It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms (MUS) applied in primary healthcare. The relevance of embodiment and arts practices in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: (1) body with mind connections; (2) importance of facilitation; (3) potential benefits; (4) preparedness for change; (5) self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing.The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach The aims of TBMA are for participants to develop a changed relationship with their MUS and to enable self-management, both unique to TBMA.This article reports on original, pre-clinical trials of qualitative research. It is based on an analysis of the views of patient-participants, with medically unexplained symptoms (MUS), on an embodied arts-based practice, “The BodyMind ApproachFive themes we call key principles were derived from a synthesis of the analysis of data collected from interviews and questionnaires. These principles explain why TBMA, delivered in the English National Health Service (NHS), demonstrates effectiveness in supporting self-management.The MUS patient population lacks appropriate, accessible, and acceptable interventions , physiotPreviously called “psychosomatic conditions,” MUS (or somatic symptom disorder/body distress disorder) is now defined as chronic bodily complaints for which examinations do not show explanatory structural or other specified pathology , for exaSelf-management in healthcare is defined in different ways, incorporating prevention and decline. It aims to increase the capacity for self-regulation monitoring thoughts, sensations, feelings, and behaviors. The impact of self-management groups has the potential to improve health outcomes, such as increases in patient confidence and physical functioning, adherence to treatment/medication, and reduction of anxiety .Multiple ways of knowing  incorpor® satisfies the aforementioned findings through a facilitated group self-management program with individual goal setting and action plans for people with MUS. It emphasizes multiple ways of knowing, social facilitation, and managing physical and emotional responses. Addressing the long-term aim of self-managing symptoms in a sustainable manner reduces the gap between patient needs and funding constraints.The BodyMind Approach® was first researched in 2004 , the MUS person’s mind-set , and the social and the body environment (the group and the symptom respectively).The BodyMind Approach® has been specifically designed to support patients with MUS. It consists of an embodied, enactivist  has on emotional regulation, and threat management. From the symptom feeling like the “enemy” to be “got rid of,” it can change to becoming an “ally” and to be “accepted.” People begin to recognize that it is their perception of their symptom which is mediating their bodily experience and by relating to it differently, they are more able to see ways of managing it. As a result, there is a change in the perception of mind-set, self, and agency. The symptom symbolized by movement, marks on paper, etc., becomes the gateway to self-development and self-management. Arts practices are an ideal vehicle for distancing the symptom from the person, making it safer for exploration.® with its integrated arts bias involves the social model of health where improvements in social inclusion and cohesion are important indicators. This contrasts with the medical model, employed by pain management and CBT which separates body from mind. In addition, CBT uses solely verbal methods. TBMA contrasts with other body-oriented models . Participants are supported in challenging the notion of hopelessness and helplessness giving a sense of agency. The arts are a perfect medium for combating social isolation, developing agency, and group cohesion. A group can generate new experiences and ideas for creativity, support, and learning.The intervention included 15 small groups delivered over 12 × 2 hourly sessions, over 10 weeks. Individual consultations, before and after the group, took place with the group facilitator. Group numbers varied between 4 and 10.Groupwork can be challenging for people, especially if already vulnerable, lacking confidence, and highly anxious, often the case for people with MUS. Groups can be destructive, and access problematic, as research has shown . Consequ“What are participants” perspectives on their experiences of TBMA?’ was the research question, aiming to establish participants’ experience of TBMA and if any aspects of TBMA were helpful to developing their self-management of symptoms.N = 3) in different geographical areas and at different times. The qualitative findings reported here, derived from these deliveries, are consistent with the quantitative results previously published , combined with written qualitative data post-intervention from a PEF (N = 24) for which there was a 65% (24/37) response rate. The open-ended questions asked in the PEF were also based on the need to understand participants’ experience of TBMA. The rich descriptive narratives describe participants’ lived world experience of TBMA. The two sources of data collection  provide for a method of cross-checking data to search for regularities and/or differences. The point of combining all perceptions was to create a larger number of perceptions.This research is a synthesis of qualitative data collected from face-to-face semi-structured interviews (which were recorded and transcribed) on participants’ experiences of TBMA post-intervention . For subsequent data collection (2012–2016), participants gave written consent to feedback/evaluations being used for research and could withdraw at any time without having to provide a reason. All participants agreed the data could be used for research purposes. Permission was gained from the NHS Clinical Commissioning Group to report on data anonymously in published articles. In all cases, participants were assured of anonymity and confidentiality in the reporting without names or pseudonyms, i.e., only location and year of the group deliveries are referred to in participants’ quotations.Participants were drawn from patients suffering from MUS in primary care in two clinical commissioning groups in the East of England. Recruitment for the groups was via GPs and self-referral confirmed by GPs. All participants presented in primary care with MUS for 6 months plus.Of the 18 participants interviewed, 15 were female and 3 were male. Of those participants who were invited to complete the PEF, 24 were returned out of which only 14 answered the question on gender. The gender mix, 8% male and 92% female, reflects the literature whereby more women than men somatize .Of those interviewed, 18 reported being white, although not all British. Out of the 24 PEFs returned, 7 answered British white, and 17 did not answer.Adults of all ages are likely to experience MUS. Of those interviewed, ages ranged from 21 to 81 years; of those completing the PEF, the biggest age category was 46–57 years. The youngest was 24 years and the eldest 63. One did not disclose date of birth.There were 12 different symptoms for this data set of 12/18 patients:1.Fatigue2.Widespread chronic pain3.Back pain4.Left side pain5.Lower back pain6.Being cold7.Movement restriction8.Muscle hardening9.Pain10.Tiredness11.Irritable bowel syndrome12.AnxietyThere were data for only eight patients with a mixture of unemployed, retired, and employed full or part time. For all deliveries, most patients remained in the same employment. At the outset, 1/8 (12%) of patients were retired, 0/8 (0%) were in full-time and 3/8 (38%) part-time employment, and 4/8 (50%) were unemployed.Patients had a range of educational backgrounds, for example, none, A levels, degree, and post-graduate. Socio-economic groups were not collected.Inclusion:•18+ years;•MUS diagnosis for at least 6 months;•Frequent general practice (GP) attender (four visits plus per annum);•Presentation for 6 months plus;•Co-morbid depression/anxiety;•Fluent English speaker.Exclusion criteria:•Current relevant physical health problems;•Fewer than four GP consultations in previous year;•Trauma in previous 6 months;•Current relevant physical disability;•Complex bereavement previous 6 months;•Learning disability;•Primary diagnosis of psychiatric condition in previous 6 months;•Current substance misuse;•A diagnosed eating disorder.There were two methods of recruitment. Health professionals referring were aware of the nature of the research, the intervention, and inclusion/exclusion criteria having attended a presentation and/or received a handout. They selected appropriate patients to whom to give a flyer and made a referral on their behalf. A second method was self-referral, for example, from