Reflexivity: A Strategy for Ethics- and Values-Driven Community Partnerships in Mental Health

In Emily E. Anderson (ed.), Ethical Issues in Community and Patient Stakeholder–Engaged Health Research. Springer Verlag. pp. 81-92 (2023)
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Abstract

Dissemination and implementation of evidence-based mental health care often relies on community-engaged research (CEnR) to remove barriers, encourage adoption, and shape adaptations to evidence-based practice. Traditional ethics codes were not designed with community-based programs in mind, such as those serving youth in healthcare (Mikesell L, Bromley E, Khodyakov D, American Journal of Public Health:103;7-14, 2013), afterschool (Chou T, Frazier SL, Ethics & Behavior:0;1-15, 2019), or juvenile justice settings (Javdani S, Singh S, Sichel CE, American Journal of Community Psychology:439–449, 2017). To address gaps in guidance, an emerging literature provides CEnR investigators with concrete strategies and examples for navigating ethical dilemmas in real-time (Campbell R, Morris M, American Journal of Community Psychology:299-301, 2017). This chapter describes reflexivity, a procedure of reflection utilized in implementation science (Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC, Implementation Science:4;1-15, 2009), community engagement (Case AD, American Journal of Community Psychology:398–405, 2017) and compassionate practice (Kanov J, Powley EH, & Walshe ND, Human Relations:70;751-777, 2017) to guide values- and ethics-driven science. We review the historical context of clinical science to set the stage for re-examining biases implicit in academia. Further, we provide actionable suggestions for introspection and discussions within research teams and between academic investigators and their community partners, illustrated by case examples. Lastly, we present 4R, a methodology by which to structure reflection, record learning, and contribute to the growing CEnR ethics literature (Chou T, Frazier SL, Ethics & Behavior:0;1-15, 2019).

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