Aproximaciones en la superficie ocular

‘Eco-maps’ are pen-and-paper diagrams of an individual, community or process that allows participants to draw relationships while ‘ecomaps’ are geographical maps used in ecosystem mapping (Blasi & Frondoni, 2011; Morgan et al., 1994). Sometimes these terms are used interchangeably in the literature but ‘eco-map’ is the term used to describe the research tool used in this thesis.

Eco-maps are graphical representations that allow a participant to organise and objectify the systems at play on an individual or community level. Eco-maps are social ecological maps developed by Hartman (1979) to depict the ecological systems that encompass an individual, community, or process (Hartman, 1995) and pictorially demonstrate the ‘complexity of human existence’ (Hartman, 1975). Based on Bertalanffy’s 1936 ‘General Systems Theory’ (cited in Costanza, Wainger, Folke & Mäler, 1993), where ‘wholeness’ refers to any object or element within a system that produces an entity greater than the sum of the separate parts, Hartman’s eco-map is an anti-reductionist approach to identification of need/s in individuals, families, or communities (Zastrow, 2001) by diagramming a person’s connection with larger social systems (Compton, Galaway, & Cournoyer, 1999).

An eco-map is most often used by therapists as a tool to create a narrative around the social support structures in an individual’s life (see for example, Kerson & McCoyd, 2010). However, they are also used as a base to gain thick findings from a research participant (see for example, Emam, 2014). Whatever the aim of use, eco-maps can help capture and organise data in a conceptual level, and allow for differing literacy skills

among participants, and can be appropriate for use in individuals who prefer visual cues for positioning their opinions of self. This pictorial representation and understanding of an individual in his or her environment/world lets a person’s position be viewed as a system interlaced with multiple systems, and identification of the major dynamics in operation for that individual (Hartman, 1979), in therapeutic (De Oliveira, Nascif‐Júnior, & Rocha, 2010) and research settings (Vodde & Giddings, 2000), especially with the variable or outcome of interest in clinical and research projects is social support (Baumgartner, Burnett, DiCarlo, & Buchanan, 2012). Eco-maps in this thesis will be used as visual prompts for the interviews, and allow participants to describe their experience of living in community. These eco-maps are informed by Bronfenbrenner’s ecological social capital framework, so the concentric circles for yarning with the participant are based on the most common vehicles of social inclusion that match Bronfenbrenner’s framework including work, family, religion, education, and culture (that is, activities relating to Indigenous culture such as membership in Indigenous organisations).

5.8.4.1 Use of eco-maps in therapy and research

Initially, eco-maps were used as an assessment tool for social support.67 While still used for assessment in social settings, and as a tool for therapeutic interaction in, for example, people who were adopted (Spiteri, 2012), eco-maps have been increasingly used in research.68 _{However, while there are multiple advantages in using an eco-map in clinical} practice (see Cusinato & Colesso, 2010; Gallagher, 2013), its use in research is increasing as its validity (Hodge & Limb, 2014) and specificity (L’Abate, 2013) has become more widely accepted (see Bennett & Grant, 2016).

5.8.4.2 Eco-maps and Indigenous people

The primary concern of eco-maps are social relationships and networks and the positive or negative nature of connections or bonds for individuals or communities, expressed as visual representations of social relationships, including family, friends, and community networks (Elliott, 2012; Rempel, Neufeld, & Kushner, 2007). Acknowledging the importance of social support to assist health maintenance and wellbeing (see Nausheen, Gidron, Peveler, & Moss-Morris, 2009), and given that eco-maps are a practical and accessible way to identify both positive support and social conflicts impeding wellbeing (Ray & Street, 2005), the use of eco-maps has relevance for the holistic approach

67 _{For example, in disability nursing (Valentine, 2013), family nursing (Wright & Leahey, 1999), chronic}

illness (Collier, 1990) and social work (Hartman, 1995).

promoted by Indigenous social and emotional wellbeing (SEWB) frameworks (see Stewart & Allan, 2012).

There are a few examples of the use of eco-maps in research or as therapeutic tools in indigenous communities. Elliot (2012), a First Nations Canadian, researched eco-maps as a tool to promote culturally appropriate mental health services. Elliot (2012) created an eco-map with Canadian Aboriginal designs that facilitated eco-map completion by participants. Elliot (2012) then used the findings to inform practices in mental health services in areas with a large indigenous catchment population, by demonstrating the need for family access to clients in mental health services by being able to show the need for continued family relationships in Canadian Aboriginal people.

Like Elliot (2012), Stewart and Allan (2013) used eco-maps to research how to build relationships with Australian Indigenous people and human services workers, and developed a ‘cultural mapping toolbox’ for use across disciplines. This cultural mapping toolbox reminds practitioners to include the complexities of cultural relationships with indigenous people in health settings. O’Donoghue and Maidment (2013) recommend Bronfenbrenner’s ecological social capital approach when using eco-maps with Indigenous people, as this approach seeks to understand the centrality of the person in the environment. O’Donogue and Maidment (2013)’s research reinforces the use of Bronfenbrenner’s social capital ecological model in this PhD research.

5.8.4.3 Eco-maps using Bronfenbrenner’s ecological social capital models

Bronfenbrenner’s model fits in well with the way eco-maps provide a pictorial representation that fosters understanding of an individual in his or her environment/world, by organising meso-levels, exo-levels, and micro-levels ecological contingencies (Calix, 2004). Bronfenbrenner’s (1992) ecological systems theory contends that there are certain environmental influences that have the potential for greater direct effect than others, with other factors have a more indirect effect, and these effects vary among individuals (cf. Härkönen, 2005), while seeking to understand the centrality of the person in their environment (Bronfenbrenner, 1979). Given that eco-maps can clearly demonstrate and measure these effects to the researcher and the participant, and the strength of relationships of these factors, I have theorised that Bronfenbrenner’s ecological social capital theory can inform the eco-map and might therefore demonstrate the research variables as vehicles of social inclusion.

