Group Meeting Dynamics in a Community-Based Participatory Research Photovoice Project with Exited Sex Trade Workers

Abstract

This article is based on a secondary analysis of transcripts from a community-based participatory research (CBPR) project that sought to represent through photovoice the lived experience of five exited sex trade workers. The focus of the secondary thematic transcript analysis was to discern group processes and describe group dynamics of six two-hour group meetings. Creating and maintaining an environment of safety emerged as a primary theme. The group processes resembled mutual aid groups, which are characterized by people offering assistance to each other in an interpersonal forum that demands personal reflection. Group dynamics revealed that an important aspect of CBPR photovoice research is the collaborative creation of a safe place for showing photographs and storytelling.

Keywords

sex trade community-based participatory research group dynamics secondary data analysis group meetings photovoice

The Context

In spring 2007, the United Way of Calgary, Alberta, Canada released a report based on an assessment of services for people involved in the Calgary sex trade. The report was entitled Building a Calgary Community Response for Children, Youth and Adults Involved in the Sex Trade (2006). It noted both a lack of empathy for sex workers from some service providers and clients not involved in the sex trade and a paucity of research on the sex trade/sexual exploitation trade in the Calgary area. One of the many recommendations of the report called for further study to develop a better understanding of the psychosocial histories of people involved in the sex trade. Other research-related recommendations emphasized the importance of collaboration with sex trade workers and community service agencies, a non-biased and nonjudgmental research stance, and an applied component that moved beyond the academic community.

To address these recommendations, the United Way of Calgary partnered with the University of Calgary, Faculty of Social Work and AIDS Calgary Awareness Association to launch a community-based participatory research (CBPR) study. The purpose of the project was to engage exited sex workers in the development and dissemination of knowledge that would enhance the public's understanding of the layered dynamics and experience of women in the sex trade. The photovoice project was entitled “Do You Know What I Mean: The Lived Experience of Sex Trade Workers.” Phase 1 of this project began with the recruitment of five exited sex trade workers who subsequently documented their lived experience through photographs and digital stories. A final outcome of the project was the creation of an integrated photography exhibit and five digital stories. Since its inception, these materials have been used in 14 presentations and workshops, six gallery events, and five social action events, with audiences totaling over 1500 people. Phase 2 of the project, entitled “Walk With Me,” replicated the initial “Do You Know What I Mean?” project and added artifacts. At the time of this writing it is currently being exhibited at local and provincial venues. This article is based on data derived from Phase 1 of the project, “Do You Know What I Mean?”

Our interest in CBPR group dynamics emerged in the planning stage as we considered the nature of our engagement with the sex workers. How could we create and maintain an inclusive space for sex trade workers to talk openly about their experiences? How could we enact principles of inclusion that are the cornerstone of participatory inquiry? How would we co-construct meaning and the opportunity to compare the experiences of vulnerable individuals on an emotionally intense subject?

Vander Stoep, Williams, Jones, Green, and Trupin (1999) defined the role of the community-based participatory researcher as technician, observer, and activist. In this project, group leaders' roles varied with the purpose of the meetings. For example, in meetings with funders and event organizers, the role was primarily administrative and often involved related issues of funding, accountability, and planning. The planning process for these events involved over 30 group meetings with a range of stakeholders, including the funders, creative and technical consultants, curators of galleries, and event organizers.

Guiding research on group facilitation in community-based research with vulnerable populations is limited (Campbell, 2002; Koch & Kralick, 2001). Chiu (2003) noted that because the dominant discourse in participatory action research emphasizes macro-political processes rather than the micro processes, literature on the dynamics of group meetings for this type of research is underdeveloped. Yet concurrently, a growing body of literature on successful community partnerships calls for attention to group dynamics (Becker, Israel, & Allen, 2005).

What, specifically, does attention to group dynamics mean within the context of CBPR that seeks to understand the lived experience of sex workers? In an attempt to understand the nature of group dynamics in this project, we conducted a secondary analysis of our data. Secondary analysis includes the situation where the researcher returns to the data with another research question that is distinct from the original work (Seale, 2011). Our data included the transcripts of our six meetings with the exited sex workers who participated in Phase 1, “Do You Know What I Mean.” Although the transcripts were the primary data source, this article also considers and reflects on aspects of the research project that set the context for group dynamics, such as establishment of the research team, recruitment, choice of research method, and the decision to be guided by the principles of accompaniment.

Method

Data Collection

Access to feelings and lived experiences is a common goal of qualitative research. Photovoice is a qualitative research method in which participants, often considered co-researchers, document the realities of their lives by using images. Digital stories are an autobiographical genre that uses these photographs, voices, and soundtracks to highlight a specific story within a two to three minute timeframe (Lambert, 2006). By showing and talking about their photographs, participants communicate their life experiences and become true partners in knowledge building. The photographs allow them to record and reflect on their strengths and concerns; to engage in critical dialogue and knowledge building through group discussion of the photographs; and, ultimately, to reach policy makers (Wang & Burris, 1997). Wang and Burris (1997) emphasized the importance of contextualizing images, that is, telling stories about what the photographs mean. The purpose of the storytelling, within the context of a group, is to VOICE–voicing our individual and collective experience. Using photographs outside of a group context, according to Wang and Burris, would contradict the essence of photovoice, which is based on telling a story to an audience.

