THE STRENGTHS AND NEEDS OF PALESTINIAN YOUTH: PERSPECTIVES OF YOUTH SERVICE PROVIDERS IN BETHLEHEM, PALESTINE By Lucas Al-Zoughbi A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of Psychology—Master of Arts 2020 ABSTRACT THE STRENGTHS AND NEEDS OF PALESTINIAN YOUTH: PERSPECTIVES OF YOUTH SERVICE PROVIDERS IN BETHLEHEM, PALESTINE By Lucas Al-Zoughbi Background: Palestinian youth are subject to a reality predicated on political and social injustice. The extant literature tends to view these youth through a deficit lens without adequate contextualization. This study aims to address this gap by documenting Palestinian youth strengths, challenges, and root causes according to youth-service providers. Methods: We conducted interviews with youth-service providers in the Bethlehem area. Interviews were followed by a member-checking survey to improve accurate capture of their experiences. Results: Utilizing Graneheim and Lundman’s (2004) pragmatic qualitative data analysis, we extracted nuanced themes that mapped onto the analytical categories. We identified five analytical categories: educational, societal, political, economic, and individual. Discussion: Our findings suggest a complex and nuanced perspective of Palestinian youth according to youth service providers in the Bethlehem area. We discuss implications for practitioners and researchers interested in youth development and well-being in the Palestinian context TABLE OF CONTENTS LIST OF TABLES..................................................................................................................................................... v LIST OF FIGURES .................................................................................................................................................. vi INTRODUCTION ..................................................................................................................................................... 1 Palestinian Youth .............................................................................................................................................. 5 LITERATURE REVIEW ........................................................................................................................................ 8 Strengths .............................................................................................................................................................. 9 Needs ..................................................................................................................................................................... 9 Root causes ...................................................................................................................................................... 10 Psychopolitcal Validity ................................................................................................................................ 16 METHODS .............................................................................................................................................................. 18 Research Paradigm and Qualitative Approach .................................................................................. 18 Reflexivity ......................................................................................................................................................... 19 Context ............................................................................................................................................................... 19 Sampling ............................................................................................................................................................ 20 Recruitment ..................................................................................................................................................... 20 Participants ...................................................................................................................................................... 21 Interviews ..................................................................................................................................................... 21 Member-Checking ...................................................................................................................................... 21 Ethical Considerations ................................................................................................................................. 22 Data Collection Methods ............................................................................................................................. 23 Interviews ..................................................................................................................................................... 23 Member-checking surveys ....................................................................................................................... 24 Data Processing .............................................................................................................................................. 24 Data Analysis ................................................................................................................................................... 25 Quantitative ................................................................................................................................................. 25 Qualitative .................................................................................................................................................... 25 Trustworthiness ............................................................................................................................................. 25 iii RESULTS ................................................................................................................................................................ 27 Strengths and Assets .................................................................................................................................... 27 Strengths ....................................................................................................................................................... 27 Assets .............................................................................................................................................................. 28 Needs and Challenges .................................................................................................................................. 30 Economic Challenges................................................................................................................................. 30 Political Challenges ................................................................................................................................... 30 Social Challenges ........................................................................................................................................ 31 Educational Challenges ............................................................................................................................ 31 Individual Challenges ................................................................................................................................ 32 Root Causes of Needs and Challenges Facing Palestinian Youth ................................................ 34 Gendered Challenges Facing Palestinian Youth in Bethlehem ..................................................... 36 Analytical Categories .................................................................................................................................... 37 Education ...................................................................................................................................................... 37 Societal ........................................................................................................................................................... 38 Economics ..................................................................................................................................................... 39 Politics ............................................................................................................................................................ 39 Individual ...................................................................................................................................................... 40 DISCUSSION.......................................................................................................................................................... 41 Implications for Research........................................................................................................................... 42 Implications for Practice ............................................................................................................................. 43 Implications for Policy ................................................................................................................................. 44 Limitations ....................................................................................................................................................... 45 CONCLUSIONS ..................................................................................................................................................... 47 APPENDICES ........................................................................................................................................................ 48 APPENDIX A: Verbal Informed Consent Guidelines ......................................................................... 49 APPENDIX B: Delphi Study Interview Protocol ................................................................................. 51 REFERENCES ....................................................................................................................................................... 52 iv LIST OF TABLES Table 1: Inclusion and Exclusion Criteria for Litearature Review ........................................................ 8 Table 2: Literature Review and Psychopolitical Validity Score .......................................................... 11 Table 3: Psychopolitical Validity Questions ............................................................................................... 16 Table 4: Strengths and Assets ......................................................................................................................... 