Dr Janet Smithson
Senior Lecturer in Psychology

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Publications by category



Journal articles
Owens C, Sharkey S, Smithson J, Hewis E, Emmens T, Ford T, Jones R (2015). Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study. Health Expect, 18(1), 81-94.

Abstract:
Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study.

BACKGROUND: Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa. AIM: We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice. METHODS: We allocated 77 young people aged 16-'5 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; '5%; 50% respectively) to allow us to observe the effect of the professionals on online interaction. RESULTS: the young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private-professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators. CONCLUSIONS: Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.
 Abstract.  Author URL
Chatrakul Na Ayudhya U, Smithson J, Lewis S (2014). Focus group methodology in a life course approach - individual accounts within a peer cohort group. International Journal of Social Research Methodology, 17(2), 157-171.

Abstract:
Focus group methodology in a life course approach - individual accounts within a peer cohort group

This paper explores the use of focus group methodology as part of a life course approach building on Julia Brannen's pioneering work in these two areas. Much life course research uses individual interviews, including biographical interview techniques. It is less usual to find focus groups used within the life course perspective. This paper draws on a PhD study of young British and Asian adults' experiences of the transition from university to full-time employment, using focus groups as part of a multi-method approach, within a life course perspective. The study drew explicitly on Julia Brannen's approach to life course transitions. Three focus group excerpts are presented and discussed to illustrate how focus group data can further the understanding of the ways in which a group of peers discuss the transition to work and especially future work-life balance. We show how focus group discussions about individual choice for future work and 'life' or 'lifestyle' can highlight shared assumptions of this birth cohort group as well as areas of disagreement and contention, rooted in both individual experiences and societal and socio-cultural expectations. We relate this to Julia Brannen's conceptualisation of the three different modalities which young people draw on to talk about the future. (C) '014 (C) '014 Taylor and Francis.
 Abstract.
Lishman E, Cheston R, Smithson J (2014). The paradox of dementia: Changes in assimilation after receiving a diagnosis of dementia. Dementia (london).

Abstract:
The paradox of dementia: Changes in assimilation after receiving a diagnosis of dementia.

This qualitative study used semi-structured interviews to explore how six people talked about their difficulties before and after a dementia diagnosis. Participants' accounts of their memory problems were analysed in terms of the verbal Markers of Assimilation of Problematic Voices Scale. This analysis indicated that after diagnosis some participants were able to integrate aspects of their illness that had previously been too painful, and which had been warded off. The process by which individuals were able to integrate a dementia diagnosis into their sense of self-involved stepping in and out of awareness, with both acceptance and denial featuring in their accounts as they approached and then retreated from addressing the diagnosis. In contrast, other participants resisted moving towards explicitly acknowledging their dementia but were instead able to express concerns about what this movement would entail, for instance voicing their fears that it would mean that they had surrendered. Social support seems to have been crucial in enabling participants to sustain a positive sense of self in the face of this adjustment.
 Abstract.  Author URL
Pedersen S, Smithson J (2013). Mothers with attitude - how the Mumsnet parenting forum offers space for new forms of femininity to emerge online. Women's Studies International Forum, 97-106.
Smithson J, Jones RB, Ashurst E (2012). Developing an online learning community for mental health professionals and service users: a discursive analysis. Bmc Medical Education, 12(1).

Abstract:
Developing an online learning community for mental health professionals and service users: a discursive analysis