Planning

The researcher role: Emerging tensions

Grounded in the pedagogy of Paulo Freire (1970), CBPR endeavors to improve quality of life by engaging community partners in a research process. To increase knowledge and understanding of a phenomenon, CBPR translates research findings into direct interventions or social change (Israel, Schulz, Parker, Becker, Allen, & Guzman, 2003). CBPR highlights the importance of participation, power, and knowledge generated through dialogue. It is fundamentally a group process that represents the collective efforts of participants to identify problems in their lives and build capacity to change their reality (Finn, Jacobson, & Campana, 2004).

An overarching aspect of participatory research is dialogue, which is described as sharing of perceptions of problems, offering opinions, and participating in decisions and recommendations (Hope & Timmel, 1999). Group meetings are central to facilitating change (Chiu, 2003). Eschewing the traditional role of a researcher—that of information collector—the researcher must cooperatively align the interests of all those involved using small group dialogue, which then becomes the site for integrating individual circumstances into a collective, socially transformative experience (Reason & Heron, 2001).

To accept that dialogue is essential in CBPR invites a reconsideration of the academic researcher's role. Freire (1970) believed that dialogue, which is founded upon love, humility, and faith, is a horizontal relationship. Mutual trust between dialoguers is the logical consequence. Notions of love, humility, and faith are for the most part foreign to traditional academic research, which normally promotes distancing to maintain scientific rigor and limited power sharing in the construction of knowledge. Because the academic researcher must assume roles in CBPR that are commonly beyond the scope of the traditional researcher, tension is inevitable.

Guiding principles

In light of the goals for the project, we determined that first and foremost the methods utilized must honor the subjective experience of women and be underscored by a commitment to social action. We were guided by the principles of accompaniment. Quite simply, accompaniment means “to go with, to support and enhance the process” (Finn, Jacobson, & Campana, 2004, p. 316). Whitmore and Wilson (1997) noted that the principles of accompaniment parallel feminist principles and are well suited to participatory research. Reid (2004) defined feminist action research as a “conceptual and methodological framework that enables a critical understanding of women's multiple perspectives and works toward inclusion, participation, action and social change while confronting the underlying assumptions the researcher brings to the research process” (p. 2). Accompaniment principles include: nonintrusive collaboration, mutual trust and respect, common analysis of the problem, commitment to solidarity, and explicit focus on process. Philosophically, we were committed to avoiding the academic pitfall of advertently or inadvertently appropriating and misrepresenting the voices of our co-researchers and sought to create an environment that was inclusive and collaborative (Reid, 2004). Consequently, the following principles were developed to guide the project:

Exited sex trade workers will be key partners in the research and equal partners in defining the research goals, taking the photographs, analyzing the data, and disseminating the findings.

Knowledge about the lived experience of sex workers will be generated through conversation.

The mode of inquiry will be consensual and will support inclusion and the emergence of new leaders.

Knowledge developed in the project will lead to a clear dissemination plan that supports the goals of the project.

The sex workers are considered insiders who will ultimately direct the action component of the project. Academic researchers and community-based researchers are considered outsiders who will assume catalytic and supportive roles in the study.

To secure funding for the project, the lead academic researcher, Debb Hurlock, prepared the research proposal and negotiated with the United Way on issues related to research goals and objectives, method, duration of the project, and project funding. Recognizing the vulnerability of the sex workers and the real potential for this project to elicit intense emotions, the budget included funds for any therapy that might be needed.

The Research Team

All participants were considered peer researchers, but for the purposes of this article, in an attempt to provide clarity, distinctions among the researchers are made in the following ways. Community-based researchers included two employees of the United Way of Calgary and one outreach service provider from AIDS Calgary. One of the community-based researchers was of Aboriginal ancestry. The exited sex trade workers elected to self-reference as “peer researchers.” The lead researcher held a joint appointment with the University of Calgary, Faculty of Social Work and the United Way of Calgary, and the second was a trained psychologist and full-time faculty member in Social Work.

Recruitment

Sex trade workers are considered hard to reach or hidden populations because of the stigma associated with prostitution. To escape being the objects of hate, scorn, and persecution, they routinely hide their involvement, are distrustful, and often refuse to cooperate with outsiders such as researchers (Dalla, 2001). When researchers seek to study this group, they rely on purposive or snowball sampling instead of traditional random sampling, which is not feasible because the size and membership is unknown (Benoit, Jansson, Millar, & Phillips, 2005).

For this project, recruitment began with an informal conversation with an exited sex trade worker who was a speaker at a United Way sponsored presentation to a group of community stakeholders. The academic researchers invited her to participate in the study and to talk with other sex trade workers who might be interested. She was able to recruit two members who then recruited three additional members. They were invited to an introductory meeting, after which one participant withdrew from the project, saying “I'm not ready for this yet.” The remaining five women participated fully in the project; they actively contributed to the photovoice exhibit and created their individual digital stories.

One barrier to participation was the limited incomes of potential participants. Therefore, prior to recruitment, arrangements were made to secure a central meeting place that was accessible by public transportation, to reimburse participants for babysitting, and to provide an hourly stipend for participating in the meetings and an additional stipend for public presentations and workshops. Meetings were held biweekly from 5:00-7:00 p.m., with a light evening meal provided.

At the time of the project the women ranged in age from 28 to 42 years. All of them had exited the sex trade and were in recovery from drug and/or alcohol addiction. Two of the women held administrative positions in small businesses, one worked in health care, and one was enrolled in a post-secondary institution while living in a facility designed to support sobriety. The fifth individual and her children were in a supported living situation that served women in recovery. All but one woman had children who ranged in age from 3 years to 23 years. One lived with her partner and their three children while the remainder would be considered single adults who lived alone, with other family members, or in a recovery center that supported their sobriety. Three women were of Aboriginal ancestry.

