) have argued that skills in conceptualization, intervention, evaluation, and description are important for community psychologists. Similarly, Lykes and Hellstedt (1987) stated that community psychologists need to develop skills in as participant-observers, evaluators, intervenors-change agents, and planners-designers. More recently, Thomas, Neill, and Robertson (1997) proposed that there are three broad sets of skills that cut across the different roles noted by Lykes and Hellstedt (1987) and Julnes et al. (1987). These include: (a) technical skills (e. g., skills in grant writing, research, evaluation), (b) collaboration skills (e. g., consultation, networking, partnering), (c) personal effectiveness skills (e. g., communication and interpersonal skills).

Elsewhere, we have suggested that the skill set for critical community psychologists can be conceptualized ecologically at multiple levels of analysis (Prilleltensky & Nelson, 2002). At the individual level, community psychologists need skills in communication, assertiveness, consultation with individuals, leadership, and the ability to be open to personal growth and consciousness-raising. At the level of the group and organization, skills in group process facilitation, group intervention, and organization development (including visioning, team-building, program and intervention planning) are important for community psychology. At the community and societal levels, key community psychology skills include working in solidarity with disadvantaged people, community development, community organizing, networking, coalition-building, advocacy, and influencing social policy.

All of these important skills require professional training in applied settings. The need for supervised, competency-based training in diverse field placement, practicum, and internship experiences in applied settings has been underscored by many different community psychologists (Bennett & Hallman, 1987; Julnes et al., 1987; Lykes & Hellstedt, 1987; Thomas et al., 1997).

Summary

In this section, we discussed a number of issues related to the community psychologist as an agent of social change. Becoming a community psychologist is more than acquiring professional credentials. It is a process of identity development in which the community psychologist develops a critical awareness of herself or himself in the context of one=s life experiences in the larger social and political milieu. This identity development involves connecting the personal, political, and professional parts of oneself. We noted different ways in which community psychologists can function as insiders and outsiders disrupting the status quo and creating social change. While few settings will employ people as social change agents, we discussed some possibilities that permit community psychologists to make a living and make change. Finally, we provided an overview of some of the core competencies and skills that characterize community psychologists as professionals.

THE FOCUS OF COMMUNITY PSYCHOLOGY INTERVENTIONS:

AMELIORATION VS. TRANSFORMATION

In this section we examine the focus of community psychology interventions, making a distinction between ameliorative and transformative interventions (Prilleltensky & Nelson, 1997). Ameliorative interventions are those that aim to promote well-being. Transformative interventions, while also concerned with the promotion of well-being, focus on changing power relationships and striving to eliminate oppression. Community psychologists have also used the systems theory concepts of first-order and second-order change to capture this distinction (Bennett, 1987; Rappaport, 1977; Seidman, 1983; Seidman & Rappaport, 1986). First-order change, amelioration, creates change within a system, while second-order change, transformation, strives to change the system and its assumptions. Ameliorative and transformative interventions can be contrasted along several dimensions, as is shown in Table 7.1.

Insert Table 7.1 about here

Framing of Issues and Problems

How issues and problems are framed often dictates what interventions will be used to address those problems (Seidman & Rappaport, 1986). Ameliorative interventions tend to frame issues and problems as technical matters that can be resolved through rational-empirical problem-solving (Sarason, 1978). Power dynamics are ignored in this formulation. For example, one might examine the issue of teen pregnancy by studying its prevalence and the negative life outcomes that follow teen pregnancy (e. g., failure to complete education or gain employment, mental health, drug, and alcohol problems, etc.), and the risk and protective factors that help to understand the prevalence of this problem. Poverty may be constructed as a risk factor, but there is no class analysis or analysis of power dynamics that challenges existing social structures. Programs to help prevent teen pregnancy through increased knowledge about birth control or support groups or educational programs for teen mothers are developed to address this problem and promote the well-being of teen mothers and their babies.