Background: There is increasing interest in online collaborative learning tools in health education, to reduce costs, and to offer alternative communication opportunities. Patients and students often have extensive experience of using the Internet for health information and support, and many health organisations are increasingly trying out online tools, while many healthcare professionals are unused to, and have reservations about, online interaction. Methods. We ran three week-long collaborative learning courses, in which 19 mental health professionals (MHPs) and 1' mental health service users (MHSUs) participated. Data were analysed using a discursive approach to consider the ways in which participants interacted, and how this contributed to the goal of online learning about using Internet technologies for mental health practice. Results. MHSUs and MHPs were able to discuss issues together, listening to the views of the other stakeholders. Discussions on synchronous format encouraged participation by service users while the MHPs showed a preference for an asynchronous format with longer, reasoned postings. Although participants regularly drew on their MHP or MHSU status in discussions, and participants typically drew on either a medical expert discourse or a "lived experience" discourse, there was a blurred boundary as participants shifted between these positions. Conclusions. The anonymous format was successful in that it produced a "co-constructed asymmetry" which permitted the MHPs and MHSUs to discuss issues online, listening to the views of other stakeholders. Although anonymity was essential for this course to 'work' at all, the recourse to expert or lay discourses demonstrates that it did not eliminate the hierarchies between teacher and learner, or MHP and MHSU. The mix of synchronous and asynchronous formats helped MHSUs to contribute. Moderators might best facilitate service user experience by responding within an experiential discourse rather than an academic one. (C) '01' Smithson et al; licensee BioMed Central Ltd.
 Abstract.
Barlow A, Smithson J (2012). Is modern marriage a bargain? Exploring Perceptions of Pre-Nuptial Agreements in England and Wales. Child and Family Law Quarterly, 3(24), 304-319.
Smithson J, Hennessey C, Means R (2012). Online interaction and "real information flow": analysis of an interdisciplinary research forum. Journal of Research Practice, 1(8).
Sharkey S, Smithson J, Hewis E, Jones R, Emmens T, Ford T, Owens C (2012). Supportive interchanges and face-work as 'protective talk' in an online self-harm support forum. Communication and Medicine, 9(1), 71-82.

Abstract:
Supportive interchanges and face-work as 'protective talk' in an online self-harm support forum

Within a context of concern about inappropriate advice-giving online, we examined how young people who self-harm behave online, and how professionals might engage with them. We use Discourse Analysis to focus on participant interactions (posts) from a forum's crisis/support rooms, and highlight the prevalence of disclaimers, hedges, questions and tags in the young people's online interactions. We use the concept of facework as a framework to help understand interactions in the forum SharpTalk. The findings demonstrate the use of a range of mitigation devices, and suggest that the young people orientate to a 'protective' line in their supportive interactions. These findings echo Goffman's (1967) 'supportive interchanges' in that the young people's online interactions may help to preserve face, in an emotionally complex setting, whose vulnerable members also need 'protective' and sensitive support. Taking this 'line' may enable members to create a more open and trusting context for support, and to remain in a forum which they find both helpful and challenging. In light of concerns about online support, the findings provide a new perspective on online peer-support for young people who self-harm. (C) Equinox Publishing Ltd.
 Abstract.
Smithson J, Britten N, Paterson C, Lewith G, Evans M (2012). The experience of using complementary therapies after a diagnosis of cancer: a qualitative synthesis. Health (london), 16(1), 19-39.

Abstract:
The experience of using complementary therapies after a diagnosis of cancer: a qualitative synthesis.

This article describes a qualitative synthesis of published research on cancer patients' experiences of complementary therapies. We conducted a systematic search for qualitative studies on this subject published between 1998 and '007. Twenty-six refereed journal articles met the inclusion criteria. These '6 articles were repeatedly read by the research team and key concepts emerging from them were identified. Differences and variations were examined in association with treatment, therapy type and by stage of cancer (early stage, mid-treatment, advanced cancer, palliative care and long term 'survivors'). Six overarching concepts were located, which describe the key aspects of patients' experiences of the use of complementary and alternative medicine after a diagnosis of cancer: Connection; Control; Well-being; Transformation; Integration; and Polarization. These are described in a 'line of argument' synthesis, and differences associated with treatment type and stage of disease are noted. The findings are presented in a table showing the six concepts according to treatment type and stage; as a composite story; and in a diagrammatic model showing the individual, practitioner and organizational levels. The synthesis identified various specific ways in which complementary therapies supported cancer patients, as well as occasional negative effects. The most notable barrier was the perceived polarization of complementary therapies and biomedicine; patients reported better experiences in integrated settings.
 Abstract.  Author URL
den Dulk L, Peper A, Cernigoj Sadar N, Lewis S, Smithson J, van Doorne-Huiskes A (2012). Work, family and managerial attitudes and practices in the European workplace: comparing Dutch, British and Slovenian financial sector managers. Social Politics: International Studies in Gender, State, and Society, 2(18), 300-329.
Smithson J, Garside R, Pearson M (2011). Barriers to, and facilitators of, the prevention of unintentional injury in children in the home: a systematic review and synthesis of qualitative research. Inj Prev, 17(2), 119-126.