Introductory Meeting

At the introductory meeting, the peer researchers received training from a professional photographer and were each given a digital camera. They were encouraged to take pictures that captured images of what it means to be a sex worker in Calgary, images that conveyed their sense of resilience, images of the barriers and supports found in the community, and images of the policies and programs they think should be kept or changed. At this meeting, issues of women's safety and potential harm were addressed, which included discussion on selection of appropriate subjects for the photographs, ethical considerations related to including people in the photographs, and safety when taking photographs. Transcripts from this introductory meeting were not included in the analysis. The peer researchers attended six subsequent biweekly meetings with the academic researcher, and these six meetings were taped, transcribed, and analyzed. To ensure accuracy of the transcripts, before the meetings each member of the research team received an electronic copy of the prior meeting's transcript. Between meetings, contact was maintained primarily by email.

Data Analysis

Using photovoice to represent the lived experience of exited sex trade workers was accomplished at two levels. The first level entailed a two-stage process that involved selection and contextualization (Wang, Yi, Tao, & Carovano, 1998). Initially the peer researchers selected pictures to present at our meetings. Ultimately, they used their photos to create a personal digital video and a photo exhibit that were testimonials to their experiences. They sifted through over 400 images, and each selected ten to fifteen photos for an exhibit in print format. The peer researchers chose photos, music, images, and words to create the videos, which culminated in five digital videos that ranged from four to eleven minutes in length. Some chose to personally narrate their video and others chose music that exemplified and further articulated the themes of their work. For the photo exhibit, peer researchers chose to accompany their photos with poetic narration, simple lines, or more lengthy prosaic narratives; each was an expression of their uniqueness, yet when shown collectively the exhibit became an organic display of the threaded themes of the sex trade.

The second level of analysis entailed “identifying, analyzing and reporting patterns (themes) within data” (Braun & Clarke, 2006, p. 79). The peer researchers were reluctant to engage in transcript analysis and voiced their skepticism. One asked, “When does this analysis begin? What do we mean by interpretation? ‘Cause I think we've been analyzing since day one. I think we're all critical thinkers and we do it automatically. I think we're already interpreting our experiences.” Another added, “I'll bring my fucking notes from the last 25 years.” Ultimately, the peer researchers decided to direct their attention to creating the digital stories and developing the photo exhibit while the academic and community-based researchers read and thematically analyzed the transcripts.

The decision to engage in team-based analysis of the transcripts is consistent with the observations of Forbat and Henderson (2005) who argued that analytical rigor, research reflexivity, and positive empowering research relationships are enhanced when data is co-analyzed by team members. The meeting transcripts and the emerging themes were periodically discussed with the peer researchers at our group meetings.

A secondary analysis of the transcripts, which forms the basis of this article, was directed at identifying elements of the group process (Seale, 2011). Group data lends itself to the inductive process of thematic and ethnographic analysis (Creswell, 2002; Duggleby, 2005; Wilkinson, 2011). Initially we reviewed the transcripts as a whole and then engaged in a line-by-line analysis that resulted in substantive codes (Strauss & Corbin, 1998) representing the words of the group members. Categories were created from the codes and initial themes were compared to the data set for examples that fit and did not fit (Braun & Clarke, 2006). The specifics of each theme were refined and linkages were created between the themes, which resulted in the emergence of an overarching theme of creating safety. Ethnographic analysis attended to what is going on between and among participants and considered particular transcript segments in greater analytic depth to offer a detailed, contextual account of group dynamics. As an adjunct to thematic analysis, ethnographic analysis offered access to what lies behind and beyond the conversations of group members (Wilkinson, 2011).

For the presentation of the findings, participant references are attached to most quotations to provide the reader with a sense of the diversity of opinions expressed by team members. The names of the peer researchers, Heather, Tanis, Carmen, Vicki, and Nina, are pseudonyms to preserve anonymity.

Findings

Creating and Maintaining Safety

For funding purposes, project goals were determined prior to the introductory meeting with the peer researchers; however, these goals were fluid and up for reconsideration. The overarching theme was creating and maintaining a safe space.

Finding Common Ground

Why are we doing this?

A first step in creating safety was finding common ground. The academic researchers initially presented to the research team their understanding of the goals for the project; however, the peer researchers redefined the goals to encompass personal, collective, and political dimensions. Throughout the life of the project, they regularly revisited their reasons for participating in the project.

At the first group meeting, one peer researcher, Heather, asked, “Isn't the purpose behind photovoice to evoke feelings in other people?” Tara responded, “I want to create something beautiful out of something ugly.” After saying this, she paused and soberly shared her belief that this was not possible considering the ugliness of her experiences. However, in a public address several years after this meeting, she said, “We took something tragic and made it beautiful.” Carmen added, “My understanding was that there's education behind it.” Nina, who had recently left the sex trade, said, “I'm using this as a catapult to heal me. I am not looking for a support group or a common denominator in this, I'm looking to stop the anxiety and to function.”