notices in the community/GP surgery. Self-referrers completed a form reflecting inclusion/exclusion criteria and seeking permission to check suitability with GPs.For recruitment to groups, following referral on a first-come-first-served basis, patients received a leaflet about the learning group and then, if still interested, attended a half-hour screening interview to establish suitability.The subsequent manual analysis of the PEF open-ended questions and the interview transcriptions resulted in several themes. Participants recounted examples of their experience of TBMA and ways in which they benefited. For the written responses, the authors scrutinized the narratives identifying common themes and/or differences. Themes were derived from a step-by-step process of categorizing quotations which related to specific content, tracking This study employed a form of cross-verification to check the credibility of the researchers’ interpretation of the data, against the opinions of six different stakeholders engaged with the study . In qualitative research, truthfulness can be assessed if the reader resonates with the outcomes as believable, consistent, applicable, and useful to readers and other researchers. All stakeholders were invited to comment on the findings. One of the ways of enhancing validity is respondent validation: “a process whereby a researcher provides the people on whom he or she has conducted research with an account of his or her findings [in order to] seek corroboration or otherwise of the account” , p. 274.From the stakeholders’ point of view, there is some evidence for transferability to other settings. The reflexive translation into other contexts is where researchers/practitioners assess the extent to which findings in one context apply (or are transferable) to other contexts . Hence, P = participant, P1 = participant 1, P2 = participant 2 in the same group/the initial letter of the venue used for the group and the number of the group in which the participant participated where relevant, i.e., P (participant) 1 or 2/the venue followed by year in which the group took place.People enjoyed attending TBMA, and 95% said they would recommend it to family and friends. The attrition rate was only 3% and satisfaction rated good/very good on all aspects. It is noticeable that participants mentioned elements which they took away from the experience of the intervention without commenting directly on the content of TBMA, which involved movement, dance, and art-making practices; a common finding in similar interventions examining participants’ views .Categories were repeated, and comments were plentiful showing saturation of patterns and repetitions. These were formed into five key principles presented here with one or two examples of participants’ comments: (1) body with mind connections, (2) the importance of the facilitator, (3) positive benefits, (4) preparedness for change, and (5) self-acceptance/compassion. It is proposed that the interaction between these elements leads to an integration for self-management.“I learned to link my body with my mind” . This theme continued throughout the analysis, respondents commenting on how the embodied arts practices helped them find a voice and gain insight into their relationship with their body; listen to and accept their energy levels, and use this monitoring to pace themselves, becoming more in touch with their body, “Able to pace my day”  and “Getting down to the root of the problem” . Links were made between feelings and symptom severity, how mind tuned in with body giving more of an understanding of the relationship between body and mind, for example, they liked that “the group was different in that they did unusual exercises like dancing, walking, breathing which helped me cope with my symptoms” .Movement and arts practices were designed to help people make connections between body and mind. People said they learned from witnessing others change their relationship with their symptoms/body. The term “BodyMind” derived from an analysis of participants’ comments who, retrospectively, thought the workshop aim was to link the body with the mind—an aim which, they thought, had been met, for example: “live with the symptoms more easily”  as well as to “learn how to cope with the symptoms” .Participants reported listening to warning signals in the body which helped to learn how to “I learnt so much, and the facilitator is brilliant, she is patient, understanding and very knowledgeable” .The data analysis led to the conclusion that the facilitator was essential to the process engendering an inclusive and collaborative style, safety, and support, and challenging participants to take risks. Participants commented that the facilitators were very warm and understanding, knowledgeable, patient, and helpful. For example: “I won’t trust people easily but trusted the facilitator from day one” ; “Our leader was a great help in bringing about the group to gel from the start” .Some participants noted the facilitator created a safe environment, for example, for the changes required for self-management: “[the facilitator] enforced or found boundaries, encouraging participants to listen to their inner voices” . In addition, they saw facilitators as being approachable, insightful, and giving time to each person to be heard and understood. Some facilitators were also seen as nurturers, for example: “She was nurturing or trying to caress them in a gentle way of exploring something that’s quite painful for some people” ; “by providing safety —nurturing the group” . It can be argued the non-judgmental, nurturing, kind attitudes demonstrated by facilitators helped people to open up to self-compassion which is needed for self-management. The facilitator modeled the practices and joined in to lead dance/movement practices and directed the mark-making for participants to engage with and to link these to their symptom/s. Facilitators then guided discussion about symptoms and meanings derived from the embodied experience or artwork.They thought the facilitator listened well, facilitated changes, gave freedom of choice/no pushing, and helped people to learn how to open up, for example: “it was a deep relationship” enabling people to identify and express feelings giving tools to overcome symptoms: “the fact we were given time to express our feelings was helpful” ; “positive encouragement and tools and space to overcome symptoms” .Facilitators were seen to help people learn how feelings are generated from themselves as opposed to from others—another aspect required for self-management. Participants explained the relationship with facilitators was profound Realising my emotional situation is not helping my physical problems” . Recognizing these states, participants were guided by facilitators to inform themselves of their needs and ways to self-manage: “I learned new ways of coping” . Facilitators convinced people to become interested in the meaning of their symptoms, and the part the symptom plays in their lives, accepting the symptom for what it is without judgment. The reward for learning is the continued capacity for growth, to go forward knowing they can be resilient in the face of adversity when it hits: “[the facilitator] helped me find a way of moving forward” .Facilitators helped participants to attribute new meaning to symptoms, i.e., turning bodily symptoms into meaningful information about current emotional states, typically saying: ““[the facilitator] helped me be more in the present” ; “[the facilitator] was excellent and always present” ; “learned to be more present with me and symptoms”  which helped to promote connection with the body and the symptom to bring about self-management. Focusing on bodily sensation aids in the intention to be present, as well as focusing on the arts-making or movement process (as in adaptive authentic movement). Furthermore, creative experimentation with reference to the symptom in a safe environment, for example, creative movement with hands, reflective writing, or mark-making, encourages an intention to stay with the present moment.Facilitator attributes include the ability to model staying in the present moment , for exa“I liked fact it is free and non-judgemental” ; “meeting others who had similar problems and not being judged” .Facilitators engender and model non-judgmental and empathic attitudes, picked up by participants, to provide sufficient safety and support to open up to playing, creativity, risk-taking, and exploration, etc. For example, “[it] worked like a catalyst” , or as a starting point offering an option: “This group sort of showed me a road, and I could go down it, or not” ; “[The] group supported me and helped me to accept the limits of my condition” .From