Staying Strong and Sexy : Research and reflections on sexual occupational influences for social workers assisting sex workers

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Staying Strong and Sexy

Research and reflections on sexual occupational

influences for social workers assisting sex

workers

Master thesis Master Social Work

Amsterdam University of Applied Sciences

Anke van den Dries

studentno. 500740946

Defence at 30th of June 2017 Defence committee:

Marc Hoijtink, AUAS (supervisor) Mike de Kreek, AUAS

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Cover: Sentinels, Marios Kotsonis Photography

Keywords (English): social work, sex work, sexuality, sexual occupational influences, occupational health and wellbeing, (self) care, practice-based research

Keywords (Dutch): sociaal werk, maatschappelijk werk, sekswerk, sek-sualiteit, werkgerelateerde invloeden, gezondheid en welzijn, (zelf)zorg, praktijkgericht onderzoek

Correspondence: ankevandendries@gmail.com

I explicitly welcome you to contact me for further in-formation or to share your reflections on the topic.

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v Let’s talk about sex, baby

Let’s talk about you and me

Let’s talk about all the good things And the bad things that may be Let’s talk about sex...

(Lyrics by Hurby Azor for Salt-n-Pepa, 1991)

To my social work colleagues at Humanitas PMW over the past two years,

Annemieke, Evelien, Judith, Karina, Maaike, Marita, Maryline, Mira, Miranda, Nick, Nicole, Rolinka, Steffie and Teodora

whose expertise and contributions were vital for this research project. We as social workers tend to sometimes be modest or even uncertain about our profession and our place in the social domain. However, one thing the master program for sure has taught me is: we rock! :) I thank and salute you.

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Abstract (English)

This master thesis reports the outcomes of a pioneering research project into sexual occupational influences for social workers assisting sex workers. Al-though occupational influences on the wellbeing of social workers have been recognized, influences on the private sexuality or intimate relationship(s) par-ticularly, remained unknown to this point. However, an urgent solution to this issue is of importance for maintaining and improving sustainable employa-bility of the social worker and indirectly the quality of the offered social work services to clients that work or worked in the sex industry.

The followed methodology was practice-based with research, change and pro-fessionalization processes going hand in hand. A multimethod and cocre-ative approach was chosen with literature study, interactive model building, an anonymous survey and focus group. Analysis was largely inductive qualita-tive but also quantitaqualita-tive.

Results indicate a high prevalence of both positive and negative sexual occupa-tional influences - respectively 87% and 85% - among the professionals. In the area of positive influences at the micro level (intrapersonal), most commonly the social workers describe that they have become more broad-minded in ex-ploring their own sexuality or sexual behaviour. At meso level (interpersonal), most often the positive influence is indicated by the professionals that they are communicating more easily about sexuality with their partner. In the area of negative influences at micro level, the most common influence is the experi-ence that due to the work they occasionally are not in the mood for sexuality or intimacy. At meso level, most often it is described that the practitioners feel more distrust towards (the loyalty of) their (future) partner.

Although self-care methods are applied, most social workers do not experi-ence much organizational support to cope with negative sexual occupational influences. The research shows that they would appreciate acknowledgement for the intensity of this particular type of social work and possible sexual oc-cupational influences. Considering the taboo nature of the topic, outreach information and compulsory periodical checks with an external specialist are recommended as possible helpful methods of care for the social worker.

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Abstract (Dutch)

In deze master thesis wordt verslag gedaan van een pionierend onderzoeks-project naar werkgerelateerde invloeden op de seksualiteit van sociaal werkers die sekswerkers ondersteunen. Hoewel werkgerelateerde invloeden of werkge-relateerde stress voor sociaal werkers zijn beschreven, bleken invloeden op in het bijzonder de seksualiteit en intieme relatie(s) van de werker onbesproken te blijven. Het vraagstuk is echter relevant voor het handhaven en verbeteren van duurzame inzetbaarheid van professionals en daarmee indirect ook voor de hulp- en dienstverlening aan cliënten die werken of gewerkt hebben in de seksindustrie.

De methodologie is praktijkgericht, waarbij onderzoeks-, verander- en profes-sionaliseringsprocessen samen opgaan. Een multimethodische en cocreatieve aanpak werd gekozen met literatuuronderzoek, interactieve model bouw, een anonieme vragenlijst en een focusgroep. Data-analyse was grotendeels induc-tief kwalitainduc-tief, maar tevens kwantitainduc-tief.

De uitkomsten laten zien dat zowel positieve als negatieve invloeden op de seksualiteit en intimiteit veel voorkomen. Maar liefst 87% en 85% van de soci-aal werkers rapporteren enige respectievelijk positieve en negatieve invloeden op de eigen seksualiteit. Qua positieve invloed op microniveau (intrapersoon-lijk) wordt het meest genoemd dat men meer ruimdenkendheid ervaart in het verkennen van de eigen seksualiteit. Op mesoniveau (interpersoonlijk) geeft men het vaakst als positieve invloed aan door het werk geleerd te hebben makkelijker over seksualiteit te praten met intieme partner(s). Qua negatieve invloeden op microniveau wordt het vaakst genoemd dat men door het werk soms geen zin heeft in seks of moeite heeft om opgewonden te raken. Op mesoniveau tenslotte wordt als negatieve invloed het meest genoemd dat men toenemend wantrouwen ervaart naar de eigen (toekomstige) partner(s). Hoewel zelfzorgtechnieken worden toegepast, ervaren de meeste hulpverlen-ers weinig ondhulpverlen-ersteuning vanuit de werkgever in het omgaan met negatieve werkgerelateerde invloeden op de eigen seksualiteit. Meer erkenning voor de intensiteit van dit specifieke werkveld en de mogelijkheid van het bestaan van dergelijke invloeden, zou worden gewaardeerd. Gezien de taboesfeer rondom het onderwerp, worden het outreachend aanbieden van informatie over het verschijnsel en verplichte periodieke gesprekken met een externe deskundige aanbevolen als mogelijke ondersteuningsinstrumenten in de zorg voor de so-ciaal werker.

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Samenvatting

Deze thesis is het verslag van een pionierend onderzoeksproject naar werkgerelateerde invloeden op de seksualiteit van sociaal werkers die seks-werkers ondersteunen, wat ik uitvoerde in het kader van de Master Social Work aan de Hogeschool van Amsterdam. Hoewel werkgerelateerde invloeden of werkgerelateerde stress voor sociaal werkers in literatuur zijn beschreven, bleken invloeden op in het bijzonder de seksualiteit en intieme relatie(s) van de sociaal werker onbesproken te blijven. Ik acht het vraagstuk echter relevant, met name voor het handhaven en verbeteren van duurzame inzetbaarheid van de professionals en daarmee indirect ook voor de hulp- en dienstverlen-ing aan cliënten die werken of gewerkt hebben in de seksindustrie.

