Kay Aranda

The resilient subject: Exploring subjectivity, identity and the body in narratives of resilience

International research and policy interest in resilience has increased enormously during the last decade. Resilience is now considered to be a valuable asset or resource with which to promote health and well-being and forms part of a broader trend towards strength based as opposed to deficit models of health. And while there is a developing critique of resilience’s conceptual limits and normative assumptions, to date there is less discussion of the subject underpinning these notions, nor related issues of subjectivity, identity or the body. Our aim in this article is to begin to address this gap. We do so by re-examining the subject within two established narratives of resilience, as ‘found’ and ‘made’. We then explore the potential of a third narrative, which we term resilience ‘unfinished’. This latter story is informed by feminist poststructural understandings of the subject, which in turn, resonate with recently articulated understandings of an emerging psychosocial subject and the contribution of psychoanalysis to these debates. We then consider the potential value of this poststructural, performative and embodied psychosocial subject and discuss the implications for resilience theory, practice and research.

Uniting Resilience Research and Practice With an Inequalities Approach

The concept of resilience has evolved, from an individual-level characteristic to a wider ecological notion that takes into account broader person–environment interactions, generating an increased interest in health and well-being research, practice and policy. At the same time, the research and policy-based attempts to build resilience are increasingly under attack for responsibilizing individuals and maintaining, rather than challenging, the inequitable structure of society. When adversities faced by children and young people result from embedded inequality and social disadvantage, resilience-based knowledge has the potential to influence the wider adversity context. Therefore, it is vital that conceptualizations of resilience encompass this potential for marginalized people to challenge and transform aspects of their adversity, without holding them responsible for the barriers they face. This article outlines and provides examples from an approach that we are taking in our research and practice, which we have called Boingboing resilience. We argue that it is possible to bring resilience research and practice together with a social justice approach, giving equal and simultaneous attention to individuals and to the wider system. To achieve this goal, we suggest future research should have a co-produced and inclusive research design that overcomes the dilemma of agency and responsibility, contains a socially transformative element, and has the potential to empower children, young people, and families.

Dignity in health-care: a critical exploration using feminism and theories of recognition

Growing concerns over undignified health-care has meant the concept of dignity is currently much discussed in the British National Health Service. This has led to a number of policies attempting to reinstate dignity as a core ethical value governing nursing practice and health-care provision. Yet these initiatives continue to draw upon a concept of dignity which remains reliant upon a depoliticised, ahistorical and decontexualised subject. In this paper, we argue the need to revise the dignity debate through the lens of feminism and theories of recognition. Postmodern feminist theories provide major challenges to what remain dominant liberal approaches as they pay attention to the contingent, reflexive, and affective aspects of care work. Theories of recognition provide a further critical resource for understanding how moral obligations and responsibilities towards others and our public and private responses to difference arise. This re-situates dignity as a highly contested and politicised concept involving complex moral deliberations and diverse political claims of recognition. The dignity debate is thus moved beyond simplistic rational injunctions to care, or to care more, and towards critical discussions of complex politicised, moral practices infused with power that involve the recognition of difference in health-care.

Resilient moves: Tinkering with practice theory to generate new ways of thinking about using resilience

Recent public health policies have re-endorsed the key role all health and social care professionals have in tackling the social determinants of health inequalities. With inequalities firmly entrenched, and much theorising focused on reproduction rather than transformation, sustaining practitioner commitment and engagement with this work and maintaining confidence in achieving change is challenging. One increasingly popular way to intervene in practice to begin to address inequalities has been the use of resilience, even though resilience is frequently critiqued for its collusion with neoliberal imperatives in favouring individualised rather than socio-political responses. This article examines these concerns through the use of the practice turn and specifically ‘slim-line’ practice theory and ‘tinkering’ to explore the potential for reframing resilience theory and practice. Using an original data set derived from evaluations of resilience-based programmes, held with parents and practitioners between 2008 and 2012, this article re-examines participants’ understandings of resilience. We show how practice theory reveals entangled and emergent meanings, competencies and materials that constitute resilience as a social practice comprised of resilient moves. The implications of this reframing are discussed in relation to ontology, agency and change; but also for resilience theory and practice and public health practices more generally. In conclusion, we argue practice theory’s attention to context as more than mere backdrop to action helps shift inequality theorising beyond the individual and reproduction towards deeper, detailed social understandings of transformation and change.