Abstract:
Barriers to, and facilitators of, the prevention of unintentional injury in children in the home: a systematic review and synthesis of qualitative research.

BACKGROUND: This review considers barriers to, and facilitators of, success for interventions to reduce unintentional injury to children in the home through supply and/or installation of home safety equipment, and looks at risk assessments. METHODS: a systematic review of qualitative research. Bibliographic databases were searched for studies on interventions to reduce unintentional child injury in the home, or on related attitudes and behaviours. Studies were quality appraised, findings extracted, and a conceptual framework was developed to assess factors affecting the success of interventions. RESULTS: Nine peer-reviewed journal articles were included. Barriers and facilitators were highlighted at organisational, environmental and personal levels. Effective provision of safety equipment involves ongoing support with installation and maintenance. Take up and success of interventions depends on adjusting interventions according to practical limitations and parents' cultural expectations. A particular barrier was parents' inability to modify rented or shared accommodation. CONCLUSIONS: the review highlights ways in which health inequalities affect the take up and success of home safety interventions, and how health workers can use this knowledge to facilitate future interventions.
 Abstract.  Author URL
Sharkey S, Jones R, Smithson J, Hewis E, Emmens T, Ford T, Owens C (2011). Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk). J Med Ethics, 37(12), 752-758.

Abstract:
Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.
 Abstract.  Author URL
Smithson J, Sharkey S, Hewis E, Jones RB, Emmens T, Ford T, Owens C (2011). Membership and boundary maintenance on an online self-harm forum. Qual Health Res, 21(11), 1567-1575.

Abstract:
Membership and boundary maintenance on an online self-harm forum.

In this article we explore how young adults became members and sustained membership in an online self-harm support forum, SharpTalk. We take a discursive approach to consider resources young people used to establish themselves, how others responded to their attempts, and how membership categories were developed and applied. Participants displayed expectations about appropriate ways of discussing self-harm, and about responses and advice. New posters made reference to other self-harm sites, provided biomedicalized narratives of their "story," and asked for help in particular ways. Participants were active in shaping interactions on the forum, requesting input from site moderators, and challenging each other both on perceived infringements of posting content, and on style of posting pertinent to membership. On the SharpTalk site, perceived deviance in posting behavior, and also the giving of health care advice, were most commonly addressed by other young people who self-harmed, rather than by the site moderators. We consider implications for creating sites that enable young people who self-harm to become members and sustain membership, and therefore access support.
 Abstract.  Author URL
Jones R, Sharkey S, Ford T, Emmens T, Hewis E, Smithson J, Sheaves B, Owens C (2011). Online discussion forums for young people who self-harm: User views. Psychiatrist, 35(10), 364-368.