Het onderzoek werd uitgevoerd vanuit de praktijk van Humanitas Prostitutie Maatschappelijk Werk (PMW) in Rotterdam, Nederland. PMW biedt hulp en ondersteuning aan sekswerkers en slachtoffers van mensenhandel, bij zowel praktische als psychosociale hulpvragen van uiteenlopende aard. Humanitas PMW strijdt tegen het nog altijd geldende maatschappelijk stigma op seks-werkers en pleit voor de acceptatie van sekswerk als vak. Het is de missie van PMW om de individuele sekswerker en sekswerkers als groep te empoweren en de (arbeids)positie te versterken.

Het vraagstuk wat centraal staat binnen dit project is dat de invloed van hulpverlening bij PMW op de eigen seksualiteit en de intieme relaties van de sociaal werker veelal onbesproken en daarmee oninzichtelijk lijkt te blijven. Dit is opmerkelijk daar het werk bij PMW onlosmakelijk verbonden is met het thema seksualiteit, bijvoorbeeld door verhalen van cliënten of door seksuele beelden tijdens het (online) veldwerk. Daarnaast kan seksualiteit natuurlijk ook een thema zijn binnen de hulpvragen van de cliënt.

Zelf ben ik sinds 2007 werkzaam als maatschappelijk (sociaal) werker bij PMW. In de loop van de tijd realiseerde ik me dat er invloeden bestonden, maar dat ze geen onderwerp van gesprek waren in het team. Verborgen bleef daarmee of een invloed een, eventueel problematische, weerslag kent op het welzijn van de sociaal werker. Het niet adresseren van mogelijke invloeden zou negatieve gevolgen kunnen hebben voor het welzijn, het werkplezier en de duurzame inzetbaarheid van de sociaal werker die werkt met sekswerkers. Uiteindelijk zou hierdoor de ondersteuning aan de doelgroep en de missie van de organ-isatie geraakt kunnen worden.

Na het ondernemen van een literatuuronderzoek ontdekte ik al snel dat er omtrent het onderwerp nog erg weinig bekend en beschreven was, noch in

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nationale noch in internationale literatuur. Dit onderzoek werd dan ook een eerste aanzet tot verkenning van het vraagstuk met een pionierend karakter. De interne doelstelling van het onderzoeksproject betrof beantwoording van een kennisvraag met betrekking tot werkgerelateerde invloeden voor de sek-sualiteit en intimiteit van de sociaal werker. De externe, overstijgende, doel-stelling was om een bijdrage te leveren aan een verandering gedurende welke invloeden op de eigen seksualiteit en intimiteit meer bespreekbaar worden en waar nodig voorkomen of voor gezorgd worden. Mijn centrale onder-zoeksvraag werd hoe sociaal werkers - die sekswerkers en/of slachtoffers van mensenhandel uit de seksindustrie ondersteunen - werkgerelateerde invloe-den op de eigen seksualiteit en intieme relaties ervaren en wat hun behoeften zijn rondom (zelf)zorg bij eventuele negatieve invloeden.

De toegepaste onderzoeksmethodologie is praktijkgericht, waarbij onderzoeks-, verander- en professionaliseringsprocessen simultaan zijn opgegaan. Een multimethodische en cocreatieve aanpak werd gekozen met literatuuronderzoek, interactieve model bouw, een anonieme vragenlijst en een focusgroep. Data-analyse was grotendeels inductief kwalitatief, maar tevens kwantitatief.

De uitkomsten laten zien dat zowel positieve als negatieve invloeden op de seksualiteit en intimiteit veel voorkomen. Maar liefst 87% en 85% van de sociaal werkers die deelnamen aan de vragenlijst (N=52) rapporteren enige respectievelijk positieve en negatieve invloeden op de eigen seksualiteit. Dit kan dan variëren van milde invloeden tot intensere invloeden. Ik heb in de resultaten een onderscheid gemaakt tussen invloeden die de hulpverleners zelf aangaven als positief of als negatief, en tussen invloeden die spelen op micro-niveau (intrapersoonlijk) en op meso-niveau (interpersoonlijk, in relatie met een ander). De vaakst genoemde invloeden binnen deze vier gebieden worden weergegeven in onderstaande matrix. Daaronder licht ik ze verder toe en illustreer ik ze met enkele citaten van respondenten zelf.

Positieve invloeden Negatieve invloeden

Micro Meer ruimdenkend in

verkennen eigen seksu-aliteit

Minder zin in seks / in-timiteit

Meso Makkelijker

commu-niceren over seksualiteit met partner(s)

Meer wantrouwen naar (toekomstige) partner(s)

Qua positieve invloed op micro-niveau (intrapersoonlijk) wordt het meest ge-noemd dat men meer ruimdenkendheid ervaart in het verkennen van de eigen seksualiteit. Op meso-niveau (interpersoonlijk) geeft men het vaakst als positieve invloed aan door het werk geleerd te hebben makkelijker over seksualiteit, en de eigen wensen en grenzen hierin, te communiceren met in-tieme partner(s). Hoewel het onderwerp van dit onderzoeksproject in het

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alge-Samenvatting xvii meen nauwelijks belicht is in de literatuur, lijken eventuele positieve werkgere-lateerde invloeden op de eigen seksualiteit en intieme relaties tot op heden helemaal onbesproken te blijven.

"Ik heb geleerd dat seksuele vrijheid ook iets moois is en dat ik zelf seksueel meer vrij en open ben geworden."

Qua negatieve invloeden op micro-niveau wordt het vaakst genoemd dat men door het werk soms geen zin heeft in seks of moeite heeft om opgewonden te raken. Met behulp van bestaande literatuur plaats ik daar de hypothese bij dat mogelijk ook werkgerelateerde stress verschijnselen zoals secundaire trauma-tisering, compassie moeheid en burnout daarin voor de sociaal werkers in dit onderzoek een rol zouden kunnen spelen. Op meso-niveau tenslotte wordt als negatieve invloed het meest genoemd dat men toenemend wantrouwen ervaart naar de eigen (toekomstige) partner(s). Dit lijkt alleen te spelen voor vrouwelijke heteroseksuele hulpverleners (het grootste deel van de responden-ten). Een veranderend beeld van mannen en de eigen partner kon worden bevestigd vanuit de bestaande literatuur, hoewel binnen de uitkomsten van dit onderzoek angst voor in het bijzonder ontrouw een grotere factor blijkt te zijn. Ik beschrijf dan genderstereotype en hetero(seksuele) sociale constructen die hierin een rol kunnen spelen.

"Soms moet ik echt schakelen en daar slaag ik het ene moment beter in dan het andere. Als het me niet lukt om opgewonden te raken, is mijn partner heel begripvol."

"Hoewel ik het niet wil, merk ik toch dat ik anders naar mannen kijk. Ik heb nu geen partner en wanneer ik met iemand aan het daten ben, vraag ik me vaak af: zou hij prostituees bezoeken?"

Invloeden op de eigen seksualiteit en intieme relatie(s) bleken minder vaak voor te komen onder hulpverleners die cliënten begeleiden die slachtoffer van mensenhandel/uitbuiting in de seksindustrie zijn geworden, dan onder hulpverleners die sekswerkers begeleiden of die zowel sekswerkers als slachtof-fers van mensenhandel begeleiden.

