Browsing by Author "Spedding, Maxine"

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    Consolidating a Model of Camouflaging in Autism Spectrum: An Integrative Systematic Review
    (2024) Nel, Jacques; Spedding, Maxine; Malcolm-Smith Susan
    Background: Research into social ‘camouflaging' (hiding difference) in Autism Spectrum (AS) is gaining momentum. Camouflaging is one explanatory facet for individuals reaching adulthood without receiving formal diagnosis. However, the term holds a multiplicity of definitions and needs to be delineated from motivational and experiential facets of ‘neurotypical' pretence. Aims and Objectives. We conducted an unfunded, integrative systematic review towards consolidating qualitative conceptions of camouflaging in AS adults into a single model by way of thematic meta-synthesis. Our objectives were to unpack the (a) strategies and behavioural exemplars of camouflaging, (b) motivational underpinnings to strategies, and (c) current/historical precedents and triggers for camouflaging. Method. 2,346 articles were extracted from EBSCOhost, PubMed, Web of Science and Scopus (April 2022) and partly co-screened between authors. Additional sources included ‘Connected papers' and citation searching. Eligibility included peer-reviewed, English studies with AS confirmed/suspected adults providing empirical, qualitative input on camouflaging domains a, b, and/or c. The authors reached a 0.77 Kappa agreement for initial screening and full agreement in committee discussion. After screening and quality-scoring, 28 studies were included. Demographic details were tabulated, and the results sections of all studies were line-coded, clustered, and thematically synthesised. Results included 2669 men, women, and non-binary individuals, as well as ‘sub-clinical', suspected AS cases – above the age of 16 years. Thematic results were audited and mapped back onto the original cohort to reduce risk of bias. (Prospero: CRD42022324957). Results. The data consolidated eight types of camouflaging strategies, with a spotlight on the role of imitation as an entire self-training structure to grow repertoires, from the basic behavioural suppression to sophisticated cognitive templating and performativity. Fifteen motivational facets arose, underscored by the sense that camouflaging involves the performance of ‘neurotypical' behaviours, and is akin to learning to speak a second language or adapt to a foreign culture. Seven contextual factors that modulate camouflaging were raised, including crucial considerations for the role played by life-stages in pre-and-post-diagnostic performance of camouflaging, towards less or more strategized enactments. Discussion. The goal of the integrative review is to propose a tentative framework to operationalise the concept of camouflaging. The results challenge future quantitative research to concretely place measures of camouflaging within this (or other) models, towards justifying the phenomena observed and bolstering the theorised connections between model elements. Contextual results also raise considerations for what respectful and collaborative social skills training might look like. Limitations included demographic bias to females and the UK (raising a question of the degree to which the current versions of camouflaging, which inform modelling, are culturally modulated), potential pop-culture understandings of camouflaging in the qualitative input, and results only reflecting a subset of the overall AS community. Keywords: Autism Spectrum. Camouflaging. Masking. Modelling. Systematic Review. Thematic Meta-synthesis.
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    Open Access
    Dialogical Selves: Exploring “Sameness and Difference” in “Queer” Identification
    (2022) Phillips, Tyler; Spedding, Maxine
    “The LGBTQIA+ community”, like all social groupings, is moulded by dialectical forces: inclusivity/exclusivity, belonging/non-belonging, sameness/difference. Literature on it is riddled with dichotomous conflicts over (dis)identification and (anti)relationality in theory, lived experiences, and political mobilisation. Dominant discourses tend to overlook intersectional complexities therein, focus on labels over interactions, and reiterate a framing of the LGBTQIA+ as inherently vulnerable. The gaps point to a need for a more open and reparative investigation that creates space for exploring and (re)negotiating the assumed coalition. This study investigated what diverse groups of queer-identified individuals experienced when sharing their lived accounts of “sameness and difference” with others. Twenty-one people each participated in one of four focus groups and in a follow-up interview were invited to reflect on their experience. Decolonial Intersectional Narrative Analysis (Boonzaier, 2019) and a Bakhtinian-dialogical analysis (Grossen & Salazar Orvig, 2011) were used to inspect the “what” and the “how” of the group dialogues, respectively. Participants recounted significant experiences of sameness and difference that both foregrounded and transcended their particular intersectional identities. Moments/relationships of being treated as more an object than a full subject, due to divergence from certain monoglossic gendered/sexed/sexual norms (both intra- and extra-communally), were conarrated as keys to ongoing queer abjection. Participants expressed that dialoguing in this particular setting was an experience of coming-out-of-isolation, intersubjective learning, and strengthening senses of self and community. Future research and activism are encouraged to invest in accessible open dialogue as a site itself for LGBTQIA+ community-building in South Africa and beyond.