Abstract:
Online discussion forums for young people who self-harm: User views

Aims and method: to explore what young people who self-harm think about online self-harm discussion forums. SharpTalk was set up to facilitate shared learning between health professionals and young people who self-harm.We extracted themes and illustrative statements from the online discussion and asked participants to rate statements. Results: of 77 young people who participated in the forum, 47 completed the questionnaire. They said they learned more about mental health issues from online discussion forums than from information sites, found it easier to talk about self-harm to strangers than to family or friends, and preferred to talk online than face-to-face or on the telephone. They valued the anonymity the forums provided and reported feeling more able to disclose and less likely to be judged online than in 'real life'. Clinical implications: Mental health professionals should be aware of the value of anonymous online discussion forums for some young people who self-harm, so that they can talk about them and assess their use with their patients. Declaration of interest: None.
 Abstract.
Smithson J, Sharkey S, Hewis E, Jones R, Emmens T, Ford T, Owens C (2011). Problem presentation and responses on an online forum for young people who self-harm. Discourse Studies, 13(4), 487-501.

Abstract:
Problem presentation and responses on an online forum for young people who self-harm

In this article we investigate the nature of problem presentation and responses on an online forum for young people who self-harm. Previous studies have raised concerns about the peer encouragement of self-harming behaviours in online forums, and this analysis considers the nature of peer interaction on a specific forum, ' SharpTalk'. This was a research forum which explored the potential of online communities to foster engagement and shared learning between NHS professionals and young people who self-harm. This analysis draws on conversation analysis methods to study problem presentation and responses, and nature of advice given. Analysis highlighted both the tendency to offer advice where it was not asked for, and the mundane 'safe' nature of advice. This awareness of how young people interact and provide support online is important for those setting up online interventions to support young people who self-harm. (C) the Author(s) '011.
 Abstract.
Jones R, Sharkey S, Smithson J, Ford T, Emmens T, Hewis E, Sheaves B, Owens C (2011). Using metrics to describe the participative stances of members within discussion forums. J Med Internet Res, 13(1).

Abstract:
Using metrics to describe the participative stances of members within discussion forums.

BACKGROUND: Researchers using forums and online focus groups need to ensure they are safe and need tools to make best use of the data. We explored the use of metrics that would allow better forum management and more effective analysis of participant contributions. OBJECTIVE: to report retrospectively calculated metrics from self-harm discussion forums and to assess whether metrics add to other methods such as discourse analysis. We asked (1) which metrics are most useful to compare and manage forums, and (') how metrics can be used to identify the participative stances of members to help manage discussion forums. METHODS: We studied the use of metrics in discussion forums on self-harm. SharpTalk comprised five discussion forums, all using the same software but with different forum compositions. SharpTalk forums were similar to most moderated forums but combined support and general social chat with online focus groups discussing issues on self-harm. Routinely recorded time-stamp data were used to derive metrics of episodes, time online, pages read, and postings. We compared metrics from the forums with views from discussion threads and from moderators. We identified patterns of participants' online behavior by plotting scattergrams and identifying outliers and clusters within different metrics. RESULTS: in comparing forums, important metrics seem to be number of participants, number of active participants, total time of all participants logged on in each '4 hours, and total number of postings by all participants in '4 hours. In examining participative stances, the important metrics were individuals' time logged per '4 hours, number of episodes, mean length of episodes, number of postings per '4 hours, and location within the forum of those postings. Metric scattergrams identified several participative stances: (1) the "caretaker," who was "always around," logged on for a much greater time than most other participants, posting but mainly in response to others and rarely initiating threads, (') the "butterfly," who "flitted in and out," had a large number of short episodes, (3) two "discussants," who initiated many more discussion threads than anybody else and posted proportionately less in the support room, (4) "here for you," who posted frequently in the support room in response to other participants' threads, and (5) seven "people in distress," who posted many comments in the support room in comparison with their total postings and tended to post on their own threads. CONCLUSIONS: Real-time metrics may be useful: (1) by offering additional ways of comparing different discussion forums helping with their management, and (') by identifying participative stances of individuals so allowing better moderation and support of forums, and more effective use of the data collected. For this to happen, researchers need to publish metrics for their discussion forums and software developers need to offer more real-time metrics facilities.
 Abstract.  Author URL
Smithson J, Paterson C, Britten N, Evans M, Lewith G (2010). Cancer patients' experiences of using complementary therapies: polarization and integration. J Health Serv Res Policy, 15 Suppl 2, 54-61.