Er is ook naar de visie van de respondenten met betrekking tot sekswerk gevraagd. Hoewel dit een erg kleine groep betrof, lijkt het dat sociaal wer-kers die werken vanuit een organisatie die een andere kijk op de seksindus-trie heeft dan de professional zelf, dat zij mogelijk vaker vaker invloeden op de eigen seksualiteit en intieme relatie(s) ervaren door hun werk.

Van de 33 respondenten die de vraag beantwoordden welk onderdeel of welke onderdelen van hun werk zij invloedrijk achten, geven de meesten (29) aan verhalen van of gesprekken met cliënten invloedrijk te vinden. Een derde geeft aan het veldwerk als een invloedrijke werktaak te zien.

Hoewel zelfzorgtechnieken worden toegepast, ervaren de meeste hulpverle-ners weinig ondersteuning vanuit de werkgever in het voorkomen van of het

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omgaan met negatieve werkgerelateerde invloeden op de eigen seksualiteit en intieme relatie(s). Ze zijn daarin op zichzelf teruggeworpen. Meer erken-ning voor de intensiteit van dit specifieke werkveld en de mogelijkheid van het bestaan van dergelijke invloeden, zou worden gewaardeerd. Gezien de taboesfeer rondom het onderwerp, worden het outreachend aanbieden van informatie over de mogelijkheid van het vóórkomen van invloeden, zowel posi-tieve als negative, en verplichte individuele periodieke gesprekken met een ex-terne deskundige, zoals bijvoorbeeld een seksuoloog, psycholoog of een spe-cialistisch coach, aanbevolen als twee mogelijke ondersteuningsinstrumenten die ingezet kunnen worden in de zorg voor de sociaal werker.

Aan de andere kant blijft er ook een spanningsveld. Zowel tijdens de vragenlijst als tijdens de focusgroep benadrukten professionals dat het ook een delicaat onderwerp is wat niet zonder meer geadresseerd kan worden, omdat het té persoonlijk, té gevoelig of té schaamtevol kan zijn. Aan de andere kant geven professionals aan dat de drempel hoog is om zelf het initiatief te nemen om het onderwerp aan te snijden en dat het drempelverlagend zou werken als het in de organisatie door anderen geïnitieerd zou worden. Aangegeven werd dat dit onderzoek al een bijdrage levert aan het openen van de reflectie op en het gesprek over het vraagstuk.

Het is belangrijk om met zowel die genoemde gevoeligheid als met de ge-noemde drempel rekening te houden bij het bepalen van ondersteunings-instrumenten. Samenstelling hiervan dient dan ook altijd per werkpraktijk in cocreatie met de uitvoerend werkers plaats te vinden. Aan het einde van het verslag formuleer ik nog drie aanbevelingen die mij van belang lijken voor be-trokkenen om in overweging te nemen:

• Het adresseren van dit onderwerp en het mogelijk maken van ondersteu-ning dient een gedeelde verantwoordelijkheid te zijn van professionals en werkgevers. Daarnaast zouden ook sociaal werk opleidingen meer hun rol kunnen pakken in het voorbereiden van sociaal werkers.

• Ondersteuningsinstrumenten aanbieden als standaard vanzelfsprekende procedures normaliseert het bestaan van invloeden en verlaagt de drem-pel en mogelijke schaamte voor de individuele werker. Negatieve werkge-relateerde invloeden moeten niet gelabeld worden als slechte coping van het individu (‘victim blaming’), maar eerder als een beroepsrisico wat ken-merkend is of kan zijn voor de specifieke werkpraktijk.

• Investeren in gedeelde waarden en missie is van belang om PMW speci-fieke professionaliteit te articuleren. Te denken valt aan het ontwikke-len van een specifiek competentieprofiel voor sociaal werkers die werken met sekswerkers, waarin seksualiteit een prominente plaats inneemt. Het articuleren van het specifieke aan ‘prostitutie maatschappelijk werk’ zou daarnaast bij kunnen dragen aan de beroepsidentiteit en het verantwoor-den en veilig stellen van dat specialistische werkveld in tijverantwoor-den van sociaal beleid tendensen met een focus op generalistisch sociaal werk.

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PART 1

In this foreplay of the report the research topic is introduced alongside the specific social work practice from which it arose. The aims of the research and the ways in which these have been pursued are explained, both methodically and ethically.

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Introduction

1.1 Organisation Humanitas PMW

Humanitas was founded just after the Second World War in the Netherlands. The, at the time, strongly pillarised society of the Netherlands had resulted into social support that was not available for all citizens. The aim of the ‘foundation of social work on humanistic grounds’ - soon renamed ‘Humanitas’ - was to offer easily available support on humanistic grounds, independent of the reli-gious or ideological background of the individuals receiving the aid (Verenig-ing Humanitas, n.d.). The core values of Humanitas were and continue to be equality for all citizens, preservation of control over one’s own life and citizens taking responsibility for themselves and others. Assistance was largely given through volunteers from the civil society. The mission and values can therefore considered to be still very up-to-date in the Dutch contemporary transforming welfare state and social domain (Kampen, Verhoeven and Verplanke, 2013). Humanitas in Rotterdam has explicitly added to the Humanitas core values the importance of focus on happiness and joy in life and is known for the re-peated mantra of the ‘yes-culture’, where one thinks in possibilities rather than impossibilities and where any innovation proposed by any stakeholder is wel-comed and considered (Stichting Humanitas, n.d., and Marrewijk and Becker, 2004).

Humanitas PMW (Dutch: Prostitutie Maatschappelijk Werk) was founded as a branch of Humanitas Rotterdam in 1989, after a call of the Dutch govern-ment for an outreach field worker for sex workers in every major city of the Netherlands (Willigenburg, 1993). PMW started with one field worker and fur-thermore took the social task upon itself to assist Rotterdam based sex work-ers. Since then, this specialised field work and social work has expanded to the wider regions of Rotterdam, Dordrecht and Zuid-Holland-Zuid (see figure 1.1), practiced currently by a team of nine social workers. Since 2017, PMW is part of the Humanitas Expertise centre on Sexuality, Sex work and Human trafficking (Expertisecentrum Seksualiteit, Sekswerk en Mensenhandel).

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4 1. Introduction

Figure 1.1: Map of region of PMW in the Netherlands

Men, women and transgenders who make or made money with sex and have a question can turn to PMW for support (Humanitas PMW, n.d.). Sex work can be described as ‘the provision of sexual services in a financial exchange between consenting adults’ (Giddens and Sutton, 2013). Prostitution is therefore only one form of sex work. Sex workers also include erotic masseuses, porn actors, lap dancers, etc.

The target group of PMW can roughly be divided in the following subgroups of clients or service users1_:

• sex workers (male/female/transgender) who are working for themselves and have a question

• sex workers (m/f/t) who want to leave the business and request support with this

• victims of (inter)national trafficking or sexual exploitation (m/f/t)

• children of youngsters (m/f/t) that have been groomed or recruited for youth prostitution

1_{In the social domain in the Netherlands the term client is mostly used to refer to a person}

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1.2. Exposed issue

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5 The mission of PMW is to support sex workers, empower them on micro, meso and macro level and to improve their (labour) position. This happens on micro-level through the individual assistance to sex workers, on meso-level through, for example, influencing regional policies and making agreements for sex workers with local organizations and on macro-level through lobbying for national relevant policies and through contributing to fight the sex work stigma in society.