the data analysis, it is concluded that positive benefits from the arts practices in TBMA were feelings of (1) belonging, (2) support, (3) safety, and (4) shared purpose all of which are required to help develop the confidence to learn to self-manage. In a group, each person brings potential for rich experience whereby numerous perspectives are available. The experience in the group, and the group itself, was an important vehicle for change for almost all participants, for example: “Feeling less alone” , support and sharing: “This course gave me the chance to unite, share experiences and support each other and gave a sense of belonging” . Discovering others with similar, or other, unexplained conditions helped feelings of belonging. Understanding they have had similar NHS experiences and seeing symptoms from new perspectives bonded people: “being part of a group with people who are in a similar situation and learning to see your symptoms from a different angle” . Feelings of isolation were reduced: “I found getting other people’s feedback and hearing their experiences helpful” . Participants made friends: “The group and our leader were all very friendly and helped each other, a good experience, I made a number of new friends, the group really gelled from the start” . Participants mentioned they met group members post course on a voluntary basis: “I met people with a similar condition to myself and we are still meeting after it all ended” . Seeing how others changed in their relationship to their body helped participants too “I have gained from the experience, particularly learning about my relationship with my body, and seeing it reflected in the others in the group” .The experience gave people a sense of belonging: “I achieved a return to work and overcoming of fibromyalgia pains and symptoms in an on-going manner” .Participants appeared to make changes, whereas previously they had resisted this. They reported on changes in their symptoms, lifestyle, and mind-set (thinking) resulting from the experience of engaging with embodied experiments with the arts and creative movement. Such change could form the basis for self-management: “Changing thinking patterns and habits” , as did changes in lifestyle: “I was very set in a pattern, and it sort of acted as a catalyst to start my life changing, and it’s changing more now, and quicker”  and mind-sets—all aiding self-management: “a shift in outlook, [I have] a more positive approach” ; “facilitated a shift in how to manage life” .Changes in thinking and habits developed, for example: “I have been able to feel less worried and anxious about the future” ; “I feel more positive in my outlook and look forward to my future” . Mentioned frequently was the phrase:“I had enough help to go forward” . Other comments on hope for change included: “I will find life more enjoyable since being involved with the facilitator and the group” .Hope for the future became important in the embedment and maintenance of new habits, reduced worries, and changed mind-sets for sustaining self-management: “I do take breaks and do whatever—silly things, but to give pleasure… jogging, listening to music or bubbling around somehow” ; “I question myself more before I commit myself to do so many things” .Comments concerning change and choices included: “Taught me a great deal about myself” ; “Questions I was asked made me look deeper into what was happening to me, making me think deep thoughts I had never realised needed looking into but have helped me very much” ” . Other comments were symptom related such as insight into the meaning or cause, developing coping strategies, and learning about their symptoms through the different art forms: “[I learned] to find out more about the symptoms” . Flexibility and embracing the possibility of change in their life emerged; some mentioned reduced anxiety/stress: “improved stress management, therefore the symptom disappeared!” .Some participants referred to the change in reflections on the “self”; these statements concern a deeper knowledge and understanding of self as a pre-requisite to change, for example: “My wellbeing has really improved generally” . Valuing self, indicating improved self-esteem emerged: “I now value myself and the quality of my life”  and having more will power and self-reflection. For self-management, there needs to be acknowledgment of physical change as well as self-reflection and motivation to sustain it. Ego strength provides the energy for self-agency and the ability to show it improved: “I have direction now” ; “enabled me to help myself” .Participants thought the intervention had affected their lives to change both physically, such as feeling more energetic, relaxed, fitter, and in their overall wellbeing: [The] activities taught has enabled me to control my anxiety and be more in tune with what my body needs. The many concepts and strategies taught have made me feel more empowered to tackle this illness and I am noticing a direct correlation between the level of anxiety and the severity of pain felt .“more control of life, more structure/routine e.g. in family life” ; “It might give you your independence back from seeking medical advice all the time” . This would suggest that TBMA may save health service resources.With reference to agency, it was not only about managing symptoms but also facilitating a shift in how to manage life and feeling more in control: “I discovered that I get my symptoms through a lack of expressing how I feel” ; “to understand how worries can trigger symptoms”  show participants appear to have learned about repression, the influence of feelings on symptoms, and the importance of expression as fostered by the embodied arts practices. Such learning can support strategies for self-management.Other changes involving the management of feelings, characterized by comments such as “I feel I am only beginning this journey, as the changes I am putting in place will hopefully have an accumulative effect over time” . People said they were taking more time for fun things, breaks, changes in diet, and how to improve their stress levels. In terms of the sustainability of changes, a typical comment was: “[the course] was life changing” .Participants found they had changed to be at the start of a journey: “friends have commented on how much I have improved with my positivity”  and “the course brought me to the point of ‘I need to start living again’—it has helped me no end” . The latter suggests life has been on hold due to MUS. Participants appeared to feel more empowered to tackle their illness, to start to do things for themselves such as meditation or painting, were more able to take on new things, and found a way to move forward with self-care and less dependence on the NHS.Emphasizing the change in positivity more readily appeared from a number of comments: “I have become much more tolerant and understanding of my condition” ; “It was a reminder to make time and space for myself, be more accepting and more relaxed” ; “I have learned to accept it is OK to have limitations on what I can do” ; “Whilst I know the sessions won’t cure my illness but I have learnt to accept it more, through different ways” ; “[I] let go of my shame about my condition. [I am] in a much more accepting place which will help me achieve my goal of managing my energy better” . Valuing the self is required for self-management: “[I have] enhanced self-value, self-confidence” ; “being kinder to self” ; “learning to try and relax more and think about myself” .Self-acceptance and compassion derived from many comments. The symptom is transformed from being an “enemy” into an “ally” highlighting tolerance and acceptance—part of what is needed for self-management: All these findings represent participants’ take-home experience of the intervention in their terms. The content of sessions was based on arts and embodied practices to exploring the symptom. While participants have not generally reported on these, they were the vehicle for experimentation and exploration to learn more about their symptoms, to provide a platform for self-management.It is acknowledged that MUS sufferers are hard to reach, perhaps because of the limited treatments acceptable to them; they are hard to define and have varying levels of trust and confidence in the health service. TBMA appears to be a safe and non-threatening pathway to engaging this population.