29 Table 5: Needs and Challenges Facing Palestinian Youth .................................................................... 32 Table 6: Root Causes of Needs and Challenges Facing Palestinian Youth....................................... 35 Table 7: Challenges Influenced By Gender Identity ................................................................................. 36 v LIST OF FIGURES Figure 1. Change in Land Allotment in Palestine/Israel, 1946-2013. Taken from Heller, S. (2014). ....................................................................................................................................................................... 1 Figure 2. Map of area C in the West Bank. Taken from Zahriyah, E. (2014). ................................. 2 Figure 3: Map of West Bank Access Restrictions January 2017. Taken from OCHA (2017a). 4 vi INTRODUCTION Palestine has historically been identified as the land between the Jordan river and the Mediterranean Sea, bordering Egypt, Lebanon, Syria, and Jordan. For the past 70 years, Palestine has been occupied and controlled by the Israeli military. Current day Palestine is surrounded by Israel, with borders shared with Jordan and Egypt. However, Israel remains in complete control over all but one of these borders, the Rafah Crossing, which remains closed apart from exceptional cases (Office for the Coordination of Humanitarian Affairs [OCHA], 2017b). The Israeli occupation of Palestine began in 1948, the year that Israel was created by the expulsion, murder, and flight of 720,000 of the 900,000 Palestinians who lived in the Palestinian land that became Israel (Pappe, 2006). This dispossession involved the erasure of over 500 Palestinian villages from existence (Pappe, 2006). Since these events, Israel has continued to control resources, movement, borders, and the liberty of the Palestinian people. Figure 1 illustrates the Palestinian experience as examined through loss of land. Gaza Strip West Bank Figure 1. Change in Land Allotment in Palestine/Israel, 1946-2013. Taken from Heller, S. (2014). 1 The West bank and Gaza Strip are labeled in red. The current study took place in Bethlehem, a city in the West Bank. As illustrated in Figure 1, contemporary Palestine comprises the territories of the West Bank and Gaza Strip. Figure 2 illustrates that the West Bank is further split into Areas A, B, and C. Only area A is under Palestinian Authority civil control and security. Area B is Figure 2. Map of area C in the West Bank. Taken from Zahriyah, E. (2014). under Palestinian civil control and Israeli military control. Area C is completely under Israeli control. Area A makes up 18% of the West Bank. When comparing the historical 2 territory of Palestine with current control of land in area A of the West Bank and the Gaza Strip, Palestinians control less than five percent of pre-1947 Palestine. (Zahriya, 2014; World Atlas, n.d.; New World Encyclopedia, n.d.). Although a comprehensive discussion of the Israeli occupation is beyond the scope of this paper, it is important to introduce its systematic nature, which can be successfully illustrated by discussing restrictions on movement. As of July 2018, there are 64 checkpoints in the West Bank that are continuously staffed by the Israeli army (OCHA, 2018). At these checkpoints, interspersed throughout the West Bank, Palestinians must present their ID cards, and can be searched, detained, and denied further passage at the staffing soldiers’ discretion. In addition, there are 705 permanent obstacles to movement across the West Bank placed or constructed by the Israeli Army (e.g., roadblocks, gates, trenches). Figure 3 contains a map of checkpoints and obstacles (OCHA, 2017a). The effects of these restrictions on movement are significant. For example, a study examining the effect of checkpoints on childbirth found that, between 2000 and 2007, 10% of pregnant Palestinian women were delayed at checkpoints, leading to 69 births at these checkpoints, which were associated with the deaths of 35 infants and 5 mothers (Shoaibi, 2011). These data are particularly relevant for young women, considering that those between the ages of 20 and 29 have the highest rates of fertility per thousand people in the Palestinian territories (Palestinian Central Bureau of Statistics [PCBS], 2009). 3 Figure 3: Map of West Bank Access Restrictions January 2017. Taken from OCHA (2017a). 4 Restrictions on movement significantly influence the daily lives of Palestinians. In the face of chronic unemployment within Palestine, a small proportion of Palestinians are granted military permits to work in Jerusalem. Palestinians with work permits earn higher wages than those in the West Bank. Given the restrictions on movement, these individuals face long and unpredictable commutes in order to traverse the short distance that separates them from Jerusalem (B’tselem, 2013). Under occupation, checkpoints can be closed unpredictably, and functioning checkpoints tend to disproportionately detain, search, and question young Palestinian men. Although, restrictions vary by year, Palestinian men aged 16-29 can often be ineligible to apply for permits (Stead, 2019). The following excerpt from a report written by an Israeli human rights organization, illustrates the way these issues affect the lives of Palestinians. When the [human rights organization] staff arrived, at approximately 2:30 A.M, there were already some 200 laborers waiting in line, and the numbers quickly rose. Less than an hour later, there were thousands. […] They [Palestinian laborers] reported that only four of the eight inspection stations at the checkpoint are usually open, even on Sunday, the first and busiest day of the work week. The [Israeli] security guards randomly pick twenty to forty persons and send them into a room, where they must wait until the room fills up, at which point they undergo a physical inspection. They usually stay in the room for forty to ninety minutes and can leave it only when the last person is inspected. The conditions in the room are harsh: there are no chairs and the workers must stand, crowded together. Although there is an air conditioner in the room, it is not turned on. Palestinians have dubbed it “The Room of Death” (B’tselem, 2013, para. 4). Palestinian Youth Two-thirds of Palestinians in the West Bank and Gaza Strip are under the age of 30, and almost half of these are between the ages of 15 and 29 (PCBS, 2018). These young people are heavily targeted by occupation policies. For example, the Addameer Prisoner Support and Human Rights Association (2010) states that Israel intends to, “un-educate the 5 Palestinian people” (p. 9) through the practice of child imprisonment, which overwhelmingly affects youth aged 15-17. Beyond denying education to Palestinian children, the Israeli military uses child imprisonment to recruit military informants, as youth at that age are susceptible to coercion (Addameer, 2010). In addition, Israeli military forces are known to raid Palestinian universities and regularly imprison university students engaged in social and political organizing (Baramki, 1996; “Israeli forces injure dozen, raid university in Abu Dis”, 2018; Fulbright, 2018). Young Palestinians face a disproportionate amount of the country’s social burden. Unemployment rates among Palestinians aged 15-29 are above 40% (PCBS, 2018). Among university graduates, unemployment rates are even higher. Overall, 55% of bachelor level graduates are unemployed, with rates disproportionately higher among young Palestinian women within this group, where they reach 72% (PCBS, 2018). Less than one percent of Palestinian youth are in decision-making positions such as management or public leadership (PCBS, 2018). Despite these many challenges, Palestinian youth are at the center of the struggle for liberation under the Israeli occupation. Youth have been the driving force for the pursuit of justice and peace in Palestine/Israel. For example, the First Intifada – a grassroots Palestinian movement in pursuit of human rights and self-determination –led to the Oslo Peace Accords and was heavily youth led (e.g. Hammad, 2017). The most recent example of youth’s centrality to the Palestinian struggle is “The Great March of Return” that began in 2018 – a nonviolent campaign meant to emphasize the Palestinian Right of Return as stipulated by United Nations Resolution 194 (Abusalem, 2018). The right of return refers to 6 the right of Palestinians who are displaced by the formation of the Israeli nation state in 1948 to return to their land. (Karmi, 2018). My goal for this current study is to document Palestinian youth service providers’ perspectives on Palestinian youth strengths, needs, and root causes. 7 LITERATURE REVIEW In order to understand the documented strengths and needs of Palestinian youth, we examined the peer-reviewed empirical literature published in the last ten years. Table 1 presents the inclusion/exclusion criteria that guided my selection of studies for this review. Using these criteria, we found nine peer-reviewed articles that focused explicitly on Palestinians in the age range of 15-29. These are summarized in Table 2. In terms of population, studies tended to neglect youth aged 24-29, with all studies focusing on youth between the ages of 15 and 24. In terms of content, more than half of the studies focused on risky behaviors (extramarital sexual relations, alcohol use, tobacco consumption, and other illicit substances) (Glick et. al., 2018; Massad et. al., 2014; Massad et. al., 2016; Musmar 2012; Tucktuck et. al., 2018). Three of the studies were strengths-based and rooted in understanding youth experiences, with particular focus on how youth cope with the ongoing military occupation (Aitcheson et. al., 2017; Nguyen-Gillham et. al., 2008; Rabaia et. al., 2010). One study was focused on understanding youth narratives and their connection to a master narrative of displacement and suffering (Hammack, 2010). As we surveyed the literature for identified strengths, needs, and root causes, we found that the needs are most documented, leading a gap in documentation of strengths and root causes. Table 1: Inclusion and Exclusion Criteria for Litearature Review Inclusion Criteria Exclusion Criteria Any study examining Palestinian youth (within age 15-29) Exclude studies that include participants under the age of 15 or over 29 (e.g. Hobfoll et. al) Published from the year 2008 Have a sample of youth earlier than 2,000 Peer-reviewed journals. Anything that doesn’t examine youth 8 Table 1 (cont’d) Inclusion Criteria Exclusion Criteria Studies in West Bank, Gaza, and East Jerusalem. Studies outside of Palestine (West Bank, Gaza, and East Jerusalem). Published in either