Sex workers that come to PMW are not necessarily representative for the group of sex workers as a whole. After all, sex workers at PMW all have some type of problem, small or larger, for which they need help. The nature of questions put in front of the social workers at PMW vary from practical or juridical assis-tance to psychosocial support. The used methods draw upon psychodynamic practice, crisis and strengths practice, cognitive-behavioural practice, feminist and multicultural approaches, empowerment and advocacy (Payne, 2014). A big division remains in the discourse on sex work. In one camp the sex worker activists and pro-sex feminists advocate free choice and empowerment. In the other camp the abolitionist or radical feminists emphasize that there is no such thing as choice in selling sex and see prostitution solely as a form of sexual violence towards the woman’s body (McLaughlin, 1991 and Vanwesenbeeck, 2001). Although the discourse is quite divided, this research will show that in practice, as usual, it is not black and white: quite some professionals stand by a hybrid view on sex work (more in paragraph 5.2).

PMW follows a pro-sex feminist perspective by emphasizing sex work as a form of labour. PMW explicitely does not have the objective of getting people out of the job. However, clients who do want assistance to leave the business, will be offered assistance through the exit program at PMW. Regrettably a considerable part of the clients at PMW did not choose sex work voluntarily or were exploited. Social workers at PMW often work with clients that struggle with psychological complaints like anxiety, trauma or depression.

1.2 Exposed issue

As will be further elaborated on in paragraph 1.4, social workers that work with target groups with complex and heavy problems can experience occupational influences in their private lives. It is striking that sexual occupational influences for social workers - influences one might experience on the private sexuality or intimacy due to his or her occupation - are hardly discussed in literature on occupational influences and seem to remain a taboo topic.

At PMW organizational support for the wellbeing, health and employability is currently tended to through individual coaching with the team coach of PMW, individual progress meetings with the team manager, team intervision, work meetings, professional development training programmes and more in-formally through peer consultation.

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6 1. Introduction

The target group of PMW is inherently and inevitably connected with sexuality. On one hand, social workers at PMW are regularly exposed to intense sexual stories - varying from positive experiences on one hand to histories of sexual trauma on the other - and explicit sexual (pornographic) images during (online) fieldwork. On the other hand, needs or questions for support of clients can lie in the area of their intimacy and sexuality. Through the questions of clients the topic of sexuality can also be brought into the consulting room.

I have been working as a social worker at PMW since 2007. Over time I came to realize that the work can influence the private wellbeing and in particular the private personal relationships and sexuality of the professional. I also observed that the prevalence or possibility of these influences were hardly a topic of discussion in the PMW team, either informally or formally during meetings, intervision or coaching. Before the start of this research project, the team ma-nager and team coach of PMW have confirmed this observation. The influence on the social worker that works with sex workers remained unknown.

1.3 Urgency

The specialised social work team of PMW at Humanitas in Rotterdam has mostly been expanding in recent years. This is contradictory to the overall de-velopment in the Dutch social domain, referred to as ‘New Style Social Work’ (Ministry of Health, Welfare and Sport, 2010 and Kluft, 2011) in which social workers become less specialized but more generalist practitioners. Therefore, the legitimation of the continuation of PMW as specialized social work de-pends heavily on the profiling and professionalization of PMW as an expert on sex work and sexuality, and emphasises the importance of the issue addressed in this research project.

Occupational influences on the private sexuality and intimacy of social work-ers in general and social workwork-ers at PMW specifically remains unknown until this point. The matter is nevertheless urgent. Influences could have negative impact on the wellbeing of the worker: when influences remain unaddressed and taboo, the related risks might be heightened. Lodewijk Asscher, the Dutch minister of Social Affairs, recently raised the alarm regarding work related stress, which he stated has risen in the Netherlands as the most prevalent occupa-tional disease, resulting in a third of sick leave (Sloot, 2014). According to research of CBS and TNO, nearly 14% of professional caregivers in the Nether-lands had some type of burnout complaints in 2015. This was manifested by frequent feelings of emptiness at the end of a working day or emotional ex-haustion by their work (Hooftman et al., 2015). Because of a high prevalence of long-term sick leave, Humanitas started in 2014 a project to promote sus-tainable employability. The health and wellbeing of the employee was defined as one of the key pillars (Stichting Humanitas, 2015).

Occupational stress affects a professional’s capabilities and productivity (Karasek and Theorell, 1990, Kompier and Cooper, 1999, Adaramola, 2012).

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1.3. Urgency

1

7 Specifically in social work, the quality of the work is to a great extent deter-mined by the quality of the relationship between the worker and the client and the ways in which the social worker uses his or her own self as a tool in the process (Vries, 2008, Payne, 2014). In social work with ‘messy problems’, where clear and ready-made solutions are not available (Schön, 1983), professional knowledge is developed by the social worker through what works and what does not work in specific situations (Kwakman, 2003, Ewijk, 2014). With this, it becomes not merely a question of ‘what works’ but also a question of ‘who works’ (Vries, 2008, Rooijen e.a., 2011). When the social worker is not feeling well or is occupied with personal matters, he or she will not be able to invest as much in the interpersonal relationship with the client. This further emphasizes the need for care for the worker and his/her professional competence. Within social work as a relationship-based profession, the sexual self is automatically also an important aspect of the self (Dunk-West and Hafford-Letchfield, 2011). Next to this, influences on the private sexuality of the social worker or the topic of sexuality coming ‘too close’ for the worker could (subconsciously) result in an avoidance of the topic in the social counselling sessions and goals. Perceived hints that discussion of sexuality or intimacy might be too personal, shameful, taboo or simply ‘no go’ are easily picked up or interpreted by clients. The per-sonal comfort of the social worker with addressing sexuality in the interaction with clients is consequently likely to influence the space that the client expe-riences to address and work on these topics together with the social worker, and reflection on this by the professional therefore becomes important. Both the aspects of the quality of the interpersonal relationship, as of the space that is given to topics of sexuality and intimacy in client talks, could have significant effects on the quality of the assistance and support given. This makes the re-search question put forward in this paper urgent at meso level for the target group of PMW.

Urgency is consistently unmistakable for other stakeholders. From the micro perspective of the individual social worker, addressing this question seems ur-gent to get a grasp on possible influences and to put self-care on the agenda. Investigating the influence on their personal wellbeing opens the way towards taking appropriate measures to further safeguard the wellbeing of the worker and his or her sustainable employability. Automatically, keeping healthy and durably employable professionals that can offer quality assistance to sex work-ers, according to the mission statement, gives urgency for the organization Humanitas PMW at meso level. Lastly, the social assignment of PMW was not only taken upon by the organization itself, but has also been confirmed and financially supported by the local and national government. Therefore, the en-dorsed importance and urgency can be assumed from the macro perspective of policy makers to maintain assistance to sex worker and address this issue.