Transformative interventions, on the other hand, frame issues and problems in terms of oppression and inequities in power. While research and problem-solving are used to address the problem, the overall focus is on liberation from oppression and changing the social systems that give rise to teen pregnancy. Gender, race, and class are examined as intersections of oppression, and vulnerable young women are engaged in a process of consciousness-raising about themselves and their political reality. The larger macro context of global capitalism is seen as overarching specific risk and protective factors at the micro and meso levels of analysis. The increasing numbers of women living in poverty with few real opportunities for economic advancement and the corresponding increased wealth of a small segment of the population (both corporations and individuals) are examined in relation to the problem of teen pregnancy to understand the Acauses of the causes.@

Values

Since issues and problems are framed in technical terms in ameliorative interventions, the value emphasis of the intervention is often ignored or in the background of the conceptual framework. However, the values of holism, health, and caring and compassion are implicitly given the most emphasis in ameliorative interventions. Programs to promote health and prevent problems in living most often focus on skill-building and the development of social support networks, as was mentioned in the previous section.

In contrast, values are in the foreground and play a central role in the conceptualization of transformative interventions. While the values of holism, health, and caring and compassion are present, greater emphasis is placed on the values of self-determination, participation, social justice, respect for diversity, and accountability to oppressed groups. These latter values are consistent with the thrust of transformative interventions that strive to reduce power inequities (Prilleltensky & Nelson, 1997).

Levels of Analysis

Ameliorative interventions examine issues and problems in terms of an ecological perspective that is attuned to multiple levels of analysis. However, interventions are often targeted at the personal and relational levels. Prevention programs that strive to enhance competence and build social support are examples. When the macro level is addressed, power dynamics are ignored. For example, macro level health promotion interventions may aim to change social norms and practices regarding eating, drinking, smoking, and exercise to prevent heart disease or other health problems. Issues of power and exploitation, such as the role of tobacco companies in promoting nicotine addiction or the fast food industry (McDonald=s, Coca Cola) in promoting poor diet and obesity, are seldom addressed.

In transformative interventions, issues and problems are examined in terms of power dynamics that are conceptualized as occurring at multiple levels of analysis. Intervention occurs at all levels of analysis, but there is concerted effort to change power relationships. The collective level of analysis is in the foreground, even for interventions at the personal and relational levels. An example of this is a smoking prevention program that Isaac developed with Latin American community in Kitchener-Waterloo, Canada, in which children and parents engaged in social action against cigarette companies (Prilleltensky, Nelson, & Sanchez Valdes, 2000).

Prevention Focus

Albee=s (1982) equation, presented in Chapter 4, asserts that prevalence is equal to risk factors divided by protective factors. Prevention programs then should strive to reduce risk factors and enhance protective factors. Ameliorative prevention programs primarily address the bottom half of the equation, the protective factors, including coping skills, self-esteem, and support systems. The risk factors include both biological (organic) factors and environmental systemic (stress and exploitation) factors. Transformative preventive interventions strive to address systemic factors, including racism, sexism, and poverty (Albee, 1982). Most community psychology prevention programs are ameliorative in nature and do not address these macro systemic risk factors.

Desired Outcomes

The primary desired outcome of ameliorative interventions is enhanced well-being, which is conceptualized apolitically and narrowly at the individual level of analysis. Specific outcomes include: the promotion of individual well-being, which includes self-esteem, independence, and competence, the prevention of psychosocial problems in living, and the enhancement of social support. Outcomes at the individual level of analysis are in the foreground.

The primary desired outcome of transformative interventions is enhanced well-being, which is conceptualized in terms of power at multiple levels of analysis. Specific outcomes include personal changes (e. g., increased control, choice, self-esteem, competence, independence, political awareness, political rights and a positive identity), relational changes (e. g., enhanced socially supportive relationships, freedom from abuse and violence, and participation in social, community, and political life), and the acquisition of valued resources (e. g., employment, income, education, housing, freedom from exploitation) (Nelson, Lord, & Ochocka, 2001a, 2001b; Prilleltensky, Nelson, & Peirson, 2001). Outcomes at multiple levels of analysis that emphasize power-sharing and equity are in the foreground.

Intervention Process

Ameliorative interventions are often Aexpert-driven@ (Nelson, Amio, Prilleltensky, & Nickels, 2000). The community psychologist uses her or his knowledge of risk and protective factors and program models to design the intervention. While the community psychologist may play the leadership role in designing ameliorative interventions, there is also collaboration with multiple stakeholders from the community.

In contrast, the intervention process in transformative interventions involves a partnership in which community psychologists work in solidarity with oppressed groups and possibly other stakeholders from the community (Nelson, Prilleltensky, & MacGillivary, 2001). Conscientization, power-sharing, mutual learning, resistance, participation, supportive and egalitarian relationships, and resource mobilization are key aspects of the intervention process.

