Opening the Conversation about Children's Well-being: Tensions, Confluences and Possibilities in School-based Mental Health Promotion
Author(s):
Catriona O'Toole (presenting / submitting)
Conference:
ECER 2016
Format:
Paper

Session Information

08 SES 03 JS, Interventions to Promote Wellbeing: Schools and Community

Joint Paper Session NW 08 and NW 14

Time:
2016-08-23
17:15-18:45
Room:
OB-H2.32
Chair:
Venka Simovska

Contribution

There is growing concern about apparent increases in childhood mental health difficulties particularly in the Western and English speaking world. The World Health Organisation estimates that up to 20% of children and young people experience a disabling mental health problem (Amnesty International, 2011). Discussion of the causes of these difficulties often focuses on individual deficits such as poor self-regulation skills or diminished self-efficacy (Wyman, 2010). However, the causes of childhood mental health difficulties are multifaceted and need to be understood, not just at individual or micro level, but at meso and macro levels as well.

The increases in childhood distress have been attributed to features of contemporary culture.  Among the issues of concern are the incessant commercialisation of childhood by the advertising industry (Palmer, 2007; Schor, 2014), the sexualisation of children at increasingly young age (Lamb & Mykel-Brown, 2006), the growth of an audit culture in education which places emphasis on test performance (Torrance, 2004), and reduced time and space for free, unstructured play (Grey, 2013).

It is important to note however, that certain groups of children are more negatively affected by these cultural trends than others. For instance, a substantial body of research shows that mental health problems are more common in areas of poverty and deprivation (Freidli, 2009). Likewise, the sexualisation and commercialisation of childhood has a more pernicious effect on girls, who are frequently objectified and faced with narrow and unrealistic ideals of feminine beauty (Coy, 2009; Fredrickson & Roberts, 1997).

In response to the growing levels of distress amongst children, schools have emerged as an ideal setting in which to promote wellbeing. School-based interventions may be targeted towards children who might benefit most, such as those who have encountered significant adversity or risk. They can also be delivered as part of a universal preventative approach, which can be important both in terms of cost-effectiveness and in reducing stigma (Kuyken, Weare, Ukoumunne, 2012; Rutter, 2013).

However, there is considerable debate surrounding how to best promote mental health in schools. Two diverse approaches will be explored in this paper. First, the psychological sciences have given rise to an increasing number of mental health programmes aimed at school-going populations.  Examples include FRIENDS (Barrett, et.al, 2006), Social and Emotional Aspects of Learning (SEAL, Humphries, 2010), and Mindfulness Based Cognitive Therapy for Children (MBCT-C; Semple et.al, 2005).  In general these programmes are based on sound principles and theoretical frameworks, and there is a wealth of research supporting their effectiveness (e.g., Weare& Nind, 2011). These programmes also tend to be prescriptive in nature, developed and driven by “experts” and often have strict requirements around training and fidelity.

In contrast, others stress that individual and collective wellbeing can best be enhanced by bottom-up processes of empowerment, democracy and participation. Feminist, post-colonial and critical social theorists have been instrumental in drawing attention to structures and processes that maintain dominant and oppressive traditions (Freire, 1993; hooks, 1993; Moane, 2011). Such theorists are acutely aware that mental health difficulties are more likely amongst oppressed and marginalised groups. Thus a critical awareness of oppressive conditions is central to any attempts to improve wellbeing. Prescriptive solutions by detached experts are not the answer, precisely because experts form part of the dominant, powerful and oppressive culture. Marginalised groups must apprehend reality in their own way and must themselves become agents in a process Freire calls “consientization”.

These two positions are ideologically and epistemologically opposed. In this paper I first review the different traditions along with their respective approaches and methods. I then use theoretical and philosophical frameworks to explore ways that the two traditions can be brought into conversation.

Method

This is a conceptual paper, which seeks to explore school-based mental health promotion by drawing on diverging theoretical perspectives. The two broad approaches outlined above are each rooted in different philosophical traditions. Psychological interventions are underpinned by a positivist epistemology, which assumes there is an objective reality that can be observed, measured and understood outside of its social context. In contrast, the empowerment approach is rooted in an interpretivist philosophy, which views phenomena as socially constructed and which challenges the idea of fixed realities and objective truths. Both positivism and interpretivism have strengths but also practical limitations. Their opposing positions present problems for researchers and practitioners interested in school-based health promotion. In this paper, I draw on bio-ecological (Bronfenbrenner & Morris, 2006) and dynamic systems theories (Thalen & Smith, 1994) to demonstrate the contextual, emergent, and dynamic nature of human thought and action, and I outline how these theories are broadly compatible with both positivist and interpretativist approaches. I also draw on the philosophy of critical realism (Bhaskar, 1993, 1998, 2002), which offers an alternative to the problems and limitations presented by positivist empiricism and hermeneutical interpretivism.

Expected Outcomes

To fully understand and respond to child and youth mental health difficulties, it is necessary for theorists and practitioners from different traditions to come together in dialogue. Those from positivist traditions risk pathologising and individualising children’s distress by conveying the message that the solution to mental health difficulties lies in altering children’s own thoughts and emotions. Interpretivists, on the other hand, are in danger of denying the reality of children’s distress and embodied experience. These opposing and polarised positions are unhelpful and detract from an understanding of the totality of children’s experiences. In bringing together these two diverse approaches my aim is not to collapse or attempt to reconcile the differences between them. Rather it is to explore the tensions and convergences and to suggest critical realism as a coherent framework that might support interdisciplinary work around school-based mental health promotion. A theoretical convergence and openness to learning from each other has much to offer for the future of health promotion research and practice.

References

Amnesty International and Children‟s Rights Alliance (2011). Children‟s Mental Health Coalition Background Paper Alderson, P. (2013). Childhoods real and imagined: Volume 1 An introduction to critical realism and childhood studies. Oxen: Routledge. Bronfenbrenner, U., & Morris, P. A. (2006). The bioecological model of human development. In W. Damon & R. M. Bhaskar, (1993/2008b). Dialectic: the pulse of freedom. Abingdon: Routledge. Lerner (Eds.), Handbook of child psychology, Vol. 1: Theoretical models of human development (6th ed., pp. 793–828). New York: Wiley. Barrett, Farrell, Ollendick, Dadds (2006). Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the FRIENDS programme. Journal of Clinical Child and Adolescent Psychology, 53, 3 Dunn J. & Layard R. (2009). A Good Childhood: Searching for Values in a Competitive Age. Penguin Elkind, D (2001). The hurried child: Growing up too fast, too soon. Perseus Publishing Freire, P. (1993). Greene, S. (2015) The psychological development of girls and women: Rethinking change in time. Routledge: London. Palmer, S. (2007). Toxic Childhood: How The Modern World Is Damaging Our Children And What We Can Do About It. Orion Schor, J. (2014). Born to Buy: The Commercialized Child and the New Consumer Culture. Scribner Thelen E. Development as a dynamic system. Current Directions in Psychological Science. 1992;1:189–193. Weare, K. and Nind, M. (2011) “Mental health promotion and problem prevention in schools: what does theevidence say?” Health Promotion International, 26 No. S1, 29-69.

Author Information

Catriona O'Toole (presenting / submitting)
Maynooth University
Education
Maynooth

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