“I learned to let go of shame about my condition” . Such feelings of shame can be resolved if meaning can be attributed to the symptom, providing for a sense of control.They may also be hard-to-reach due to the shame attached to being ill and/or sometimes absent from work with symptoms which are unexplained , for example, one participant said: The themes mentioned demonstrate several important ingredients and inter-relating aspects for self-management. The following discussion for each of the five themes makes links to the literature.The body with mind connection concept is a new and emerging area within the worldwide problem of MUS. In TBMA, the individual is nurtured toward engaging with their body symbolically, to view/experience it not only as a source of pain, discomfort, and negative experiences, but also to acknowledge healthy, functioning aspects. Identifying sensations of symptoms, and where they are in the body in a mindful way, with kind attention, leads to being able to control the distress. TBMA links sensations (interoception) to feelings and the imagination (via arts practices) and perception of the external environment, raising body awareness to find meaning in the symptom.Seeing others make connections between body and mind and making meaning of their symptoms can stimulate participants to make their own body with mind connections. Making these connections brings an appreciation of the ability to use bodily signals to self-regulate in a positive way, as opposed to previous, rather hostile, perspectives. TBMA promotes inhibition of old habits, reappraisal of pre-existing assumptions, and possibilities to respond to stress in novel ways offering greater emotional self-regulation. Because emotions and movement are so closely related , non-verExploring the nature (or purpose) of the symptom, through experimenting with arts practices, creates distance between participant and symptom, allowing safety for meaningful aspects to emerge. Exploring sensorimotor experiences of symptoms, and employing grounding, synchronous movement together with others, mirroring, and centering practices, can help reclaim emotional self-regulation and feelings of safety, leading to a greater sense of control.Facilitators were perceived as catalysts, crucial for engendering hope for change. They were seen as knowledgeable specialists, role models, and a safe pair of hands, creating a secure boundaried environment, helping people to open up and feel comfortable, ensuring all were heard and understood. Participants felt safe enough to take risks required to engage with the practices, and express feelings, because group cohesion  could beFacilitators honored symptoms, accepting them, and the person, unconditionally without judgment or questioning. Participants did not need to disclose their symptoms, but all were invited to bear their symptom in mind when engaging with practices. Symptoms were perceived as acting as agents for participants to listen to their own inner body-felt voices and address their problems. Facilitators valued participants’ lived body experience, helping them to look at it afresh and focus on it as opposed to pushing it away; seeing, feeling, and experiencing it “as is” rather than what they would like it to be, i.e., gone forever.The benefits were feelings of (1) belonging, (2) support, (3) safety, and (4) shared purpose. These were all present in TBMA groups and seemed important to the efficacy of TBMA according to participants. Cohesion is a general term for assessing the quality of the whole group, based on group integration and individual attraction to the group . ParticiWith reference to “support,” participants commented on the significance of the individual members of the group, many opting to continue to meet voluntarily after the sessions and when the program finished. Most participants commented that the interaction with group members improved wellbeing and gave a sense of support. For example, many arts practices took place individually (as in mark-making), in dyads (as in mirroring), or as a whole group when employing the In TBMA groups, “safety” is fundamental, and the program is designed with that in mind  because If this group is about mental health then I am leaving now!” Sharing experiences of symptoms normalizes such fears and the MUS itself.Participants perceived members as understanding and non-judgmental as people shared experiences of symptoms, and the NHS. They had all joined the program to learn more about their symptoms which already gave a shared purpose. It was never mentioned that the program would cure symptoms, but there was ambition that people could learn to self-manage them. Living with the unknown is extremely stressful; people can begin to imagine the worst, for example, assuming they have the “big C.” They also fear a mental health diagnosis because the assumption is that without a medical diagnosis, all is imagined; one participant said at the first session “The experiences promoted change in symptom perception, coping styles, illness beliefs, and personal dynamics—all necessary to achieve an increase in feelings of agency and control for self-management. Survival as a species is dependent on the needs and experiences of others . Hence, ® groups share a purpose, practices, values, and beliefs, and these can influence each member of the group positively. We propose the outcome of self-agency, required for self-management, is derived from the social construction developed from confidence gained from the group’s shared purpose, support, sense of belonging, and safety.The BodyMind ApproachPhysiologically, although the intervention did not suggest it would cure or reduce symptom distress, many participants commented on how their symptoms had reduced or disappeared. Pain, particularly, was reported to have decreased.Cohesion in the group leads to safety and more risk taking in giving feedback and establishing interpersonal relationships . Risk taParticipants described the group as life-changing, such as helping reduce anxiety about the future, improving stress management, and regaining interest in past pursuits. Participants reported improved physical and mental wellbeing enhancing self-esteem, willpower, and self-regulation, pacing themselves better and cultivating healthier routines. Recognizing feelings and understanding their relationship with symptoms and triggers for their symptoms and emotions were important in the group. Links were made between thoughts, feelings, and the sensation of symptoms.Change was described as the beginning of a journey, and the belief expressed that the improvement can accumulate over time, with on-going conscious and/or unconscious impact. Some people felt empowered to tackle their illness noticing a relationship between anxiety and pain. Role play  is both Confidence gained in the group enabled the reduction of shame and improved wellbeing, self-esteem, and the capacity to believe things could change for the better, promoting the development of a mind-set to embrace change and self-management skills.Through the accepting ethos offered by TBMA, participants are afforded the opportunity to learn the value of self and others. Self-acceptance/compassion was concerned with understanding other participants’ conditions and having a tolerance of them, with kindness. For example, the notion of accepting the symptom, non-judgmentally, appeared often. Being more connected to their body appeared to allow a greater capacity to notice energy limits and for when to rest/relax. Sharing experiences in the group helped participants gain a perspective of their own situation. Journaling provided enforced time to reflect on experiences each session. Participants learned, for example, it was acceptable to have limitations allowing them to accept what their body tells them it needs. Comments on outcomes included enhanced self-value and self-confidence changing the mind-set to one of self-compassion.The honesty encouraged by the facilitator in the group nurtures people to accept the idea they have a condition which, although may not be curable, is something they can learn to manage. It should be noted in some cases symptoms did disappear. Finally, acceptance (of their condition) in the supportive group and self-acceptance/compassion appear to be key to starting to self-manage , as oppoThe changes made to TBMA over the years were only structural, for example, omitting assessments halfway through the program and front loading sessions to twice weekly for the first 2 weeks to facilitate group cohesion and engagement. The reason for few changes is because TBMA is not a prescriptive model, setting out tasks per session as with other structured programs. Trained facilitators will modify TBMA interventions to the group needs, but, within a known framework with topics to be covered, the tailoring of which is down to the professional judgment of the facilitator, i.e., TBMA, responds to the group rather than the group having to adhere to it. There is a manual, and facilitator training is standardized in that it was delivered by the same trainers, and