Dissertations / Theses: 'Health, Clinical and Counselling Psychology'

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Davison, Elizabeth. "The wounded healer : clinical and counselling psychologists with experience of mental health problems." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12535/.

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This study aimed to explore how the experience of previous mental-health problems affects clinical and counselling psychologists’ approach to practice. Semi-structured interviews were conducted with six clinical and four counselling psychologists who had experienced mental-health difficulties. Data was analysed using Interpretative Phenomenological Analysis. Analysis of the interviews highlighted five master themes: Use of the personal-self of psychologist; Ambivalence; Identity as a psychologist; Psychologists as agent of change; and Finding meaning in suffering. The results of this research showed that psychologists with a history of mental-health problems actively draw upon their experience. In managing their dual identity of service-user and professional, they reported a degree of ambivalence which influenced the way that they viewed themselves and their practice. Their personal experiences seemed to be closely tied up with their professional-identity, which either conflicted with their sense of self or complemented it through highlighting how fortunate they were compared to others. The interviews frequently highlighted how psychologists’ experiences can provide an impetus to speak out for patients’ rights to ensure that they are treated with respect and dignity. A number of psychologists with an experience of mental-health difficulties felt that they might not have pursued their career had they not had previous mental-health difficulties. There appeared to be mixed findings concerning whether the participants felt that their mental-health difficulties had helped or hindered their practice.

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Campbell, Tomas. "Reasons for HIV testing in a heterosexual sample : the role played by affective factors and constructs from the health belief model." Thesis, University of Surrey, 1997. http://epubs.surrey.ac.uk/618/.

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Hauraki, Jennifer. "A model minority?: Chinese youth and mental health services in New Zealand." Thesis, University of Auckland, 2005. http://hdl.handle.net/2292/1876.

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The 'model minority' label given to Chinese populations in New Zealand and other Western countries have made it difficult to truly comprehend the difficulties faced by some Chinese ethnic minorities. Despite comparable rates and types of mental health problems to their European counterparts, identifiable barriers have led to Chinese ethnic minorities underutilising mental health services. The present study investigated the mental health service utilisation in native- and foreign-born Chinese youth in New Zealand, paying particular attention to barriers to service utilisation and viable solutions for these difficulties. It consisted of three individual projects and explored the views of Chinese community and mental health professionals and Chinese university students, comparing their perspectives to university students of other ethnicities. Findings showed that despite a willingness to seek help from their family and mental health professionals (e.g., psychologists, school counsellors), respondents identified a myriad of obstacles to the help seeking of Chinese youth. These included physical barriers (e.g., financial and transport constraints), personal barriers (e.g., stigma, problems accepting their difficulties), service barriers (e.g., paucity of knowledge regarding mental health problems and available services) and family barriers (e.g., obstruction from family members). Family and service barriers distinguished the difficulties faced by Chinese in comparison to European youth, particularly with regards to the adherence of professionals to stereotypes of Chinese youth, a unique finding of this study. In order to reduce such barriers, the Chinese university students and professionals advocated for greater education regarding mental health problems and services in the Chinese community, education for Chinese parents regarding adolescent issues, an increase in the number of practicing Chinese professionals that is coupled with improved cross-cultural training for non-Chinese professionals, as well as individual assessment and treatment approaches with Chinese youth and their families.
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Van, Wyk Sherine. "Locating a counselling internship within a community setting." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/49732.

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Thesis (MA) -- University of Stellenbosch, 2002.
ENGLISH ABSTRACT: no abstract available
AFRIKAANSE OPSOMMING: Hierdie navorsing ondersoek die behoefte van Sielkunde as professie om meer sosiaal relevante en gepaste dienste vir al die mense van Suid-Afrika te lewer. Dit bespreek die kritiek teen tradisionele sielkunde en die dringende behoefte vir 'n meer kontekstuele benadering om the negatiewe sielkundige verskynsels in the samelewing te begryp en verklaar. Die waarde van Gemeenskapsielkunde om voorkomende, kuratiewe en bevorderende geestesgesondheidsdienste aan gemeenskappe te lewer, word ook ondersoek. Verskeie modelle van gemeenskapsielkunde en die voorgestelde integrasie van geestesgesondheidsdienste by Primere Gesondheid word bespreek. Die plasing van 'n voorligtingsielkunde internskap binne 'n gemeenskapsomgewing, naamlik, die Don en Pat Bilton Kliniek, Jamestown, word beskryf en qeevalueer.

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Raphela, Ramadimetja Elsie. "Training of health care workers in adherence counselling for comprehensive care, management and treatment clinics." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6858.

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Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011.
ENGLISH ABSTRACT: “Treatment failure, defaulter rate, patients lost to follow up”. These are the words usually spoken by health care workers at the CCMT clinics in the country. These are words that they try at all times to come with solutions to, without much success. Much as both the health care workers and patients know the importance of taking medication, often medication is not taken as required. Adherence is defined as the degree to which a patient follows a treatment regimen which has been designed in the context of a consultative partnership between the client and the health care worker. This obligation is comprehensive as it tends to examine all factors that can affect adherence. It includes characteristics such as the treatment regimen, the provider behaviour, social and environmental factors that may hinder adherence on the patient. There are several factors that lead to non-adherence to treatment. The factors may be classified as Biomedical, Psychological and Social factors. The major tool that can be used to address such issues is adequate training of all staff members working at the CCMT clinics. The researcher explored training needs and gaps at a CCMT site that will assist to combat problems of non-adherence to treatment. Health care works at an identified site where questioned on the level of training they have received and on what they need to improve their management of patients and adherence. It was realised that some categories of staff at the clinic do not receive training as expected and that others do not receive adequate training that will assist them in adherence counselling. Recommendations made by staff members were that training should be readily available to all staff members and that it should also be rolled out to other departments and sections within the hospital so there is continuum of care of HIV positive patients. Non adherence to antiretroviral treatment is a challenge faced by health care providers as well as patients themselves. It results in treatment failure, a decrease in the quality of life of the patient and an increase in morbidity and mobility. Non-adherence means any reason where the patient is not taking recommended doses, not sticking to the recommended time or not taking it in the recommended way.
AFRIKAANSE OPSOMMING: Navolging word gedefinieer as die mate waarop die pasiënt die behandeling wat voorgeskryf is in samewerking tussen die pasiënt en die gesondheidsorgwerker, nakom. Hierdie vepligting is omvattend omdat dit geneig is om alle faktore wat die nakoming kan beinvloed, ondersoek. Dit sluit eienskappe in soos die behandeling regimen, die verskaffersgedrag, sosiale en omgewingsfaktore wat ‘n struikelblok kan wees vir die nakoming van die pasiënt. Daar is verskeie faktore wat kan lei tot nie-nakoming van behandeling. Die faktore kan geklassifiseer word as bio-mediese, sielkundige en sosiale faktore. Die belangrike instrument wat gebruik word om sulke sake aan te spreek, is voldoende opleiding van alle personeellede wat by CCMT klinieke werk. Die navorser ondersoek opvoedkundige behoeftes en leemtes by ‘n CCMT perseel, wat sal help om probleme van nie-nakoming van behandeling sal bestry. Gesondheidsorgwerkers by ‘n geïdentifiseerde perseel, was ondervra oor die vlak van opleiding wat hulle ontvang het en wat hulle nodig het vir beter bestuur van pasiënte en nakoming van behandeling deur pasiënte. Daar is gevind dat sommige kategorieë van personeel by die klinkiek nie die opleiding ontvang het wat nodig is nie en dat ander personeellede nie voldoende opleiding ontvang het wat hulle sal help met nakoming van berading nie. Personeellede het aanbeveel dat opleiding geredelik beskikbaar gemaak moet word aan alle personneel en dat dit na ander departemente en afdelings binne die hospitaal uitgebrei moet word om die voortsetting van sorg vir MIV/VIGS-positiewe pasiënte te verseker. Nie-nakoming van antiretrovirale behandeling is ‘n uitdaging vir beide gesondheidsorgwerkers en pasiënte. Dit lei tot die mislukking van behandeling, ‘n afname in die kwaliteit van die pasiënt se lewe en ‘n verhoging in morbiditeit en mobiliteit.

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Woodfield, Melanie Joslyn. "Exploring the relationship between family involvement and outcome in residential interventions for children." Thesis, University of Auckland, 2005. http://hdl.handle.net/2292/3193.

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Family participation in residential interventions for children has been reliably shown to enhance children’s adaptation to the community following discharge. This finding, however, had predominantly been observed in long-term residential programmes in North America. This thesis examines the influence of family involvement on outcome for children in a short-term residential intervention - the Children’s Health Camp, in Auckland, New Zealand. This service offers children and families, who may be experiencing social, emotional, physical and/or behavioural challenges, individualised interventions that often include a five-week residential stay. A ‘high family involvement’ condition, a community-based programme that followed a residential intervention, was compared with a ‘low family involvement’ condition (the traditional residential programme). No statistically significant differences were observed between the groups on parent-report measures of child behaviour and parenting practices, although significant improvements in children’s behaviour (including emotional, social and conduct aspects) for both groups were found. Reasons for the lack of difference between the groups, and the difficulties inherent in conducting outcome research in a residential facility for children are highlighted. Other influences on outcome for children and families, such as residential staff members’ attitudes toward family involvement were also examined. The optimal conditions for successful short-term residential interventions for children are proposed.

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Pack, Sylvia. "New Zealand counsellors talk about ritual abuse: A discourse analysis." Massey University, 2009. http://hdl.handle.net/10179/1098.