English or Arabic Non-empirical Studies Unable to discern age of sample or study participants Conference Abstract only Strengths Although most studies did not explicitly identify strengths, three identified resilience, collective identity, and resistance in the face of political injustice as key strengths of Palestinian youth (Aitcheson et. al., 2017; Nguyen-Gillham et. al., 2008; Rabaia et. al., 2010). These studies tended to describe Palestinian youth as exhibiting admirable rates of normalcy and ability to cope with extreme stressors such as military occupation and economic strangulation (Aitcheson et. al., 2017; Nguyen-Gillham et. al., 2008; Rabaia et. al., 2010). Needs Eight studies identified needs. Six of these focused on problematic behaviors and two focused on sociopolitical needs. The problematic behaviors identified in these studies included alcohol and drug use, extramarital sex, interpersonal violence, tobacco use, anxiety, and depression (Aitcheson et. al., 2017; Glick et. al., 2018; Massad et. al., 2014; Massad et. al., 2016; Musmar 2012; Tucktuck et. al., 2018). Sociopolitical needs included poverty, emotional distress and boredom, desperation, dehumanization under occupation, economic strangulation, collaborators creating climate of suspicion and tension, hopelessness and boredom (Nguyen-Gillham et. al., 2008), and a lack of freedom of 9 movement (Rabaia et. al., 2010). The predominant focus of existing studies on problem behaviors undermines the effect of the longstanding military occupation and ignores the importance of addressing the sociopolitical context that drives these behaviors. Root causes Three of the studies had no mention of root causes or reasons for listed challenges (Aitcheson et. al., 2017; Hammack, 2010; Tucktuck et. al., 2018). Four studies that were deficit based and focused on risky behaviors listed a number of reasons to engage in these behaviors. For pre-marital sex and substance use, reasons included challenging conservative culture, financial constraints, fear of rejection by the partner’s family, human need, boredom, curiosity, to experience something new, for men to prove their manhood, for girls, suppression and then freedom, inadequate parental control, Israeli occupation, lack of awareness, unhappiness, and for entertainment (Glick et. al., 2018; Massad et. al., 2014; Massad et. al., 2016; Musmar 2012). In addition, unemployment, political and economic instability, exposure to modern media and internet were seen as contributing to decisions to engage in risky sexual behavior (Massad et. al., 2014; Massad et. al., 2016; Musmar 2012). One study found that economic differences among various regions in the West Bank influenced engagement with risky behavior (Glick et. al., 2018). The occupation was rarely mentioned in these studies; however, when it was mentioned, no critical analysis or further discussion was provided (Glick et. al., 2018; Massad et. al., 2016). 10 Table 2: Literature Review and Psychopolitical Validity Score Short form citation N Sample Descript ion Summary i. Needs ii. Root Causes iii. Strengths M a x : 4 E p i s t e m i c P P V M a x : 9 O v e r a l l P P V P P V M a x : 5 T r a n s f o r m a t i v e Hammack (2010) 16 335 Aitcheson et al. (2017) 16-year- old Palestini ans Palestini ans 17- 19 years old; 11th- 12th grade Examines the narrative of youth in Palestine that are interested in intergroup dialogue. Youth have a narrative that adheres to the master narrative of Palestinian dispossession and tragedy. 2 0 2 i. No explicit needs identified. ii. NA iii. No strengths identified. Examined sociocultural, familial, and individual resilience factors in young Palestinians living in refugee camps in Gaza. i. 60% of youth examined had mild to severe anxiety symptoms or a combination of mild to severe anxiety and depressive symptoms. Poverty and impoverished conditions of the refugee camps in Gaza. ii. NA iii. 40% of youth were identified as resilient (low to no anxiety or depressive symptoms). Stronger national identity, family coherence, self-regulation, and optimism had less depressive and anxious symptoms. Predictors of resilience were Optimism, family sense of coherence, ethnic identity, self-regulation, and coping skills. 2 1 3 11 Table 2 (cont’d) 301 Nguyen- Gillham et al. (2009) 15-18 years old; 164 girls, 137 boys 4 5 9 Examined youth’s interpretations and meanings of resilience and challenges faced by youth in the Ramallah area of Palestine. Findings suggest that youth are more complex than the literature leads us to believe as youth often do not speak with one voice, though they may share a common struggle and experience. Expressions of resilience manifest differently among boys and girls. i. ii. iii. Emotional distress and boredom, desperation, dehumanization under occupation, economic strangulation, collaborators creating climate of suspicion and tension, hopelessness and boredom. Boys enjoy a larger degree of freedom than girls. Critiques the distortion “of social suffering of war into individual illness” (p.292). The Israeli military occupation of Palestine is at the root of most of the listed challenges. Palestinian youth are resilient. Normalizing life fostered resilience, optimism, communal care and support, collective resilience, political participation, educational resilience, sumud (withstanding). “the will to survive cannot be extricated from political resistance” (p. 295). Rabaia et al. (2010) 3415 10th- 11th grade Examine how Palestinian youth respond to trauma and violence. The traumatic experiences are more collective than individual. The severity of their trauma was seen as less compared to other Palestinian localities. Resistance and perceptions are fluid, where some days throwing stones was considered resistance, at the same time simply traveling to school through the military checkpoints was also resistance. 4 5 9 Freedom of travel, envy of freedom in other areas of the world. i. ii. Military occupation. iii. Youth categorized themselves as groups, rather than individual. Resistance was central to their lives, resistance included normalizing their contexts and life. 12 Table 2 (cont’d) Glick et al. (2018) 2481 15-24 years old Examines health risk behaviors for Palestinian youth as well as their reflections of the risks and benefits. Additionally, look at the interactions among violence, mental health, and risky behaviors. 2 1 3 i. Risk behaviors: 22.4% males 11.6% females tried alcohol, 10.5% male, 4.3% females tried drugs. A quarter of unmarried youth reported sexual experience. Almost half of males and one fifth of females reported tobacco use. It seems that urban and refugee camp residents are at greatest risk. Interpersonal violence is high as well with around 50% reporting engagement in a physical fight in the last year. ii. Not discussed in depth however, Glick et al (2018) highlighted the location differences in engagement while subtly connecting this to possible economic challenges. Little to no mention of military occupation, political violence, or structural injustice. iii. NA 13 Table 2 (cont’d) Massad et al. (2014) 83 42 male, 41 female; 16-24 years old Focus groups examining sexual risk behaviors of Palestinians in the West Bank in 2012. 2 1 3 i. Participants help perceptions of prevalent sexual activity outside of wedlock. Negative consequences of risky sexual behavior: health problems; social stigma, and disruption to social relationships; and sadness, regret, or mental repercussions. Positive consequences: personal pleasure; novelty; increased status of manhood and masculinity (men only). ii. Reasons to engage in extramarital sex: “to challenge conservative culture, financial constraints, fear of rejection by the family of partner, human need, boredom, curiosity, novelty, for men to prove their manhood, for some girls because of the experience suppression followed by freedom, or blaming family for not keeping an eye on them. “Unemployment, political and economic instability, and exposure to modern media and the internet may counteract the effects of conservative values and contribute to risk behaviors among Palestinian youth” (p.6). iii. NA Massad et al. (2016) 83 42 male, 41 female Examines alcohol and substance use in the West Bank through focus groups and individual interviews. i. Substance use (e.g. alcohol and drugs) and lack of youth-friendly counseling services. 2 1 3 ii. Reasons were fun, curiosity, challenge society, stress, Israeli occupation, inadequate parental control, lack of awareness, unhappiness, curiosity, and for entertainment. iii. NA 14 Table 2 (cont’d) Musmar (2012) 960 Najah Universi ty Student s Examines smoking habits among college students through questionnaire. i. High prevalence of tobacco use, 34.7% total used tobacco (52.7% male, 16.5% female). ii. Reasons for smoking: recreation, proving manhood. iii. NA 2 1 3 Tucktuck et al. (2018) 1891 Five Examines tobacco use among university students in Palestine. 2 1 3 i. Waterpipe Tobacco Smoking and cigarette smoking are of concern. Waterpipe tobacco smoking 24%, cigarettes 18% ii. NA iii. NA universi ties samples with age 20.1 +- 2 years 15 Psychopolitcal Validity Table 2 also includes an assessment of each study’s psyschopolitical validity. Scholars have argued that research in contexts of oppression, violence, and trauma is most ethical when it is conducted in a pscyhopolitically valid manner (Prilleltensky, 2003). For this reason, we examined the degree to which identified each of the studies incorporated components associated with two main types of psychopolitical validity: epistemic and transformative. Epistemic psychopolitical validity examines to the degree to which studies incorporate knowledge from different sources and include experiences and consequences of oppression. Transformative psychopolitical validity focuses on the strategies shared or used with participants to promote liberation (political and psychological) in the personal, relational, and collective spheres (Prilleltensky, 2003). we coded whether the studies had each of the characteristics of psychopolitical validity identified by Prilleltensky (2003). Table 3 describes my approach to coding the psychopolitical validity of each study. Table 3: Psychopolitical Validity Questions Epistemic Question posed by Prilleltensky (2003). Change to Proposed Questions 1. Is there an understanding of the impact of global, political, and economic forces on the issue at hand? 2. Is there an understanding of how global, political, economic forces and social norms influence the perceptions and experiences of individuals and groups affected by the issue at hand? 3. Is there an understanding of how the cognitions, behaviors, experiences, feelings, and perceptions of individuals, groups, and entire communities perpetuate or transform the forces and dynamics affecting the issue at hand? No change. No change. No Change. 