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8 1. Introduction

1.4 Context

The world changes into an increasingly complex and unpredictable space. When the complexity of problems increase, simple solutions no longer qualify and more is demanded of the social worker operating in that space (Nieuwen-hof and Verdult, 2016a). Since the founding of PMW the circumstances of sex workers and their needs and requests for support have also become increas-ingly complex. There has been a surge of forces making sex work more difficult and making social work for sex workers more challenging. To name a few; the policy to lift the Dutch ban on brothels in 2000 and the following vacuum of labour conditions and rights, the continuously developing influx of vulnerable migrants with increased risks for exploitation in the sex industry, the progres-sively more repressive and abolitionistic political tendencies among sex work national and regional policy makers, the increased awareness and attention in society for so-called ‘loverboy’ pimping and youth prostitution, the economic crisis and it’s negative financial implications for the sex industry and the un-curbed rise of the use of the internet (Dries, 2015). These are some profound developments that have further complicated the Dutch sex industry and have made the practice of field work and social assistance more demanding for the professional at PMW. Yet, perhaps also more needed than ever before.

It has become evident that the complex and demanding nature of work of social professionals can influence their own health and wellbeing. Positive or negative moods from work lead to positive or negative moods experienced in the private life of the worker, and vice versa. As one researcher notes, there is ‘spillover’ from both family to work and work to family (Goldblatt, Buchbinder, Eisikovits and Arizon-Mesinger, 2009). Smullens (2012) raises the point that social workers might be extra sensitive to occupational stress, not only because of the nature of the work, but also because of a relative high prevalance of in-tense personal life stories among social workers themselves that inspired them to enter this particular profession in the first place.

Newel and MacNeil (2010) conceptualize the emotional and psychological occupational risks associated with providing direct social work services to vul-nerable populations in two separate forms: trauma-related stress and profes-sional burnout. Vicarious or secondary traumatic stress and compassion fatigue are conditions related specifically to work with traumatized populations, while professional burnout is considered a more general phenomenon that may oc-cur within any social service setting. Social workers are found to be more likely to experience higher levels of stress and burnout than comparable occupa-tional groups (Lloyd, King and Chenoweth, 2002). In line with these findings, the research of Bride (2007) found that social workers are likely to experience some secondary traumatic stress complaints; a significant minority may even meet the diagnostic criteria for PTSD (Post Traumatic Stress Disorder).

In the international body of knowledge there is little known specifically on occupational influences for social workers that work with sex workers and/or victims of trafficking and sexual exploitation. Merely three studies were found.

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1.4. Context

1

9 Jung, Song, Chong, Seo and Chae (2008) report that social workers assisting (former) sex workers in a South-Korean shelter experienced significantly higher problems with tension, sleep and smoking than a control group and struggled more frequently with traumatic stress symptoms. Kliner and Stroud (2012) and Snyder (2015) performed research on care providers that assist victims of (sex) trafficking. Respondents reported that they found working with this group more difficult than other target groups they worked with as a social worker and described their work as heavily impacting their life (Kliner and Stroud, 2012). Snyder (2015) found that workers are being stretched beyond capacity in help-ing survivors of forced prostitution and reported that the needs of this group of clients are far greater than other marginalized groups and require more time-consuming, lengthy and structured specialized services. Kliner and Stroud (2012) showed that workers frequently experience burnout. They described that their ability to provide high quality assistance was negatively influenced, as they were for example often tired or lost patience with their clients. Snyder (2015) found moderate to high levels of secondary traumatic stress. Further-more, this study showed that having a personal sexual trauma history does not affect the care provider negatively compared to workers that did not experi-ence sexual abuse themselves. However, none of these publications mention possible sexual occupational influences for social workers that work with sex workers.

The topic of sexual occupational influences shines in absence in related liter-ature. Up to this day there seems to be a taboo on sexuality in society (Gid-dens and Sutton, 2013). The dominant contemporary Western discourse con-structs sexuality as a private affair with a strong focus on gender differentiations and heteronormativity (Laqueur, 1992 and Lavie-Ajayi, 2016). Trotter, Crawley, Duggan, Forster and Levie (2009) describe that there has been some develop-ment in social work concerning sexuality, when linked to for example particular client groups or health. Yet, personal issues or subjective experiences of social workers around sexuality are hardly discussed. Lavie-Ajayi (2016) argues that sexuality is always personal, physical ànd social. McEntfarfer, Skiba and Robert (2012) found that social work students consider discussing topics on sexu-ality inappropriate and unacceptable in social interaction. Pope, Sonne and Greene (2006) argued that the possibility of interaction between the profes-sion and the sexuality of the social profesprofes-sional remains an even bigger taboo. And when the topic is touched upon, discussion mostly covers the situation of sexual attraction, intimacy or sexual relations between the client and the worker (Bernsen, Tabachnick and Pope, 1994, Heemelaar, 2008, and Jacobs, 2014) but not the private sexuality of the worker.

As said, no research was found that explicitly mentions the possible impact on the intimate personal relationships and/or sexuality of social workers. There is however some research available concerning other professions, mostly mental health therapists, where connections between (traumatic) stress and the pri-vate sexuality are revealed (Glenwright, 2015, Branson, 2011, Minnen, 1998, Garrity, 2011 and Goldblatt et al., 2009). It was found for example that more

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10 1. Introduction

work-related stress correlates with less satisfaction in the partner relationship, less intimacy (Glenwright, 2015) and that prevalence of secondary trauma complaints correlate with reduced sexual desire (Branson, 2011). Since litera-ture shows that occupational influences like (traumatic) stress and burnout are also prevalent for social workers, the hypothesis that influences on the intimate private relationship and sexuality of the social worker exist seems justified on the basis of the literature. The practice-based problem drafted in this research project appeared real and urgent and demanded further exploration.

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2

Goals

2.1 Internal goal

The internal goal of the research describes which knowledge or information is required to explore the topic (Verschuren, 2009). On the basis of literature study and practice-based experience the existence of any occupational influ-ences for social workers at PMW, on their personal wellbeing and in particular their private sexuality and intimate relationships, is assumed. This research aims to acquire knowledge into the nature of sexual occupational influences for social workers that assist sex workers and/or victims of trafficking, and into the needs for support or self-care to cope with possible negative influences. See also chapter 3.

2.2 External goal

The external goal in practise-based research is the specific goal to which the project aims to contribute towards a solution (Verschuren. 2009). This research project aims to contribute to a change in the organization during which influ-ences on the sexuality and intimacy of the social worker at PMW become a subject that can be more openly discussed and where these influences when deemed unpleasant can be prevented or coped with. By researching this topic from within the practice of PMW, it can be expected that processes of change and professionalization will go hand in hand with the process of research (Ver-maak, 2009).

With this, the project indirectly targets sustainable employability of the social worker working at PMW. A longer term external goal on which this research project however does not explicitly focus, is the ultimate wish to contribute to securing and improving execution of the mission statement of PMW: offer-ing specialised support to sex workers to empower them on micro, meso and macro level and to improve their (labour) position.