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    Intersectional sameness and difference in psychotherapy: Women of colour s experiences of the therapeutic alliance
    (2024) Isaacs, Faranha; Spedding, Maxine
    The therapeutic alliance is crucial for positive therapeutic outcomes, as it sets the foundation for the therapeutic process. In South Africa, a diverse and multilingual country with high levels of inequality, access to healthcare services, poor quality of healthcare, and discrimination in healthcare settings are persistent issues. Women of colour are often disproportionately affected by these health inequities. However, little is known about how sameness and difference are experienced in the therapeutic alliance in South Africa, which makes it essential to explore experiences of women of colour in this context. Using an exploratory qualitative research design, this study recruited and interviewed 11 self-identified women of colour using purposive sampling. Data collected were analysed using a reflexive thematic analysis to identify themes and analyse the findings. Two primary themes emerged: feeling understood and agency. The study suggests that sameness and difference are palpably experienced in the therapeutic encounter. Various factors shaped the role that sameness and difference played in the therapeutic experience, including feeling understood, having agency, therapist disclosure, validation, cultural competence, collaboration/engagement, socioeconomic status, and setting up the frame. Previous research highlights the importance of exploring the therapeutic alliance in diverse contexts, where clients' diversity may influence their therapeutic experiences. The findings of this study contribute to the literature on the therapeutic alliance in diverse contexts and emphasise the importance of acknowledging and engaging with sameness and difference in the therapeutic process. The results have implications for mental health practitioners working with women of colour in South Africa and highlight the need for cultural competence training in the field of psychology. Further research is required to explore the experiences of women of colour in the therapeutic alliance in other diverse contexts. Keywords: therapeutic alliance; sameness and difference; South Africa; psychotherapy; intersectionality
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    "Motherhood brings Joy and Happiness", Discourses of the Ideal Mother in South Africa
    (2023) Levey, Laura; Spedding, Maxine
    This research explores the effect of mothering ideologies found in dominant discourses by examining the discourses mothers draw on when describing mothering. First-time mothers who attended perinatal care in public healthcare centres are often faced with interventions like the First 1000 Days of Life Campaign drawn from the Global North. Using Thematic Discourse Analysis, the dominant effect discourses have on South African women's experiences, and practices of mothering will be explored. This research draws on 12 interviews with first-time mothers in low-income areas in Cape Town, exploring first-time mothers' experiences of motherhood. There is limited research on how patriarchal values imposed by the Global North affect South African mothers' discourses and experiences of motherhood. The research took the form of secondary data analysis of semi-structured interviews. Thematic Discourse Analysis was used to discern dominant discourses in the qualitative data. An intersectional feminist lens was used to highlight significant discourses identified through the literature. Results: The analysis highlighted three primary discourse themes. Discourses of the ideal mother had three subthemes: motherhood comes naturally and brings fulfilling joy, mothers should be baby-centred, and good mothers are professionally guided. These medicalised mothering ideals from the Global North promulgated by the medical fraternity left many mothers feeling unsure of their own mothering knowledge and choices. Discourses of the ideal mother often split mothers into good or bad mothers. Discourses of the present mother and absent father were identified and often resulted in discourses of mothering in poverty. Discourses that contested patriarchal gender norms were found to be omitted. Mothers revealed high levels of stress, shame and impoverishment. Asymmetrical power dynamics favouring men combined with a systemic lack of supportive social and economic policies for mothers often resulted in their oppression, grant dependence and poverty. Conclusion: The research demonstrated the ways in which local mothers' mothering practices were significantly entrenched in powerful patriarchal ideologies promulgated by medical and social discourses. Ideologies imposed on mothers through primary healthcare facilities were shown to cause mothers uncertainty, anxiety and fears of inadequacy. Lack of adequate social support through the child grant was shown to maintain systems of class and gender inequity and often resulted in significant impoverishment. Key words: motherhood, mothering ideals, discourse analysis, primary healthcare, perinatal healthcare
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    "Motherhood brings Joy and Happiness", Discourses of the Ideal Mother in South Africa
    (2023) Levey, Laura; Spedding, Maxine