Roles for Community Psychologists

Since ameliorative interventions frame issues and problems as technical matters that can be resolved through rational-empirical problem-solving, the role of the community psychologist is to lend her or his professional expertise to the community to solve problems. The roles of program developer and program evaluator are emphasized. The professional expertise of the community psychologist is in the foreground, while the political role of the community psychologist is in the background. Goldenberg (1978) argues that the roles of social technician and social reformer characterize the ameliorative approach. Social technicians and reformers work with those who hold power; they identify with and accept the goals of existing settings; they emphasize adaptation to social conditions; and they do not believe that basic change is needed.

Since transformative interventions frame issues and problems in terms of oppression and inequities in power that require resistance and liberatory solutions, the role of community psychologists is to work in solidarity with oppressed groups to challenge the status quo and create social change. Social and political action is emphasized, along with program development and evaluation. The political role of the community psychologist shares the foreground with the professional role. In contrast to the previously mentioned roles of social technician and social reformer, Goldenberg (1978) argues that social interventionists work with oppressed groups; they do not identify with or accept the goals of existing settings; they emphasize consciousness-raising; and they believe that fundamental social change is needed.

Summary

As we have shown, ameliorative and transformative interventions differ in many ways. Currently, most community psychology interventions are ameliorative in nature. Prevention programs, support programs, and community development initiatives are typically designed to promote well-being at the individual and relational levels. Transformative interventions that strive to change the status quo through an alteration of structural conditions and power relations are less well-developed than ameliorative interventions. Our point here is not to suggest that ameliorative interventions are not worthwhile; they are quite useful and important. Rather what we are suggesting is that greater emphasis needs to be placed on transformative interventions. Unless we challenge unjust social conditions and power inequities, we will forever be engaged in ameliorative interventions.

The need for a shift in emphasis from amelioration to transformation is much like community psychology=s initial shift in emphasis from treatment to prevention and from individual to community interventions. Treatment and individual interventions are needed, but they can never prevent or eliminate problems in living. We believe that it is time for a new shift in emphasis in community psychology interventions that promote social justice.

SETTINGS FOR INTERVENTIONS

Community psychologists work in a variety of settings. In Great Britain, for instance, many community psychologists work in community mental health settings delivering social support services. Others in that country work for early intervention programs like Sure Start (see Chapter 22 and web resource at the end of this chapter). In South Africa, community psychologists also work in a variety of programs and projects, within government and Non-government organizations, dealing with violence reduction and prevention, child health, injury prevention, reconciliation, and mental health (Seedat, Duncan, & Lazarus, 2001). In Canada and the United States, many community psychologists work in agencies delivering a variety of human, education, and health related services, including health promotion, social skills in schools, and home visiting programs. In Australia and New Zealand, some community psychologists work in government agencies dealing with aboriginal issues (see Chapter 16). In South America, our colleagues work also in grass roots organizations (see Chapter 24 and Montero, 1994).

In our view, there are four main settings where we can practice the trade of community psychology. Human services, alternative settings, and settings for social change provide an opportunity for us to use our training and skills in a professional capacity. But there is one more setting where our professional skills and our lives intertwine: home.

Community Psychology Begins at Home

By home we mean the place where we live, study, train, work, and play. In other words, it is not just what we do from 9 to 5, or what we do when we wear the official hat of community psychologist. It is what we do all the time. Since values and social ethics inform all aspects of our human experience, not just our professional work, community psychologists try to promote these values in all spheres of life. The values we presented in Chapters 2 and 3 apply to relationships with our family, peers, co-workers, fellow students, and community members. It would be inconsistent with the value of accountability to witness injustice at home and remain silent, just as it would be incoherent to behave compassionately towards community members but despotically towards family members.

This does not mean that we have to behave like formal professionals all the time and that we have to treat our friends and relatives as if they were in need of help. Not at all, it simply means that we try to incorporate our values at home as much as at work. We do this naturally, because it is part of who we want to become, not because we are supposed to wear a badge of community psychologist all the time.

This natural integration of values into our lives makes our profession exciting. It affords us an opportunity to become more integrated human beings, trying to do what is beneficial for us, our partners, our relatives, our friends, and our communities at the same time. Box 7.1 offers some examples of what community psychologists working in universities can do to integrate their values in their workplace.