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Research indicates that in the last five decades, claims of Satanic ritual abuse (RA), and the numbers of clients receiving counselling for RA, have increased in all Western countries. This has resulted in an increased corpus of related literature overseas, which includes studies in which facticity as well as aetiology, symptomology and treatment are debated. This present study focuses on a New Zealand context, and examines the talk of New Zealand counsellors in relation to their views regarding RA and the counselling of RA clients. Social constructionist and positivist epistemologies were evaluated in terms of their suitability for this research, and the discourse analytic method developed by Potter and Wetherell (1987) chosen as the means by which participants’ talk might be analysed in such a way as to allow the inclusion of multiple constructions and the emergence of the many discourses and conflicting ideas which occur in overseas literature. A broad selection of the literature was first critically analysed to give an understanding of the topic. Nine counsellors gave interviews, eight women and one man, all Pakeha, six of whom were ACC-registered (Accident Compensation Commission, 2009). The participants constructed RA as a physical reality, which was justified by the use of the credible client discourse. A traditional linguistic repertoire furnished a discourse of government backing, which was employed to warrant voice. A moral stake in counselling, named concern for the client, was shown to be present in all arguments. The participants constructed three truths relative to context: a legal truth, the counsellor’s truth, and the client’s truth. Recovered memories were given a dual construction which legitimised correct and incorrect recall. DSM-IV (American Psychiatric Association, 2000) labelling was debated in a discourse of ambivalence. Finally in a discourse of preparedness, the participants constructed the therapeutic skills needed to treat RA clients. The thesis concludes by highlighting the participants’ comments regarding the need for openness and awareness, and specialised literature and training for counsellors treating RA clients.

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Mace, Janet-Lee. "An inquiry into the meaning of Guillain-Barré syndrome : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts." Massey University, 2001. http://hdl.handle.net/10179/1180.

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Guillain-Barré Syndrome (GBS) is an autoimmune syndrome characterized by a severe and rapid onset of paralysis that ascends without warning. It has an unknown aetiology and is generally unknown by most people, including medical professionals. When a person who has had GBS is asked to speak about their experience, they are likely to talk about aspects of it that are personally meaningful. Their account can be likened to a story in that it collates seemingly unconnected facts, episodes of activity and emotional attributions into a sequence that provides knowledge and understanding. A story is a powerful form for expressing suffering and experiences and so is particularly suitable for the study of trauma and illness. The actual process of creating the story, plus its presentational and organisational forms, provides sources for uncovering the identities authors choose to create and present of themselves. Six people who have had GBS were interviewed about their experience, and their stories were analysed using a narrative inquiry to discern the meanings attributed to GBS from the participants’ own understandings and perspectives. The intended focus of the research was holistic and content based. The result of the narrative inquiry was a plot common to all six narratives. Namely, GBS is an inexplicable condition, during which horrendous things happen, but people do recover with time and it is likely their life view will be changed in the process. Four fundamental issues, identity, meaning, making sense and meaningfulness were drawn from the stories and configured into a narrative of the researcher’s making. What the participants chose to speak about became the meanings, or themes, major and minor, of their stories. No event has meaning in itself, however traumatic events can precipitate crises of meaning. When these crises are viewed within the context of other events, and are perceived to add value to life, then they have meaningfulness. In the telling of meanings and meaningfulness, the purpose for storying and the audience to whom the story is directed are the criteria for which the storylines are chosen. Both the story and the storying provide opportunities for the authors to create and offer images of themselves, that are then open to interpretation by an audience. As a traumatic experience, GBS enabled six people to tell their stories. In doing so they were able to make sense of important issues for themselves, and re-examine the way they saw themselves and the world.

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Haarhoff, Beverly Ann. ""The map, the navigator, and the explorer": evaluating the content and quality of CBT case conceptualization and the role of self-practice/self-reflection as a training intervention : a thesis presented in partial fulfillment of the requirements of the Doctor of Philosophy in Psychology at Massey University, Albany, New Zealand." Massey University, 2008. http://hdl.handle.net/10179/1077.

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Cognitive Behaviour Therapy (CBT) leads the way as an evidenced based psychotherapy, and the evaluation of CBT training programs is increasingly seen as important if this position is to be maintained. In this dissertation, CBT case conceptualization, as a core psychotherapeutic competency, acquired in training, is evaluated. Case conceptualization, integrates precipitating, predisposing, maintaining, and protective factors, functioning as an explanatory and prescriptive roadmap for therapy. Gaining self-knowledge through exposure to some form of personal therapy is cited as important in gaining psychotherapeutic competency. Self-practice/ self-reflection, show promise as a form of personal therapy compatible with the principles of CBT. This study evaluates the content and quality of CBT case conceptualizations produced by a sample of 26 participants who have completed the Massey University Post Graduate Diploma, using three case conceptualization rating scales. In addition, the impact of a self-practice/self-reflection manualised training intervention designed to improve the quality of case conceptualization in trainee cognitive behaviour therapists, is explored using thematic analysis. The evaluation of the CBT conceptualizations showed predisposing factors and psychological mechanisms as receiving the most attention from participants. However, the majority of participants failed to pay attention to socio-cultural, biological, protective factors and factors pertaining to the therapeutic relationship. The majority of the participants were able to produce a 'good enough' CBT case conceptualization, however the ‘problem list’ was not well developed, and the conceptually relevant aspects of the therapeutic relationship and protective factors were given less attention. The effect of a self-practice/self-reflection training intervention on the quality of CBT case conceptualizations produced by the intervention group (n = 16) drawn from the main participant sample, was qualitatively evaluated using thematic analysis. Theoretical understanding of the model, self awareness, empathy, conceptualization of the therapeutic relationship, adaptation of clinical interventions, and clinical practice were all subjectively perceived by participants to have increased as a result of the intervention. An inferential analysis compared the performance of the intervention group (n=16) that of a comparison group (n=10), made up of the remainder of the larger sample described in the context of the first question. The comparison group had not been exposed to the manualised intervention. The comparison was both within, and between the two groups. The quality of the intervention group showed an improvement on one of the rating scales, indicating a possible link between the training intervention and case conceptualization competency, however, the improvement was not replicated by the other two rating scales. The findings are discussed in the context of improving CBT training with regard to case conceptualization.

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Andrae, Daniela. ""Diabetes? I can live with it" : a qualitative evaluation of a diabetes self-management programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1199.

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Self-management programmes provide one form of education for people with diabetes. Evaluations of these programmes allow for a better understanding in regard to their impact and whether outcomes are met. Very little research has used qualitative methods to capture participants’ experiences of these programmes and their perception of psychological outcomes. This is the first qualitative evaluation of the Type 2 Diabetes Self-Management Programme in Whangarei. It has adopted an interpretative-phenomenological approach to explore participants’ experiences of the programme and participants’ perceptions in regard to their self-efficacy and quality of life after attending a course. A sample of 7 participants with diabetes provided data via interviews 4 weeks and 3 months after attending the course. The themes that emerged from the initial interview were separated into three evaluation components. In “6 weeks sounded very long but it was worth the time”, participants discussed enrolment, benefits of the course and suggestions for future participants. In “I know what I need to do and I’m confident to do it”, participants linked the gained knowledge from the course to improvements in their self-efficacy regarding self-management behaviours, education and control of own life. In “Life is good, diabetes is just another thing to handle”, participants reflected on the impact of living with diabetes and changes to their life. An overarching theme of settling into a comfortable routine emerged from the follow-up interview. Participants reflected positively on their course and research participation. The programme was perceived to be beneficial to participants, impacting positively on increasing knowledge, self-efficacy development, behaviour changes and quality of life. The participants maintained these benefits in the short-term. These results are discussed in terms of the need for further research to evaluate if benefits are maintained in the long-term, referral process to the programme, decision-making process in regard to enrolment and impact of a support person attending the programme. Practice implications for the programme are discussed in regard to incorporating a follow-up phone call to participants after they attended a course and offering follow-up sessions with the latest information on diabetes care.

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Moxon, Alicia M. "The effectiveness of a brief psychoeducational intervention for people with schizophrenia and their families : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1143.

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In an attempt to replicate and extend previous research, the present study conducted a brief psychoeducational intervention through community organisations designed to overcome methodological shortcomings of past studies. The two session intervention (one session with follow-up phone call) sought to establish if a brief community intervention was effective in both improving family members’ knowledge about schizophrenia and various other indicators linked to improved client functioning. People with schizophrenia and their family members (N = 50) were recruited into a controlled trial of a brief educational intervention. Clients and their corresponding key family members were randomly allocated to a treatment group or a wait-list control group. Measures included those reflecting knowledge about schizophrenia, expressed emotion, perceived coping ability, burden of care and distress. Analyses showed that knowledge increased significantly after the intervention and not after the control condition and was maintained at a nine-month follow-up. Family members’ and clients’ expressed emotion ratings significantly decreased from pre- to post-test with changes in total expressed emotion scores improving across treatment by over twice the magnitude compared to the control condition. All gains were maintained at the nine-month follow-up, with continuing improvement seen in family members’ intrusiveness ratings. A similar pattern of findings was reflected on other indices, with significant improvements in burden of care, coping and distress that were more a function of intervention than the control condition. All gains were maintained at the nine-month follow-up. Additionally, assessment of relapse rates at this follow-up interval indicated that no client had relapsed. Overall the results suggested that although knowledge increased as a result of education, the improvements in all indicators other than knowledge appeared to be due to education combined with some non-specific factors. These non-specific factors may have included expectancy effects, setting effects, sampling bias and other possibilities. These issues are considered in terms of implementation of brief programs in supportive community settings and in terms of future research.

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Rifshana, Fathimath. "Outcome evaluation of the Massey University Concussion Clinic: a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1165.