Although the peer researchers believed that working in the sex trade was “soul destroying,” they also understood that, in the short term, Canadian laws that criminalized the sex trade would likely not change. Therefore, they agreed that advocacy for the de-criminalization of the sex trade or the abolition of sex trade work was not their objective. Rather, they decided to focus on education directed at increasing social consciousness about the sex trade and on challenging negative stereotypes about women in the sex trade. One mutually-determined group goal was to heighten public awareness by telling their stories. One action aspect of the project was to develop supports for sex workers who “leave the job.” A safe house in Calgary was considered essential because when sex trade workers exit, they are often destitute, homeless, addicted, and lacking a sense of personal self-worth.

How will we do this?

At the second group meeting, an academic researcher introduced the issue of safety:

So we wanted to just have a quick conversation with all of you, around some thoughts and ideas of what you might suggest for ways that we can insure that this is a safe space for everyone, and everyone feels comfortable sharing. If you feel you've been misunderstood, how can you bring that forward and feel safe to do that?

In reality, “a quick conversation” about the creation of a safe space became a central theme that was periodically revisited and redefined.

Preserving Anonymity

The process of naming the project revealed the depth of concern for anonymity and the vulnerability felt by the peer researchers. Fearing exposure among workplace and student colleagues, they stressed the importance of confidentiality. For example, in email correspondences related to the project, one peer researcher referred to the project as the U of C Project while the academic researchers called it the Sex Trade Study. At the first two meetings, an agenda entitled “Sex Trade Study Meeting Agenda” was distributed to the peer researchers. After the second meeting, when the academic researchers were clearing the table, they found the title ripped off from the larger document and left on the meeting table, a clear communication of one woman's discomfort with the study's title. At the next meeting, an academic researcher asked the group to reconsider the name of the project. “What would you like to call this study, ‘cause right now we keep referring to it as the sex trade study?” One peer researcher, Vicki, responded, “Didn't we already figure out what we were called—‘Do You Know What I Mean?’ I'm down with that. That's what I've been calling it all the way.” Another replied, “That's what it's called on my computer.”

The group meetings invited co-construction of meaning and the opportunity to compare experiences, thereby reducing the risk of the researchers appropriating and misrepresenting the voices of the sex trade workers. Most importantly, the meetings minimized the risk of academic researchers speaking for others, which would have marginalized and disenfranchised the peer researchers (Alcoff, 1992). However, a double bind emerged when strategies for dissemination were considered. The academic researchers and the community-based researchers expressed reservations about “speaking for” the peer researchers at photovoice exhibits and presentations of the digital stories. Yet how could the peer researchers honor their anonymity and present their stories in a public forum? Vicki agreed, “It's my story. It's my life.” Ultimately, two peer researchers chose to tell their own stories. They were involved in community presentations and spoke at the gallery showings, either alone or partnered with an academic researcher and another peer researcher. The remaining three, who wanted to remain anonymous, entrusted the telling of their stories to the group.

Watching Out for Myself, Watching Out for Each Other

Creating safety in precarious circumstances was a familiar process for the peer researchers, who during their time on the street were constantly assessing their environment, on the lookout for danger. Therefore in response to the academic researcher's question on how to keep safe, one peer researcher, Vicki, suggested:

I think maybe you know—just watch out for each other. I wouldn't want this to be an atmosphere of differences but rather of coming together. I think one thing might be good is not to interrupt, yeah, like, just watch out for each other, like that's what we did on the streets or in the parlors. We looked out for each other. And maybe we should do that here. That's just a natural instinct.

Negotiating the tension between taking care of others and self care, as exemplified in this interchange, began with the observation from one peer researcher, Tanis, that taking care of oneself meant “taking responsibility.” She stated:

I think we just need to take responsibility for ourselves. I'm not going to change who I am because you're sensitive. I'm not here to caretake. I'm just not sensitive [pause] like there's no shame anymore for me [pause] so if I come off flippant and insensitive it's just ‘cause I really don't give a fuck anymore.

Another peer researcher, Heather, observed that not everyone would be comfortable vocalizing their feelings: “Yeah, but not everybody's there, and that's what I am trying to say.” In the spirit of compromise, another peer researcher suggested, “Go with the instincts but don't go above and beyond.” Additionally, the group resolved to follow the suggestion of a peer researcher who said, “I have an idea, like maybe just do like a debrief, like a check-in on a scale of one to ten how you feeling. If it's below four we need to stay and work it out.” The academic researchers and community-based researchers participated minimally in this negotiation.

Without exception, each group meeting ended with a checkout in response to “How are you feeling?” Researchers could choose to elaborate on their response or simply state a number and pass. If a peer researcher self-assessed with a number of four or less, the entire group would be required to remain for additional debriefing. The four or less assessment did not arise throughout the course of the project meetings; most meetings ended with self-ratings in the range of seven to ten.

Being Respectful

An important aspect of safety was respect. Acknowledging that diverse views would emerge in the course of our work together, Tanis explained, “Respect me if I'm not at the same place as you. I still expect to be able to be me, and be respected. I think it goes both ways, you know?” The enactment of respect entailed being sensitive to physical and emotional boundaries and lessons learned from prior involvement in treatment. Nina added:

I remember being in treatment with people with physical, spatial issues, and having learning to ask for permission. Like, “Can I give you a hug?” “Do you need a hug?” and understanding that there's that physical space and that boundary for some people who come from extremely violent situations or traumatic childhoods. The movement of going to give somebody a hug could literally put them into the fight or flight mode, right? It's verbal statements like “Can I ask you?” “Can I give you?” You know [pause] “Will you allow?” It breeds respect and it breeds that open honest communication. “Yes I give you permission” or “You know what, I really don't need feedback about this right now, can you come back to me later?” Right?