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12 2.Goals

2.3 Place in the regulative research cycle

Since so little is yet known on this topic, practice-based research would be in the problem and diagnostic phase of the regulative cycle (Boeije, 2005 and Kreek, Diekmann and Vels, 2014). Although the step of identifying the prob-lem is partially taken, the full scope and circumstances remain unclear. The challenge of the research project during those phases is to further investigate the issue in detail, which intends to lead to a thorough analysis or diagnosis of the current situation. Furthermore, the project wishes to commence with the subsequent phase in the regulative cycle, planning, by formulating recom-mendations for further steps on the basis of the outcomes of the diagnostic phase.

2.4 Relevance

The research has practical relevance at micro-level for the individual social worker at PMW and possibly at meso-level through the quality of the care for the target group of sex workers, the private family life of the social worker and the community of social workers assisting the same target group at organiza-tions in other cities.

Nevertheless, it is also imaginable that the relevance of the outcomes of this research project could also be transferred at an higher macro-level to other professionals that offer services to sex workers like specialised (mental) health practitioners or the police. Or that it could even be transferred to an overall social work or care work domain. Many social professionals after all come in their work into contact with themes of sexuality one way or the other, and the reservations in society related to it.

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Research questions

3.1 Central research question

In the central question and sub questions below, ‘social workers’ are defined as the group of social workers that assist sex workers and/or victims of trafficking and sexual exploitation in the Netherlands and Flanders.

How do social workers experience sexual occupational influences and what are their needs for support or self-care concerning pos-sible negative influences?

3.2 Sub questions

1. What sexual occupational influences, positive or negative, do social workers experience?

2. What methods of self-care and organizational support do social workers employ to cope with possible negative sexual occupational influences?

3. What needs for support do social workers have in order to cope with possible negative sexual occupational influences?

4. What advice can be given to help social workers cope with sexual occupa-tional influences and contribute to their sustainable employability?

3.3 Theoretical framework and key concepts

In this paragraph I will give a few definitions as used in this research project and will elaborate on some key concepts that are expected to be relevant. Also see figure 3.1 for the in this research recognized coherence between the concepts. Considering the pioneering and inductive nature of the project the anterior conceptual framework was limited.

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14 3. Research questions

Thesis, Master Social Work, Amsterdam University of Applied Sciences - Anke van den Dries, student number 500740946 - page 23

that can have both positive and negative connotations. Sexuality is also a social concept. The notion that sexuality is, at least partially, a social construct implies an orientation to the social sphere where social constructs are made. Specifically from a social work perspective sexuality should not only be seen as part of an individuals psyche or body, but can also be looked at through social attitudes and values, strongly linked with concepts like sexual orientation, sexual identity and gender. (Dunk-West and Hafford-Letchfield, 2011).

Intimate relationship

An intimate relationship can be seen as a subjective connection between a person and his or her sexual and/or romantic partner(s). It is the person him or herself who defines whether the relationship with another person is considered an intimate relationship.

Sex work

“The provision of sexual services in a financial exchange between consenting adults” (Giddens and Sutton, 2013, p.661). Prostitution is therefore only one form of sex work. Sex workers also include erotic masseuses, porn actors, lap dancers, webcam sex workers etcetera. Like sexuality, sex work exists within a highly normative societal framework.

clients: sex workers/victims of trafficking self-care + organizational support social worker neg . pos.

Fig.2 Concept map

Figure 3.1: Concept map

Sexuality

Sexuality entails a person’s sexual feelings, sexual orientation or preference and sexual activities (Oxford Dictionaries. n.d.). Up to this day there seems to be a taboo on (talking about) sexuality in society (Giddens and Sutton, 2013), which is considered a crucial aspect in this project. Furthermore, in theoretical contexts sexuality often seems to be problematized with a focus on sexual de-viance, sexual pathology and abnormality (Aggleton, 2016). Also in social work, the orientation is usually towards ‘difficult sexuality’, either deviant sexuality or risky sexuality (Dunk-West, 2011).

However, sexuality is also a happy and pleasurable thing. Sex is about sensa-tions, about pleasure and about physical arousal. This research project builds on sexuality as a phenomenon that can have both positive and negative con-notations. Sexuality is also a social concept. The notion that sexuality is, at least partially, a social construct implies an orientation to the social sphere where social constructs are made. Specifically from a social work perspective sexu-ality should not only be seen as part of an individual’s psyche or body, but can also be looked at through social attitudes and values, strongly linked with concepts like sexual orientation, sexual identity and gender. (Dunk-West and Hafford-Letchfield, 2011).

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3.3. Theoretical framework and key concepts

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15 Intimate relationship

An intimate relationship can be seen as a subjective connection between a person and his or her sexual and/or romantic partner(s). It is the person itself who defines whether the relationship with another person is considered an intimate relationship.

Sex work

"The provision of sexual services in a financial exchange between consenting adults" (Giddens and Sutton, 2013, p.661). Prostitution is therefore only one form of sex work. Sex workers also include erotic masseuses, porn actors, lap dancers, webcam sex workers etcetera. Like sexuality, sex work exists within a highly normative societal framework.

Human trafficking

Forcibly recruiting, transporting, moving, accommodating or sheltering an-other person with the intention of exploiting that person. Exploitation may occur in the sex industry or in other sectors (National Rapporteur on Trafficking in Human Beings and Sexual Violence against Children, n.d.). In this research project the focus is on social workers that work with sex workers and/or victims of trafficking that have been exploited in the sex industry. Some of the people that have been exploited in the sex industry might self identify as sex workers, some might not. It is important to specify that the point that somebody has been trafficked or exploited within a certain labour industry, in this case the sex industry, does not imply anything about whether that person him- or herself chose to or agreed to work in that sector in the first place. Social workers that give assistance to victims of human trafficking from other labour sectors, vic-tims of exploitation of criminal activities or vicvic-tims of trafficking due to forced organ removal do not fall in the scope of this project.

Occupational influences

The influences of an occupation - the tasks and activities that persons form on a daily basis - on a person’s health, wellbeing and occupational per-formance (Law, Steinwender and Leclair, 1998). Although occupational ences may touch the full private sphere of a worker, sexual occupational influ-ences, involve particularly the influences one might experience on the private sexuality or intimate relationship(s) due to his or her occupation.

Occupational stress

As with sexuality, occupational influences can have positive and negative con-notations. Negative influences, occupational stress, can be conceptualized

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16 3. Research questions

in the two separate forms of trauma-related stress and professional burnout. Vicarious or secondary traumatic stress and compassion fatigue are related specifically to work with traumatized populations, while professional burnout is considered as a more general phenomenon (Newel and MacNeil, 2010). Sustainable employability

A worker is sustainably employable when his or her knowledge and skills, per-sonality and health are durably consistent with the demands of the labour market (Kossen and Albayrak, 2015). In the context of this research sustain-able employability would refer to keeping healthy and durably employsustain-able professionals that can offer high quality assistance to sex workers according to the social assignment and mission statement of the organization.