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The primary aim of the present study was to evaluate the effectiveness of the intervention provided by Massey University Concussion Clinic for individuals following Mild Traumatic Brain Injury (MTBI). Concussion Clinics were set up across New Zealand to provide early intervention and assessment for individuals with MTBI to prevent long term complaints. Treatment outcomes at these clinics have not been empirically examined before. The current study compared the levels of post concussion symptoms, anxiety, depression, and psychosocial functioning between an intervention and a control group using a quasi-experimental design. In addition, reasons for nonattendance to the clinic, and participants’ perceptions of their recovery were also explored. The main outcome measures used were the Rivermead Postconcussion Symptoms Questionnaire, the Hospital Anxiety and Depression Scale, and the Sydney Psychosocial Reintegration Scale-2. Outcomes were initially assessed soon after injury or referral to the clinic and then three months later. Participants were recruited from the Palmerston North Hospital Emergency Department and the Massey University Concussion Clinic. With 20 participants in the intervention group and 15 in the control group, the main results showed that the Concussion Clinic intervention significantly decreased the level of anxiety and depression reported by participants in the intervention group over the control group. Greater improvements in post concussion symptoms and psychosocial functioning were also indicated in the intervention group. Additional findings suggest difficulty with transportation as a reason for nonattendance, which could be a potential barrier to recovery. Furthermore, participants highlighted the benefits of attending the service and its role in their recovery. Important issues relating to the referral processes were also identified. Findings of the current study suggest that the Concussion Clinic intervention is effective in improving recovery for those accessing the service. Nevertheless, these results must be interpreted with caution due to the small sample size. Further research is warranted to examine the effectiveness of the Concussion Clinics with larger samples, and the current study may serve as a valuable pilot for these future investigations.

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Mapekula, Luyanda Rita. "Psychological explanations in HIV/AIDS counselling." Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/13486.

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Bibliography: leaves 75-77.
This research investigated the extent to which explanations of the aetiology, course, treatment, and prognosis of Human Immuno-Deficiency Virus (HIV) and Acquired Immuno-Deficiency Syndrome (AIDS) are shared or differ between African health workers (counsellors) and their African clients who are affected. Medical anthropology and constructionist theory provided theoretical frameworks to explore the significance and meaning of explanations as well as implications for counselling objectives. A qualitative methodology, drawn from theoretical models which emphasize the cultural construction of explanations of disease, was used. Findings suggest that counsellors' explanations are medical and objective with passive notions of bodily processes, while clients' explanations reflect subjective, personal experiences with the condition attributed to active human agency, supernatural and natural powers. Both counsellors and clients use personal characteristics, social stereotypes and people's actions as determinants for infection. The findings suggest that clients use these to empower themselves in order to cope with the disease, while counsellors use them to assert their power both over clients and in the health care systems; and thus contribute to obstacles in counselling. Suggestions for addressing issues in HIV/AIDS counselling and recommendations for future research in this area are included.

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De, Kock Nicola. "Counselling survivors of crime: the psychological impact on volunteers." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/10397.

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Includes bibliographical references.
The purpose of this study was to explore the negative and positive psychological impacts on victim support volunteers who counsel survivors of crime as part of the Victim Empowerment Programme (VEP). A qualitative, multiple case study research design was employed. Semi-structured interviews were conducted with 12 Cape Town based participants who are volunteer counsellors of the VEP. The data were analysed using thematic analysis. While the majority of the sample had experienced negative symptoms at some stage in their volunteering history, these symptoms were generally of a transient nature. The themes relating to these negative consequences included: continued concern for or unwanted thoughts about past clients and cases; sleep disturbances; feelings of despondency in relation to the work; avoidant behaviours; difficulty regulating emotions; and reduced empathy and tolerance for certain types of crime survivors. All of the participants reported positive consequences of a long-term nature as a result of their support work, including: the witnessing of benefits to crime survivors; the volunteers' experience of the work as rewarding and fulfilling; and, personal growth and development. A final theme which defied simple categorisation as either positive or negative was the participants' increased awareness of safety and security needs due to their volunteer work. Factors raised by participants that were considered to have an impact on their negative and positive experiences were: training and education; organisational processes and support structures; partnerships with other organisations; and individual factors. Recommendations for future research are offered, as well as suggestions regarding ways to better protect volunteers from the possible negative psychological consequences associated with their support work, and to enhance their potential to experience positive impacts.

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Sandenbergh, Rob. "AIDS/representation and psychological practice : (inter)subjectivity in HIV counselling." Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/13501.

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Bibliography: leaves 52-63.
This study undertakes a discourse analysis of a counselling session with an HIV positive man. Literature, informed by post-structuralism, on the representations and practices that surround the HIV/AIDS epidemic is examined as a background to the study. Self psychological theory concerning mourning, the psychodynamic consequences of having AIDS and selfobject phantasies is examined. This theory is criticised for ignoring the content of phantasies as well as the imbrication of the subject within the social. In an attempt to address these gaps theorisation of stigma and gendered development is introduced, as well as Hollway's (1984) broadly Foucauldian notions of investment in subject positionings. A multiple theoretical position conceptualising counselling as (inter)subjective process re-producing particular subject positionings is developed. The relations between various subject positions are described, drawing on self psychological theory to consider the investments the participants in the session may have had in each position. The analytic reading suggests that in the elaboration of particular selfobject phantasies the HIV positive client is able to cohese his sense of self and to disavow a knowing of himself as a stigmatised person with AIDS. The counsellor, through subject positionings which are in conjuncture with those of the client, disavows a knowing of the client as a person with AIDS. Through these positionings a necessary allusion of attunement is produced, allowing the counsellor to mirror the client. From this analysis various implications for consultation, supervision and training are drawn. The study .suggests that multiple ways in which HIV I AIDS is represented requires psychologists to explore their own positionings with regards to salient HIV/AIDS related issues, as these positionings have effects in work in this field.

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Clayton, Janine Lydia. "An analysis of client trends in gay and lesbian counselling service." Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/7719.

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Bibliography: leaves 74-77.
Due to experiences of homophobia encountered within mainstream mental health services, sexual minorities have established mental health services that address their needs. This study explored client patterns and trends at Triangle Project, a counselling service, aimed at gay, lesbian, bisexual and transgendered (GLBT) individuals. The data was collected and analysed by examining existing documentation that contained clients’ information. This method of secondary analysis also included looking at the organisation's annual reports and an evaluation report. The ﬁndings indicated that GLBT communities favour counselling services aimed speciﬁcally at meeting their needs. Furthermore, GLBT individuals do not necessarily present with concerns relating to their sexuality, but there are commonalities with heterosexual individuals’ presenting concerns. In addition, it was apparent that gay men and lesbians presented with different concerns. Lesbians expressed their primary concern as relationship difficulties, followed by depression, while gay men reported issues such loneliness and other situational concerns. White gay men made use of services more so than other sexual minorities of colour. The ﬁndings also revealed that youth, lesbians and gay men of colour, were not well represented, and that youth, particularly, were at risk of possibly experiencing mental ill health. This study recommends that it is crucial for mental health workers to be equipped to provide effective mental health services for GLBT communities and that interventions are designed to facilitate and promote the mental health of GLBT individuals. It is also imperative that the GLBT community is not viewed as a monolithic group and that mental health workers are sensitive to differences of culture and ethnicity.

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Robins, Jenny. "Counselling psychology in a changing National Health Service." Thesis, City University London, 2014. http://openaccess.city.ac.uk/3701/.

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Aim: Within the field of obesity, evidence shows that weight regain following weight loss is extremely common, demonstrating that weight loss treatments are not effective. Considering that attachment history influences a person’s capacity for emotional regulation and that some people use food to self-soothe, increasing our understanding of the relationship between attachment style and obesity might inform better treatments. This study is comprised of two parts: the first part investigates whether attachment style predicts outcome in a 12-session group treatment for obesity and the second part explores the experience of that treatment. Design: The study utilises a mixed methods design with participants from a group treatment for obesity which comprises: the Attachment Style Questionniare (ASQ), completed by 52 group members, along with their body mass index (BMI) measures at the start and end of the treatment, analysed using a backwards multiple regression to test whether the 5 dimensions of the ASQ can predict participants’ change in BMI; and semi-structured interviews with 7 people from the same treatment analysed according to Interpretative Phenomenological Analysis (IPA) guidelines. Method: Data was collected from 52 people attending group treatment for obesity with an NHS service in South East England, which included the ASQ and BMI measures at Week 1 and Week 12 of treatment. The change in BMI was entered as the dependent variable for the regression in SPSS and the five attachment dimensions were entered as predictors. 7 people who had taken part in Part I of this research participated in interviews about their group experience. Transcripts were subjected to IPA. Results: Quantitative findings produced a model in which the ASQ dimension Confidence (in relationships) significantly predicted change in BMI in a negative direction (i.e. the participants who scored higher on Confidence lost less weight than those with lower scores). Confidence explained 8% of the variance (R2=0.08, F(1,50)=4.32, p<0.05). Qualitative findings produced four super-ordinate themes which included: the sadness at the course ending; the support and comfort felt from others in the group experience; the positive aspects of the group treatment; and the negative aspects of the group treatment. Other group members appeared to have a substantial impact on participants, whether positive or negative. Some accounts reflected the importance of others in feeling accepted and supported. Other accounts conveyed less of an emphasis on feeling part of the group and more on feeling separate. Conclusions: The quantitative results are inconclusive and possible reasons for this are discussed. The qualitative findings suggest that it is likely that group intervention for obesity could be improved by attention to attachment and by tailoring treatments more specifically to individuals.

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Nell, Erika. "The Effects of a DVD counselling programme in preventing the breakdown of a partner relationships of Master's students in Clinical Psychology." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/680.

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Thesis (MSc (Clinical Psychology)) -- University of Limpopo, 2010.
The Clinical Psychology training program at the University of Limpopo (Medunsa Campus) is based on the theoretical paradigm of General Systems Theory. The functioning of systems in terms of patterns, structure, organization and relationships can therefore also be applied to the trainee and his/her partner relationship system which is characterized by circular patterns of interaction. Ernst (2008) states that within the context of General Systems theory it became evident that the trainee does not function in isolation but as part of a system. The trainee undergoes significant changes throughout the training year if training is effective and this in turn may also impact on the trainee's partner relationship. This investigation was done to establish the effect of a DVD Counselling Programme on the partner-relationship of the trainee in Clinical Psychology with his/her partner/spouse. This is done in order to provide feedback to the trainers of the Clinical Psychology training at Medunsa. This may also possibly assist in establishing a more scientifically founded aid for the trainees in Msc. Clinical Psychology and their partners/spouses. It was a qualitative research project, in which person centered interviews were held with participants and thematically analyzed by three independent clinicians. The entire research project and findings are contextualized in accordance with General Systems Theory. The results indicated that the DVD had a moderate effect on 4/6 of the sample population that reported that their relationship improved in respect of the nature and quality based on mutual understanding, emotional closeness, obtaining of relational skills, effective communication and awareness regarding the impact of the training year on their relationship. The impact of the DVD was somewhat limited in that not all the participants watched it and the manner iIi which some of the trainees approached their partners/spouses, which may have had an effect on how the DVD is received and experienced.