Insert Box 7.1 about here

Human Services

Human services is a generic term for organizations providing, among others, health, mental health, disability, housing, community, and child and family services. These organizations can be (a) part of government, (b) funded by government, (c) funded by charities, or (d) private agencies. Some human service agencies receive funding from a combination of sources, government, charities, and foundations. In table 7.2 we see some examples of the various settings, along with possible roles for community psychologists.

Insert Table 7.2 About Here

Examples of human services include community mental health centres, children=s mental health services, counseling agencies, alcoholism and substance abuse treatment facilities, child welfare agencies, community-based correctional services, and services for people with disabilities. These services are typically staffed by psychologists, social workers, and a variety of other health and social service professionals, and afford community psychologists an opportunity to redefine ways of helping.

Community psychologists can promote change as insiders or outsiders (see Chapter 9). In either case, chances are that some resistance will be encountered by management and workers alike. Sometimes the resistance derives from diverse strategies; sometimes it derives from divergent values. If the former is the case, a partnership for change is possible. If the latter is the case, we may have to reconsider our ability to work with organizations that do not share our vision and values. To guard against unpleasant surprises, Cherniss (1993) pointed out that before considering an intervention in a human service organization, it is important to consider such questions as:

C Whose interests will be served?

C Is there value congruence between the change agent and those with whom she or he will be consulting?

C What form will the intervention take (e.g., action research, consultation, skills training)?

C What previous interventions have been tried and with what success?

Along with our colleagues Leslea Peirson and Judy Gould, the two of us consulted with a children=s mental health agency in a review of its mandate. A value-based approach was utilized as the foundation for organizational change (Peirson, Prilleltensky, Nelson, & Gould, 1997; Prilleltensky, Peirson, Gould, & Nelson, 1997). As consultants, we negotiated with the agency to have an advisory committee with representation from management, staff, board members, parent-consumers, service-providers from other agencies, and members of the community at large. The primary guiding values of the mandate review were self-determination (what stakeholders want), collaboration (participation of stakeholders), and distributive justice (how stakeholders believe the agency should allocate scarce resources). Focus groups and survey questionnaires were used to gather data regarding the agency=s values and vision, needs, resources, and mission from a wide range of stakeholders, including youth involved with the agency, non-referred youth, parent-consumers, non-referred parents, agency workers and board members, school personnel, and other service-providers. This approach was designed to be highly inclusive in gaining input on stakeholders= views about what the mandate of the agency should be.

When we were first interviewed for the job of the mandate review, we explicitly acknowledged our bias in favour of prevention, and staff were concerned that we would push our agenda on them. We indicated that while we were biassed toward prevention, that decisions about prevention vs. treatment would be made by them, not us. In the end, the staff wanted more prevention too! We had an initial disagreement on strategies for children=s mental health, but not on values.

We asked agency staff and other service-providers how they would allocate the budget of the agency to different service areas. In the preferred budget, respondents indicated that 39% of the budget should be devoted to prevention and consultation programs. While the agency did provide some prevention programs at the time of the review, these findings suggested that the agency should increase its commitment to prevention. In our follow-up with the agency, we found that several of the final recommendations and directions were being implemented by the agency.

Another interesting finding emerged from this change process. When youth were asked what mattered to them, they stressed the importance of employment opportunities, making sure parents, teachers, and service-providers listen to and understand youth, youth support groups for different problems, and prevention programs. In other words, the youth wanted community change and community-oriented intervention approaches, not traditional clinical services. These findings underscored for us the value of involving the young people themselves in the process of change.

Geoff and his colleagues witnessed the transformational work of psychologists and other service providers in the field of community mental health. Mental health services began to shift from institutional settings to community programs beginning in the 1960s. It was assumed that this process of deinstitutionalization would lead to more humane and effective practices, but there has been increasing recognition that many community mental health programs have retained the values and character of the institutional settings that they were designed to replace (Nelson & Walsh-Bowers, 1994; Nelson, Walsh-Bowers, & Hall, 1998). While there have been changes in language (e.g., Apatients@ are now Aclients@) and emphasis (i.e., more emphasis on rehabilitation and psychosocial deficits rather than medical treatment and psychiatric diagnoses), the underlying values of community treatment and rehabilitation are quite similar to those of institutional treatment (Nelson et al., 2001a, 2001b).