16 Table 3 (cont’d) 4. Is there an appreciation of how interactions between political and psychological power at the personal, relational, and collective levels affect the phenomena of interest? No Change. Transformative Question posed by Prilleltensky (2003). Change to Proposed Questions 1. Do interventions promote psychopolitical literacy? Does the research promote psychopolitical literacy? 2. Do interventions educate participants on the timing, components, targets, and dynamics of best strategic actions to overcome oppression? Does the research study educate participants and/or readers on the timing, components, targets, and dynamics of best strategic actions to overcome oppression? 3. Do interventions empower participants to take action to address political inequities and social injustice within their relationships, settings, communities, states, and at the international level? Does the research empower participants to take action to address political inequities and social injustice within their relationships, settings, communities, states, and at the international level? 4. Do interventions promote solidarity and strategic alliances and coalitions with groups facing similar issues? Does the research promote solidarity and strategic alliances and coalitions with groups facing similar issues? 5. Do interventions account for the subjectivity and psychological limitations of the agents of change? Does the research account for the subjectivity, psychological, and physical limitations of the agents of change? In terms of psychopolitical validity, studies tended to fall into one of two groups. The first had a large degree of psychopolitical validity (total of 9 out of 9), the second very little (2-3 out of 9). Studies that scored on the lower end of psychopolitical validity tended to have no to very little discussion of the socio-political realities of military occupation. The connections were not made between the Israeli occupation policies around Palestinian economic development and differing degrees of engagement in risky behavior or varying needs. A substantial gap in the literature is the experience specific to female youth in Palestine, particularly the differing levels of social and personal freedom. 17 METHODS Research Paradigm and Qualitative Approach Theoretically, this research study is framed by Makkawi’s (2009) call for a critical community psychology paradigm in Palestine. Makkawi suggests that this paradigm finds its roots in Latin American social liberation psychology which is guided by six common principles: “(a) acknowledge the sociopolitical nature of traumatic experiences, (b) take a position against repression and state violence, (c) name the source of oppression, (d) assist people in the reconstruction of their lives, (e) rely on community-based approaches for therapy and education, and (f) link therapeutic work with human rights and activism” (Hernandez, 2002, p. 335, as cited in Makkawi, 2009, p.77). In order to practice participatory research without putting the burden of heavy time commitments on participants, we used Graneheim and Lundman’s (2004) pragmatic qualitative data approach. The choice of this approach was guided by two considerations. First, it is a broad pragmatic approach to trustworthy qualitative data analysis. Second, it is appropriate for the abstraction of emergent themes from the comprehensive field notes we collected. The data used were collected in the first and second phase of the Delphi study, which involved qualitative semi-structured interviews of youth service providers in Bethlehem, Palestine. Following analysis, the second phase was sent out as a member- checking process through Qualtrics. The data were collected in Bethlehem, Palestine May - December 2018 (Phase 1) and August-September 2019 (Phase 2). 18 Reflexivity There are over 6 million Palestinians living diaspora, with over 3 million registered as refugees (Palestinian Central Bureau of Statistics [PCBS], 2015a; PCBS, 2015b). As a Palestinian continuing education in the diaspora, we have seven assumptions that influence the way we approach this study. First, Palestinians are subjected to a reality that is predicated on injustice, expulsion, and displacement by the modern Israeli state. Second, Palestinians deserve the right to self-determination. Third, research in Palestine should not be done independently of the struggle for liberation and justice. Fourth, researchers must incorporate a perspective that sees Palestinians as agents for change and resistance. Fifth, researchers must place Palestinians as experts on their experiences, strengths, needs, and paths to freedom. Sixth, male Palestinian voices continue to center maleness as the norm, suggesting that perspectives may not adequately capture the experience of Palestinian women. Seventh, the experience of female Palestinians is positioned between patriarchy, colonialism, and class exploitation (Makkawi & Jaramillo, 2005). Context There are two components of context that are relevant to this study. One is the overall socio-political context faced by Palestinian youth, which we have already described. The next is the context of Bethlehem, the city in which data were collected. In this section, we describe relevant characteristics of Bethlehem, a city in the West Bank region of Palestine with a population of approximately 220,000. Sixteen-thousand residents of Bethlehem live in refugee camps existing within the city. This city has endured Israeli occupation since 1967. At the present time, Israel occupies 87% of historic Bethlehem, and has built 18 illegal Israeli settlements—housing over 130,000 settlers—within this 19 occupied land (Negotiations Affairs Department, 2017). Between 2009 and 2015, over 100 Palestinian structures—such as apartment buildings, schools, or businesses—in Bethlehem have been demolished by the Israeli occupation forces (OCHA, 2015). The Israeli military controls access to Bethlehem and can freeze Palestinian movement at will as a form of collective punishment (e.g. “Israeli Forces set up checkpoints around Bethlehem,” 2017). As of 2017, there were a total of 47 total obstacles to Palestinian movement in Bethlehem, including 17 checkpoints (OCHA, 2017a). The military occupation affects every aspect of life, from economic growth to freedom of travel. Bethlehem has one of the highest unemployment rates in the West Bank at 21% (Negotiation Affairs Department, 2016). More than 150 cultural centers and Non- Governmental Organizations (NGO) are based in Bethlehem in attempts to address the issues facing Bethlehemites (Negotiation Affairs Department, 2017). Sampling The goal of sampling was to recruit experts on Palestinian youth in Bethlehem. We selected the participants for this study using a combination of purposive sampling techniques. These sampling techniques included critical case sampling, emergent sampling based on those critical cases, and chain sampling to expand on the emergent sample (Teddlie & Yu 2007). Recruitment To qualify as an expert, participants had to meet the following criteria: 1) have lived in the Bethlehem area for the past 5 years, and 2) have worked in the realm of youth services in the Bethlehem area for at least two of the past 5 years. we identified ten critical cases who met these expert criteria. we either called or visited these people in person and 20 inquired about their willingness to participate in the study. All ten agreed, and those who were available to be interviewed—after completing an informed consent procedure—were first screened using the inclusion criteria. At the conclusion of each interview, we asked participants if they could identify any other individuals that would meet expert criteria. we contacted each new potential participant and attempted to engage them using the same recruitment procedures as with the initial critical cases. Participants Interviews In the first phase, we compiled 14 interviews with adults who met expert criteria. Twelve experts self-identified as men and 2 self-identified as women. Participants’ ages ranged from 26 to 67 years old (M= 42 years old, SD=11.5), and their experience as a youth service provider ranged from 3 to 40 years (M=16 years of experience, SD= 10.6). Participants experiences as youth service providers included youth organizing, training, workshops, coordination of youth efforts, youth-focused social work, and religiously affiliated youth group facilitation. Member-Checking A total of 10 of the 14 participants from the interview phase participated in a subsequent member-checking phase. Eight participants answered all the member-checking questions. There were two participants that had incomplete responses at this phase. Member-checking participants’ ages ranged from 26 to 67 years of age (M= 42, SD= 12.8), 21 and the number of years as a youth service provider ranged from 3 to 40 (M= 16, SD= 11.8). Eight of the member checking participants identified as men and two identified as women. Ethical Considerations The protocol for this study was reviewed by Michigan State University’s Institutional Review Board and determined exempt under 45 CFR 46.101(b) category 2. In order to be responsive to Palestinian cultural norms emphasizing personal relationships of trust and honor, only verbal informed consent was obtained from all participants (see Appendix A). The requirement to sign a form, particularly one associated with a US institution, can create suspicion as it is atypical and can be perceived as indicating that the person requesting the signature is attempting to have signees release their rights and/or attempting to be released of liability. In the context of Israeli occupation, additional attention was given to maintaining the privacy and security of the data provided by participants. Loss of confidentiality can have significant repercussions for the safety and integrity of participants, the groups that they are affiliated with, and the data that they provide. For example, the Israeli army may arrest or detain participants, raid the groups that they are affiliated with, or confiscate data (“IDF raids Palestinian rights organizations in Ramallah”, 2012; Ahronheim, 2017). Four additional precautions were taken to ensure participants’ confidentiality and privacy. First, participants were contacted and recruited using methods indistinguishable from activities of daily living. Second, participants were interviewed at times and locations of their choosing. Third, no paper consent forms were used. Fourth, researchers recorded 22 data in handwritten field notes until these could be brought to the US and transcribed electronically within a secure environment. Data Collection Methods Interviews Between May and December of 2018, 13 interviews were conducted with 14 participants, as two participants from the same organization opted to be interviewed together. After providing informed consent, participants were interviewed by either the first author or a trained research affiliate, both of whom are fully fluent English/Arabic bilinguals. The interviews were conducted in Arabic, except for one which was conducted in English. Interviewers took field notes in English, which included the recording of pre- established meaning units (i.e., specific needs, strengths, and root causes). Pilot interviews were conducted by the interviewers and discussed in order to increase fidelity of the interview process. Recording of data at the pre-established meaning unit was done to improve the accuracy of the handwritten note in lieu of verbatim audio recordings. Member-checking Member-checking surveys were completed by participants in August and September 2019. We sent the survey to each participant that completed interviews by using an email address that they provided. We contacted participants up to four times to remind them of the survey. One participant’s email was invalid, and we were unable to contact them. Participants could complete the member-checking survey until the end of September, at which point we deactivated the links. 