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Fritz, Nabillia Jocasta. "Clinical and Counselling Psychology Student Attitudes and Receptiveness towards Evidence-Based Practice." University of the Western Cape, 2020. http://hdl.handle.net/11394/7962.

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Magister Psychologiae - MPsych
Evidence-based practice (EBP) has been internationally recognised as the gold standard for the provision of safe and compassionate health care, and entails integrating clinical expertise with the best available research evidence in order to make effective decisions about the care of patients. The adoption of EBP remains slow, and this has been identified as a significant public health concern as few people with mental disorders in South Africa are treated using evidence-based psychological treatments (EBTs). Proponents of EBP have argued that the most effective way of sustaining the use of EBTs is by adopting EBP as a guiding pedagogical principle in professional psychology training programmes. For such efforts to be successful, it is pertinent to assess the receptiveness of the target population. Attitudes towards EBP remain the top indicator of successful adoption. The current study explored the attitudes and receptiveness towards EBP among clinical and counselling psychology students (N=57) at 11 accredited institutions nationally. Participation in the study was voluntary and the procedure followed all ethical requirements. All data collection occurred online. Participants completed a general questionnaire, the Evidence-Based Practice Attitudes Scale-15 (EBPAS-15) and the Organisational Culture and Readiness for System-wide Integration of Evidence-based Practice (OCRSIEP) Scale All data collection instruments demonstrated sound psychometric properties. A major finding of this study was that clinical and counselling psychology students reported favourable attitudes and receptiveness towards the adoption of EBP. The overall score on the EBPAS-15 indicated that students were likely to adopt EBP, while results on the ORCSIEP overall score indicated that they were receptive towards EBP and were ready to adopt EBP. An exploration of the association between attitudes and receptiveness towards EBP indicated that no correlation exists. Additionally, factors such as age, gender, psychology programme enrolment and preferred therapeutic orientation were not significantly associated with attitudes and receptiveness towards EBP. In conclusion, the results of this study suggest that there is a sound foundation on which to incorporate EBP into the professional training programmes of psychology students.

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Kerr, Lucy. "Ways in which clinical supervision impacts practice as an experienced counselling psychologist : an interpretative phenomenological analysis." Thesis, University of Roehampton, 2014. https://pure.roehampton.ac.uk/portal/en/studentthesis/ways-in-which-clinical-supervision-impacts-practice-as-an-experienced-counselling-psychologist(e1eb8145-038c-469c-9a5a-650d11abdbaf).html.

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Clinical supervision is viewed as being an essential and integral part of both trainee and experienced therapists’ development. The cultural shift towards Evidence Based Practice has led to increased practitioner accountability and a requirement to ensure that patients gain access to the best-available mental health care. Supervision is heralded as the vehicle through which best practice can be obtained and, as a result, a strong demand for more research to support supervision practice has emerged. Most of the existing research is based on trainees with very little attention given to the views of more experienced or ‘expert’ practitioners. This study aimed to explore ways in which clinical supervision impacts the practice of experienced Counselling Psychologists by asking seven experienced practitioners (with 7-31 years of post-accreditation experience) to describe how they see their lived experience of supervision as having helped or hindered their practice. Data were collected using open-ended semi-structured interviews and were analysed using Interpretative Phenomenological Analysis (IPA). Participants’ experiences clustered into three superordinate themes: a) Factors which Help Supervisee; b) Factors which Hinder Supervisee; and c) Impact on Working with Clients. The empirical findings suggest that clinical supervision can have both a helpful and hindering impact on practice and that experience-levels play a significant role in determining the way in which learning in supervision is viewed and experienced, the attitude with which supervision is approached, and the expectations of the supervisory alliance. In particular, these experienced practitioners adopted an open, flexible, curious and sometimes humorous attitude towards learning in supervision, valuing supervisor flexibility and insight whilst deploring supervisor rigidity. Furthermore, these experienced practitioners did not express a need or desire for a mutually strong supervisory alliance in supervision. Rather, the analysis revealed a one-way need to be able to trust and respect the supervisor for his/her insight and expertise. Findings are discussed in relation to existing literature and research. In addition, questions are raised about the positivist approach to knowledge which underpins most supervision research and it is argued that a broader conceptualization of knowledge might serve to expand our understanding of this important phenomenon. Implications for counselling psychology and for further research are explored.

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Washkansky, Denise. ""Go cry by the river" : a case study of a counselling service for abused women in rural Swaziland." Master's thesis, University of Cape Town, 2000. http://hdl.handle.net/11427/11128.

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Bibliography: leaves 79-83.
In February 1999 a counselling service for women abuse survivors in rural Swaziland was evaluated. The evaluation highlighted that a number of organisational factors were undermining utilisation of the service. However, the evaluation failed to address broader contextual issues. This study, in the form of an in-depth case study, is a re-examination of the information gathered for the initial evaluation. It aims to explore the contextual issues underlying the poor utilisation of the counselling service. Within a qualitative paradigm, information for the initial evaluation was gathered through participant observation, open-ended interviews and a review of relevant documentation. A thematic analysis revealed that many perceptions about the meaning of the concept of 'women abuse' exist, both between and within the organisation and community groupings. As a result of the lack of a common definition of abuse and due to a pervasive silence around abuse in the community, it was perceived to be difficult for women to utilise local and organisational methods of healing. Furthermore, abuse in the community was perceived to be influenced by the broader context of women's inferior status in Swaziland. Recommendations are made with regard to strengthening the relationship between organisation and community. It is suggested that rather than importing organisational definitions and interventions into the community, the organisation play a facilitative role firstly, in encouraging community members to develop their own definitions of abuse - which are both guided by human rights principles and sensitive to the local context – and secondly, to devise their own strategies to deal with it.

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Dobson, Nick. "Women counselling psychology trainees' accounts of clinical supervision : an exploration of discursive power." Thesis, University of Roehampton, 2012. https://pure.roehampton.ac.uk/portal/en/studentthesis/women-counselling-psychology-trainees’-accounts-of-clinical-supervision(eb512278-60c6-4126-9f4b-32b0cf040c3b).html.

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This research has drawn on poststructuralist thinking to posit that assertions of supervision being a benign and necessary process or activity rely on modernist assumptions. Utilising Foucault’s work on discourses and power, this study conceptualised supervision as a social construction that has implications for practice and subjectivity, and that this process, within the context of counselling psychology, with its particular epistemological underpinnings, is worthy of further exploration. This study makes an original contribution through extending the work by Crocket (2004, 2007), who has investigated supervision’s shaping effects on professional identity, to apply it to the particular epistemological and theoretical context of counselling psychology, a profession said to value postmodern ideas such as pluralism and ambiguity (Rizq, 2006). Semi-structured interviews with six women counselling psychology trainees were analysed using Foucauldian discourse analysis, a social constructionist methodology, and found a number of discourses implicated in trainees’ subjectivity and practice. Whilst expert, developmental and gender discourses were found to be implicated in constructions of supervision as hierarchical, which was seen as a key aspect of constructions of power in supervision, other discourses were identified that offered positions from which to resist this. The researcher acknowledges that the discursive resources identified are based on this particular sample, could have been read in other ways and does not assume they can be applied to all trainee counselling psychologists. Rather, it is hoped this study may contribute to debate around supervision and it’s shaping effects and consequently be useful in enhancing counselling psychology’s reflexivity in research and practice.

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Malur, Malini. "Experiencing natural environments, experiencing health : a health psychology perspective : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Health Psychology, Massey University, Albany, New Zealand." 2010. http://hdl.handle.net/10179/1655.

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This aim of this study was to explore the importance of natural surroundings to human health from a health psychology perspective. The increase in built environments have replaced green spaces in the urban areas and the effects of this has been explored by several disciplines ranging from environmental psychology, leisure studies, urban planning, public health to name a few. Findings from these studies have shown that natural environments do play a significant role in human health. However, it was deemed that exploring the influence of nature on human health from a health psychology viewpoint would provide a different dimension to this established link between nature and humans to press for preserving and providing more green spaces in the cities. Urban green areas offer several benefits such as space for exercise, leisure, psychological space for rejuvenating, healing and social connections that are all crucial for our wellbeing. This study explores the many ways natural settings contribute to health and well-being from a health psychology angle. A qualitative design was employed using a phenomenological approach to understand the everyday experience of being in nature/natural environments. Cornwall Park/One Tree Hill in Auckland was chosen as the site for this study. Nine women and men between the ages of 30 and 70 were chosen from this site to take part in the study. Methods of data collection were mainly in-depth interviews and photo-discussion. The data was analysed using a phenomenological approach based on the guidelines developed by Moustakas (1994) and van Manen (1990). The findings revealed that natural surroundings influenced people positively in many ways that contributed to their physical, mental and spiritual well-being. Natural environments satisfied a wide-range of needs, such as providing a place/space to exercise, to be alone and reflect, connect with nature, recreate, heal and socialise to name a few, in green, quiet, pollution-free, aesthetically pleasing settings. The essence of the phenomenon that is estimated to have been captured in the study is, “human experience in nature from the point of view of health psychology, or human experience of wellness, being in nature”.

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Keenan, Denise. "Rescuing the rescuer: early psychological intervention for firefighters following exposure to potentially traumatic line-of-duty events." 2008. http://arrow.unisa.edu.au:8081/1959.8/43092.

