By Anita Neal Harrison
by day, Michelle Teti was an unassuming nutrition major at Pennsylvania State University. By night, she was an advocate providing escape routes for women leaving violent relationships.
Under cover of darkness, Teti would climb into her blue Corolla, drive deep into the central Pennsylvania countryside, pick up the women, then bring them back to the domestic abuse shelter where she worked.
Though her time at the shelter also involved desk-job tasks, such as answering the 24-hour hot line and steering women toward resources like the county assistance office, courts, and medical visits, Teti found all of it much more fulfilling than her major. She ended up taking a full-time position there upon her graduation.
“It really, really changed my life working there [at the shelter],” she says. “It was so rewarding. It was the most meaningful thing to me.”
A master’s degree and community health doctorate later, Teti, an assistant professor of health psychology, is still finding meaning in helping women in tough situations. Though, now, instead of a shelter, she’s working in academia. And instead of focusing solely on domestic violence, she’s concentrating on HIV/AIDS.
Her latest work involves a pilot project in which she gives women living with HIV/AIDS digital cameras and asks them to document their lives. “It’s about facilitating empowerment,” Teti says. “It’s giving women opportunities to identify the ways they are in control, and seeing them become stronger and more confident.... I tell them to go forth and take pictures that capture what it’s like to be you, to live with HIV/AIDS, that capture your assets and your challenges.”
The project, entitled Picturing New Possibilities, is an example of “photovoice,” a form of empowerment education. Through photovoice, underserved individuals identify and address both personal and community concerns through photography, critical dialogue and political action.
The women take photos for a week or two before reconvening with Teti. The photos then become a tool for Teti to engage the women in critical group discussions about their lives. Teti asks such questions as what the women were thinking when they took their photos and what the photos mean or indicate about them and their health. Teti also helps the participants identify the priorities, needs and/or challenges captured in their images, and, when appropriate, she engages the women in problem-solving conversations.
This approach, which allows the women to set the agenda, seems more constructive to Teti than the traditional top-down interventions she has seen, and even led, where the focus is on strategies for safe sex. “What struck me was that while those messages are important — women are interested in learning how to use a condom and how to tell their partners about their [HIV/AIDS] status — but sometimes those weren’t the most relevant issues,” she says. “Sometimes I would just feel a little stupid going in and saying, ‘This is how you use a condom,’ when they were telling me, ‘I have no heat,’ or ‘I have nowhere to sleep tonight.’”
Those “mismatch” moments took Teti back to her days working at the domestic abuse shelter when she first began to see how complex issues often receive simplistic treatment.
“I became frustrated with systems that were in place that weren’t helping women,” she explains. In particular, she was dissatisfied with domestic abuse laws, and she was also disappointed that schools weren’t teaching girls how to identify unhealthy relationships.
“I wanted to design health education programs to help those young women,” she says. “I wanted to develop health education policies that better fit women’s lives.”
And so, after a couple of years working at the shelter, she returned to her hometown of Philadelphia to earn her advanced degrees in community health at Drexel University. Before coming to MU in 2010, Teti completed a project in Philadelphia similar to the one she’s working on now with women from St. Louis.
“In Philadelphia, women used the photos to express themselves in different ways,” she says. “Some women chose to combat the stereotype of what someone with HIV looks like by taking pictures of themselves looking beautiful and healthy. Another woman chose to take pictures of broken kitchen appliances and substandard living conditions to detail her horrible housing situation and used the pictures to advocate for help.”
While that first project involved just ten women — the current one will involve 28 — Teti has seen enough positive change in participants’ lives to get her excited.
“The women said the camera has given them a new outlook on life,” she reports. “They notice a lot more and have gained a greater awareness of their strengths and their challenges. Women have said it helps them identify what’s important, what they can attack and get done that day.”
Still in the middle of the project, Teti says she’s not sure just where it’s going — that is, just what new interventions might be developed based on this research — but she’s enjoying seeing participants steering their lives toward better, healthier places.