23 Data Collection Instruments and Technologies Interviews All participants opted to be interviewed at their place of employment. At the outset of the interview, inclusion criteria were confirmed, and verbal informed consent taken (see Appendix A). Interviews continued with the collection of background information (i.e., age, gender, years and nature of experience working with youth, email, and phone number). The remainder of the interview followed interview protocol (see Appendix B) guided around the constructs of interest (e.g. strengths, needs, and root causes). Member-checking surveys We used Qualtrics, an online survey service, to develop a survey that presented each of the main findings from the interview and asked participants to indicate which of the findings were true according to their experience and perceptions. The survey also included an open-ended question that allowed participants to provide additional written comments. We generated personalized links for each participant to ensure that we did not continue to contact participants who had already completed the member-checking survey. Data Processing After being securely transferred to the US, handwritten field notes were transcribed electronically. To protect participants anonymity and confidentiality, demographic information and contact information were transcribed into a different database than the qualitative interviews. 24 Quantitative Data Analysis In order to accurately describe the sample, we summarized quantitative demographic indicators using basic descriptive statistics (e.g., means, ranges, standard deviations). we report member-checking data as percentage of participants endorsing each finding. Qualitative I examined the data guided by Graneheim and Lundman’s (2004) four-step qualitative analysis approach. The process of organizing and reorganizing the data was iterative. The first of these steps was conducted during the interviews, where field notes were taken at analytical unit level. The next step included a review of the analytical units and identifying meaning units (i.e. grouping answers discussing similar ideas to form meaning units). Following meaning unit identification, we grouped them into subcategories. For example, political challenges that were directly related to the Israeli military occupation—such as imprisonment of youth by occupation forces—were grouped under the broad category of Israeli military occupation. Following subcategorization, emerging categories were reorganized into more concrete categories (e.g. political challenges). Trustworthiness Trustworthiness is established by ensuring that a qualitative study is credible, dependable, and transferable (Graneheim & Lundman, 2004). Credibility is influenced by 25 participant background. The expert selection criteria were meant to render a credible sample of expert Palestinian youth workers. However, it is important to note that only two of 14 participants were female, suggesting that any findings may not credibly reflect the perspectives of women who provide youth services in Bethlehem. In order to further support credibility, we included member-checking. Dependability is established by using consistent protocols throughout a study, such that their replication could be reasonably expected to render similar results (Graneheim & Lundman, 2004). To establish dependability, each interview was guided by the protocol included in Appendix B. Prior to conducting interviews, each of two interviewers was trained via a pilot training interview, followed by a discussion focused on identifying and addressing any inconsistencies in the application of the interview protocol. To ensure analytical dependability, the main analyst will have regular meetings with his faculty sponsor that focus on fostering careful adherence to the proposed analytical approach. Transferability is the extent to which the findings can be applied to other groups or settings (Graneheim & Lundman, 2004). The research conducted is not intended to be transferred to settings outside of Bethlehem, Palestine. However, findings may have some relevance in other areas of the West Bank but are unlikely to be transferable to the settings in the Gaza Strip or to Palestinians living in Israel as the experience of settler-colonialism is different in those settings. 26 RESULTS Tables 4 through 7 present results based on the themes identified during preliminary interviews. They include the percent of participants that discussed specific themes during preliminary interviews, and the percent of participants that endorsed each theme during member checking. In my written description of results, we focus on items that received at least 50% endorsement from participants in member checking. Strengths and Assets Table 4 summarizes participants’ responses regarding the strengths of, and assets available to, Palestinian youth in Bethlehem. Some of these responses were self- explanatory while others require more careful description. In reporting results, we list the former and go into further detail on the latter. Strengths We categorized participant responses into nine strengths of Palestinian youth in Bethlehem. International relationships, the first of these strengths, describes youths’ tendency toward engaging with cultures and peoples outside of Palestine. For example, through routine contact with international travelers to Bethlehem, youth are exposed to a variety of cultures, and many learn second and third languages. The next strength, resilience, refers to youths’ ability to cope with stress and pressure, and to persevere in the face of challenges (such as those described earlier and those which we will describe later in 27 this section). All member checking participants confirmed that international relationships and resilience were strengths of Palestinian youth. A large majority of member checking participants also endorsed a sense of community, ambition, interest in education, community belongingness, civic participation, and interests in sports as strengths. Civic participation captured participants’ descriptions of youths’ interest in pursuing social justice within their city and region. A little more than half of the participants also endorsed trades skills as an asset of Palestinian youth. Many of these responses were focused on youths’ involvement in the artisanal traditions of Bethlehem, such as traditional wood carving. Assets We categorized participant responses into six assets available to Palestinian youth in Bethlehem. Two of these assets had fewer than 50% member-checking endorsement and will not be discussed. All member-checking respondents endorsed opportunities for cultural and artistic growth as an asset available to youth. As noted in our discussion on strengths, Bethlehem is rich in artistic and cultural traditions, and there are many opportunities for youth to develop related strengths and abilities. International relationships with tourists and other foreigners were also seen as assets that broaden youth experiences. These assets provided the foundation for the international relationships that participants characterized as a strength of Palestinian youth in Bethlehem. 28 Educational institutions, and the opportunities and programs offered within them, were viewed by participants as an asset available to youth. For example, one participant discussed civic engagement opportunities available through schools. Community organizations, such as non-profit community organizations and local municipalities, are also seen as assets for Palestinian youth in Bethlehem. 1 Table 4: Strengths and Assets Category Theme Strengths International Relationships Resilience Sense of community Interest in Education Ambitious Community Belonging Civic Participation Sports Trades Skills Assets Opportunities for cultural and artistic growth International Relationship Education and educational institutions Family Community Organizations Health Number of Sources from Interviews (N=14) Number of Sources from Member Checking 71% 29% 64% 71% 29% 36% 79% 14% 7% 7% 14% 43% 7% 64% 7% N=9 100% 100% 89% 89% 78% 78% 78% 78% 56% N=8 100% 88% 75% 75% 38% 1 Family was a theme that showed up in the interviews from one participant; however, due to a technical error, it was not included in the member-checking process. 