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Investigation of assistance Australian firefighters want to assist recovery following exposure to traumatic stressors. Results demonstrated firefighters want to exercise control in how they recover, employing personal choice regarding information, sources and forms of support they use. Interventions provided to operational firefighters within five Australian fire service agencies were documented.

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(11191980), Brittany J. Wright. "Training Health Service Psychologists for International Engagement: Perspectives for Training Programs." Thesis, 2021.

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As psychologists continue to engage the growing diversity within the United States and around the world, there is an imperative need for psychological services that are specific to cultural needs and integrate relevant sociohistorical and community factors. Currently, ethnocentrism in psychological interventions, research, and graduate training limit psychologists’ international engagement and perpetuate a focus on U.S. psychology. For graduate programs in health service psychology (i.e., clinical, school, and counseling psychology), there is a dearth of literature on their methods of preparation of health service professionals engaging in psychological work outside of the U.S. However, graduate training programs have opportunities to intervene on the field’s colonialism by preparing professionals to effectively engage internationally. Addressing ethnocentrism in training is a critical next step for the field of health service psychology.

This dissertation is comprised of two distinct chapters that are conceptually related. In the first chapter, I review health service psychology’s current international engagement. As psychologists engage outside of the United States, the field of psychology and the training community must critically examine the applicability of psychological interventions, research, and graduate education to international contexts. I propose six recommendations for training programs to deconstruct colonialism and enhance preparation of graduates for competent work outside of the U.S.

In the second chapter, I report an original, empirical study, using qualitative descriptive methodology, which critically examines how U.S. training prepares graduates to work internationally. Through semi-structured interviews, I explored internationally based psychologists’ reflections on their training experiences and preparation for their current roles in teaching, practice, research, consultation and policy, and psychological infrastructure. Data analysis utilized consensual qualitative research methodology (CQR). Results provided valuable information regarding psychologists’ professional roles outside of the U.S., factors contributing to their vocational experiences, country-specific mental health attitudes, values, and practices, the impact of U.S.-centric psychology in the country of location, lessons taken from their graduate training, and recommendations for international work. Findings provided recommendations to the training community to incorporate more of an international focus and enhance preparation of students for work outside of the U.S.

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(9755867), Zachary T. Whitt. "Mapping Recovery: A Qualitative Node Map Approach to Understanding Factors Proximal to Relapse Among Adolescents in Recovery." Thesis, 2021.

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Despite data suggesting that current substance use disorder treatments are largely effective in reducing substance use, most adolescents in SUD treatment experience relapse after finishing treatment. Understanding the factors proximal to relapse is crucial to understanding the course of substance use disorder and how best to improve recovery among adolescents. The current study represents part of a novel line of research using qualitative data analysis to examine these factors. Data for the present study were 200 de-identified node-maps, completed by high school students at Hope Academy, a recovery high school in Indianapolis, Indiana. The reported age in this sample ranged from 14-20 years (64.1% male, 89.1% White), with a mean age of 16.8 years (SD = 1.9 years). After a four-phase process of qualitative data sorting, primary people, places, and things most frequently described included using with others (n=153, 76.5%), away from home (n=156, 78.0%), and in response to negative affect (n=93, 48.4%). Eleven relapse pathways emerged: escaping (n=16), self-medicating (n=3), coping with tragedy (n=5), critical mass (n=6), unexpected activation (n=8), unexpected offer (n=22), planned use (n=19), resistant to recovery (n=5), not in recovery (n=22), passive agency (n=30), and acting out (n=15). Recovery is a system made up of many interrelated parts, including those related to the individual person in recovery, their thoughts, beliefs, feelings, and emotions; and those related to external factors, their environment, adverse life events, and the actions of other people. By considering the pathways together for their common features, they can each be said to represent one of three critical failures related to those three overarching facets of the system: failure to cope, failure to guard against temptation, and failure of belief. Identifying these overarching failures in the system is helpful because the failures contain in themselves the seeds of their solution, so by examining them as critical components to a relapse event, it may be possible to gain insight into how to prevent the same type of relapses from occurring in the future.

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Love, Catherine Maarie Amohia. "Maori voices in the construction of indigenous models of counselling theory and practice : a thesis completed in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University." 1999. http://hdl.handle.net/10179/1682.

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Irregular pagination: Page numbers 572 to 582 & 755 missing, 754 is not numbered
This thesis explores the stories of four Maori counsellors who are employed in Western style organisations. Two 'readings' of participants' narratives are provided. The 'readings' are constructed from two distinct discursive frames, identified as ENGLISH-Maori and MAORI-English. It is proposed that participants' conceptions of self and other are constructed through narratives based in a MAORI-English discursive frame, and that their models of counselling are developed within this discursive frame. It is further proposed that meanings made within this discursive frame are not readily available to 'others' whose constructions of self and other are based in an ENGLISH-Maori or Western discursive frame. This mismatch leads to misunderstandings which impact negatively on the credibility and status of Maori counsellors and Maori models of counselling when viewed from the perspective of Western models of counselling theory, practice and organisation. It is also posited in this thesis that a form of 'sub-textual' communication exists within which Maori meanings are made and conveyed in the English language

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Browne, Eric Donald. "Workflow modelling of coordinated inter-health-provider care plans." 2005. http://arrow.unisa.edu.au:8081/1959.8/28367.

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Workflow in healthcare, particularly for the shared and coordinated management of chronic illnesses, is very difficult to model. It is also difficult to support via current Clinical information Systems and current information technologies. This dissertation contributes significant enhancements to the current methodologies for designing and implementing workflow Management Systems (WfMSs) suitable for healthcare. The contribution comprises three interrelated aspects of workflow system architecture as follows:- Firstly, it shifts the emphasis of workflow modelling and enactment to a focus on goals, and the monitoring and facilitation of their achievement. Secondly, it introduces the concept of self-modifying workflow in the context of health care planning, whereby explicit tasks in the goal-based care plan are devoted to assessing and modifying downstream workflow. Thirdly, this dissertation proposes methodologies for identifying and dealing with tasks which overlap, subsume or interfere with other tasks elsewhere in a given workflow.
PhD Doctorate

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Harris, Mary. "A hermeneutic investigation of the influences on and perceptions of breastfeeding and mother-child bonding from the perspectives of survivors of child abuse." 2008. http://arrow.unisa.edu.au/vital/access/manager/Repository/unisa:38417.

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This research investigated an issue that has implications for early breastfeeding cessation and impaired mother-child bonding. It focused on child abuse survivors' perceptions and reactions surrounding breastfeeding and bonding, the necessity of trust before disclosing abuse, and the transition to self-efficacy. It also provided recommendations for health professionals' practice.

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(7861526), Danielle Bowman Tometich. "A PROSPECTIVE EXAMINATION OF CHANGE IN EXECUTIVE FUNCTION AND PHYSICAL ACTIVITY IN OLDER BREAST CANCER SURVIVORS." Thesis, 2019.

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Only one third of older breast cancer survivors (BCS) meet national physical activity (PA) guidelines. Theories of self-regulation and research with older adults suggest that executive function (EF) plays an important role in PA, yet the impact of lower EF on older survivors’ PA is unknown. My project addressed this gap using secondary data from the Thinking and Living with Cancer (TLC) cohort study, which examined cognitive function among older BCS pre-treatment, followed every 12 months, and contemporaneously assessed matched controls. My first aim was to test two hypotheses regarding EF change and PA and determine if these relationships differ between BCS and controls. My hypotheses were: 1) EF decline from baseline to 12 months will predict lower PA at 24 months, and 2) lower PA at 12 months will predict EF decline from 12 to 24 months. My second aim was to explore whether the effects of EF change on PA in BCS differed based on risk factors for accelerated cognitive decline (i.e., older age, more advanced cancer stage, comorbidity, and APOE ε4 genotype). The TLC study measured EF with neuropsychological tests and PA with the International Physical Activity Questionnaire-Short Form. For aims 1 and 2, I used multiple regression with multiple imputation. Primary results showed no significant effect of EF change from baseline to 12 months on PA at 24 months (β=-0.01, p=0.88) and no significant group (BCS vs. controls) by EF interaction (β=-0.05, p=0.33). Separate models in BCS and controls showed similar findings. In the entire sample, PA at 12 months significantly predicted EF change from 12 to 24 months (β=0.17, p=0.01), but there was no significant group by PA interaction (β=-0.06, p=0.54). Separate analyses by group found a significant effect of PA for controls (β=0.07, p=0.02), but not for BCS (β=0.05, p=0.27). Regarding the second aim, there were no significant interactions between EF change and the proposed risk factors on PA. Findings were largely inconsistent with theory and prior research. Continued research in this area will inform future exercise interventions to improve physical and cognitive health for the growing population of older cancer survivors.

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(11191341), Ife K. Sinclair. "Understanding the Experiences of Black College Students in the Current Era." Thesis, 2021.

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Mental health concerns of college students are important due to their developmental and life stages and adjustment challenges they must navigate in a new and difficult environment. Compared to students of other ethnicities, Black college students in the United States have historically reported poorer mental health outcomes with higher risk for depression and anxiety than their non-Black counterparts (McClain et al., 2016; Mushonga & Henneberger, 2019). The African American activism work done by Black college students has become increasingly visible and influential since the creation of the Black Lives Matter (BLM) movement and student protests aimed at improving university climates for minority students. Using Critical Race Theory (CRT) as a framework, this study investigated the roles of racial identity attitudes and sociopolitical attitudes on the relationships between race-related stress and mental health, and race-related stress and African American activism for Black college students in the U.S. The results indicated that increased race-related stress was associated with worsened mental health outcomes but increased engagement in activism, negative sociopolitical attitudes were related to poorer mental health, positive sociopolitical attitudes were related to decreased activism, and the six racial identity attitudes varied in their associations to mental health and activism based on racial centrality. The Internalization Multiculturalist Inclusive racial identity attitude was found to moderate the relationship between race-related stress and an indicator of mental health, and the Internalization Afrocentricity identity attitude strengthened the relationship between race-related stress and activism. The discussion addresses implications for future counseling psychology research and practice.

