[1] In the 1970s, she refocused her work towards documentary photography, adopting a politicized approach to her art form, with socialist and feminist themes revisited throughout her career.

She gained a first class Honours Degree and moved on from her previous notions of photography, taking greater account of visual semiotics manifested in the medium.

[6] In a companion piece for Beyond the Family Album, Public Images, Private Conventions she wrote on how she wished to "question [...] who represents who in society, how they do it and for what purpose.

[9] It was through experiencing the effectiveness of using photography in confronting and documenting her hospitalisation and illness that Spence, with Rosy Martin, developed 'photo therapy' in which the subject was empowered to control their image to discover and represent unexpressed or repressed feelings and ideas.

[citation needed] Alongside her photography, Spence maintained a career as an educator, writer, and broadcaster and undertook a three-month tour with her work to Australia,[11][12] Canada, and the United States before discovering that she had leukemia from which she later died in London in June 1992, shortly after a civil marriage in May formalising her partnership with David Roberts.