Abstract:
Cancer patients' experiences of using complementary therapies: polarization and integration.

OBJECTIVE: the use of complementary therapies by people with cancer is commonplace. In a recent synthesis of '6 qualitative studies of patients' experiences of complementary therapy use after a diagnosis of cancer, the emergent theme of 'polarization' was the most notable barrier to a positive experience of complementary therapies. In this paper, we explore the two synthesis concepts of 'polarization' and 'integration', and their relationship to health service policies and guidelines on integrated services. METHODS: a systematic literature search and a meta-ethnography to synthesize key concepts. RESULTS: the majority of patients who used complementary therapies after a diagnosis of cancer wanted to be certain that the therapies were not interfering with their conventional cancer treatment. They valued the therapies in wider terms including: taking 'a niche of control', relieving symptoms, improving wellbeing, and promoting reconnection and social interaction. The emergent theme of 'polarization' suggested that conventional physicians who are perceived to be poorly informed or negative about complementary approaches induce patient anxiety, safety concerns, and difficulties in access. They may compromise their therapeutic relationship and, rarely, they may trigger patients to abandon conventional medicine altogether. In contrast, integrated advice and/or services were highly valued by patients, although some patients preferred their complementary health care to be provided in a non-medicalized environment. CONCLUSIONS: Our findings suggest that the current polarized situation is unhelpful to patients, detrimental to therapeutic relationships and may occasionally be dangerous. They indicate that complementary therapies, in a supportive role, should be integrated into mainstream cancer care.
 Abstract.  Author URL
Barlow A, Smithson J (2010). Legal assumptions, cohabitants' talk and the rocky road to reform. Child and Family Law Quarterly, 3(22), 328-350.
Pedersen S, Smithson J (2010). Membership and activity in an online parenting community. , 1, 88-103.

Abstract:
Membership and activity in an online parenting community

Recent studies have shown that British women, especially mothers of young children, spend a particularly large amount of time online. Many are logging on to parenting websites. This chapter investigates Mumsnet, a large British parenting site, and evaluates how members use and conceptualise the site. A combined method of a questionnaire survey with open and closed-ended questions, and discourse analysis of discussions on the site, was used to explore this. The analysis considers how membership and expertise are displayed and acknowledged in online groups, how people view their involvement with the site, how online and "real life" are segregated or integrated in various ways. The positioning of "lurkers" (those who read but do not post) and of "trolls" (those who post false information or fake identities) is explored within the context of how power is reproduced and challenged in the type of discourse produced in an online discussion forum. (C) '010, IGI Global.
 Abstract.
Sumer S, Smithson J, Das Dores Guerreiro M, Granlund L (2008). Becoming working mothers: Reconciling work and family at three particular workplaces in Norway, the UK, and Portugal. Community, Work and Family, 11(4), 365-384.

Abstract:
Becoming working mothers: Reconciling work and family at three particular workplaces in Norway, the UK, and Portugal

This paper investigates how differences in national and organisational welfare policies and in cultural norms on national, organisational, and familial levels influence work-family reconciliation for mothers. Drawing on case study and interview data gathered through a large European study of parenthood and organisations, we compare experiences of transition to motherhood in three organisations in Norway, the UK, and Portugal. The specific question which is considered in this paper is how mothers manage the reconciliation of work and family in the period of time following parental leave. Our case analyses highlight the differences in organisational, national policy, and family support in the three contexts, and show that having a child is still conceptualised as a predominantly 'private problem' in the UK and Portugal, while it has come closer to having the status of a 'public issue' in Norway. (C) '008 Taylor and Francis.
 Abstract.
Sullivan C, Smithson J (2007). Perspectives of homeworkers and their partners on working flexibility and gender equity. International Journal of Human Resource Management, 18(3), 448-461. Author URL

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