This statement served multiple purposes in that it began with the assumption of common ground— that of reviewing the lessons that had been learned in therapy, in this case the issues of understanding and respecting physical and emotional boundaries. The peer researcher then explicitly stated how to ask questions that acknowledge and respect boundaries and how to respond to the questions. Moreover, in keeping with her commitment to collaboration and equal status, she presented her views in a tentative way. By ending with a gently questioning tone, “Right?” she was indirectly inviting further discussion.

Respect could also be demonstrated by “really listening,” acknowledging vulnerability and talking about feelings. One peer researcher, Vicki, observed that being vigilant of the psychological risks of this project was a way of keeping safe. For her, maintaining emotional balance meant that over a given week she might disengage emotionally and cognitively from the project and not take any photos: “I go almost a week without doing anything with this because other stuff's happening. I don't want to push myself and risk relapsing, you know.”

With guidance from the Aboriginal community-based researcher, the group decided to adapt a basic premise of the traditional Aboriginal group process that utilizes the talking stick within a talking circle as a tool for healing relationships. It entails speaking one's own truth while holding the talking stick, and then listening while others speak their truth (Dylan, 2003; Forest & Pearpoint, 1995). This process supports the premise that one can speak from a deep place without fear of being judged or interrupted. In this tradition, facilitation of the circle does not involve trying to impress the group with wisdom and power but rather serves as a catalyst for interconnection and dialogue. The group decided that an actual physical artifact (e.g., the talking stick) would not be necessary; however, adherence to the spirit of the tradition would be honored in the meetings.

Deciding What Photographs I Can Show and How I Will Talk about Them

Initially there was some uncertainty as to how to begin. One peer researcher, Carmen, wondered, “How do I tell this? Right like, how do I tell this, is it just snippets of my experience or is there a beginning, middle, and an end and do I put it in the box with a pretty little bow?” Heather brought forward the question of “how graphic to get?” She followed her question with an example:

Can I give an example? Like white face cloths? I will never have a white face cloth in my house; all it reminds me of is going–doing hotel dates and washing up afterwards, they all got white face cloths in them. And you just wanna get the hell out of there, you wanna wash up quickly, they don't want you using the shower, you know? And, I don't know how far to go with it and what makes people uncomfortable or you know there's even more graphic than that, but things that pop up? Flashbacks and things like that.

Nina responded, “If you're comfortable bringing it in, then we're comfortable. And if something greater comes out of it then good, you know? But like this is, I need to tell my story the way that I need to tell it.” Therefore the group consensus was “whatever” goes. The academic researcher described her thoughts regarding the process of showing the pictures:

My sense would be that you'd each take sort of a turn and have the floor, and it would be up to you to determine what you want from the floor, from the people … For example you could say, “Well, I want silence while I go through this and then I want questions or feedback” or “I'm good with having questions and feedback,” or do you each do one picture at a time?

Heather responded, “I would probably prefer to go through all the pictures and then give you my random thoughts as to what they meant to me and then be like ‘Okay, any questions about those pictures?’”

The peer researchers were explicit in relation to their preferred process. For example, Tanis declared:

I'd like to know if my pictures touch you, right? ‘Cause if it strikes a chord then I wanna know that, ‘cause then I know the pictures are doing their job—as to the bigger picture. If it evokes feelings in you, then you're saying “Wow, like this is how I feel about that picture.” Or ask me why I took that picture.

Each member was allotted 20 minutes to show her photographs without interruption. At the end of the showing, an additional 10 minutes would be available for reflections and questions from the group. To ensure that all members had an opportunity to show their photographs, one group member volunteered to be the timekeeper. The emerging norm was that group members would speak honestly and listen attentively.

Each week the peer researchers brought in photographs that were then downloaded to a computer. We all gathered around the small screen and were generally silent during the photo presentation, except for occasional words of support such as “That's awesome “; “Perfect picture”; “You did good, honey”; and “Like I know that, like I can't even begin to imagine what you went through taking those, but just seeing those photographs—you have a talent girl.” By this process, each researcher showed a series of pictures and told a story about each photo. In the final exhibit, the narrative was displayed with the picture, as in the following example:

So, that's a picture of a graveyard. I contacted the medical examiner and just asked questions, like “Where do they bury Jane Does that he finds on the streets of Calgary?” And, they actually do burials for them. But, it's really, really hard to get information about what facility they actually go through to do the burials. You know, the lucky ones have the grave markers and headstones [pause] on every headstone there's a date of birth and a date of death. The dash between the two is what signifies your life. What do you want your dash to be?

Providing Feedback and Talking about Feelings

How and when to offer feedback concerned Nina:

Can I just kind of like ask for a favor for me. ‘Cause sometimes when I'm in situations like this I'm not really good at unwelcome feedback. I just don't need a running commentary. And so maybe we could start with a question like “Could I give you some feedback?” or something. Otherwise I can see this going really bad. And if it does, I'll be like, “You know what? Shut the fuck up.” Like I really will. I think I need that boundary for me.

This peer researcher clarified that her distrust of feedback was based on prior experiences in group therapy that were hurtful, and while her tone and pace in this statement are tentative and questioning the message is very clear: do not give me feedback without first asking. She was giving the team members notice—a public challenge likely ending with “Shut the fuck up” would be her response to what she identified as unwelcome feedback.