29 Needs and Challenges Table 5 summarizes the responses to the question regarding needs and challenges facing Palestinian youth. The table includes the percentage of participants that gave a response during preliminary interviews, followed by the number of participants that confirmed said response in the member-checking survey. There were five broad categories into which we organized the responses: Economic Challenges, Educational Challenges, Personal Challenges, Political Challenges, and Societal Challenges. Economic Challenges We categorized six of the responses as economic challenges. Each of these responses was linked to economic development and opportunity. Although some responses focused broadly on economic deprivation, most were specific. All of the participants involved in member-checking endorsed a desire to immigrate as a result of unemployment or underemployment as a significant need faced by Palestinian youth. Restricted movement was also endorsed as an economic challenge. For example, checkpoints limit youth’s access to jobs, services, and goods. Additionally, most participants endorsed a general lack of investment in youth and their employment. One concrete example of lack of investment was limited basic healthcare. Political Challenges We categorized five responses as linked to political challenges. The most elaborate set of responses related to the Israeli military occupation, which participants identified as a challenge both broadly and in several specific ways. The specific impacts include economic harm, political prisoners, land confiscation, lack of freedom of movement, and physical 30 harm caused by the Israeli military. Participants also identified more abstract ideas relating to the occupation’s effects, such as the lack of justice and freedom. We identified four other political themes within participants' responses. First, participants endorsed issues in the Palestinian Authority as a challenge facing youth. These issues included corruption and a non-functioning government. Second, a general sense of political instability, and an associated sense of insecurity regarding the future. Third, lack of self-determination. Finally, a lack of youth influence within decision making processes. Social Challenges We categorized seven of the responses as social challenges. Each of these responses described a factor linked to social relationships. Some of these were factors that should be removed from society, others were factors that needed to be increased. The factors that should be removed were the imposition of religion and culture, female social repression, distrust due to Palestinian collaborators with the Israeli occupation, and nepotism. The factors that should be increased were social, green, and safe recreational spaces, youth empowerment, and a sense of community and connection. 2 Educational Challenges We categorized four of the responses as educational challenges. However, two of the responses only achieved a 25% endorsement in the member checking therefore we will 2Due to a technical error, youth empowerment was not included in the English version of the member checking survey. 31 not be addressing those. Both responses describe shortcomings of the educational institutions. First, it is not strategically tied to the opportunities available on the job market. Second, the educational system lacked critical thinking training. Individual Challenges We categorized seven of the responses as individual challenges. However, three of the responses only achieved a 25% endorsement in the member checking phase, therefore, we will not address them. Each of these responses described needs as experienced by persons separately from the collective. Although these responses have parallels in the economic, political, and social categories, the current category captures experiences at the individual level. Participants endorsed the broad themes of the need for freedom of expression, safety, and for their basic needs to be met. Finally, participants endorsed psychological experiences such as boredom, depression, and emotional distress as a difficulty facing Palestinian youth in Bethlehem. Table 5: Needs and Challenges Facing Palestinian Youth Category Theme. Sub-Theme. Economic Challenges Economic Deprivation Unemployment Underemployment Desire to Immigrate Restricted Movement Lack of Investment in Youth Development 32 Number of Sources from Interviews (N=14) Number of Sources from Member Checking (N=8) 14% 93% 36% 21% 43% 36% 75% 88% 75% 100% 88% 88% Table 5 (cont’d) Limited Access to Healthcare Political Challenges The Israeli Military Occupation Economic Harm from Occupation Political Prisoners Land Confiscation No Freedom of Movement Physical Harm from Israeli Military Forces Justice Freedom Issues in Palestinian Authority (PA) Government 36% 21% 7% 21% 14% 14% 7% 14% 29% 36% Political Instability Relating to Lack of Security in The Future 7% Lack of Self-Determination Youth Lack Representation in Political Systems or Decision Making Social Challenges Distrust Due to Palestinian Collaborators with The Israeli Occupation Need for Social, Green, Safe, Recreational Spaces Female Social Repression as A Challenge Relationships Over Knowledge and Experience Culture/Religion Imposed Through A Close-Minded Upbringing Need for Community and Connection Need for Youth Empowerment Educational Challenges Education Not Tied to Employment Opportunities Lack of Critical Thinking Training Interpersonal Relationships Distracting from Education Low Quality Educational System Individual Challenges 33 7% 14% 7% 36% 14% 7% 29% 36% 14% 14% 36% 7% 50% 63% 88% 88% 63% 88% 88% 63% 75% 88% 88% 75% 63% 50% 88% 88% 63% 75% 63% 50% 50% 63% 63% 25% 25% Table 5 (cont’d) Freedom of Expression (Youth Need A Space to Vent and Express Themselves) Basic Needs Must Be Met Safety (Need to Feel Safe, Youth Feel Unsafe at Home, Economically, Etc.) Psychological Distress (Boredom, Exhaustion, Helplessness, Depression, Emotional Distress, Etc.) Disinterest in Volunteer Work Media Consumption (Inability to Consume Media Critically) Spiritual Development (Need Centers for Spiritual Growth, And Spiritual Connection to God). 21% 14% 14% 71% 7% 7% 7% 63% 50% 63% 50% 25% 25% 25% Root Causes of Needs and Challenges Facing Palestinian Youth Table 6 summarizes the responses to the question regarding the root causes of needs and challenges facing Palestinian youth. The table includes the percentage of participants that gave a response during preliminary interviews, followed by the number of participants that confirmed those responses in the member-checking survey. There were six broad categories into which we organized the responses: economic, educational, personal, political, and social challenges. Most categories were broadly endorsed as a root cause to the needs and challenges identified by participants. Social challenges received less than 50% endorsement in the member-checking process and will not be addressed here. First, the economic reality in Bethlehem was identified as a root cause to needs and challenges faced by Palestinian youth. This broad category is described as the lack of work, unequal distribution of ministry funding, income inequality, and elitism. Second, oppressive social norms and patriarchy. Third, personal challenges such as depression, hopelessness, and shifting 34 values. Fourth, educational shortcomings, with specific commentary on the inadequate critical thinking training. Fifth, political realities as a root cause was the most endorsed category. The political reality consisted of the Israeli military occupation of Palestine, socio- political economic instability, and issues with the Palestinian Authority government. One hundred percent of participants in member checking endorsed this as a root cause for challenges and needs faced by Palestinian youth in Bethlehem. The occupation is characterized by lack of freedom, sieges, and economic strangulation by the occupation. Participants endorsed a general theme of socio-political-economic destabilization as a root cause. Specifically, Palestinian Authority government issues such as corruption, poor government policies, and unequal budgets were endorsed as root causes to Palestinian youth challenges in Bethlehem. Table 6: Root Causes of Needs and Challenges Facing Palestinian Youth Category Theme Sub-theme Number of Sources from Interviews (N=14) Number of Sources from Member Checking (N=8) Economic (no work, ministry funding, income inequality, elitism in Palestine) Oppressive Social Norms and Patriarchy (social limits and patriarchal system) Personal (depression, no hope, shifting values) Educational (Education not focused on critical thinking) Political Israeli Military Occupation (lack of freedom, economic strangulation by occupation, sieges and strikes) Socio-economic political destabilization Issues with Government (poor government policies, unequal budget, corruption) Social (Bullying) 21% 14% 21% 7% 93% 14% 36% 7% 88% 75% 63% 50% 100% 88% 88% 38% 35 Gendered Challenges Facing Palestinian Youth in Bethlehem Table 7 summarizes the responses to the question regarding gendered challenges facing Palestinian youth in Bethlehem. There were three broad categories into which we organized the responses: Patriarchal social norms, male socio-economic burden, and gender equality in Bethlehem. One theme and one sub-theme achieved less than 50% endorsement and will not be discussed here. Patriarchal social norms as a general example of gendered challenges achieved 100% endorsement in member checking. Participants provided several specific manifestations of the patriarchal social norms, including male privilege, the exclusion of women from decision making, and labor discrimination of women. The second category involved participants’ discussion and endorsement of gendered expectations regarding economic and political participation, which tend to place men in the position of being more likely to participate in both realms. One nuance of this gendered expectation is that young men are perceived to be more likely to be targeted by occupation forces. Table 7: Challenges Influenced By Gender Identity Theme Sub-theme Number of Sources from Interviews (N=14) Number of Sources from Member Checking (N=8) Patriarchal Social Norms: Women Face Repressed Social Freedom, Difficulty Being Accepted in Workforce Exclusion of Women from Decision Making Male Privilege, More Social Freedom and Access to Resources Labor Discrimination: Fewer Women in Workforce, Limited Opportunities for Women, Highest Educational Attainment but Least Employed. 