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(6865775), Kathy Ann Wierzchowski. "THE ROLE OF STEREOTYPE THREAT AND IMPOSTOR PHENOMENON IN PREDICTING FEMALE UNDERGRADUATE STUDENTS’ PERSISTENCE IN STEM." Thesis, 2019.

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There is a lack of literature that has investigated the relationships between stereotype threat, impostor phenomenon, and other related constructs on career development, particularly for women in STEM. While various resources (National Science Foundation, 2013; Sax, Kanny, Jacobs, Whang, Weintraub, & Hroch, 2016; US Department of Labor, 2014) have highlighted the gender gap and “leaky pipeline” in STEM, it is important to further investigate and understand why these phenomena occur and continue to persist. In this study, I used a mixed methods approach which used a quantitative SEM analyses and qualitative interview to further examine the paths between chilly climate, impostor phenomenon, stereotype threat, science self-efficacy, fear of failure, fear of success, academic major satisfaction, and persistence in STEM in a sample of undergraduate females. Several hypotheses were formed in order to better understand the mediation effects of these variables upon one another. Stereotype threat was found to be endorsed at a lesser rate than anticipated, while impostor phenomenon was endorsed at a higher rate. Science self-efficacy was also found to play an important role in the predicted relationships among variables, relating to both academic major satisfaction and persistence. These quantitative results were supported by data gathered in qualitative interviews. Implications for research and practice around concerns of impostor phenomenon, stereotype threat, and fears of failure and success are discussed.

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Bhagwandeen, Yuraisha Bianca. "Perceptions that social workers and occupational health nurses in the Pietermaritzburg region have, of clinical psychologists, counselling psychologists, psychiatrists, physicians, and priests." Thesis, 1998. http://hdl.handle.net/10413/5759.

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This study involved an investigation of the perceptions that social workers and occupational health nurses have, of clinical and counselling psychologists, psychiatrists, physicians, and priests. The present study includes a sample of social workers and occupational health nurses in the Pietermaritzburg region. Subjects were required to i) rate their confidence in the ability of each of these professionals to treat 5 clinical cases, ii) rate their confidence in each of the professionals to help them with their own problems iii) rate each of the 5 cases in terms of the severity of each case, iv) rate each of these practitioners on 11 personal qualities developed by Webb and Speer (1986), and v) choose from a list of 10 professions the one they would like their off-spring to persue. Repeated measures anovas, Tukey's HSD test, and descriptive statistics, were used to analyse the data. The results indicated that the sample i) was moderately confident in the abilities of psychologists to treat 5 cases ii) was moderately confident in the abilities of psychologists to treat their own problems, iii) rated case 3 as being most severe and psychiatrists as being more competent to treat this 'severe' case, iv) rated psychologists quite favourably in terms of personal qualities, and chose engineers and accountants above psychologists. Further analysis revealed that in certain instances, the sample appeared to have a preference for counselling psychologists over clinical psychologists, and rated mental health professionals more favourably than non-mental health professionals. The results also indicated that the sample appeared to lack clarity about the roles, functions and skills of psychologists. Implications for the job security of psychologists, and the need for educational and public relations efforts are discussed.
Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 1998.

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(8774147), Ellen Frances Krueger. "Development of a Patient Centered Outcomes Questionnaire for Advanced Lung Cancer Patients." Thesis, 2020.

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Symptom research with advanced lung cancer patients has primarily focused on symptom severity, frequency, and distress; yet, little is known about advanced lung cancer patients’ priorities and success criteria for symptom improvement. To address these gaps in the literature, this study examined these outcomes using a modified Patient Centered Outcomes Questionnaire (PCOQ), which has largely been used with adults with chronic pain. Advanced lung cancer patients (N = 102) were recruited from the Indiana University Simon Cancer Center to participate in a one-time self-report survey, including demographic and medical questionnaires, symptom treatment history, standardized measures of symptom severity and quality of life, and the modified PCOQ focused on eight common symptoms in advanced lung cancer. Cancer information was collected from medical records. My primary aim was to evaluate the construct validity of the PCOQ. As hypothesized, symptom severity ratings on the PCOQ were positively correlated with standardized assessments of the same symptoms as well as functional status. Greater severity of most symptoms on the PCOQ was also correlated with worse quality of life, and greater severity of four symptoms was correlated with having more medical comorbidities. Positive, moderate correlations were found between the severity and importance of seeing improvement in cough, fatigue, sleep problems, and pain on the PCOQ. Patients considered low levels of symptom severity to be acceptable following symptom treatment; no differences were found across the eight symptoms. Latent profile analysis identified four patient subgroups based on the importance of seeing improvement in each of the symptoms: (1) those who rated all symptoms as low in importance (n = 12); (2) those who rated bronchial symptoms and sleep problems as low in importance and all other symptoms as moderately important (n = 29); (3) those who rated nausea and emotional distress as low in importance and all other symptoms as moderately important (n = 23); and (4) those who rated all symptoms as highly important (n = 33). These subgroups were unrelated to demographic and clinical factors, except for functional status. Findings suggest that symptom severity and importance are related yet distinct aspects of the advanced lung cancer symptom experience. Furthermore, patients have heterogeneous priorities for symptom management, which has implications for tailoring treatment.

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(8803466), Crystal J. Thornhill. "Understanding the Attitudes Towards Reporting Sexual Violence Against Black Women." Thesis, 2020.

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Black women appear to be less likely than other groups to report sexual violence (Catalano et al., 2009). There are a number of factors that may potentially impact Black women’s reporting sexual violence, such as fear of shame or rejection from religious congregations or social groups, fear of police officers, and a history of violence amongst family members that may normalize sexual violence to the level of not reporting (Truman & Morgan, 2016). This study examined the connection between the strong Black women’s ideal, trust of law enforcement, and Black identity on Black women’s attitudes towards reporting sexual violence among 112 women. In this study, I also explored the impact of previous sexual violence on Black women’s attitudes towards reporting sexual violence. The responses from participants showed that whether or not someone had experienced sexual violence was a significant predictor of people’s attitudes towards reporting. The participants were significantly more likely to have negative attitudes towards reporting if they had previously experienced sexual violence. In addition, the relationship between mistrust of police and negative attitudes towards reporting sexual violence was more significant when the Black female participant had experienced sexual violence. Future studies should continue to explore the impact of experiencing sexual violence on Black women’s attitudes towards reporting.

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(6270590), Samantha A. Morel. "Exploring a career path towards well-being: How parental behaviors, career values awareness, and career decision-making self-efficacy impact well-being in undergraduate college students." Thesis, 2019.

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While there is evidence about the relationship between career development and psychological outcomes, more work is needed to understand how career development is related to personal mental health outcomes in college students. Studying some of the social and cognitive predictors of self-efficacy, this study espouses a holistic perspective to career development and aims to better understand its impact on well-being. Using social cognitive career theory (SCCT) and Super's life-span, life-space theory, this study examines how social (e.g., parental support) and cognitive (e.g., career values awareness) factors influence career decision-making self-efficacy, and furthermore, how this impacts well-being in undergraduate students. Specific mediation hypotheses were assessed, including the mediating role of career values awareness in the relationship between parental support and career decision-making self-efficacy, and the mediating effect of career-decision-making self-efficacy on well-being. Data were collected from 1446 undergraduate students at a large Midwestern public land-grant university through an online survey. Using structural equation modeling to analyze the data, results indicated that: (a) career values awareness mediated the relationship between parental behaviors and CDMSE; (b) CDMSE mediated the relationship between parental behaviors and well-being; and (c) CDMSE mediated the relationship between career values awareness and well-being. In an alternative model, parental support and socioeconomic status (SES) were also found to be significant positive predictors of well-being. Post hoc analysis revealed that academic standing (i.e., year in school) did not moderate the relationship between CDMSE and well-being. Limitations of the study and recommendations for future research are suggested along with implications for clinical practice.

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Watts, Peter Murray. "A qualitative study of emotional experiences during the pre-psychotic period." 2004. http://hdl.handle.net/2292/620.

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Psychosis typically emerges after a heterogeneous range of premonitory symptoms. This has been labelled the ‘pre-psychotic period’ (PPP). Emotional disturbances are prominent features of this state and have shown to be risk factors for psychosis. The present study had two interrelated aims: to explore in-depth the experiential nature of the emotional changes that occur during the PPP; and to examine whether there are similarities between these pre-psychotic emotional changes and the concept of delusional atmosphere. Twelve men experiencing first-episode psychosis with delusional thought content were recruited for the study. Information regarding their emotional experiences during the PPP was gathered using a semi-structured interview format. Corroborating information about observable changes in the men’s behaviour during the PPP was also gathered from a family member or friend of theirs who had close contact with them during this time. The data was analysed using interpretative phenomenological analysis. A variety of strong emotional changes were reported during the PPP, including depression, anxiety, anger, and guilt, as well as love and happiness. Negative emotions were prominent during this time, but positive emotions were also found to be a feature of this state for some people. Overall, the PPP was characterised by an increase in distress over time. Features of delusional atmosphere that were evident during the PPP included: experiences of derealisation and the environment feeling different; anxiety and confusion and a drive to find and explanation for the changes that were being experienced; and a sense of apprehension that something significant was about to happen. The relevance of these findings to researchers and clinicians working in this area is discussed.

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(8781260), Briana N. Walker. "Societal Influences on Relationship Satisfaction in Black-White Interracial Couples." Thesis, 2020.