    This research explores the effect of mothering ideologies found in dominant discourses by examining the discourses mothers draw on when describing mothering. First-time mothers who attended perinatal care in public healthcare centres are often faced with interventions like the First 1000 Days of Life Campaign drawn from the Global North. Using Thematic Discourse Analysis, the dominant effect discourses have on South African women's experiences, and practices of mothering will be explored. This research draws on 12 interviews with first-time mothers in low-income areas in Cape Town, exploring first-time mothers' experiences of motherhood. There is limited research on how patriarchal values imposed by the Global North affect South African mothers' discourses and experiences of motherhood. The research took the form of secondary data analysis of semi-structured interviews. Thematic Discourse Analysis was used to discern dominant discourses in the qualitative data. An intersectional feminist lens was used to highlight significant discourses identified through the literature. Results: The analysis highlighted three primary discourse themes. Discourses of the ideal mother had three subthemes: motherhood comes naturally and brings fulfilling joy, mothers should be baby-centred, and good mothers are professionally guided. These medicalised mothering ideals from the Global North promulgated by the medical fraternity left many mothers feeling unsure of their own mothering knowledge and choices. Discourses of the ideal mother often split mothers into good or bad mothers. Discourses of the present mother and absent father were identified and often resulted in discourses of mothering in poverty. Discourses that contested patriarchal gender norms were found to be omitted. Mothers revealed high levels of stress, shame and impoverishment. Asymmetrical power dynamics favouring men combined with a systemic lack of supportive social and economic policies for mothers often resulted in their oppression, grant dependence and poverty. Conclusion: The research demonstrated the ways in which local mothers' mothering practices were significantly entrenched in powerful patriarchal ideologies promulgated by medical and social discourses. Ideologies imposed on mothers through primary healthcare facilities were shown to cause mothers uncertainty, anxiety and fears of inadequacy. Lack of adequate social support through the child grant was shown to maintain systems of class and gender inequity and often resulted in significant impoverishment. Key words: motherhood, mothering ideals, discourse analysis, primary healthcare, perinatal healthcare
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    South African university students' user experience of mobile applications for anxiety and depression
    (2024) Chipps, Wesley; Spedding, Maxine; Kaminer, Debra
    Background: Globally, university students have been shown to be disproportionately affected by common mental disorders (CMDs). The primary CMDs reported by students have been anxiety and depression. Research on South African students has proven no exception. Moreover, this predicament is worsened by low rates of help-seeking, historically entrenched systemic inequality regarding access to resources, a lack of culturally appropriate interventions, and a population that tends to be overly self-reliant. Objective: With the prevalence of CMDs in mind, as well as the many challenges students face, it was deemed worth exploring current, available alternatives. Given some evidence for the use of mobile mental health (MMH) applications (apps) among university students in high income countries, the current study aimed to investigate South African university students' user experience of MMH apps for depression and anxiety. Methods: South African students in the psychology department of the University of Cape Town were recruited to make use of two MMH apps, Headspace and Woebot, for two weeks total, but one week per app. They then completed online questionnaires related to their experience of using these apps, and semi-structured interviews were conducted, recorded, and transcribed by the researcher. Due to a lack of meaningful data from the online questionnaires, only the semi-structured interviews were used for analysis. Braun and Clarke's (2006) method of thematic analysis was used to analyse the data. Results: After analysing the semi-structured individual interviews, themes were defined, described, and discussed. The participants expressed that the apps facilitated insight and self-awareness, and were found to be supportive, encouraging, and convenient. However, they valued different aspects of the two apps, with each offering something that the other did not. The importance of each design was also highlighted as a vital factor in the overall user experience, while affordability was also emphasised for the student population in particular. Conclusion: The two apps were found to be accessible and acceptable for participants in this South African university setting. Additionally, user experience design enhanced their experiences. However, as each app offered different approaches and benefits, the integration of features could be something to work towards. There are also important ethical considerations that need to be factored before recommending them. Further research and development are required in order to address these concerns.