92% 14% 14% 50% 100% 100% 88% 50% 36 Table 7 (cont’d) Educational Discrimination by Reserving Money for Expenses of Male Children’s Education Men Carry Economic Responsibility and Are More Targeted by Occupation Equality Exists in Bethlehem 21% 36% 14% 25% 88% 38% Analytical Categories Five concrete analytical categories that transcend the specific questions of needs, challenges, or root causes emerged in our analysis: educational, societal, economic, political, and individual effects. We note that the last of these categories represents person- level effects of the four previous ones, and that all of these categories are linked, often through their relation to political or cultural phenomena. For example, educational challenges are related to politics through the Israeli military occupation. For instance, during the First Intifada in 1987, an Israeli military decree mandated all Palestinian educational institutions be closed until further notice, with some universities remaining closed more than four years (Birzeit University, n.d.; Hussein, 2005). Since then, Palestinian university students are often targeted by Israeli forces (“Israeli forces injure dozen, raid university in Abu Dis”, 2018; Fulbright, 2018). Additionally, close to 40% of the male Palestinian population has been detained by Israel, including children (Negotiation Affairs Department, 2018). We discuss these analytical categories in dedicated subsections. Education Participants offered a nuanced perspective on education in Bethlehem. Although they identified key strengths and assets related to education, they also raised specific limitations to the existing education system. Participants identified youth’s interest in 37 education as a strength and pointed to specific educational institutions as assets. That said, participants also reported that the education system’s lack of training in critical thinking was a challenge and a root cause of many of the other challenges. Participants critiqued the education system for not strategically connecting to employment opportunities in Palestine. Participants identification of labor discrimination against women, despite the reality that they have the highest educational attainment in Palestine, powerfully highlights the intersection of education, societal factors, and economics. Societal Like education, the societal analytic category offers several strengths and assets that were also balanced by elements that are problematic. Societal strengths included youth participation in the traditional artisanal trades (e.g., wood carving), the importance of family structure, and international relationships. The latter of these results from Bethlehem being an international destination for the Abrahamic faith traditions of Christianity, Judaism, and Islam. Although there are strengths and positive aspects of society, there are some problematic social norms and challenges that participants identified such as female social repression, nepotism, imposition of religion and culture, and distrust due to Palestinian collaborators. Additionally, participants identified societal needs such as the need for social, green, and safe recreational spaces, youth empowerment, and community. Root causes that fit within the societal analytic category were oppressive social norms and patriarchy. This offers a complex examination of the societal analytic category in ways that complicate the relationship between strengths and challenges such as the importance of family structure while at the same time having nepotism as societal challenge. 38 Economics In contrast to education and culture, economic issues were typically discussed as challenges and root causes. Youth’s desire to emigrate was the only economic challenge that achieved 100% endorsement from member-checking participants. This relates to underemployment and unemployment, in that the desire to emigrate was partially due to lack of opportunities in Palestine or Bethlehem. While the restrictions on freedom of movement also added to economic deprivation, participants described much of the economic deprivation as tied to the Israeli military occupation. The economic deprivation facing Bethlehem and Palestine generally, can be tied to the political realities, which may then negatively impact funding available for other systems such as healthcare and education. Politics Although there was some discussion of political strengths, participants disproportionately identified political related items as challenges and root causes. The Israeli military occupation was the most extensive issue and root cause. The Palestinian Authority was mentioned, but depth and focus seemed to be on the military occupation, even when considering strengths, they were strengths in response to the political needs. Participants identified resilience and civic participation as strengths of youth in Bethlehem. Resilience is classified as political, as youth were identified as resilient in the face of economic deprivation and direct oppression. Participants identified challenges and needs that range from lack of youth representation in the government to many issues relating to or caused by the Israeli military occupation of Palestine. Although participants identified 39 the problems in the PA government as a challenge, the challenges identified as part of the military occupation were more prevalent. When identifying root causes, the Israeli military occupation was the only item that achieved 100% endorsement. More discussion on how this specific analytic category transcends other categories will follow in the discussion. Individual We have classified the individual category as the manifestation of the other four categories of challenges and needs in the individual. For example, the psychological expressions of boredom, exhaustion, helplessness, and depression can be viewed as the result of the abnormal political, social, economic, and educational reality. Boredom may be influenced by the restrictions on travel, strangulation of the economy, and lack of opportunities as identified by participants during interviews. The interweaving of the various analytical categories provides a holistic approach to improving Palestinian quality of life and addressing issues facing youth in Bethlehem. 40 DISCUSSION In this study, we sought to identify and document strengths, needs, and root causes among Bethlehemite youth according to youth service providers. Our findings suggest a complex reality among youth in Bethlehem where agentic and capable young people endure political and cultural oppression. We identified five domains within which strengths, needs, and root causes are concentrated: the individual, educational, economic, societal, and political. Although some readers may argue that such a holistic understanding of Palestinian youth is intuitive, it is an understanding that is infrequently incorporated by researchers who study Palestinian youth. Most researchers have focused on needs and challenges in the individual domain such as substance use, extramarital sex, and interpersonal violence (Musmar 2012; Massad et. al., 2014; Massad et. al., 2016; Aitcheson et. al., 2017; Glick et. al., 2018; Tucktuck et. al., 2018). We also note that the participants in our study tended to emphasize factors within the societal, political, or economic domains more often than factors within the individual domain. For instance, fewer than 65% of participants confirmed that psychological distress, freedom of expression, and need for safety—individual-level needs—were a challenge for Palestinian youth. As a comparison, more than 85% of participants agreed that the desire to emigrate, restricted movement, unemployment, and the Israeli military occupation—economically and politically driven needs—were a challenge. One implication of this pattern of emphasis on higher level domains is that, by focusing on the individual domain, researchers may be forgoing attention to domains that have more salience for Bethlehemite youth. 41 Implications for Research The findings from our study can support researchers who wish to use psychopolitically valid approaches to study Palestinian youth. As we noted in our introduction to this paper, there are two components to psychopolitical validity: epistemic and transformative. Briefly, epistemic validity refers to the extent that various forms of knowledge such as the consequences of oppressive systems are included in the study. Transformative validity refers to the strategies utilized with participants in pursuit of the dismantling of oppressive systems towards political and psychological liberation at the collective, relational, and personal levels (Prilleltensky, 2003). By situating their phenomena of interest within the domains identified in our study, researchers can further the epistemic validity of their projects focused on Palestinian youth. For example, researchers interested in psychological distress among Palestinian youth should consider the educational, political, societal, and economic contexts within which this distress occurs. Correctly understanding individual-level phenomena in the context of economic need, educational uncertainties, political oppression, and violence requires fundamentally different approaches than those used in contexts that do not include these realities (Nguyen et al., 2008). For example, although the pursuit of well-being and justice are not mutually exclusive (Nguyen et al., 2008), attempts to address these individual-level needs without addressing their higher-level contexts and facilitators are likely to have limited long-term effects (Shah, 2015). For example, Shah (2015) notes the short-lived success of a large-scale school-based intervention to decrease psychological symptoms of trauma that was delivered in the Gaza Strip. Despite promising early success, this intervention was obviated by Protective Edge, an Israeli military operation that destroyed or damaged 42 countless schools, displaced half a million Palestinians, and resulted in the deaths of more than 500 children (Shah, 2015). This example illustrates that advancing individually focused interventions without also considering the higher order factors that drive these individual needs may have limited impact among Palestinian Youth. Implications for Practice Our documentation of some consensus among youth service providers’ around a holistic understanding of the experiences of Bethlehemite youth findings can—in turn— inform the work of these practitioners. Practitioners may be willing to consider modifications that leverage existing—but previously unaccounted for—strengths and assets in order to address both youths’ individual-level needs and the root causes of these needs. One example of grass roots organizing that accounts for Palestinian strengths and assets while directly targeting higher-level root causes is the Boycott, Divestment and Sanctions movement, which attempts to leverage international relationships in pursuit of nonviolent political and economic action to pressure Israel and its allies into compliance with international law (Weizman, 2017). For example, through boycott, divestment, and sanctions, Palestinians and their international allies were able to improve the lived experiences of youth by forcing the withdrawal of G4S, the world’s largest transnational security company, from most of its illegal business in Israel (Palestine BDS National Committee, 2016). G4S provided “equipment and services to Israeli military checkpoints, illegal settlements and to military and police facilities” (Palestine BDS National Committee, 2016, para. 8). Although G4S’ departure does not equate to the dismantling of checkpoints and prisons, it does return Israel to a position of direct responsibility for any human rights violations that occupying forces commit against youth or their families. 