A psychological training programme given to a group of sex workers in Kolkota, India, not only increased their self-esteem, it also helped them to choose better healthcare for themselves and save more for their future. These are the central findings of research by Sanchari Roy and colleagues to be presented at the Royal Economic Society''s 2015 annual conference.
Their study, which involved a ''randomised controlled trial'' among 476 sex workers under the age of 35 from Kolkata''s red light district, used a course of psychological training designed to reduce feelings of helplessness and pessimism. At the end of the study:
• Sex workers who received the training programme were 68 percentage points more likely to report higher self-esteem, and 29 percentage points more likely to report a positive self-image.
• Participants were also 12 percentage points more likely to report being happy and 40 percentage points less likely to feel ashamed of their occupation.
• They took better care of themselves: they were also nine percentage points more likely to have visited a doctor since the programme began.
• They were more likely to invest: when offered a payment of 100 rupees (about £1), they were also 25-50 percentage points more likely to choose to defer the reward for a year to take advantage of a method of saving that offered a higher rate of interest.
The authors worked with a local NGO, which was using the programme to help sex workers challenge the stigma placed on them, and to take charge of their lives. The psychological training programme proved to be an effective means of improving sex workers'' sense of self-worth, and making them more willing to invest in their future.
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Participants in a psychological training programme aimed at boosting their self-esteem and self-efficacy exhibited greater willingness to invest in their future – in the form of savings and health. This is the key finding of research by Sanchari Roy and co-authors, summarised in a University of Warwick working paper.
Stigma and social exclusion can lower a person''s self-esteem and distort her self-image, leading to a feeling of not being capable, or worthy, of a better life situation. Research in psychology suggests that a sense of ''self-efficacy'' (the belief in one''s ability to succeed in a particular situation, despite barriers) is important to motivate individuals to put in effort to achieve one''s goal.
This study examines whether psychological training can overcome the adverse effects of stigma and exclusion. The authors, in collaboration with a local NGO, worked with a population that faces such acute stigma – sex workers in India. As with other marginalised groups, these workers face prejudice from mainstream society, are deprived of access to education and healthcare, leading to a feeling of pessimism and hopelessness.
The study consists of an eight-week psychological training programme aimed at raising their self-esteem and ''self-efficacy'', and uses a randomised control trial design to measure the programme''s impact on their self-reported wellbeing measures, and their savings and health-related choices.
The eight-week training programme was instituted with sex workers from three ''red-light'' districts in Kolkata, India. 467 sex workers, all less than 35 years old, were chosen to participate. 264 sex workers were randomly assigned to the ''treatment'' arm, who participated in the eight-week programme, while the remaining 203 sex workers were assigned to the ''control'' arm, who did not.
The two main goals of the sessions were to empower the sex workers mentally to challenge the stigmatised view that society imposes on them, and to instil in them the belief that they can take charge of their own lives, and achieve their goal in life.
At the end of the training sessions, both treatment and control participants were given 100 rupees (about £1) with three options regarding how they would like to receive the payment: as a ''cash injection'' into their bank account, as a contribution to a one-year fixed deposit or as a contribution to a one-year fixed deposit that the participant would match with her own money.
The first option offered an 8% interest rate with no lock-in period, while the remaining two options offered 12% and 15% respectively, but the returns to investment from these two options would not be accessible to participants before one year. These compensation options were put in place to gauge the level of ''future-oriented'' commitment from the subjects after the training programme, with second and third options being more ''future-oriented'' than the first.
The study finds that sex workers who received the training programme were 68 percentage points more likely to report higher self-esteem, and 29 percentage points more likely to report a positive self-image, compared with those who did not receive the training programme.
In addition, they were also nine percentage points more likely to have visited a doctor since the programme began, even though the initial rate of average health-check up visits was quite high (79%) in this population. Participants were also 12 percentage points more likely to report being happy, but 40 percentage points less likely to feel ashamed of their occupation.
Finally, participating sex workers were 25-50 percentage points more likely to choose the future-oriented savings products over the present-biased one. Hence, the psychological training programme proved to be an effective means of improving sex workers'' sense of self-worth, and making them more willing to invest in their future.
Sex Workers, Stigma and Self-Beliefs: Evidence from a Psychological Training Program in India – Sanchari Roy