Along with his colleagues John Lord and Joanna Ochocka, Geoff documented the process and outcomes of the transformation of mainstream community mental health services in their community (Nelson et al., 2001b). They found that organizational renewal processes which were based on the emerging paradigm of empowerment and community participation led to changes in organizational practices and programs, which, in turn, led to positive impacts on the people served by the organizations. The organizations that were studied engaged in a conscious reversal of power in which mental health consumers were encouraged to step up and play a major role in organizational decision-making and the provision of services and supports. They found that with the change occurring in mainstream organizations and the creation of a consumer-controlled, self-help organization, that change extended beyond the organizations to the community level.

Alternative Settings

Alternative settings are voluntary associations that are created and controlled by people who share a problem or an oppressive condition. Within alternative settings, there is a strong emphasis on

C creating a supportive community,

C non-hierarchical structures,

C holistic approaches to health,

C consensual decision making,

C horizontal organizational structures that promote participation and power-sharing,

C building on the strengths of diverse people who do not Afit@ into existing programs, and

C advocacy for social change

Such settings are formed as an alternative to mainstream organizations that are not based on these same values and which often blame the victims for not adjusting to existing social conditions (Cherniss & Deegan, 2000; Reinharz, 1984). Community psychologists can assist in the creation of such settings, as well as with ongoing consultation.

Self-help/mutual aid organizations are an example of an alternative setting (Humphreys & Rappaport, 1994; Levy, 2000). Self-help/mutual aid groups have several characteristics. They are small groups in which people who share a common problem, experience, or concern come together to both provide and receive support. Members are equals, and the groups are voluntary and not for profit. Some of the more well-known groups are Alcoholics Anonymous (AA) and Parents Without Partners. There is a wide variety of such groups and organizations including the following: loss-transition groups (e.g., bereavement groups, separation/divorce support groups), groups for people who do not have a problem themselves but who have a family member with a problem (e.g., Association for Children with Learning Disabilities - parent support group, Al Anon and Alateen), stress, coping, and support groups (e.g., AA, psychiatric survivor groups), and consciousness-raising and advocacy groups (e.g., Mothers Against Drunk Driving, women=s groups). There is a large range of different types of self-help groups available to people, and it has been estimated that in the U. S., more than 10 million people participate in a self-help group every year (Kessler, Mickelson, & Zhao, 1997).

How should professionals relate to self-help groups? When self-help group members are asked this question, they basically state that they want professionals to be Aon tap but not on top@ (Constantino & Nelson, 1995; MacGillivary & Nelson, 1998). In other words, self-helpers want professionals to practice good partnership, emphasizing respect, collaboration, equality, and appreciation for the knowledge and experience of self-helpers. One vehicle through which professional and self-help collaboration has occurred is through self-help clearinghouses and resource centres (Madara, 1990). Self-help clearinghouses are organizations which promote the self-help concept through information and referral, education, networking, consultation, and research. Community psychologists can assist self-helpers through research and evaluation, consultation, and advocacy. However, it is crucial that community psychologists act in an enabling manner rather than in a way that promotes professional dominance and consumer dependency.

Insert Boxes 7.2 and 7.3 About Here

Settings for Social Change

Of all the settings where community psychologists can practice their trade, this is perhaps the most neglected and most important area at the same time. On the continuum of transformation, this is the end where most profound change may be accomplished.

Community psychologists have an opportunity to participate in social movements as organizers, consultants, researchers, and as citizens exercising their democratic rights to have a voice (Maton, 2000). There are social change and social movement organizations, described in Chapter 8, that have great potential to go beyond amelioration and towards transformation.

As we have argued elsewhere (Prilleltensky & Nelson, 1997), there are a number of social movement organizations with which community psychologists could ally themselves. These include anti-poverty movements (see Chapter 14); feminist movement organizations (See Chapter 18), peace organizations, and environmental organizations (see Chapter 23), among many others. These organizations are often coalitions of groups and individuals who view themselves as a part of broader movements for social change. The guiding vision is one of a society free of racism, sexism, heterosexism, poverty, violence, and environmental degradation, a society which celebrates diversity, shares the wealth, and practices equality, peace, sustainability, and preservation of the natural environment.

