TC3 - Photovoice - A New Hope - Addictions and Mental Health

PhotoVoice: A
New Hope
Heather Elliott, BSW, RSW, ADSTV
Jenna Slater, BSW, CAS
Luisa Tula, BSW, CAS
PhotoVoice background
Stage-based Treatment
Why Use Creative Arts
PhotoVoice: A New
Benefits of Working in
The Next PhotoVoice
Creating a PhotoVoice
“Standing in the dark”
“One of the biggest
changes for me was
letting go of the
unhealthy people in my
life. I am like this
flower, surrounded by
others but out on my
own. I feel that I am
alone standing in the
dark, but I know when I
am ready I will
welcome the right
people into my life.”
PhotoVoice: Background
Photovoice essays are a documentary
style of photography using participatory
action research methods.
 First developed in 1990s by Caroline
Wang, University of Michigan.
 created "Photo Novella," what is now
known as Photovoice, as a way to
enable rural women of Yunnan Province,
China, to influence the policies and
programs that affected them.
As Carolyn Wang says:
“Photovoice blends a grassroots approach to photography
and social action. It provides cameras not to health
specialists, policy makers, or professionals, but to people
with least access to those who make decisions affecting
their lives…”
“Photovoice is a process by which people can identify,
represent, and enhance their community through a specific
photographic technique. It entrusts cameras to the hands
of people to enable them to act as recorders, and potential
catalysts for social action and change, in their own
communities. It uses the immediacy of the visual image
and accompanying stories to furnish evidence and to
promote an effective, participatory means of sharing
expertise to create healthful public policy.”
PhotoVoice: Background
Designed to empower traditional subjects of
documentary photography to educate
themselves, the general public, and policy
makers about identified issues.
 By providing cameras to a marginalized
population without a voice in society, they
are able express themselves through
photography, empowering them to share
their thoughts and feelings about
community issues, reduce social isolation
and vulnerability
“Footprints in the sand”
“This represents my
future and my journey.
It reminds me of the
poem Footprints in the
sand. Addiction brings
you down. I felt alone
and my life sucked, but
now I know that I was
not alone, even if I
didn't always feel it at
the time. There were
always signs of life
around me.”
Stages of Change Paradigm –
Prochaska and DiClemente
Model well tested; used all over the
world; portable
 Has created a paradigm shift
 How to understand behaviour
 How to influence behaviour change
 New framework to work with
 Based on research with selfchangers
Stages of Change
Introduction to Six
◦ Re-engagement with
problem behaviour
“Walking Spirits”
“This picture represents
the people in my life
who protect me and
help keep me safe. It
helps me to
remember the people
I have lost over the
years and to know
that they are still with
me in spirit.”
What is Stage-based
Addiction treatment that is designed
specifically for individuals at various
stages of change
Increases effectiveness of treatment
when all group participants are in the
same/ similar stage of change
PhotoVoice: Maintenance
Stage of Change
PhotoVoice: A New Hope was
specifically designed for women in the
maintenance stage of change
 Created to help them focus on what
gives them hope in recovery
 Help to convey hope to others as well
 Stability required due to some
locations of the outings for the pictures
“The first few steps were the hardest”
“Being at the bottom is
like being messed upgoing through recovery
is not easy, it's
challenging. The first
few steps were the
hardest and then it got
easier. At the top I
achieved freedom and
having my son back.
You can't always see
what's at the top.”
PhotoVoice: A New Hope
Stigmatized individuals are given a
“voice” to share their experiences
Individuals who are stigmatized in society are
given a “voice” to share their experiences for
the purpose of educating the general
population, including policy makers.
 The identified population are often the
“subjects” of photographs
 The participants create the artistic images and
the accompanying messages, assisting them
to gain control over their own perceptions of
their surroundings
Creating a theme…
Allows the photographer to examine and
visually express thoughts and feelings
 Helps the artist to internalize the
 The literature shows that people who
reflect on a subject begin to internalize its
 Examining the idea of hope can serve as
a vehicle to acquiring hope
Photo therapy…
Complements traditional therapies in
improving self-esteem, and overall quality of
 Studies have found that engaging
marginalized peoples in artistic programs
increased confidence, self-esteem and skill
 Noted that participants benefited in many
other ways from participation in communitybased arts projects, including making new
friends, trying something new, feeling
success, being creative, changing ideas, and
learning about other people
“Messed Up”
“This picture reminds
me of being messed
up, out of control.