Self-care

Law, Steinwender and Leclair (1998) define self-care as all the things that indi-viduals do to look after themselves. In a social worker context, self-care refers to the techniques or activities professionals use to care for themselves and cope with occupational stress. Together with organizational support instruments, self-care techniques are seen in this research as a repertoire of possible tools that can be employed to diminish possible negative effects of sexual occupa-tional influences and to maintain or enhance the professional’s wellbeing and employability

Organizational support

In the context of this research project organizational support refers to the tech-niques or activities an organization uses or offers to diminish negative effects of occupational influences for the employee and to maintain or enhance his or her wellbeing and employability in the work for the target group of the organization; sex workers and/or victims of trafficking and sexual exploitation.

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4

Research design

4.1 Practice based approach: research, change, professionalization

Paulo Freire stated that we "learn how to swim in water, not in a library" (in: Nieuwenhof and Weerdt, 2006). Practice-based researching and learning de-mand acting in the social context of a given reality. This type of action research assumes that explorations are done from within a social context with the aim for social change within that context. In this view, the validity of the research is not primarily determined by scientific tests or truths, but first of all by its use-fulness to help people in that social practice to act more skilfully, wisely and qualitatively (Elliot in Donk and Lanen, 2015). When dealing with the tough and complex research issues that social workers can come across daily in the social domain, the processes of researching, professionalization and change can not be seen separately (Vermaak, 2009).

This research too is firmly based in social work practice and aims to bring im-provement and support to that practice. The Master Social Work intents to teach social workers to build bridges between worlds or professional practice, of social policy makers and of academic research, or - to speak in terms of En-geström (in: Stam, 2012) - to enter into boundary crossing between separate activity systems and explore and make full use of the boundary zone.

Dunk-West and Hafford-Leffield (2011) have emphasized that consulting var-ious forms of knowledge from different systems, is particularly needed sur-rounding the complexities inherent to topics of sexuality and social work. They point out that the current high pressure on theoretical knowledge and evi-dence or research based practice due to the rise of measurable professionalism tends to let risk averse frameworks to dominate, where often also more me-andering and out of the box approaches are required in such delicate topics to meet the validity and usefulness as described above. Combining research knowledge with practice based knowledge and critical reflection aims to en-rich the practice discussed here.

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18 4.Research design

Simultaneous research and change processes lead to the importance of un-dertaking steps in micro collaborative creation or cocreation (Nieuwenhof and Weerdt, 2006, Masselink and Jong, 2008, Thölke, Nabben, Kuffman, Wet-zels and Sigaloff, 2009 and Wierdsma and Swieringa, 2011). Wierdsma and Swieringa (2011) describe that during cocreation in change processes the stakeholders are simultaneously observant and participant. Stakeholders have to feel and claim actorship within the Community of Practice or learning net-work that faces the practice-based issue in question. Nieuwenhof and Verdult (2016b) refer to this as ‘getting the right people on the bus’ to be able to move towards change. Change is however often difficult, especially when it comes to delicate yet tough questions like the one addressed in this research. Wierdsma and Swieringa (2011) describe that for change places of pain or effort need to be confronted. Masselink and De Jong (2008) add to this that to be able to break away from the usual ways, unusual questions need to be asked that incite reflection.

This research project has been initiated bottom-up and has involved the so-cial workers who are subjects in the topic in multiple ways. As will be further elaborated on in this chapter, in an early stage of this research a method of interactive model building (Swanborn, 2006) was applied during which an asynchronous yet cumulative group discussion was made possible. Both dur-ing this phase and the phase of surveys, anonymity was a main attention point. For cocreation it is necessary that stakeholders refrain from self-censorship and are prepared to enter into a sincere dialogue: something that does not come automatically in the complex and taboo nature of this topic.

The focus group in a later phase of the research further enhanced the pro-cess of learning and cocreation. This group talk did not aim to emphasize the individual occupational experiences (who experiences exactly what) but instead focused on a collective interpretation of the outcomes of the survey data, best-practices in self-care and organizational support, and resolutions and recommendations that could enhance further professionalization.

Welcoming people ‘on the bus’ and into the Community of Practice is not easy considering the nature of this topic. Some colleagues expressed in an early stage not wanting to take part in the research for finding the topic indeed too personal. The research project has tried to also make a low threshold for these voices to be considered, for example in ways that allowed for participation without self-disclosure on possible personal occupational influences. Some social workers might however not have felt the need to engage in any way. Kwakman (2003) emphasizes that participation should always be voluntary. According to Wheatley and Frieze (2007) it is not necessary to get everybody convinced and ‘on board’; finding connection with likeminded others is in an initial stage of a pioneering project important. In their theory of emergence small changes on micro levels can eventually contribute to bigger changes with more people involved. Although these things can not exactly be planned or forced, I hope that this research project can have such emerging effects.

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4.2. Methods and phases of data collection and analysis

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19 Although it is therefore not a necessity for everybody to participate in this pio-neering project, I found it nevertheless important to stay connected to people that are involved in the topic but did for any reason not take a seat in the ‘bus’. The multimethod approach in data collection helped in this. Some colleagues that did not want to take part in for example the survey for finding the topic indeed too personal, were willing to participate in the focus group where the questions were not directly about the individually experiences occupational influences. Laat and Poel (2003) also suggest that there should be possibility of legitimate peripheral participation in a Community of Practice: newcomers can for example get the possibility to reside in the periphery and make use of the recourses en outcomes of the communities, while when desired getting the opportunity to grow towards a more active participation.

4.2 Methods and phases of data collection and analysis

The applied methods in subsequent phases are described below and depicted in figure 4.1.

i. Literature study I, including informal interviews/dialogues with key experts: team manager PMW, team coach PMW, sexologists and academia from the area of gender and sexuality studies. See also chapter 1 for outcomes of this study. From this phase statements were taken that could point to occupational influences and in particular sexual occupational influences: see appendix A. ii. Interactive model building with the social work team at PMW (see also appendix B). In an early explorative stage of the research a cocreative data collection method was used. A brainstorm board was placed in a central but private location of the PMW office and colleague social workers were asked to write down their thoughts on or experiences with possible occupational influences. Contributions concerning both possible negative and positive in-fluences, both on the general wellbeing and on sexuality and intimacy in par-ticular, were welcomed. As an elicitation technique (Evers, 2007), some of the statements from literature study and from personal communication with several key experts were already written on the board. An asynchronous yet cumulative group discussion arose, with respect for anonymity and inhibitions (Swanborn, 2006).

iii. Analysis of interactive model building. The resulting statements were analy-sed through clustering (Swanborn, 2006) and visually represented in a collec-tive mindmap (Donk and Lanen, 2015): see appendix B.

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Thesis, Master Social Work, Amsterdam University of Applied Sciences - Anke van den Dries, student number 500740946 - page 28 Thesis, Master Social Work, Amsterdam University of Applied Sciences - Anke van den Dries, student number 500740946 - page 28

of the recourses en outcomes of the communities, while when desired getting the opportunity to

grow towards a more active participation.