with the same content, adjusted as would be expected, depending on trainees’ needs. There is an assessment process for certification.After the first 2 weeks, the groups became closed to new participants and remained constant. Group size appears to have been relatively unimportant, probably because the facilitator was responsive to the needs of each group, irrespective of size. The smaller groups did miss those absent at times; there was some depletion of the richness because of this.We employed dance movement psychotherapists rather than other professional psychotherapists because they would have knowledge, skills, and experience of body-centered exercises and understand the body with mind interdependency. Although TBMA does employ elements from all the arts, specialists in other therapies may have different skills, for example, music, talking, or art therapists.N = 20), all groups conducted in one south of England middle-class area, and the need for more trained facilitators and groups. Funding was also limited.Potential limitations were the small numbers of participants, the limited amount interviewed  and integrates the body and mind in one holistic biopsychosocial model. Furthermore, it could reduce the high costs for MUS conditions, freeing up GP time, and increasing capacity and resources. The program is unique in its potential reach, significance, and impact because MUS is ubiquitous.This study is relevant to healthcare as well as to DMP. Benefits from participation in TBMA were feelings of belonging, support, safety, and shared purpose, all important for people in distress. Facilitated group experience is a vehicle for change, and the use of TBMA makes it even stronger.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by the University of Hertfordshire and NHS ethical approval. The patients/participants provided their written informed consent to participate in this study.HP designed the study and collected the data. SB participated fully in the analysis of the data and the writing of the manuscript. Both authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


N = 19,414). In support of DFT and in replication of the literature, lineups yielded higher discriminability than showups. In support of encoding specificity, conditions that matched information between encoding and retrieval were generally superior to mismatch conditions. More importantly, we supported several DFT and encoding specificity predictions not previously tested, including that (a) adding non-diagnostic information will reduce discriminability for showups more so than lineups, and (b) removing diagnostic information will lower discriminability for both showups and lineups. These results have implications for police deciding whether to conduct a showup or a lineup, and when dealing with partially disguised perpetrators .The diagnostic feature-detection theory (DFT) of eyewitness identification is based on facial information that is diagnostic versus non-diagnostic of suspect guilt. It primarily has been tested by discounting non-diagnostic information at retrieval, typically by surrounding a single suspect showup with good fillers to create a lineup. We tested additional DFT predictions by manipulating the presence of facial information  at both encoding and retrieval with a large between-subjects factorial design ( DNA exoneration cases have revealed the prevalence of mistaken eyewitness identifications, and it is critical to develop theory-driven approaches to improving eyewitness identification accuracy. According to diagnostic feature-detection theory (DFT), eyewitnesses assess suspect guilt by evaluating facial information that matches their memory for the perpetrator but is not also shared by innocent lineup members. We tested several DFT predictions by manipulating the presence of facial information at both encoding  and retrieval . By adding this encoding manipulation, we also tested a popular cognitive theory known as encoding specificity, which predicts that eyewitness performance should be superior when encoding conditions match retrieval conditions . A nationwide sample of participants viewed either a full face or the internal region only and were later tested with a showup or lineup containing full faces or only internal regions. We supported DFT by replicating the lineup advantage over showups, and we supported encoding specificity such that match conditions were generally superior to mismatch conditions. We also confirmed DFT predictions that (a) removing diagnostic information will harm performance and (b) adding non-diagnostic information will harm showups more than lineups. These results provide additional support for DFT as a powerful theory of eyewitness decision-making.Mistaken eyewitness identification (ID) is a factor in approximately 71% of the convictions revealed by DNA exoneration in the USA , and diagnostic information is represented in the right-center two columns (f3 and f4). It is important to note that DFT is agnostic regarding what exactly the so-called features represent. Wixted and Mickes used examples such as face shape and size of eyes. However, any aspect of facial information, be it featural, holistic or configural, can be substituted in these columns. What is important is whether or not the information is diagnostic of suspect guilt . Notice the blank areas in this table , which represent non-diagnostic information that is being discounted or unweighted in the eyewitness decision-making process. The idea in this example is that everyone in the lineup is of the same race and age, so the eyewitness discounts those aspects and focuses instead on diagnostic information such as face shape and size of eyes. This differential weighting of diagnostic over non-diagnostic information is what drives discriminability.This original table from Wixted and Mickes  demonstrLineup with Non-Diagnostic Features Added Prediction  and the second the Showup with Non-Diagnostic Features Added Prediction .Turning back to Table Showup with Diagnostic Features Removed Prediction  and Lineup with Diagnostic Features Removed Prediction .The second way to change discriminability that has not been addressed in the literature is removing diagnostic information, which should lower discriminability for both showups and lineups. In our experiment, this is possible by presenting a full-face target at encoding and then at test presenting only the internal region of the face, either as a showup or in a lineup . Unlike the hoodie example above, we can think of no real-world example of this scenario and we included this manipulation for theoretical reasons only. Why would police intentionally hide part of the suspect’s face during an ID procedure, if it was visible during the crime and has not changed? We will call the first prediction the Lineup with Non-Diagnostic Features Added Prediction modifies this prediction due to the DFT process of discounting non-diagnostic information. We still expect that the match condition  could outperform the mismatch condition , but, critically, we expect this difference to be smaller (and possibly nonsignificant) for lineups compared to showups. As described further below, this prediction is our most direct novel test of DFT. If there is a DFT process of discounting shared non-diagnostic information , this should reduce the encoding specificity effect of reduced performance  for mismatch compared to match conditions, for lineups more so than showups.It is important to note that these DFT predictions also come from encoding specificity  or full faces (lineup) at test. The same logic could not be applied to adding diagnostic information because, if the information is not in memory, how could it become diagnostic? This is why we had no predictions specific to this issue of potentially adding diagnostic information. However, we could certainly remove diagnostic information to test other predictions, by requiring other participants to encode a full target face and then be tested on an internal face (showup) or internal faces (lineup). Moreover, by factorially investigating full versus internal faces at both encoding and retrieval, as noted above we were also able to test encoding specificity predictions . As for our presentation of full versus internal faces in showups and lineups, this is analogous to police determining how to present a suspect to eyewitnesses when the perpetrator was disguised. Very little research has investigated this issue, but Manley, Chan, and Wells (2018) found that if the perpetrator wore a ski mask, it is best for police to present a lineup in which all members also have a ski mask , (d) if an internal face is encoded, discriminability will be (slightly) higher for an internal lineup compared to a