Vicki believed that taking the photos and sharing them with the group would be an intensely emotional experience, and considerable group time was devoted to a discussion of this concern. She introduced the discussion in a tone that was both a question and a statement: “So [pause] my impression is that this is a safe place to just [pause] actually get to feel it, and go through it?” Tanis insisted that talking about feelings was essential and offered the group her perspective: “It's important that if I feel hurt that I say I'm hurt or if I'm struggling that I not have the expectation that the group is to read my mind. And to have that trust level that when [pause] if I say I'm fine, then that should be it.” This participant noted she would not intrude and push her assistance on another and asked the group for the same consideration: “If I need something I'll ask for it.”

Fully aware that misunderstandings would emerge in the meetings, some time was spent on developing mechanisms for dealing with conflicts that might arise from misunderstanding. The academic researcher opened the discussion by asking, “So what would you suggest if there is a misunderstanding?” Carmen responded, “Just for the person to voice that they're upset, or why, you know, what did you mean by that or whatever, as long as the person can, it's not always easy.” Another suggestion for dealing with misunderstandings was “taking it offline.” This meant that “Whatever happens in that meeting won't be brought into the next meeting” but rather debriefed either at the meeting or in a one-to-one private discussion.

The question “What about feelings?” lead to conversations about therapy and what is therapeutic. All peer researchers agreed that they did not want the meetings to evolve into therapy. Nina stated, “This isn't therapy and I don't want to be analyzed.” Nevertheless, they agreed that expressing emotion and being heard, in a safe group environment, was therapeutic. Another peer researcher observed that therapy was power from the top down with the therapist holding the power. This project, they insisted, must be based on equal power amongst all team members. Therefore, by underscoring that the meetings were not therapy, the question of the inherent inequality associated with the therapeutic relationship was silently pointed out and remained on the meeting table.

As the weeks went by, the peer researchers presented their photographs and narratives in a matter-of-fact way with minimal displays of affect. The academic and community-based researchers, however, were deeply moved by the photographs and the accompanying narratives, at times to the point of tears. Tanis, noting the responses, reflected on this circumstance:

I can tell you my story, and chances are you're gonna feel more about my story than I will. Right, ‘cause it's just such a disassociation. It's just I am talking in the third person about somebody else and you know you're gonna cry about my story and parts of it I cry, you know like, there's parts but, you're gonna cry before I do.

Although at the group meetings the peer researchers did not show intense affect, they reported that taking the photographs uncovered painful memories. In the course of the project, three peer researchers re-engaged in therapy with a private practitioner and two others accessed local, publically funded residential treatment facilities designed to support women in recovery from addiction. Feeling uncertain about how participation in the research might affect them, they perceived counseling as a type of insurance. For example, Tanis explained:

You need to understand and you need to be aware that some parts of this story are traumatizing, right? Like this is my life, and this is my story. And it may just be a project at the end of the six weeks or at the end of the term, but when I do feel those things I need access to resources that are available because some of these pictures may bring up things in discussion that I am not able to disassociate anymore. And I have disassociated and I have played peek-a-boo with this portion of my life for a very long time and through this process I am being forced, for lack of a better word, to take a look at it and to relive part of it. All the sudden something can just come up, and it hits you, the truth and the pure feelings, and you can't help it, it happens.

Sharing Power

The commonly held belief that the academic researchers have ultimate power in the research endeavor must be reconsidered in the case of community-based participatory research. DeVito (1993) noted that in relationships, the more powerful person is the one who can exit with least difficulty, has less need for the rewards than the other controls, and can more easily endure the other's punishment. The more a person needs the relationship, the less power they have.

In this project, the peer researchers owned the knowledge and had the experiences necessary to complete the study. The project's success was dependent on their willingness to share their stories. They also chose what they would reveal and the extent to which they would participate. Under these circumstances, the negotiation of power was subtle and ongoing. For example, the group considered that one aspect of “being safe” was equality. When this subject was introduced, Vicki described being hurt, in the past, when she was invited to participate on equal footing with professionals:

It's a good philosophy when it works but people can get really hurt when it's not equal. A lot of time you can only go so far and then you get hit by an invisible wall. I'm willing to give it another shot but you've got to be damn clear that I'm equal to you.

Nina cautioned, “The big thing is, don't ever be fake with us.” Nevertheless, the academic researchers' power was evident in that, for example, a relationship of power-over was established by declaring that all participants would be equal. Ultimately, we discovered that there was no real way to avoid tension associated with ongoing negotiation of power relations.

The peer researchers held the academic researchers accountable. For example, when transcripts of the first meeting were being reviewed, the academic and community team members were designated as “researchers” while the sex trade workers were designated as “participants.” Because they were intuitively aware that these terms represented an unequal power relationship, the sex trade workers challenged the wording. Nina said, “How come if you say we're equal, then it's ‘researcher’ and ‘participant’ in these transcripts? Come on now, aren't we all equal?” Consequently, future transcripts did not make that distinction.

Also, the peer researchers unilaterally determined “smoke breaks,” usually within the first hour of each two-hour meeting. The academic and community-based researchers did not smoke, so they were not involved in the informal smoke break conversations. Moreover, the peer researchers also called smoke breaks when tension was high. On one occasion during an impasse related to how the photo exhibit was to be created, tension increased. One peer researcher called a smoke break, which extended from the usual 15 minutes to over 30 minutes. When the group meeting was reconvened, they unilaterally offered an innovative solution to the impasse, which was agreeable to all members.