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Interracial couples have different experiences compared to their intraracial counterparts. Interracial couples and their relationships (particularly their marriages) have been studied to see whether there are any effects on the relationship due to the couple’s inherent differences. However, the literature heavily focuses on interracial marriages while only touching on interracial relationships in general, with a primary focus on interracial couples of all kinds. With the tension between White and Black Americans over the years, one can wonder if there would be any noticeable differences within Black/White interracial couples with regard to racial identification and experienced discrimination due to the Black-White racial disparity. This study tested whether these factors contribute to the overall relationship satisfaction in Black/White interracial couples. Data were collected via MTurk and participants completed three assessments to capture how racial identity and experienced discrimination impact their relationship. Racial identity was assessed using Worrell, Mendoza, and Wang’s (2019) Cross Ethnic-racial Identity Scale- Adult (CERIS-A); perceived racial discrimination was assessed Conger’s (2006) revised version of Landrine et al.’s (2006) General Ethnic Discrimination Scale; and relationship satisfaction was assessed using Funk and Rogge’s (2007) Couples Satisfaction Index (CSI-16). It was predicted that experienced discrimination and racial identity would impact the relationship satisfaction of Black-White interracial couples. The results showed that experienced discrimination did significantly impact relationship satisfaction and racial identity, however, racial identity did not significantly impact relationship satisfaction in Black-White interracial couples. The lack of research on the CERIS-A’s validity when interacting with other constructs, a missing question on the CSI-16, and not accounting for biracial participants and their experiences with racial identity development are all limitations that should be considered when reviewing the results. Clinicians can use the information from this study to assist clients in having more conversations about their experiences of discrimination with one another and having them create their own meanings around interracial dating and racial identity.

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Niland, Patricia Ruth. "Metaphors of menopause in medicine : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Wellington, New Zealand." 2010. http://hdl.handle.net/10179/1338.

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Medical textbooks have previously represented women’s bodies and menopause life transitions by using notions of ‘machine productivity’ and ‘machine breakdown’ (Martin, 1987). This study aimed to explore whether these representations have changed, especially given recent HRT clinical trial results. Eight relevant compulsory medical textbooks for first and second year medical students at two New Zealand Universities were identified. A Foucauldian discourse analysis (Parker, 1990) was undertaken on relevant content to identify representations of menopause, HRT, women’s bodies, and ageing. Five major discourses were employed in the textbooks in descriptions of menopause and HRT: failure, estrogen deficiency as disease; HRT as saviour; obscurity and the new discovery discourse. Menopause continues to be represented as resulting from a ‘failure’ of a machine-like body. Although the recent HRT clinical trials were reported as a serious risk factor in half of the textbooks, HRT was also represented as a saviour particularly against postmenopausal osteoporosis. The discovery of ‘new’ drugs to ‘treat’ HRT and the ‘postmenopausal’ patient were heralded with much excitement. Medical textbooks continue to use failure discourses to describe women’s bodies at menopause. New risk-based HRT assessments for ‘patients’ with menopause ‘symptoms’ are promoted. These portrayals reinforce linear and reductionist ways of thinking about menopause and women at midlife and provide few spaces for resistance or alternative constructions to more accurately reflect women’s embodied worlds.

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(8889137), Chye Hong Liew. "Family Grief Communication, Self-Construal, and the Functioning of Grieving College Students." Thesis, 2020.

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Grieving the deaths of immediate and extended family members as well as friends is a common experience among traditional-age college students. The overarching purpose of this study was to provide a more nuanced understanding of how various family grief communication factors (i.e., frequency, quality, willingness to communicate—personal/perceived family, reasons for grief communication avoidance—self-protection/relationship-protection) and self-construal might be related to the post-loss functioning of grieving traditional-age college students. Using hierarchical multiple regressions, I analyzed survey data from 369 grieving college students who were between ages 18 and 24 and had experienced the death of at least one individual they considered as family member within the last two years. First, the current findings indicated that the more frequent grieving students communicated about their grief with their family, the stronger their grief reactions. Second, the more students reported family grief communication of high quality, the weaker their grief reactions and the higher their post-loss family satisfaction. Third, there were no relationships between grieving college students’ personal willingness or their perceived family willingness to communicate about grief and their own grief reactions. Fourth, grieving students’ post-loss family satisfaction levels were similar regardless of how personally willing they were to communicate their grief, but increased as they perceived their family members as more willing to communicate about their grief. Fifth, the more grieving students avoided family grief communicate for self-protection reasons, the stronger their grief reactions and the lower their post-loss family satisfaction. Sixth, college students reported similar levels of grief reactions and post-loss family satisfaction regardless of how much they reported avoiding grief communication to protect their family relationships. Seventh, quality, personal and family willingness to communication, and reasons for grief communication avoidance did not moderate the relationship between the frequency of family grief communication and grieving students’ post-loss functioning. Eighth, grieving students reported similar levels of grief reactions and post-loss family satisfaction regardless of how much they identified with interdependent self-construal, independent self-construal, or a combination of both. Finally, the relationships between grieving students’ reasons for grief communication avoidance (i.e., self-protection, relationship protection) and their post-loss functioning (i.e., grief reactions, post-loss family satisfaction) remained similar regardless of how much they identified with independent or interdependent self-construal. The results of this study may be used to inform clinical interventions and outreach efforts for grieving traditional-age college students and their family members.

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(8103725), Alexandra L. Gillespie. "Impacts of Pornography Acceptance and Use on Self-esteem, Sexual Satisfaction, and Overall Relationship Satisfaction." Thesis, 2019.

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Using a Structural Equation Modeling Approach, this study examines the relationship between pornography acceptance and frequency of use and self-esteem, sexual satisfaction, and overall relationship satisfaction. Almost all published studies prior to the present study have only measured pornography acceptance or frequency of use. This study is to help contribute to the literature of understanding pornography through measuring pornography acceptance and frequency of use. The model was run overall and based on gender as previous literature had indicated differences in sexual satisfaction and relationship satisfaction with the use of pornography. It was expected that acceptance and more frequent use of pornography would positively predict self-esteem for men but negatively predict self-esteem for women. It was also expected that acceptance of pornography use would positively predict sexual satisfaction for men and negatively predict sexual satisfaction for women. Additionally, it was expected that higher self-esteem and higher sexual satisfaction will lead to a higher level of relationship satisfaction. Results indicated frequency of pornography use resulted in increased self-esteem for men and not for women. Findings also highlighted that acceptance of pornography resulted in decreased self-esteem for men but not for women. Results showed that acceptance of pornography use positively predicted sexual satisfaction for both men and women. Self-esteem as impacted by pornography was found to have no significant relationship with relationship satisfaction although sexual satisfaction was positively related to relationship satisfaction

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(8083058), Rachael E. Martin. "Impact of Parent Trauma on Parents' Beliefs Regarding the Benefit of Child Mental Health Care Services." Thesis, 2019.

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The purpose of this quantitative study was to examine the interaction between parents’ own trauma and their assessment of their child’s functioning and its relationship to the parent’s belief that their child would benefit from mental health care services. The parents’ trauma experience was measured using the Adverse Childhood Experiences (ACEs) questionnaire and Trauma History Questionnaire (THQ), and the child’s functioning was measured using the Columbia Impairment Scale (CIS). It was hypothesized that the higher number of traumas a parent experienced was associated with a weaker relationship between a parent’s assessment of their child’s functional impairment and the likelihood a parent recognizes the benefit of mental health care services for their child. One hundred and eighty-four people participated in this study. Data were analyzed using multiple binary logistic regression, and no significant relationship was found between a parent’s assessment of their child’s functional impairment and that parent’s belief that their child would benefit from mental healthcare services. The parent’s childhood THQ score and age were found to have significant positive relationships with the parent’s belief that their child would benefit from mental healthcare services. The variable found to have the most significant positive relationship with the parent’s belief that their child would benefit from mental healthcare services was an educational or healthcare professional telling the parent that the child would benefit from mental health care services. Clinical implications, limitations, and future directions for research were addressed.

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(11204100), Alia Azmat. "Mind, Body, Spirit: Muslim Women's Experiences in Therapy." Thesis, 2021.

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This dissertation presents in the form of two distinct chapters conceptually related in nature. The first chapter integrates literature from various fields such as indigenous, womanist, and feminist lenses to propose nine principles when working with Muslim women. The purpose of the second chapter is to examine Muslim women’s experiences in therapy at university counseling centers. The study explores women’s experiences from a social determinants of health perspective and a narrative inquiry method—namely, how intrapersonal, interpersonal, institutional, community, and policy factors inform women’s experiences. Qualitative analysis from interviews with six women suggests Muslim women navigate multiple systems which inform their beliefs about health and their experiences in therapy.

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Bennett, Simon Te Manihi. "Te huanga o te ao Maori : Cognitive Behavioural Therapy for Maori clients with depression : development and evaluation of a culturally adapted treatment programme : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Wellington, New Zealand." 2009. http://hdl.handle.net/10179/1159.

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A manualised cognitive behavioural therapy (CBT) programme was culturally adapted for use with adult Maori clients with depression who were receiving treatment from Te Whare Marie, a Maori Mental Health service that covers the greater Wellington region. The manual was developed in consultation with local and international literature pertaining to CBT with minority groups and the recommendations of an advisory team. The treatment programme integrated significant Maori concepts with the traditional strategies associated with CBT. The intervention was trialled with 16 Maori clients from Te Whare Marie with a primary diagnosis of depression. Case study and group analysis indicated that the adapted intervention was effective in reducing depressive symptomatology and negative cognition, and increasing general wellbeing in four culturally relevant dimensions. Differences between pre- and post- treatment scores were statistically significant in each of these areas. The intervention did not have a significant impact on the construct of cultural identity. Participants expressed high levels of satisfaction with the treatment, and in general the adaptations were positively received. Treatment was characterised by particularly low dropout rates with 15 of the 16 participants attending seven or more sessions. These results were discussed with reference to their implications for effective delivery of clinical service delivery to Maori consumers of mental health services in New Zealand.

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Foo, Koong Hean. "Comparing characteristics, practices and experiential skills of mental health practitioners in New Zealand and Singapore : implications for Chinese clients and cognitive behaviour therapy : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Albany, New Zealand." 2007. http://hdl.handle.net/10179/1540.