full lineup (Lineup with Non-Diagnostic Features Added Prediction), (e) if a full face is encoded, discriminability will be higher for a full showup compared to an internal showup (Showup with Diagnostic Features Removed Prediction), and (f) if a full face is encoded, discriminability will be higher for a full lineup compared to an internal lineup (Lineup with Diagnostic Features Removed Prediction).There are several additional simple effects that come from Table Showup with Non-Diagnostic Features Added Prediction will result in a larger discriminability difference  than the Lineup with Non-Diagnostic Features Added Prediction. As shown in Table However, as described above, we expect that the In sum, we have 10 predictions in the form of four main effects and six simple effects  was asked to select the best match to the description for each lineup. We used these data to compute Tredoux’s E’ . The simultaneous lineups were displayed in a 2 × 3 array, with the target and innocent suspect presented in either position Tredoux , a lineu Tredoux .This experiment followed a 2  × 2 (test face(s): full vs internal) × 2 (ID procedure: showup vs simultaneous lineup) × 2 (target presence in ID procedure: TP vs TA) between-subjects factorial design, for a total of 16 experimental cells. Another way to describe the design involves encoding specificity: a match or mismatch between encoded and test faces. We had two match and two mismatch conditions: (a) full face at both encoding and test, (b) internal face at both encoding and test, (c) full face at encoding and internal face at test, (d) internal face at encoding and full face at test.After providing informed consent, participants were instructed to “Pretend that you are about to witness a crime. On the next screen you will see the perpetrator's face for 5 s. Study it carefully.” They were then randomly assigned to one of the four targets for 5 s, presented as either full or internal face. Next, participants watched a 2-min distractor video about animals and then were asked a 4-item multiple-choice attention check question about the last animal they saw in the video. After completing the attention check, they were randomly assigned to a TP or TA showup or lineup, with either full or internal face(s). Just prior to their ID procedure, they were informed that the target may or may not be present. Those given a showup were instructed to identify the individual if he was the same person seen before. Those shown a lineup were instructed to either select a lineup member, labeled 1–6, if he was the person seen earlier, or select “none of the above.” After completing the ID procedure, participants were asked to rate their decision confidence on a 0–100% scale.Full will be used to represent the Full Face conditions (at encoding or test), and Internal will be used to represent the Internal Face conditions (at encoding or test). For example, the condition in which a Full Face target was encoded, but tested with the Internal region only (either showup or lineup), will be referred to as Full-Internal. Table Terminologically, Although ROC analysis is a relatively new technique in its application to eyewitness ID /s, where s is the standard error of the difference between the two pAUCs based on bootstrapping  with fillers that were highly similar to the targets and innocent suspects. Therefore, we would argue that the second set of analyses is more meaningful, as it is not affected by the variability of innocent suspect choosing rates, and low overall innocent suspect choosing rates , divided by the nominal lineup size of six. Some of our designated innocent suspects were not chosen very often, based on the fact that we had fair lineups . In other words, when comparing two ROC curves, a cutoff point must be determined for the x-axis. See Fig. p value with Bonferroni-corrected alpha of 0.05/10 = 0.005. We will describe our results in the same order as the hypotheses are laid out in the predictions section above , D = 4.37, p < 0.001.Moving now to simple effects, we had six predictions. The first two were derived from both DFT  was superior to Internal-Full Showup , D = 3.65, p < 0.001  yielded higher discriminability than the Full-Internal Showup , D = 8.63, p < 0.001  was superior to Full-Internal Lineup , D = 8.45, p < 0.001  as Internal-Full Lineups , D = 2.14, p = 0.033 d' for each condition included in our 10 predictions, along with 95% inferential confidence intervals to allow evaluation of statistical significance. This table establishes two points: (a) the theoretical discriminability results match the empirical discriminability results, and (b) the results are the same regardless of how false ID rate is calculated, such that the results based on all IDs from TA lineups  match those based on designated innocent suspects . Note how the last two conditions listed in Table d's, providing additional support for this DFT prediction.To support our ROC analyses, we confirmed all differences among pAUCs with SDT analysis applied to correct and false ID rates from Table We conducted a high-powered experiment with a demographically diverse sample to test several predictions derived from diagnostic feature-detection theory , we supported all of these predictions. One of the 10 predictions  represents a DFT prediction that qualifies the typical pattern expected based on encoding specificity . According to DFT, there will be some degree of discounting of shared non-diagnostic information in a lineup that is not possible in a showup, and therefore, we expected that the typical match > mismatch pattern from encoding specificity would be either reduced or eliminated. The comparison of pAUCs revealed a reduced and nonsignificant match > mismatch effect here, which was not the case for any other match versus mismatch comparison . Moreover, the d's were virtually identical.In contrast, we tested DFT by adding non-diagnostic information and also by removing diagnostic information. Both were made possible by manipulating the presence of facial information  at both encoding and at retrieval. Therefore, some participants could see more facial information at retrieval than they did at encoding , and others could see less facial information at retrieval than they did at encoding . As shown in Tables shared information will be discounted, which is a scenario possible for a lineup, but not for a showup (as no information can be shared across lineup members in a showup). For the sake of simplicity in the table, we assumed 100% discounting of non-diagnostic information from the lineup and 0% discounting in the showup. This assumes optimality in the decision-making process, which is unlikely in real eyewitnesses. A more realistic scenario is that discriminability will be harmed by adding non-diagnostic facial information , it was nonsignificant. Additionally, there was no difference in d' between these two conditions. We conclude from these patterns that there is evidence of a discounting process applied to added non-diagnostic information that is stronger for lineups than for showups, which supports DFT.This is arguably our most important finding, so we will expand our interpretation of it here. We presented an oversimplification of DFT assumptions in Table Our results fit well with recent studies testing other novel predictions from DFT (Carlson et al. We encourage other researchers to further test DFT, or to present alternative quantitatively specified models against which DFT can compete. There is much fertile ground left to investigate, such as the aforementioned theoretical possibility of adding diagnostic information. As we noted before, we struggle to think of a real-world example of this, and it could also be difficult to execute in an experiment. One possibility is to present a blurry image of a target, and later testing with a crystal-clear image. This would be akin to a witness who views a perpetrator from a distance (e.g., Lockamyeir et al. It is important for researchers to test quantitatively specified theories in order to develop robust methods to help police get the most from eyewitnesses. DFT is shaping up to be a powerful theory of eyewitness decision-making. It can help police to not only understand the importance of presenting fair simultaneous lineups over showups, but also to understand what makes a lineup fair. It is well known that a suspect should not stand out (e.g., Colloff et al.