However, I feel hope
when I look at it. I
can see my hands
and it feels like I am
reaching out, waiting
for somebody to take
my hands and help
me, to pull me out.”
PhotoVoice: A New Hope
PhotoVoice: A New Hope is a journey with
women who are walking through recovery,
focusing on aspects of hope within their
lives. The theme of hope is depicted
through pictures taken by the women and
through narratives that explain the
significance of these photos. The goal of
the project is not only to focus on the
individual women, but also to create a
forum to educate others about addiction
and recovery. It is meant to increase
public understanding, minimize shame,
and increase compassion.
The Women of PhotoVoice
All mothers
 Long history of substance abuse
 Extensive involvement with CAS
 Poverty
 Trauma histories
 Maintenance stage of change with
both abstinence and harm reduction
 Current clients with ADSTV or CAS
PhotoVoice: A New Hope
Partnership with CAS
London-Middlesex and
Facilitated by 2 Child
Protection Workers and
1 Addiction/ Mental
Health Counsellor
8 week group
Pre/ post tests
Participants taught basic
photography skills &
given a digital camera
 3 outings to take
pictures as a group
 Journaling of meaning of
picture related to the
theme of hope in
Pre/ Post Test
Perceived Social
Drug Taking
Questionnaire –
Alcohol and Drugs
All had an increase
in PSS for both
family and friends
Confidence level
remained the same
or increased,
except one woman
Increase in hope
for all women
Trait Hope Scale
Group Outline – Week One
Review of how the program was
 Review of Photo Voice
 Establish group norms and expectations
 Review Rights of Photographers and
potential copyright issues
 Signing of consents and releases
 Completed pre-test tools
 Women given their cameras & taught
basic functions
Group Outline – Week Two
 Discussion
◦ How do you define hope?
◦ Discuss how hope would look as a
Review of general camera use to
address any questions
 Taught basic photography techniques
 Review of women’s pictures
Group Outline – Week Three
Field Trip - Port Stanley
 CAS provided transportation to the
participants and facilitators for the field
 Women were provided with
suggestions on what to photograph
 Lunch was provided
 Review of women’s pictures
Group Outline – Week Four
Field trip downtown
 Participants and facilitators met at
ADSTV and walked downtown
 Focus is to re-write their story given
that downtown may hold negative
memories for some of the participants
 De-briefing of the women after the
 Review of women’s pictures
Group Outline – Week Five
Field trip to Springbank Park
 CAS provided transportation to the
participants and facilitators for the field
 Further discussion about their journey
and the meaning of hope
 Women provided with one to one
 Picnic lunch
Group Outline – Week Six
Women begin to select their pictures
and begin to critique - discussion
encouraged in regards to their pictures
and their meanings
 Pictures downloaded onto two laptops
to help with editing - select pictures for
the final showing
 Give helpful advice
 Volunteer support to assist with editing
and journalling
Group Outline – Weeks Seven
and Eight
Focusing on preparing for the display matting their photos and completing
any outstanding journaling
 Completed post-test tools and conduct
group evaluation
 Project termination and wrap-up
 Pizza lunch provided during week
eight as part of wrap-up celebration
The Exhibit
Held at Kings University College
 One night, two hours
 Facilitators set-up display for women
 Women attended and brought family
and friends
 Event was advertised, open to
 Copies of pictures were sold along
with note cards
Additional Showcasing
CAS of London and Middlesex has
designated a specific area within the
building in which to display the Photo
Voice photos (for both current and future
The Photo Voice project was also invited
to King’s University College during Social
Work week to display the photos
ADSTV promoted and displayed pictures
at its AGM and annual Recovery Breakfast
Proceeds from the Sales
60% of proceeds from each woman’s
pictures were given to her
 40% re-invested into the program so it
could run again
 Prices of pictures varied based on size
of picture being ordered
 Lots of note cards sold however, no
real proceeds gained due to cost of
“I am broken”
“This bridge represents
my life when I was
using. I was broken,
my heart was broken.