Some social movements begin with efforts by alternative settings. Some of the social issues identified in Table 2.2, such as discrimination, racism, powerlessness, stigma, and others, have been picked up by groups that have grown into social movements. Some psychiatric survivor self-help organizations have been vocal in protesting against psychiatry and for the civil and social rights of people who have experienced mental health problems (see Chapter 21). Rape crisis centres have been a focal point for feminist organizing for social change (Campbell, Baker, & Mazurek, 1998). Examples of feminist social action include organizing public demonstrations to raise awareness about violence against women (e.g., Take Back the Night marches), lobbying different levels of government to influence legislation regarding violence against women, and the development of programs to prevent violence against women (Campbell et al., 1998). Similarly, self-help organizations for people with disabilities have actively lobbied for resources and for the rights of citizens with disabilities (see Chapter 20). The Independent Living Centres (ILCs) movement is a good example of advocacy by people with disabilities. ILCs are cross-disability, consumer-driven, and community-based self-help organizations that have a socio-political analysis of disability (Hutchison & Pedlar, 1999). ILC advocates have pushed for a new paradigm approach to disability policy and practice, emphasizing consumer control, housing, employment, mutual support, and civil rights.

In order to guide the process of change in social justice organizations, we have to be clear about

C values

C social and cultural context

C people=s needs, and

C strategic action

Table 7.3 describes a cycle of praxis whereby we address these different four points. As noted in Figure 7.1, this is a constant cycle of reflection and action. Each one of the four elements of praxis addresses a specific set of questions and has a concrete outcome. When the outcomes of the four components come together, they create a powerful synergy. This is what we are after when we participate in settings for social change. The cycle of praxis can be applied not only to social change, but to processes of organizational and community renewal as well.

Insert About Here Table 7. 3 and Figure 7.1

While social change organizations can be effective is seeking transformation, sometimes they can perpetuate injustice within them, as we will see in Chapter 8. Group members can have different views, styles, and backgrounds. This can create strain, tension, and sometimes internecine conflict. In our experience, it is not important that coalition members agree on everything. What is important is that members strive to find common ground to advocate on those issues on which there is agreement. To guard against our own personal tendencies to monopolize agendas or neglect others= contributions, we recommend having a look at the tools for social change in Box 7.4.

Insert Box 7.4 About Here

Summary

In this section we reviewed settings for interventions. Unlike other professions that advocate a separation between personal and professional life, in community psychology we are pleased to combine our professional values with our personal lives. Hence, the practice of community psychology begins at home. Home means the places where we live, work, study, socialize and play. We can wear the official hat of community psychologists in diverse settings, including human services, alternative settings and social change organizations. Our roles in social change organizations may be guided by the cycle of praxis, which includes four interacting components: vision and values, cultural and social context, needs, and action.

CHAPTER SUMMARY

The aim of this chapter was to provide an overview of community psychology interventions. The next three chapters expand on social, community, organizational, small group and individual interventions. As community psychologists we blend the personal, the political, and the professional. This amalgam of roles enables us to be as influential as we can in our personal, civic, and occupational lives. To be as useful as we can, we need to develop technical skills, aptitudes for collaboration, and personal effectiveness skills. These skills may be used for amelioration or transformation. Whereas amelioration refers to interventions designed to promote well-being, transformation refers to interventions aimed at changing power relations in society that underpin many of the barriers to well-being in the first place. We drew a clear distinction between these two types of interventions based on values, problem definition, levels of analysis, prevention focus, desired outcomes and intervention processes. The last section of the chapter dealt with four settings for interventions: home, human services, alternative settings and social change.

RESOURCES

Websites

20. Mark Burton and Carolyn Kagan maintain the website for community psychology in the UK. The website contains very useful information. Visit www.compsy.org.uk and click on the general leaflet about community psychology at Manchester Metropolitan University. The leaflet provides an excellent overview of roles and skills for community psychology interventions

21. The Radical Psychology Network maintains an active list of resources. There are many links for practicing psychology critically and applying critical psychology concepts in field work. Visit www.radpsynet.org/applied/index.html for materials related to this chapter. For general information go to www.radpsynet.org

22. The Radical Social Work Resource List contains useful materials on working for transformation in human services: www.geocities.com/rswsg/resource.html.