This article employs computer-assisted methods to analyse references to Aboriginal and Torres Strait Islander people(s) and issues in a newspaper corpus about diabetes. The objectives are to identify both the frequency and quality of social representation. The dataset consisted of 694 items from 12 Australian newspapers in a five-year period (2013–2017). The quantitative analysis focused on frequency  and range (number/percentage of texts). The qualitative analysis focused on the identification of semantic prosody (co-occurrence with negative/positive words and phrases) and on selective social actor analysis. The qualitative analysis also compared choices made by the press to language practices recommended in relevant reporting guidelines. Key results include that references to Aboriginal and Torres Strait Islander people(s) or matters appear to be extremely rare. In addition, newspapers’ language choices only partially align with guidelines. References that do occur can be classified into four categories: a) references to [groups of] people and other references to identity; b) names of services, institutions, professions, roles etc; c) non-human nouns related to health; d) non-human nouns related to culture. Qualitative analysis of the word COMMUNITY suggests that newspapers for the most part do recognise the existence of different communities at a national level. However, analysis of all references to [groups of] people shows that the vast majority occur in contexts to do with negativity, therefore having a negative semantic prosody. More specifically, there is a strong association with mentions of a higher risk, likelihood, or incidence of having or developing diabetes (or complications/effects). In sum, Aboriginal and Torres Strait Islander people(s) and issues lack in visibility in Australian diabetes coverage, and are associated with deficit framing, which can be disempowering. To change the discourse would require both an increased visibility as well as changing the deficit lens. The use of language matters. It’s important to remember that for many Indigenous people, this is not just a story, a newsgrab, a headline. Indigenous narratives are often complex and nuanced, so journalists should … be mindful of how language is used and contextualised. , p. 4This piece of advice comes from recently published guidelines, and brings home the message that ‘language matters’. This article heeds this message and focuses on how language is used in Australian national and metropolitan newspapers in a case study on diabetes.Why diabetes? Diabetes is a major health problem in Australia, including for Aboriginal and Torres Strait Islander people –3. Statiwhat is considered important and worth reporting , as welng’; see ). In theng’; see . Furtherng’; see –17, withng’; see , p. 159)ng’; see –18).corpus linguistics is adopted to answer these questions. Corpus linguistics–computer-based linguistic analysis–involves researchers using specialised software to analyse datasets both quantitatively and qualitatively. This study focusses on a five-year dataset of almost 700 newspaper articles published between 2013 and 2017. It is, to my knowledge, the first-ever study to use a corpus linguistic approach to analyse media representation of Aboriginal and Torres Strait Islander people(s) and issues. However, corpus linguistics has been widely used to analyse representations and discourses in relation to other topics and news actors in the news, in an approach variously called corpus-assisted discourse studies or corpus-based  discourse analysis  and/or Torres Strait Islander/s or Peoples when reporting. […] If you are wanting to say “Aboriginal and Torres Strait Islander peoples” more than once in a story, then it is common practice to subsequently refer to “Indigenous people”. , p. 4Indigenous is ‘a term of convenience which, by failing to acknowledge diversity, characterises Aboriginal and Torres Strait Islander Peoples as a homogenous “Other”‘  people Names of services, institutions, professions, roles etc Non-human nouns related to health .Non-human nouns related to culture . Examples are provided in are from an Aboriginal or Torres Strait Islander, Polynesian, Asian or Middle Eastern background. In fact, all seven instances group Aboriginal and Torres Strait Islander peoples with other identity categories:First, references to identity that use the word BACKGROUND , tend to be used for what van Leeuwen calls ociation , p. 38–tChinese, Indian and the Pacific islands (2x),Mediterranean, Asian, Middle Eastern, Pacific Island,Vietnamese, Chinese, Middle Eastern, Polynesian and Melanesian,Asian, Middle Eastern, Polynesian, Mediterranean,Polynesian, Asian or Middle Eastern,Pacific island, Indian subcontinent or Chinese cultural background.These associations are mostly in reference to groupings deriving from diabetes research or health programs, which journalists draw on in their writing. However, it could be argued that these linguistic practices of association have the potential to contribute to ‘the depiction of Indigenous people as “other”‘ , p. 92.… of Aboriginal appearance implies that people are easily identifiable as Aboriginal by their skin colour and other aspects of appearance . It is again useful to quote the reporting guidelines in this respect:Second, the expression Aboriginal and Torres Strait Islander peoples are diverse. They are not one homogenous group that think, speak and look the same. […] Like many cultural groups, Aboriginal and Torres Strait Islander peoples have diverse skin tones, features and appearances. It’s easy to make assumptions on whether you think someone ‘looks’ Aboriginal or Torres Strait Islander. […] As Gamilaroi woman and sociologist Dr Bindi Bennett puts it, “According to current media constructions, a ‘real’ Aboriginal person is dark-skinned, lives in a remote area of Australia and is in abject poverty.” Aboriginality is determined by a number of factors—cultural heritage, community recognition and descent. Skin tone does not reflect whether someone is recognised as an Aboriginal or Torres Strait Islander person. , p. 7appearance . The vast majority (91.2%) of these expressions refer either to missing persons (56) or crime . Thus, the expression ‘of [ETHNIC LABEL] appearance’ seems to be associated with police reports, in relation to crime or missing people. It is not surprising, then, that of Aboriginal appearance in the DNC is also associated with a missing person’s report:In order to find out if the link between appearance and ethnicity/race is unique to the DNC and unique to Aboriginality, it is useful to briefly consult the second corpus: In NOW-OZ, the phrase ‘of [ETHNIC LABEL] appearance’ does occur with various labels, although it is infrequent (0.7 per million words). There are 250 instances of this expression in NOW-OZ, with different adjectives provided in the relevant slot before […]of Aboriginal appearance, about 180cm tall and of medium build with curly black and grey hair and a goatee. He was last seen wearing a pair of blue denim shorts with no shirt and was possibly carrying a yellow Dolphin brand torch. Anyone with information should call police on 131 444.(T15N001)Detective Acting Senior Sergeant Ian Kennon said Mr Cooper was reported missing about 8.30am on Thursday. […] “Mr Cooper is believed to be diabetic, however information suggests he was not in possession of any medication.” Mr Cooper is a 46-year-old man reproduced by the media.In other words, such problematic expressions seem to originate in police discourse, but are Aboriginal Australia. In the DNC, it seems to be used as metonymic expression for Aboriginal and Torres Strait Islander peoples in Australia or in a particular region of Australia:A third expression worth briefly commenting on is that of in Aboriginal Australia,” he said. (V13N023)Professor Alex Brown, head of the Aboriginal Research Unit at the South Australian Health and Medical Research Institute, said a majority of adults over 50 in some indigenous communities will have it. “It is probably the leading cause of preventable blindness in Aboriginal Australia is on par with countries such as Azerbaijan, Vanuatu and Guatemala. (S13N011)Life expectancy in indigenous central Australia, its only significant instance outside South America and central Africa. (A17N005)The Alice Springs-based enterprise will aim to tackle a cancer-causing virus endemic spatialization, ‘a form of objectivation in which social actors are represented by means of reference to a place with which they are, in the given context, closely associated’  Aboriginal and Torres Strait Islander people are not one monolithic, homogenous group […]’ , p. 3‘Of course there is no “indigenous community”–we are many and our issues myriad and diverse. But we know that we also share our fate and our connection runs deep.’ ‘Indigenous people are not a homogeneous group and our views reflect this diversity.’ Celeste Liddle, Arrernte woman and social commentator Aboriginal/Aboriginal and/or Torres Strait Islander/Indigenous + COMMUNITY are used uncritically . But, as Aboriginal people, communities and organisations), which would bring the plural occurrences to 11. There is one instance of non-Indigenous communities in the DNC.)All occurrences in the DNC of Aboriginal communities, especially those in which English is not commonly spoken). There are three co-textual references to remoteness . While these distinguish remote ‘communities’ from others, they imply that all remote communities are homogenous. Note that the noun use diabetics in line 1 is in itself problematic  (S13N011)Citing improvements in smoking levels, Justin Mohamed, chair of the National Aboriginal Community Controlled Health Organisation, said the results showed change was possible when the indigenous community [Lisa Jackson Pulver is a Wiradjuri woman] (S13N011)Lisa Jackson Pulver, professor of public health and director of Muru Marri indigenous health unit at the University of NSW [sic], said the decline had importance for community is interesting precisely because of its ambiguous evaluative potential, and it is important to consider whether it is used by insiders in self-descriptions or by outsiders for Othering  people. Let us now look more closely at how these references are used, by summarising the results from the concordance analysis. More specifically, I examined the expressions in As mentioned above, an important sub-category of the use of risk, different phraseologies can be identified in the corpus:The vast majority of the 79 instances refer to Aboriginal and Torres Strait Islander people in relation to a higher risk, likelihood, or incidence of having or developing diabetes (or complications/effects). The use of such statistics is regarded in  as contrBeing at risk/there being risk:at risk if you: […] Are from an Aboriginal or Torres Strait Islander, Polynesian, Asian or Middle Eastern background (W15N025)You are more at very high risk of developing diabetes, with rates between three and four times higher than in non-indigenous people. (H13NN010)Like other indigenous groups, our indigenous people are at higher risk. (N16N006)People living in Blacktown are three times as likely to develop diabetes as those living in Mosman. Part of this may be due to the region having higher proportions of Indigenous people, people with mental health problems and people in their childbearing years, who are there is increased risk if you: […] are from an Aboriginal or Torres Strait Islander background; […]. (A17N003)According to Diabetes Australia, which has a risk calculator on its website, at risk of becoming blind because of diabetes are receiving world-class healthcare for the first time. (A13N004)INDIGENOUS people who are Having a higher risk ofrisk of developing gestational diabetes, these include: Aboriginal and Torres Strait Islander, Vietnamese, Chinese, Middle Eastern, Polynesian and Melanesian women. (W16N004)Women from some ethnic backgrounds have a higher Ethnic identity/background being a risk factorrisk factors. (R15N004)Family history, age and being Aboriginal or Torres Strait Islander are also risk factors associated with developing gestational diabetes, including being over 30 years of age, being overweight, having a family history of type 2 diabetes and being from a particular ethnic background  […]. (V16NN001)While there are a number of High-risk genetic backgrounds or population:high-risk genetic backgrounds, such as indigenous, Chinese, Indian and the Pacific islands. […]” […] people from high-risk populations, such as Aboriginal communities, culturally and linguistically diverse groups and people living in rural and remote areas of WA. (W15NN010)[…] the impact of diabetes in likelihood tend to be comparative and use three similar constructions:References to BE (much/far) more likely to get/have (type) diabetes [or diabetes-related effects]BE X times more likely as/than [comparison group] to have diabetes [or diabetes-related effects]BE X times more likely to get/have diabetes [or diabetes-related effects] than/compared with [comparison group][r]efers to Indigenous peoples primarily in terms of “risk” and “vulnerability” or worse describes Indigeneity as the risk factor’  people has a negative semantic prosody. More generally, the attention paid to rates of health conditions or diseases in Indigenous peoples is part of a media theme or frame, which Tong et al “However, since the positivity is primarily associated with initiatives by governments and charities While not in relation to diabetes, but rather with respect to smoking levels, two quotations do directly reference the possibility for positive change, and are made by the two experts already mentioned above:Lisa Jackson Pulver, professor of public health and director of Muru Marri indigenous health unit at the University of NSW, said the decline [in smoking] had importance for the indigenous community because those who had quit or never smoked would have probably grown up in households with much higher rates of smoking. “These are people whose odds, according to all the reports and everything we know, were that they were going to smoke too… Now the hard-core stats are showing that doesn’t have to be you,” she said. “This is something very important for Aboriginal people, who so often get told because you’re in that environment, this is what’s going to happen.” (S13N011)Citing improvements in smoking levels, Justin Mohamed, chair of the National Aboriginal Community Controlled Health Organisation, said the results showed change was possible when indigenous communities were properly “empowered and resourced”. “This report should make government realise that things can change… This shows that when we’re given control, we can win,” he said. (S13N011)themselves experience, conceptualise, and talk about diabetes  as a ‘problem’ . There We are asking to be seen as the dynamic, resilient and self-determining people that we are. We know that there is a lot of work to do, but today we want to celebrate success and highlight our strengths and achievements. We want to acknowledge the incredible work being carried out in Aboriginal and Torres Strait Islander communities across the country. The 2019 Close the Gap report–Our Choices, Our Voices, prepared by the Lowitja Institute, highlights a number of organisations improving the health and wellbeing of our peoples. They show that when Aboriginal and Torres Strait Islander people are involved in the design and delivery of the services they need, we are far more likely to achieve success. The guidelines therefore ask newsrooms to aim for ‘a balance between “bad news” and “good news”‘ , p. 14. It is important that when writing about Aboriginal and Torres Strait Islander people that the tone and framing is not deficit focused. Many Aboriginal and Torres Strait Islander people face disadvantage however there are many strengths within communities. It is important to reflect those strengths in the language we use. , p. 1The Koori Mail has represented health issues successfully [Guardian has partnered with Indigenous X to feature diverse Indigenous voices and opinions.Both Negativity (bad news) and Positivity (good news) are news values that can be established through language to construct newsworthiness . While Nessfully , and themore negatively than other social groups. Given the general importance of the news value of Negativity, we would expect negative reporting in relation to a wide range of topics and groups. In the analysis of association for example, we have seen that other groups  may occur in similar co-texts. While the lack of comparison is a limitation of this study, it is worth pointing out that, from a historical perspective, no other social group in Australia has the same past and ongoing experiences of colonisation as Aboriginal and Torres Strait Islander people. To give just two examples that are well-known in Australia but perhaps less known elsewhere: Until 1970 many Indigenous children were taken by force from their parents (the ‘Stolen Generations’), and the 2007 Northern Territory Emergency Response (the ‘Intervention’) involved the use of the military to enforce various coercive measures in remote NT communities.There are several limitations to this study. It did not systematically analyse frames or undertake full-text analysis, and it focused only on newspapers rather than other media. Despite starting with almost 700 newspaper items, the low presence of mentions of Aboriginal and Torres Strait Islander people(s) and issues resulted in a small dataset, which brings with it inherent limitations. Further, the study did not analyse whether Aboriginal and Torres Strait Islander people are represented S1 Table(DOCX)Click here for additional data file.S2 Table(DOCX)Click here for additional data file.