I felt like two separate
people. A mother and
an addict struggling
with so many hurts. I
didn’t think it would
ever be possible to
heal, to be whole
Why did CAS & ADSTV Partner?
Began partnership with having CAS
staff co-facilitate treatment groups
 Goal to help cross train CAS and
ADSTV to better understand each
others roles with clients
 Help to demonstrate collaborative
relationship to clients
 Increase support available to clients
through increased shared
Mutual benefits of Collaboration
(CAS and Addiction Services)
Occurred on several levels:
Resources maximized (synergize)
Gap in the community addressed
Women observe agency staff working
together for their benefit
 Staff and clients are educated at the same
 Staff satisfaction
 Other partnerships get launched
Benefits of Collaboratively Using
Creative Arts Projects in Treatment
Participants were able to develop
positive relationships with the
Children’s Aid Society
 Participants were able to offer each
other support and encouragement
 Participants were able to engage in an
activity that was positive and they
were able to develop new skills
 Participant were able to observe the
collaboration between two agencies
Benefits of Collaboratively Using
Creative Arts Projects in Treatment
For staff, this type of project offers
variety and excitement to complement
everyday work responsibilities
 Participants were able to have one-onone time with counsellors, discussing
their journey and the gains they have
 Participants were given digital
cameras which could be used to take
pictures of family and friends
Participants struggled with the concept
of hope- very abstract and facilitators
needed to spend more time discussing
this concept
 Potential conflict between participants
to due previous history/affiliation
 Participants not completing the group
 Extenuating circumstances which
impact participant’s ability to take
photos or attend the outings
“I use to be scared to
get on the bus,
paranoid of people
looking at me,
ashamed of what I
looked like, feeling
that I did not fit in. I
don’t have that fear
anymore. Now I
ride the bus all the
What’s Next for PhotoVoice?
New group started May 24, 2011
 8 women registered to participate
 Increased demand to join group
 Theme – “Then & Now”
 Maintenance stage of change
 5 weeks, 2 outings, 2 weeks for
journaling and matting pictures, 1
“Life has stains and rough
“Life has stains and
rough patches, but it
all fits together. Each
person has a
different history and
layers, much like the
bricks in this wall.
Each brick has been
impacted by different
Creating Your PhotoVoice
Determine budget
 Select target client population
 Set length of group (number of weeks
and length of each session)
 Choose locations for outings & group
 Identify number of group facilitators
 Plan for the exhibit
Pre-Group Preparation
Research and development of project
 Acquire a safe and comfortable space
for programming
 Potential participant screening for
commitment and stage of change
 Creation of consent forms and
 Purchase of supplies
 Select pre/ post assessment tools
Determining a Budget
Cost of cameras
Memory cards
Printing pictures, mattes, exhibit expenses
Bus tickets/ transportation support
Snacks/ meals for outings
Child care
Facilitator salary
Target Population
Gender specific vs. co-ed
 Age range – target specific group or
leave open
 Common experiences i.e. consider
addictions, child welfare involvement,
poverty, homeless, mental health
 Reflect on potential group dynamic
issues that may arise due to
Length of Group
Determine number of sessions
 How long should each session be
 Amount of time needed may vary
based on location of outings chosen
 Leave adequate to review and
process pictures taken
 Provide increased support for
journaling, editing and matting of
Locations for Outings
Places participants are familiar with
 Places participants can’t often go to
on their own
 What is the theme of the group
 Tie location selection to supporting
theme and meaning of the group
 Consider what might be triggering vs.
opportunity to reframe past experience
Participant to facilitator ratio may vary
based on planned activities for group
 Do you want to teach any basic
photography skills
 Who will complete editing of pictures
 Support for picture selection and
completing journals – consider literacy
The Exhibit
Location accessible to participants but
also appealing to community
 Advertise in advance – especially that
pictures will be for sale
 Consider the role of group participants
 Will food be offered during event
 How to coordinate ordering of pictures
 Comfort level of participants to be
identified during the exhibit
“Finding Faith”
“I remember the day I
decided I had had
enough. I prayed to
God to help me, to give
me a sign and he did.
Throughout my
recovery, rediscovering
my spiritual life as been
critical. This cross
helps to give me hope
to believe, to stay
Questions or
Thank-you for your attention!
Helpful Websites

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