Developing novel co-produced methodology to understand ‘real-world’ help-seeking in online peer-peer communities by young people experiencing emotional abuse and neglect

Abstract

Background: Recent systematic reviews suggest mediating factors (barriers and facilitators) of help-seeking for children and young people (CYP) with a range of mental health problems but highlight the need for more robust methodology underpinned by theoretical frameworks. Emotional abuse and neglect is the most prevalent and pervasive form of abuse, with many CYP remaining unknown to professional services. These CYP are underrepresented in help-seeking research yet seek help from their peers via anonymous online publicly available message communities. Objectives: To sensitively co-develop qualitative methodology to explore ‘real-world’ data to inform our understanding of help-seeking for these CYP, and define potential mediators (barriers and facilitators) and mechanisms of change associated with online peer support.Methods: Co-production with 10 young co-researchers (YCoR; aged 14-18 years) from NeurOX Young People’s Advisory Board (YPAG) included co-development and triangulation of different research methods (i.e., interpretative phenomenological, thematic, and conversation analyses) to analyse rich ethnographic material from 20 publicly available online message conversations between help-seekers experiencing or questioning emotional abuse and neglect. A theoretical model of adolescent help-seeking proposed by Rickwood et al. (2005) was used as a conceptual framework to guide methodological development. Results: The methodological approach facilitated identification of barriers and facilitators of help-seeking contextualised to the lives of these CYP: understanding and validating of abuse, emotional competence, fears and uncertainties around disclosure, knowledge, motivational factors, and connection/trusted relationships. Notably, positive changes in expressed or perceived ‘psychological state’ and/or intention to seek help were noticed in 9 of 10 message threads that included a ‘conversation’ (≥3 posts). Themes associated with change related to: connection with supportive peers; compassionate responding; and, the safeness of the online community. The existing adolescent help-seeking model was found to be too simplistic to account for help-seeking associated with emotional abuse and neglect. Conclusion: The novel methodological approach offers a meaningful way to explore ‘real-world’ data with YCoR, for a population underrepresented in help-seeking research. Proposed relational mechanisms involve connection, compassion and online communities. Further research coproduced with YCoR with diverse care experiences and characteristics is required to upscale the methodology and further validate and extend the findings.Public contribution: The core study was co-produced with 10 young co-researchers from the NeurOX YPAG who have been involved in over 135 hours on and offline work. Their roles involved co-deciding the direction of the study, evolving methodology, detailed co-analysis and reflective processes throughout all aspects of the study, interpretation, presentation and discussion of the findings with the NSPCC and Childline, and involvement in all communications. Additional consultation and involvement included further interested members of the NeurOX YPAG for the final online workshop and dissemination outputs.

Co‐production to understand online help‐seeking for young people experiencing emotional abuse and neglect: Building capabilities, adapting research methodology and evaluating involvement and impact

“…Included two online sessions, a co‐produced two‐page young reviewer attachment and feedback from two NeurOX YPAG members on the full proposal. Submitted on 20 January 2022 (Council ref:MR/X003213/1), shortlisted (June 2022); funding declined (preparing alternative submission). Three peer‐reviewed publications (4 YCoRs) 35,36 Storytelling (as part of a broader NeurOX YPAG evaluation) 49 …”

“…A reflexive thematic analysis approach was chosen. This was achieved with: individual, paired and group reflective practices; group discussions; an exercise to refine and map the barriers and facilitators on the help‐seeking framework; and, reviewing and ranking themes identified in the conversation analysis 36 . These reiterative processes allowed further incorporation of YCoRs perspectives to develop trustworthy themes for this project.…”

“…Padlets were used in breakouts to enable all to participate and record their thoughts. This and data sampling are reported in detail elsewhere 35,36 . All YCoR copied their selected message thread URLs into a Google sheet; these threads were then imported into NVivo (v12) by adult researchers.…”

“…YCoR provided further input during the paid Work Experience Week working with representatives from the NSPCC (Policy, Fundraising and Communications Teams) and off‐line via email correspondence. Four members worked offline with the adult researchers to co‐author publications over a 1‐year period 35,36 . Three YCoR participated in an interview with the NSPCC Press officer and approved a press release distributed by the NSPCC.…”

“…Themes and a codebook were finalized by the adult researcher following this session. Full details of qualitative methodology and findings are provided in Bennett et al 36 For this short-term project, reflective processes among the YCoR and with the researcher were used to guide coding and establish trustworthy themes and subthemes. The primary formal evaluation method, using Padlets (with an option for anonymity) captured more structured feedback following the second workshop; this evolved as the relationships and the 'research environment' was established.…”