23. The Consortium for the Advancement of Social and Emotional Learning is supported by the work of many community psychologists working in schools. Roles and skills for work in this field are covered in www.casel.org

24. Many of the skills covered in this chapter relate to working with others in groups and communities. An excellent overview of community collaboration may found at www.communitycollaboration.net

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Table 7.1

Distinguishing Characteristics of Ameliorative vs. Transformative Interventions

Characteristics	Ameliorative	Transformative
Framing of issues and problems	Issues and problems are framed as technical matters that can be resolved through rational-empirical problem-solving; power dynamics are ignored. Scientific problem-solving is in the foreground; power is in the background.	Issues and problems are framed in terms of oppression and inequities in power that require liberatory solutions, as well as research and problem-solving. Power, oppression, and liberation share the foreground with scientific problem-solving.
Values	Since issues and problems are framed in technical terms, the value emphasis of the intervention is often ignored. However, the values of holism, health, and caring and compassion are implicitly given the most emphasis. Values are in the background.	Values play a central role in the conceptualization of the intervention. While the values of holism, health, and caring and compassion may be present, greater emphasis is placed on the values of self-determination, participation, social justice, respect for diversity, and accountability to oppressed groups. Values are in the foreground.
Levels of analysis	Issues and problems are examined in terms of an ecological perspective that is attuned to multiple levels of analysis. However, interventions are often targeted at improving personal and relational well-being. Intervention at the personal and relational levels is in the foreground.	Issues and problems are examined in terms of power dynamics that are conceptualized as occurring at multiple levels of analysis. Intervention occurs at all levels of analysis, but there is concerted effort to improve collective well-being. The collective level of analysis is in the foreground, even for interventions at the personal and relational levels.
Prevention focus	Prevention is aimed primarily at the enhancement of protective factors, including skills, self-esteem, and support systems.	Prevention is aimed primarily at the reduction of systemic risk factors, including, racism, sexism, and poverty.
Desired outcomes	The primary desired outcome is enhanced well-being, which is conceptualized apolitically and narrowly at the individual level of analysis. Specific outcomes include: the promotion of individual well-being, which includes self-esteem, independence, and competence, the prevention of psychosocial problems in living, and the enhancement of social support. Outcomes at the individual level of analysis are in the foreground.	The primary desired outcomes is enhanced well-being, which is conceptualized in terms of power at multiple levels of analysis. Specific outcomes include: increased control, choice, self-esteem, competence, independence, political awareness, political rights and a positive identity, enhanced socially supportive relationships and participation in social, community, and political life, the acquisition of valued resources, such as employment, income, education, and housing, and freedom from abuse, violence, and exploitation. Outcomes at multiple levels of analysis that emphasize power-sharing and equity are in the foreground.
Intervention process	The intervention process may be "expert-driven," but usually involves collaboration with multiple stakeholders from the community.	The intervention process involves a partnership in which community psychologists work in solidarity with oppressed groups and possibly other stakeholders from the community. Conscientization, power-sharing, mutual learning, resistance, participation, supportive and egalitarian relationships, and resource mobilization are in the foreground of the intervention process.
Roles for community psychologists	Since issues and problems are framed as technical matters that can be resolved through rational-empirical problem-solving, the role of community psychologists is to lend their professional expertise to the community to solve problems. Program development and evaluation are emphasized. The professional expertise of the community psychologist is in the foreground, while the political role of the community psychologist is in the background.	Since issues and problems are framed in terms of oppression and inequities in power that require resistance and liberatory solutions, the role of community psychologists is to work in solidarity with oppressed groups to challenge the status quo and create social change. Social and political action is emphasized, along with program development and evaluation. The political role of the community psychologist shares the foreground with the professional role.

Table 7.2

Settings, Examples, and Roles for Community Interventions

Settings	Examples	Roles
Human Services	Community mental health agencies Independent living centres Department of community services Department of public health School board Child and family services	Program developer Program manager Program evaluator Human resources manager Health promoter Unit manager
Alternative settings	Women's shelters Community economic development corporation Resource centre for persons with HIV/AIDS Self-help group run by community members Immigrant and refugee advocacy centre	Social advocate Team leader Community developer Group facilitator Board member
Social change settings	Public interest research group Social policy institute Social change movements Trade and labour unions Political parties	Researcher Organizer Public speaker Policy developer Writer

Table 7.3

Cycle of Praxis

Dimensions	State of Affairs	Subject of Study	Outcome
Vision and Values	What should be ideal vision? What values should guide our vision?	Social organizations that promote a balance among values for personal, relational, and collective well-being	Vision of justice, well-being and empowerment for oppressed communities
Cultural and Social Context	What is actual state of affairs?	Psychology of individual and collective as well as economy, history, society and culture	Identification of prevailing norms and social conditions oppressing minorities
Needs	How is state of affairs perceived and experienced?	Grounded theory and lived experience	Identification of needs of oppressed groups
Action	What can be done to change undesirable state of affairs?	Theories of personal and social change	Personal and social change strategies

From Prilleltensky and Nelson (2002).