In a final example of how the peer researchers doggedly challenged the academic researchers and community-based researchers, at the fifth meeting one peer researcher expressed discomfort with the academic and community-based researchers who seemed to be observers in the process, rather than “real” researchers. One noted, “You know our stories, we don't know yours.” At a subsequent meeting, academic and community-based researchers presented photographs or digital stories that depicted an aspect of their personal life stories.

Discussion

Although generalizability of the findings of this study are limited, because the five peer researchers are not representative of the collective interests of all exited sex trade workers, transferability of findings to similar research contexts using photovoice is a possibility. The following interpretations are offered as an outcome of the data analysis of the group meetings. This article makes a contribution to the literature on community-based participatory research in that it depicts the group dynamics of a photovoice methodology, a micro but elementary aspect of the research process.

Issues of Safety

The article offers a glimpse into the key dynamics that emerge when engaging vulnerable populations in participatory research. Most noteworthy is the peer researchers' focus on creating safety, a habit developed from years of feeling threatened. They brought to the group personal histories of childhood physical and/or sexual abuse, and their process of recovering from alcohol and/or drug addiction. While engaging in sex trade work, they feared for their physical and psychological safety as they endured threats and attacks by pimps, johns, members of the public, and misguided helpers. Their attunement to threat and attention to creating safety in unknown environments were enacted in the group meetings. A key aspect of trust building was the sharing of an evening meal prior to the group meeting. During this time, the “real” work was set aside as group members shared stories about work, family, and achievements and challenges in their daily lives. Here, camaraderie developed that offered space for connection and reconnection.

Other researchers working with vulnerable populations have described how they attended to issues of safety by ensuring informed consent, preserving privacy and confidentiality of participants, maintaining professional boundaries, and managing power dynamics (James & Platzer, 1999; Jones, 2002; Schneider, 2012; Stevens, Lord, Proctor, Nagy, & O'Riordan, 2010). Stevens et al. (2010) described attending to the issues of psychological safety as they recruited participants, prepared for interviews, and created sufficient space to enable participant storytelling before redirecting attention to the research questions. In our study the academic researchers, who were responsible for ensuring participant welfare, were guided by their university research ethics policies. In addition, the peer researchers actively created parameters to ensure their safety, and in doing so they offered a remarkable and unique perspective on the agency of vulnerable individuals engaged in community-based research.

The process of preparing to take photographs involved deciding on the subjects of the photographs. The peer researchers asked themselves, “What photographs would best represent my experience in the sex trade?” Such decision making required a journey to a painful past and was a testimony to the motivation and resilience of the peer researchers. Their motivation for participation was twofold: (1) as another step to healing and (2) as a way to enhance public awareness of sex work and sex workers. Doel (2006) stated that groups “are not so much a series of steps and states as a sense of emerging ‘group-ness,’ the erratic development of shared meanings and understandings” (p. 23). Members of the project were willing to walk on the swampy ground (Schon, 1983) of unpredictability and multiplicity of viewpoints because they were bound together by the common goal of “getting our story out” to educate and raise awareness, and the collective hope that this project would be one more step in their healing journey.

Motivation to participate in research is generally considered to be derived from a desire to contribute to enhancement of the well-being of the broader community (Ledogar, Penchaszadeh, Garden, & Acosta, 2000). However, Park (1993) argued that a fundamental reason for an individual's participation in research is “not just so they can reveal private facts that are hidden from others but really so they may know themselves better as individuals and as a community” (pp. 12–13). This was evident among the peer researchers. Such a perspective serves to humanize individuals involved in the research and calls for attention to group processes that attend to not only cognitive but also emotive processes of group members.

Knowing when, where, and how to exert leadership is a sophisticated group skill (Toseland & Rivas, 2009). One academic researcher assumed administrative leadership, ensuring that meeting times were established, meeting rooms were available, dinner was ordered, stipends were paid, transcriptions were completed, and all “out of meeting” telephone calls and emails were negotiated. Safeguarding the peer researchers was another important role of the academics that were responsible for minimizing risk to the peer researchers by ensuring confidentiality, anonymity, and the availability of counseling.

In many ways this group resembled mutual aid groups, which are characterized by people offering assistance to each other in an interpersonal forum that demands personal reflection (Steinberg, 2004). The mutual-aid mindset “expects that group members will contribute to the process whenever they believe they have something to contribute. It also expects that they will take from it whenever they believe there is something to take” (Steinberg, 2004, p. 21).

Expansion of the Researcher Role

This article contributes to community-based research in that it illustrates how researchers must be prepared to engage intensely with each other. Academic researchers who remain distant and analytical fail to honor the courage of their co-researchers, who share their painful, private, and intensely personal stories. The peer researchers asked that the academic and community-based researchers be transparent in turn. Group literature offered little guidance as to how to respond to this request. Initially the role of the academic and community-based researchers was fluid and evolving and best characterized as “dual focused” (Steinberg, 2010). We attended to the personal and interpersonal, working to support group goals while attending to individual needs. Guided by the tenants of accompaniment and the philosophical underpinnings of the study, we enacted our role by listening, bearing witness, not interrupting the story telling, reacting when invited, questioning in a way that was non-intrusive and served to open up the story, taking a learner stance, and being open to influence.

Theoretically, the role of the academic and community-based researchers was to be an “observant participant” (Chiu, 2003), and to be emotionally engaged with the group while attempting to view the group from an objective, analytical perspective when, for example, engaging in the process of transcript analysis and attention to ethics. However, this position was insufficient for the peer researchers and at the third meeting they “called us out” by insisting we too present our stories. In doing so, they challenged the power and privilege of the academic and community-based researchers who until that time were listening to the storytelling but, as one participant noted, “not putting yourself out there.” The peer researchers insisted that we share our personal stories through photographs and, like them, show vulnerability, examine our baggage, and demonstrate openness to personal change.