5.8.4.4 Use of eco-maps in this thesis

Eco-mapping as a research tool has been used to study a variety of health and social issues,69 as well as used as an adjunctive tool in research.70 Rather than a measure of intervention outcomes, Christiansen et al. (2007) used eco-maps to explore and measure relationships of adult survivors of incest, allowing their participants to identify relationships that were supportive and/or provided comfort during difficult times. Using an eco-map allows participants with a history of personal trauma to talk to the map, rather than to the researchers. This takes pressure off individuals by avoiding having them re- telling and thereby re-living their distress. The potential protecting of participants’ self- image and social and emotional well-being is the lead rationale for using an eco-map in this PhD research, as discussing personal events carries the possibility of making the participant re-live any trauma. Re-traumatising participants by asking them to re-live their negative experiences is a concern in any population, but a great risk in this PhD research, given that Australian Indigenous people are generally considered to be ‘highly psychologically traumatised’ (Raphael, Delaney & Bonner, 2007). Any re-traumatising is a breach of trust in a researcher, and can cause undue suffering for a participant. This goes against all research ethics, and does not fit in the Yerin Dilly Bag model. Conversely, using the eco-map to identify supportive relationships can assist participants to feel a greater connection to significant others in community (Christiansen et al., 2007), and is an example of how assessment can become therapeutic (Miller & Rollnick, 2013). The eco-map used in this thesis consists of a simple genogram in the centre of one large circle (see Figure 5.4). A coloured cartoon tree sits over this genogram. The participant is considered as the first of the four-generation genogram, with allowances for participants to add their partners and/or children if they so choose. Participants are not

69 _{For example, inclusion of school students with autism (Emam, 2014); sources of distress in people with}

cancer (McLaughlin, 2013); or children with chronic diseases (Charepe et al., 2011) or disabilities (Correa, Bonilla, & Reyes-MacPherson, 2011; Jung, 2010); dysfunctional families (Gilgun, 2011); and to identify predictors of long-term recovery in tsunami-affected children (Nastasi, Jayasena, Summerville, & Borja, 2011); and as a teaching aid for health students working with families experiencing dementia (LeNavenec, 2013).

For example, Ho et al. (2013) used eco-mapping to measure memory recovery pre- and post-intervention for in people with memory loss attributable to cancer, by asking participants to create their own eco-maps as drawings of their family relationships, administering the intervention of memory-recall exercises, then getting participants to again draw their eco-maps and relationships, and measuring an increase in recall of relationships as success of the intervention.

70 _{For example, Ho et al. (2013) used eco-mapping to measure memory recovery pre- and post-intervention}

for in people with memory loss attributable to cancer, by asking participants to create their own eco-maps as drawings of their family relationships, administering the intervention of memory-recall exercises, then getting participants to again draw their eco-maps and relationships, and measuring an increase in recall of relationships as success of the intervention.

required to give names for the four-generation genogram, instead they are asked to distinguish which parent or parents identified as Aboriginal and/or Torres Strait Islander people. One of the inclusion criteria for this research was that participants identified as Aboriginal and/or Torres Strait Islander, therefore it is axiomatic that at least one parent would have identified as Indigenous. The coloured tree in the centre of the eco-map is the only attempt to make the eco-map attractive to participants or to induce motivation with compliance.

Figure 5.4. The eco-map used in this PhD research, and its links to Bronfenbrenner’s ecological social capital theory. Participants draw the strength of their relationships as part of the interview process. Adapted from Harold, Mercer and Colarossi (1997). Copyright (1997) Western Michigan University.

For this PhD research, the participant was positioned in the centre of the eco-map. This allowed the participant to consider his or her family tree, or history, and to be able to identify indigenous heritage, one of the signifiers of Indigeneity. Even though circles can be drawn in any size, for this research, the circles were all the same size, with some prompted labels, including: health, family, education, culture, work, home, and community. One of the satellite circles was left unlabelled to allow participants to add a category, for example religion, if that met with their lived experience in the community. On the eco-map, connections or relationships are to be drawn on by the participant, per the legend at the bottom of the eco-map. The types of lines indicated the strength of the

the energy or the strength of the relationships operated. For example, a large arrow indicates a major flow of energy or resources so that a participant would be able to draw a thick arrow away from their position in the genogram, and towards the satellite circle labelled “health” if they felt that their health was a source of energy loss to them. If a participant felt that they gained a lot of strength or energy or support from their family, then they would draw the thick arrow from the satellite circle labelled “family” to the centre of the eco-map.

A pilot of this research (in New Zealand) also used the eco-map.71 _{Māori participants} were not willing to complete the genogram in the centre. This was because to be considered ‘Māori’ in NZ, individuals have to demonstrate that they are ‘descended from’ Māori (http://www.stats.govt.nz/methods/classifications-and-standards/classification- related-stats-standards/maori-descent/definition.aspx), and so Māori participants in the pilot phase were not willing to disclose their ancestry for fear of it being appropriated. Most participants requested their eco-maps remained with them, while allowing the interview recordings to be part of the research pilot phase. Considering the distress removing the eco-maps caused to some Māori participants, as well as the possible tenuous nature of some Indigenous people’s knowledge of their family history, and with the imperative that research does no harm, I have only used the eco-maps to enable participants to tell their stories. Talking ‘to’ the instrument is a technique I commonly use when treating or assessing Indigenous people in clinical mental health settings. While data on how many interviewees agreed on the strength of particular relationships would have been useful, the worth of that data was not worth the risk of traumatising participants, or causing them to feel any accusations of indigenous inauthenticity.