Promoting resilience and emotional wellbeing of transgender young people: research at the intersections of gender and sexuality

ABSTRACT Within lesbian, gay, bisexual and transgender (LGBT) research there is increasing health-related scholarship on trans lives, with a growing awareness of the impact of health inequalities on trans well-being. The aim of the paper is to provide greater understanding of transgender young people’s views of what is needed to promote their emotional well-being and resilience by undertaking specific analysis of data collected as part of wider research with young people (n = 97). The study utilised participatory qualitative methods with a cross sectional design generating data via a focus group with trans youth (n = 5), followed by thematic analysis. Findings suggest that both individual and collective capacities or resources enable and sustain resilience and well-being for trans young people. The adversity trans youth face is present in school, the community and in healthcare, but they are able to find places where they feel safe and connected to others. Practitioners, teachers and school nurses are well positioned to facilitate structural change in alliance with trans youth to promote resilience. Research results were utilised to inform health improvement, commissioning and service delivery.

The "Assistant Practitioner" as "Associate Professional"? Professional Development of Intermediate Roles in Health and Social Care and Education.

Recent years have seen the health and social care and education sectors subject to a range of policy initiatives which have been characterised by a concern for ‘modernisation’ and restructuring of the workforce which has resulted in a reappraisal and so-called ‘professionalisation’ of many existing previously lowskill roles. This has resulted in the development of new intermediate or ‘assistant practitioner’ roles such as ‘parent support advisors’ and higher level teaching assistants in schools. In Health contexts, these roles are evident in the inclusion of associate and assistant practitioner roles in health care in pay bands three and four to support the ‘professional’ workforce in bands five and above. The ‘professionalisation’ of roles in the public sector has been associated with enhanced qualification requirements and foundation degrees (FDs) have provided an appropriate work-based qualification. This paper explores notions of professional learning and professionalism in the current policy context and draws out points of commonality and divergence between the two sectors. In light of recent concern about broadening access to the professions we relate this discussion to a critique of the potential role of ‘assistant practitioner’ roles and associated intermediate level FD qualifications in widening access to the professions in these two sectors.

Healthy and active ageing: Social capital in health promotion

Objectives: This paper examines the context of health promotion actions that are focused on/contributing to strengthening social capital by increasing community participation, reciprocal trust and support as the means to achieve better health and more active ageing. Method: The methodology employed was a literature review/research synthesis, and a thematic analysis. Results: Four core themes emerged from the analysis: a) active ageing; b) the relationship between social capital and ageing; c) the importance of social capital in health promotion; and d) policy implications. The role of social capital in health promotion stresses empowerment, intergenerational support, the building of social trust, and the need to tackle loneliness among older adults. The importance of community/social participation emerged from the literature review as a key contributor to the maintenance and promotion of a healthier ageing population. Conclusion: Supporting long-term social capital building within communities can lead to improved public health and well-being for an ageing population.

Queering the relationship between evidence-based mental health and psychiatric diagnosis: some implications for international mental health nurse curricular development

This is a scholarly work based on Queer theoretical principles, with implictions for international mental health nurse curricular development.

Exploring young people’s emotional well-being and resilience in educational contexts: A resilient space?

The term ‘resilience’ is pervasive in narratives of young people’s emotional well-being. However, the meaning it has for those it describes is perhaps less well understood. Resilience was investigated as part of an engagement exercise into health improvement commissioning in educational contexts in the South East of England. One hundred and nine young people in total were involved, and this article reports data collected from two areas that were explored, comprising a sub-set of 58 participants: emotional well-being and resilience (n = 23) and the whole school approach (n = 35). It was apparent that while not all participants engaged with the term ‘resilience’ itself, they nevertheless often adopted creative individual and collective strategies to protect and enhance their emotional well-being. Furthermore, participants reported a sense of resilience that arose from a shared sense of adversity that helped strengthen collective support and solidarity, thus supporting previous work on emergent collective resilience. Theoretical and practical implications are discussed, along with a recommendation for more participatory research, so that young people can be more confident that their views are being considered within such exercises.

Communities of practice in community-university engagement: Supporting co-productive resilience research & practice

For the last 10 years, we have been exploring Communities of Practice (CoPs) as both a conceptual and practical approach to community-university engagement, most notably in our work on resilience with children, young people and families. We have found elements of CoP theory and practice to be a powerful and pragmatic way to approach many of the tensions, considerations and nuances of this work. This chapter focuses on our experiences (academics and community partners) of running a CoP with a diverse membership that meets monthly to discuss, disagree and debate about resilience research and practice. We outline those theoretical areas we have found invaluable in getting us started with CoPs, but we also discuss where we have found ourselves needing to develop our own approaches to help us with the complex circumstances and systems, rather than within one single domain. We identify a series of paradoxes that we have to navigate in making our CoP work—particularly the tensions between being social but intentional in our practice, and how we can disentangle the blend of participation and learning that occurs in our CoP space. We conclude by turning to the future, to consider the conceptual development that might be helpful in this area and to reflect on the potential of supporting co-productive research and practice in pursuing social goals through communities of practice.