4.2 Methods and phases of data collection and analysis

The applied methods in subsequent phases are described below and depicted in figure 3.

i. Literature study and informal interviews/dialogues with key experts: team manager PMW,

team coach PMW, sexologists and academia from the area of gender and sexuality studies.

influences and in particular sexual occupational influences: see attachment 1.

i. Literature study

ii. Interactive

model building

iii. Analysis

iv & v. Survey

vii. Literature study

vi. Analysis

viii. Focus group

ix. Analysis

x. Final outcomes & recommendations

subquestion 1

subquestion 2

subquestion 3 subquestion 4

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4.2. Methods and phases of data collection and analysis

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21

Results of the research so far were presented at a national meeting in Utrecht, the Netherlands, for the 16 organizations in the Netherlands that offer exit programs for sex workers: see also appendix C. The aim of the presentation was to create awareness into the topic and the research project connected to it, and raise willingness to contribute to the upcoming survey. These intermediate results were also presented at the 2016 Sexuality and Social Work conference "Transgressing Boundaries and the Intersection of Sexualities in Social Work" in Olten, Switzer-land. (The used powerpoint presentation can be found at http:

//web.fhnw.ch/plattformen/sexualityandsocialworkconferences/ conference-program/presentations/session13/presentation_anke_ vandendries_marios_kotsonis_SSW16.pdf)

iv. Pilot of online questionnaire with mainly open questions (Donk and Lanen, 2015) with two social workers at PMW. Outcomes of the earlier phases of lit-erature study and interactive model building were used in the construction of the survey questions. The survey was adapted where necessary in collaboration with the testing social workers.

v. Anonymous survey spread among (organizations that employ) social work-ers that assist sex workwork-ers and/or victims of trafficking and sexual exploitation in region of the Netherlands and Flanders based on an online questionnaire. The questionnaire used in the online survey can be found in appendix D. The research software of Qualtrics was used as a survey platform for respondents and for data collection.

vi. Inductive analysis of survey through open coding (Donk and Lanen, 2015). Data analysis was done through the research software programs MaxQDA and Matlab; the first was used for qualitative analysis through coding of the answers to survey questions, the latter for the quantitative analysis and the numerical plotting as displayed in the figures in the second part of this research rapport. vii. Literature study II on theories that relate to research outcomes, among which study into methods for self-care or organizational support and theory. viii. The results of the surveys were presented in a focus group with social workers of PMW: how do they see the outcomes? What would they advise for social workers concerning the influences on the private wellbeing and private sexuality? What would be their recommendations concerning organizational support?

Results of the research up till this point were presented in a talk show at the Sekstival, an educational festival on sexuality and sex-ual diversity which I initiated and co-organized at the Humanitas Expertise centre on Sexuality, Sex work and Human trafficking. The event attracted more than 500 visitors, most of them profes-sionals working in the social domain.

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ix. Analysis of focus group.

x. Presentation of final outcomes and recommendations at PMW.

4.3 Motivation for research approach

In this research project a combination of research methods was used: litera-ture study, interactive model building (collective mindmap and focus group interviews) and a survey through anonymous questionnaires, which involved the social workers at several moments in several ways. This brought forward both qualitative data, and to a smaller extend quantitative data.

Literature study was chosen to not start of completely blank in this complex issue but to deductively look into what is known already nationally or interna-tionally. It turned out that very little was yet uncovered concerning this topic and the research to undertake would have a strongly pioneering nature. Also in an early stage of the project interactive model building through the method of creating a collective mindmap was chosen to get inductive input in the research project from the respondents involved. As already mentioned in paragraph 4.2, both during the phase of the collective mindmap and the phase of surveys a strong attention point was anonymity. In an explorative stage of this research some social workers at PMW had already shared that they would feel inhibited to talk about this topic at all, some to just be inter-viewed about it face-to-face. Because of the complex and taboo nature of the topic and the considerable risk for socially desired answers or self censorship of respondents, anonymous data collection methods were therefore chosen. Only in the last phase of data collection there was no anonymity. The choice for a group interview was made in this phase because focus groups have proven to be good instruments for further stimulating cocreation. Furthermore, fo-cus groups have been shown to be good data eliciting methods from people or research topics that were perceived difficult (Kitzinger, 1994). The lack of anonymity in this phase of the research project was expected to not be prob-lematic, for the group interviews did not explicitly focus on the individual expe-riences of the participants. The questions put forward in the group interviews concern interpretation of the outcomes of the research so far, best-practices in self-care and organizational support, and resolutions and recommendations that could enhance further professionalization of social work for sex workers. Consequently, this approach with mixed methods not only strengthens the research outcome through triangulation of research methods (Donk and La-nen, 2015), but also stimulates the process of change and professionalization that this project aims for. As stated earlier, Vermaak (2009) described that by getting stakeholders closely involved early and continuously processes of re-searching, changing and professionalizing go hand in hand. Because of this overall and circular approach, it is not possible to pinpoint the exact

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contri-4.4. Quality criteria for practice based research

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23 bution of solely the project to the described practice based problem and the external goals of the project.

4.4 Quality criteria for practice based research

Criteria for the quality of the research product can be described through the validity and reliability (Burg, 2011). Verschuren (2009) adds to this the criteria of usefulness, which is defined by Burg (2011) as pragmatic validity. As de-scribed in the first paragraph in this chapter, it is the usefulness of the practice-based research for the practitioners themselves, to help them to act more skilfully, wisely and qualitatively, that primarily defines validity in this research project. The outcomes are furthermore relevant, as described in paragraph 1.3, not only for the social work professionals, but also for their intimate partners, their clients and the organization Humanitas PMW.

The criteria of reliability describes how traceable and ideally replicable the re-search is (Burg, 2011). In this rere-search project this will be safeguarded through detailed reporting of the different steps and continuous critical reflection on the process by myself as the researcher.

Validity is distinguished in internal and external validity. Internal validity mea-sures whether there is truly a relationship between two constructs, or whether there are other factors influencing the outcome (Burg, 2011). In social re-search this is difficult to guarantee fully because of the lack of laboratory con-ditions (Donk and Lanen, 2015). Involving different stakeholders for the input and the interpretation of outcomes in this project however backs the dialogical internal validity (Donk and Lanen, 2015). Triangulation is used in this project in both sources, methods and researchers perspective. The emphasis on pro-fessionalization of social work for sex workers in this research, which directly aims to support colleagues in their daily work, heightens the catalysing validity (Donk and Lanen, 2015) and pragmatic validity (Burg, 2011).

External validity measures until what extend outcomes of the research can be generalized to other contexts or bigger groups (Burg, 2011). It will not be auto-matically possible to generalize the outcomes of this research to another con-text or group. The proposed research project focuses primarily at social work-ers that work with sex workwork-ers and victims of trafficking and aims to formulate recommendations for the practice of PMW in Rotterdam, the Netherlands. A strong external validity is not the main point of attention. However, I believe it is also possible to transfer the relevance and usefulness of the research topic and (part of the) outcomes to an overall social work or care work domain at macro-level, as many practitioners in their work come in contact with themes of sexuality one way or the other, and the reservations within themselves and in society related to it. At the talk show on 16th of May 2017 were results where shared (also see paragraph 4.2), reactions from the audience show that the research is also deemed relevant to for example social workers working with domestic and sexual violence, but also to other professionals like police

Staying Strong and Sexy : Research and reflections on sexual occupational influences for social workers assisting sex workers