The call for self-disclosure required the academic and community-based researchers to move beyond the tenants of accompaniment. It called us to be inside the process, not looking in from the safety of the outside. Nevertheless, the onus was on the individual to decide how to use self-disclosure, with sensitivity to its impact on the group. Each was responsible for privately considering and redefining their personal and professional boundaries, which became clear when we told our stories.

As an academic researcher, I (Barlow) was uncomfortable with the call to present my personal story. How much should I share? What would be the overall subject of my story? As a psychologist and social worker, how would I frame my story to reflect appropriate self-disclosure? How would I remove my academic jacket that legitimized distancing in the name of science? Did I want to reveal my vulnerabilities in this group? What were the risks and benefits to my participation? These types of self-reflective questions are consistent with the literature on researching sensitive subjects (Dickson-Swift, James, Kippen, & Liamputtong, 2006).

The following week we were allotted 20 minutes to tell our stories of personal family conflict, struggles with issues of identity, and histories of childhood pain. One of us presented a digital story that served as a catalyst for the peer researchers to create their digital stories. The challenge to share our personal stories shifted the parameters of the research. As academic and community-based researchers, we learned that partnering in a community-based participatory project that focused on painful lived experiences called for an intense level of emotional engagement that required us to move beyond the role of the objective researcher and be joined in humanness.

Power Dynamics

Although this article represents only one project, certain elements of group dynamics may be common to many participatory photovoice groups that work with vulnerable people. These include the importance of collective and personal goals for participation and attention to the continually emerging questions of how to remain safe. This study also brings forward the importance of implementing collaborative decision-making processes, providing feedback, developing rules for emotional engagement, attending to individual and group needs, and accepting shared leadership. Underlying these dynamics is the ongoing negotiation of power.

The group meetings exemplified Freire's (1970) conceptualization of power as not static but continually being altered and reconstituted. Within the walls of our gathering, we came to learn very quickly that the peer researchers, with their indelible wounds and, at times, self-loathing, came with a fortress of strength and power that would manifest throughout our relationship. Knowledge and power moved about the room, tethered in relationships that formed among us. For example, the peer researchers' questioning of the distinction made in the first transcript between “researchers” and “participants,” and their decision not to engage in transcript analysis, can be interpreted as an act of resistance to the traditional power structures that separate the researcher (expert) and the participants (object). As equal partners in the research endeavor, they determined that the primary audience for their work was members of the general public, not academics. For the peer researchers, the tedium of transcript analysis held no interest. Nevertheless, their experience of interpreting and eventually selecting and narrating images for the exhibit and the video can be considered a form of data analysis that lead to theme identification and broad dissemination that moved beyond traditional formats of academic dissemination.

Limitations

The study is limited in that only exited sex trade workers volunteered to participate in the project, and thus it de facto excludes perspectives of sex workers who choose to remain in the sex trade. Exited workers likely have perspectives that differ from current workers because they had the ability and motivation to exit.

The limitations of CBPR research and photovoice research are noted in the literature. Some researchers have wondered if “telling the story” ultimately leads to social change. Nancy Thumin (2009) reported that participants in the project entitled “London Voices” talked about having a voice and “being heard” and how the project recognized their experiences and points of view. In response, she raised the question of whether self-representation or “having a voice” takes place instead of social change. A second limitation of photovoice noted in the literature is that it has, thus far, stopped short of engaging participants in conceptualizing and participating in action steps needed to address their needs (Wang & Pies, 2004).

In relation to this project, an email communication from an individual who had seen the photovoice exhibit echoed the second limitation. The writer urged our research group to move beyond the relating/telling of the experience to some form of social action. This email was the catalyst for Phase 2 of the project—public education. A new exhibit called “Walk With Me” was actively promoted, and resulted in public showings at galleries, social justice conferences, and social justice events, as well as CBPR workshops at community social service agencies and institutions of higher education.

Nevertheless, transformative possibilities existed for all group members. The peer researchers observed that the process of creating digital stories and the photovoice exhibit was not therapy, but was therapeutic. The digital stories represented their unique experience while the photovoice exhibit was a thematic representation of the five stories. They were proud of the quality of the exhibit and the digital stories, and they reported feeling valued and respected throughout the process and during the public presentations. Contextualizing by way of storytelling led to emotional engagement and may have been a key ingredient of healing. Additionally, an aspect of healing may have been related to the group process. Northen and Kurland (2001) noted that a supportive climate “reduces anxiety and facilitates self-expression and willingness to try our new ideas and behaviors” (p. 25). Moreover, novel experiences such as photovoice can arouse strong emotions that lead to significant cognitive shifts and communal healing (Carlson, Engebretson, & Chamberlain, 2006). This was the case for all group members.

Summary

Group meetings, an elemental facet of the participatory research process, challenge traditional academic researcher privilege, invite power sharing, and provide a framework for co-construction of knowledge. These group meetings offer both a venue for individual expression and the co-creation of a collective story, which serves to reduce the pathologizing of marginalized populations by means of isolated individual cases. The group dynamics revealed that an important aspect of community-based participatory photovoice research is the collaborative creation of a safe place for contextualization, where photographs are presented and stories told.

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