43 We acknowledge that many of the factors identified in this study, such as Israeli restrictions on Palestinian movement, are difficult to address and, in some cases, have grown in magnitude. For example, whereas in July 2010 there were 503 obstacles to Palestinian movement in the West Bank, by the end of 2016 there were 572 (OCHA, 2011; OCHA, 2017). The current intractability of solutions to some of the root causes of individual-level needs underscores both the challenges to addressing root causes, and the current value of ongoing efforts to address individual-level needs. For this reason, practitioners’ individual-level services and support are valuable; however, these services may be most effective and sustainable when they do not lose sight of the sociopolitical root causes of individual needs, which require collective political and social engagement. In the long term, the health and wellbeing of Palestinian youth is best fostered by collective and transformative change to dismantle oppressive systems. Implications for Policy Although our findings may have policy implications for Palestinian (e.g. Ministry of Education) and international institutions (e.g. United States Agency for International Development) who are vested in the wellbeing of Bethlehemite youth, a full accounting of these is beyond the scope of this paper.3 Our findings do seem to suggest that these institutions’ policy efforts should be strategic in providing relief for immediate needs while building upon a strategy to support the end of the military occupation and the elimination of oppressive social norms. We encourage scholars with interests in these areas to focus 3 Palestinian civil organizations rely heavily international organizations to support their work. Civil organizations whose primary focus is youth--which are the most numerous among such organizations--receive almost 60% of their revenue from international funders (Devoir & Tartir, 2009). 44 their future research on internal policy and funding directives from the Palestinian authority, Israeli policy as it relates to the occupying state’s responsibilities towards the occupied, and international funding agencies with an interest in the wellbeing of Palestinian youth. Researchers should build upon a literature that can inform funding directives and provide more attention to the strengths, challenges, and root causes facing Palestinian youth. Limitations We recognize several limitations to this study that should be addressed in future research. First, the results are not meant to be generalized out of the context and period in which the data were collected. Although results may be helpful in other cities in the West Bank like Nablus or Ramallah, we expect that they would not be very helpful in the Gaza Strip as the lived realities in the Gaza strip are starkly different. For example, Palestinians in the West Bank live under policies that restrict their freedom of movement, making it difficult to travel, while the Gaza Strip has been under a siege making it close to impossible to travel out of Gaza (OCHA, 2018; OCHA, 2020). Second, there is an inadequate representation of Palestinian female youth workers’ perspectives. Only two of the participants in our study were female youth service providers. Although the experience with patriarchy is universal, the specific manifestations can be unique to context (Rought-Brooks, Duaibis, & Hussein, 2010; Jamal, 2001; Shalhoub- Kevorkian, 2008). Our findings show that 100% of participants endorsed that women were excluded from decision making and that patriarchal social norms were a gendered challenge. In the future, researchers should more intentionally seek out female youth 45 service providers and participants through methods that contribute to the struggle for gender justice and encourage the development of critical reflection and action. Additionally, the gender identities of researchers may influence the depth of the discussion on gendered challenges. Third, we acknowledge the expertise and experience of the youth-service providers; however, we also realize the impossibility of gathering a unified voice when it comes to youth in Palestine. The perspectives of youth-service providers may be different to those of youth. Future studies can address this gap by engaging directly with youth, ideally through participatory methods. Finally, the decision to code data through field notes—while justified in the context of a study where identifying information, such as recordings, could have meaningful risks for participants—may have prevented the adequate capture of important nuance (Bertrand, Brown, & Ward, 1992; Kieren & Munro, 1985). In the future, researchers may weigh the risks and benefits of recording, if benefits outweigh the risks, they may decide to move forward with voice recording. 46 CONCLUSIONS Although youth make up a large and active portion of Palestinian society, they are often portrayed as passive victims of economic and political oppression during occupation. Our findings support a more nuanced and complex view of these youth. According to experienced adult providers of youth services and supports in Bethlehem, Palestinian youth make agentic decisions within the confines of lives influenced by military occupation and patriarchal social norms. Youth service providers perceive social, economic, and political forces as having the most impact on these youth, and in most cases see youths’ individual needs as reflecting the personal effects of these broader forces. Our findings have direct implications for researchers and practitioners focused on the lives of Bethlehemite youth. For researchers, they provide information needed to engage in psycholopolitically valid research that adequately contextualizes the lived experiences of these youth and that supports youth in developing the skills to address the existing social, political, and economic oppression that they face. For practitioners, our findings provide information that may be useful in crafting strategic and coordinated responses to the needs of the youth whom they serve. 47 APPENDICES 48 APPENDIX A: Verbal Informed Consent Guidelines Thank Participant Remind them who you are and why you are there Inform participant know you’d like to quickly remind them of your project before you proceed, just to give them the opportunity to ask any questions and be clear. Inform participant that they can ask for clarification at any time. (Overview) Inform Participants: That you hope to document adult experts' consensus opinions on the strengths, assets, needs, challenges, and roots of the issues faced by Palestinian youth in the Bethlehem area. That for your study an expert is an adult whose primary work responsibility have included providing services or supports for Palestinian youth for at least 2 out of the past 6 years. Confirm that participant meets criteria § If not, explain that you cannot continue the interview and thank them for their time. § If participants do, continue with the informed consent That participation will involve: A 30-60-minute semi-structured interview that will occur today. Review of a summary of findings after you’ve conducted all interviews. Completion of a survey that will ask participants to prioritize findings from the interview. (Risks) That you know of no risks to participating in this research. (Confidentiality) That you will keep all information that they provide, including their decision to participate, confidential. Clarify that this includes from the staff at the Wi’am Center (who will not know whether they participated or what they said) That results/findings will be reported and discussed in aggregate. 49 (Compensation) That, while you will share study results with all participants, no compensation for involvement in this study will be provided. That participation will have no bearing on their ability to receive any services or supports. Clarify that this includes services and supports provided by the Wi’am Center (who will not know whether they participated or what they said) (Rights to Withdraw Consent) That they may withdraw consent at any time and for any reason. (Contact Information) Provide your university contact information (e-mail). (Questions) Ask participants if they have any questions about their involvement Answer any questions participants may have (Consent) Ask participants if—having heard this information—they would like to participate. If not, explain that you cannot continue the interview and thank them for their time. If participants do, conduct semi-structured interview. 50 APPENDIX B: Delphi Study Interview Protocol Strengths 1. Strengths of youth might be the increased interest in education, or community engagement. Could you tell me about Palestinian youth strengths? 2. Where do the strengths come from? Assets 3. Assets may be money, organizations, healthcare, jobs, property, or support. What are some assets of or available to Palestinian youth? Challenges 4. Challenges can be anything like lack of access to education, health issues, violence, social injustice. What are the important challenges faced by Palestinian youth? 5. What role does gender play on the types of challenges facing the youth? 6. Could you tell me about some of the challenges that have come up as you have worked with youth? Hope 7. What is the role of hope in the youth’s lives? Needs 8. Needs can be tangible or intangible like money, jobs, freedom, or hope. What are the needs of the youth in Palestine? 9. What causes these needs? What would be helpful in meeting those needs? Solutions/Actions 10. What are actions that would be helpful in meeting the needs of youth and increasing their assets and strengths? 11. What is youth’s role in the socio-economic life in Palestine? How are they viewed? 12. Are there partnerships with other organizations to work around youth issues and strengths? Snowball Sampling 13. Who are some other people/organizations you would suggest we speak to in order to learn more about these things? 51 REFERENCES 52 REFERENCES Abusalem, J. (May, 2018). What is the Great March of Return? Retrieved from https://www.afsc.org/blogs/news-and-commentary/what-is-great-return-march Addameer Prisoners Support and Human Rights Association. (2010). The Right of Child Prisoners to Education. Ramallah, Palestine. Ahronheim, A. (2017). IDF Raids Palestinian Media Outlets Suspected of Incitement. The Jerusalem Post. Aitcheson, R. J., Abu-Bader, S. H., Howell, M. K., Khalil, D., & Elbedour, S. (2017). “Resilience in Palestinian adolescents living in Gaza”: Correction to Aitcheson et al. (2016). 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