Box 7.1

Sample of Activities on a University Campus

• •Faculty members from community psychology and other disciplines organized an anti-racism teach-in in response to psychology research conducted at another university that suggested that black people are inferior to white people, who, in turn, are inferior to oriental people.
• •Male faculty members from community psychology and other disciplines formed a group "Men Opposed to Violence Against Women." This group successfully advocated with faculty members from the Women's Studies program for the funding of a

Women's Centre on campus. This group also shared teaching materials related to sexism and violence against women to incorporate into their courses. They also participate in an annual remembrance ceremony for women at another university who died at the hands of male student who "hated feminists."

• •Faculty and students from community psychology and other disciplines organize a teach

-in, "Dismantling the Welfare State," in response to the neo-liberal policies of the newly elected provincial government, focusing on funding cuts to social assistance, health, education, social services, and programs for battered women.

• •Through protest activities, financial, and moral support, community psychology faculty and students joined with faculty and students across campus to support university staff members who go on strike over issues related to job security.

Box 7.2

Community Psychologists Study Power Issues in Alternative Setting

Derksen and Nelson (1995) reported on two central power dynamics in neighbourhood organizations. One is the relationship between professional community developers and neighbourhood residents. They found an ongoing "push and pull" in these relationships regarding who has power. A second power dynamic is the relationship between low-income and higher income residents participating in neighbourhood associations. They found that higher income residents can have prejudices about "those people" (i.e., low-income residents) and are often not attuned to their unique life stressors and circumstances. They identified the importance of "bridgers," residents and staff who can effectively link these two groups and build common ground.

Derksen and Nelson (1995) outlined three implications of their study: First, community

development must involve consciousness-raising for professionals and community members to overcome victim-blaming mythologies and to move from a charity model of intervention to

a social justice model. Second, material and human resources must be reallocated to facilitate

the process of community development. Low-income residents experience multiple barriers to

participation. Providing honoraria, child care, transportation, and hiring low-income residents are some tangible ways to overcome material barriers. Third, conflict is an integral part of the empowerment process. Working across differences of social class and social status (professional vs. community members) is inherently conflictual. But this conflict presents opportunities for growth and change for everyone who is involved in the community.

Box 7.3

Community Psychologists Help in Alternative Setting

Our colleagues Mary Sehl (1987) and Ed Bennett used a community development approach with new Canadians to create an 80-unit housing cooperative with affordable rents for new Canadians. Sand Hills Cooperative Homes became a springboard for a variety of other community-based initiatives. For example, Isaac became involved with Latin American families in the Sand Hills project, and together they formed the Latin American Educational Group. Using a participatory action research approach, the group identified the need to promote the Spanish language skills of children and prevent smoking (Prilleltensky, 1993). Heritage language classes were created, as well as a smoking prevention program with a community action component which addressed the role of cigarette companies in promoting youth addiction to tobacco (Prilleltensky, Nelson, & Sanchez-Valdez, 2000; Prilleltensky, Martell, Valenzuela, & Hernandez, 2001).

Box 7.4

Tools for Working for Social Change

Courtesy of Professor Douglas Drozdow, Department of Anthropology,

University of Western Ontario, Canada

1. Practice noticing who's in the room at meetings - how many men, how many women, how many white people, how many people of colour, is the majority heterosexual, what are people's class backgrounds. Don't assume to know people. Work at being more aware.

2. Count how many times you speak and keep track of how long you speak. Count how many times other people speak and keep track of how long they speak.

3. Be conscious of how often you are actively listening to what other people are saying as opposed to just waiting your turn and/or thinking about what you'll say next.

4. Practice supporting people by asking them to expand on ideas and get more in depth, before you decide to support the idea or not.

5. Think about whose work and contribution to the group gets recognized. Practice recognizing people for the work they do and try to do it more often.

6. Work against creating an internal organizing culture that is alienating for some people. Developing respect and solidarity across race, class, gender and sexuality is complex and difficult, but absolutely critical.

7. Be aware of how often you ask people to do something as opposed to asking other people what needs to be done.

8. Remember that social change is a process, and that our individual transformation and liberation is intimately connected with social transformation and liberation. Life is profoundly complex and there are many contradictions.

Figure 7.1

The Cycle of Praxis

From Prilleltensky and Nelson (2002).