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Content removed due to copyright restrictions: Paper titled, "Practitioner characteristics with comparison of counselling and psychotherapy practices between New Zealand and Singapore mental health practitioners" was presented and published in the proceedings of The Inaugural International Asian Health Conference, at the University of Auckland, 4-5 November 2004. 2. Workshop cum paper titled, " A modified cognitive behavioural therapy model for working with Chinese people" was also presented and published in the above Conference. 3. Abstract on paper titled, "Integrating homework assignments based on culture: Working with Chinese patients" was accepted in April 2006 for publication in the Cognitive and Behavioral Practice. 4. Paper titled, "Cultural considerations in using cognitive behaviour therapy with Chinese people: A case study of an elderly Chinese woman with generalised anxiety disorder", was published in November 2006 in the New Zealand Journal oj Counselling, Volume 35(3), 1 53- 1 62, and presented at the 29th National Conference of the Australian Association for Cognitive Behaviour Therapy, 1 8- 20 October 2006, under the title "Cultural considerations for Chinese people: Implications for CBT". 5. Abstract on paper titled, "Cognitive behaviour therapy in New Zealand and S ingapore : From a doctoral study and personal experience" was presented and published (in a book of abstracts) at the 1 st Asian Cognitive Behaviour Therapy (CBT) Conference: Evidence-based Assessment, Theory and Treatment, at The Chinese University of Hong Kong, 28-30 May 2006. 6. Paper titled, "CounsellinglPsychotherapy with Chinese Singaporean clients" was published in 2006 in the Asian Journal oj Counselling, Volume 1 3(2), 27 1 -293 .
This study compared the characteristics, self-reported practices and experiential skills of mental health practitioners (MHPs) in New Zealand and Singapore with the aim of benefiting both nations in managing the mentally ill. A mixed-research design was used consisting of a mail questionnaire survey and a structured interview. For each country, mail questionnaires were sent to 300 MHPs, namely, counsellors, psychiatrists, psychologists, psychotherapists, and social workers, while structured interviews were held with 12 MHPs. Potential participants were drawn from available electronic or printed publications on counselling and psychotherapy services in both countries. Those drawn from individual listings of MHPs were systematically sampled, whereas those drawn from organisational listings of MHPs were sampled by way of estimation. Despite the relatively low response rates of 20% to 27% from the participants of the mail questionnaire, the major findings were supported and augmented by those from the structured interviews in the combined analysis of results. Results were categorised into personal, professional and practice characteristics of MHPs. Personal characteristics included demographic characteristics. Professional characteristics included training characteristics, primary job affiliation and use of Western therapy models and interventions. Practice characteristics were sub-divided into five categories: practice setting; diagnostic system and assessment procedures; client and caseload; gender/ethnic match; and experiential skills. Similarities in personal and demographic characteristics between MHPs of both New Zealand and Singapore were found with respect to gender, ethnicity, and language ability. Differences in these characteristics were found with respect to age range and religious affiliation. Similarities in professional characteristics between MHPs of both countries were found with respect to country of therapy training, qualification in therapy, number of years of supervised training received, and use of Western therapy models and interventions. Differences in these characteristics were found with respect to primary job affiliation, availability of clinical psychology programmes, years of experience in therapy, and registration of practice. Similarities in practice characteristics between MHPs of both countries were found with respect to relevance of therapy models, focus of practice, diagnostic system and use of assessment procedures, clients seen, clients' presenting problems, and gender/ethnic match. Differences in these characteristics were found with respect to preferences of therapy models, and average number of sessions per client. Similarities in experiential skills between MHPs of both countries were found with respect to handling of self-disclosure, religious or spiritual issues, and traditional healers. Implications for Chinese clients and cognitive behaviour therapy were discussed, as well as limitations of the study.

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(9183017), Lindsay K. Mayott. "PERSPECTIVES OF MENTAL HEALTH SERVICES FOR REFUGEES IN THE U.S.: FOCUS ON RESETTLEMENT AGENCIES." Thesis, 2020.

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As of June 2020, there were nearly 71 million displaced persons worldwide fleeing their homes due to conflict and war (“Figures at a Glance,” UNHCR, 2020). One of the critical needs following displacement and subsequent resettlement is to address the immense psychological turmoil refugees may have endured. Despite the need for care, refugees often face barriers to accessing mental health care after resettlement, including inadequate translation services, poor provider cultural competence, and difficulty navigating services (Asgary & Segar, 2011). An important aspect in meeting the mental health needs of resettled refugees in the U.S. are the refugee resettlement agencies that help refugees rebuild their lives post-resettlement. Thus, this study focused on the mental health providers working with resettled refugees within refugee resettlement agencies. Through the use of mixed methods, this study collected quantitative and qualitative data across three phases to 1) obtain a greater understanding of the available mental health services within refugee resettlement agencies, 2) examine cultural competence in mental health providers working within these agencies, and 3) identify the culturally competent strategies mental health providers use to improve access to mental health services in this context. The results of this study, including an integration of the data across phases, and a discussion complete with 12 suggestions for mental health providers working with resettled refugees are presented. We hope the results and implications of this study will contribute to our understanding of, and subsequently address, the issues related to mental health service accessibility experienced by resettled refugees.

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(11166732), Meredith A. Bucher. "The longitudinal trajectory and client-therapist agreement of personality traits over the course of therapy." Thesis, 2021.

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Personality traits are important factors of psychotherapy for many reasons, as they relate to a variety of clinical outcomes, can complicate treatment, and can also be targets of treatment interventions. Because of its clinical prevalence and impact, it is imperative that therapists are able to effectively assess and treat personality pathology. Previous research has indicated that both client and therapist ratings of personality can provide meaningful information, and this varies across different sessions, but no study to date has examined both client and therapist ratings across the entire therapeutic intervention. There is also limited information on the agreement of client and therapist ratings of personality, as the majority of studies only examine the outset, the end, or a random time point of treatment. Examining only one point in time – or just the beginning and end – misses valuable information regarding possible changes in personality occurring throughout treatment. Using a naturalistic dataset of 128 client-therapist dyads (3,440 observations), the present study examined the longitudinal trajectory of client and therapist ratings of personality change throughout intervention while also accounting for state-level distress. Additionally, the agreement between clients and therapists were examined throughout treatment for any potential patterns of change using rank-order, mean-level, and absolute agreement. Significant patterns of trait change and change in absolute agreement across treatment were assessed using multilevel modeling. Last but not least, the agreement among clients and therapists were examined as potential predictors of therapeutic outcomes, such as engagement and improvement. The results provided evidence for significant decreases in neuroticism that were reported by the client but not therapist that suggest clients might be report decreases in state-level distress rather than true trait change. There were meaningful fluctuations in agreement across treatment, particularly for openness to experience and neuroticism, but the overall agreement – or lack thereof – did not significantly predict client engagement or improvement. Results highlight several clinical implications that are discussed.

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Jones, Linda Miriam. "The quicksilver quest : two psychological studies investigating the effects of mercury in dentistry : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Wellington Campus, New Zealand." 2005. http://hdl.handle.net/10179/1673.

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Content removed due to copyright restriction: Jones, L. M. (2004). Focus on fillings: A qualitative health study of people medically diagnosed with mercury poisoning, linked to dental amalgam. Acta Neuropsychiatrica, 16(3), 142-148. Jones, L. (1999). Dental amalgam and health experience: Exploring health outcomes and issues for people medically diagnosed with mercury poisoning. The Bulletin, 97, 29-33.
The longstanding debate over the safety of mercury in dentistry has latterly moved from scientific argument to public health dilemma. Mercury is a neurotoxin. Adverse psychological outcomes can result from exposure, so The Quicksilver Quest aimed to investigate mercury in dentistry from a qualitative, critical health psychology perspective, and a quantitative, neuropsychology assessment. The qualitative study used focus group methodology to explore micro-mercurialism linked to dental amalgam fillings. A random sample of people, who had been medically diagnosed with mercury poisoning, formed seven focus groups. The discussion of experiences, beliefs, and health was analysed for themes and issues. The main findings were that the participants were not a homogeneous group, as had been anticipated, but fell into categories differentiated by their symptoms, fiscal resources, and motivation. A placebo effect was rejected as an exclusive explanation for the positive health outcomes reported by those who had had amalgam removal and detoxification. The quantitative study investigated the long-term effects of occupational mercury exposure on a cohort of women in dentistry. The aim was to test the null hypothesis: that women who endured high occupational mercury exposure in the 1970s (43 participants), and matched controls (32 participants), would show no between-group differences on a general and reproductive health survey, and a nine-test neurobehavioural assessment. Results generally supported accepting the null hypothesis. Significant exceptions were current symptom experience, reproductive health, and two mood subscales. There was a suggestion of peripheral nerve damage in the exposed group. Overall, the general discussion systematically reviews tension points in the debate, in light of a proposed model of tolerance to mercury. This begins to explain how it might appear that mercury in dentistry is safe for dental personnel, as pro-amalgam debaters claim, yet unsafe for some dental patients, as anti-amalgam debaters claim. Further study is suggested for occupationally exposed women, on tremor, and to test the proposed tolerance to mercury model. Finally, as the debate has a political aspect, a recommendation is made for a shift in public health policy to dental amalgam being restricted to use only in an adult population.

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Hirini, Paul Ryan. "Ngā ara whaiora : he whakaaro noa = A study of Māori health care use : an evaluation of the Andersen model : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Turitea Campus, Palmerston North, New Zealand." 2004. http://hdl.handle.net/10179/1691.

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Using interview data the present study applied a leading health care use explanatory model (the Anderson model) to a sample of 502 community-dwelling New Zealand Māori adults. To date the Andersen model has been applied extensively in overseas (principally U.S.) research, yet not specifically to an indigenous population such as the New Zealand Māori. The Andersen model proposes that health service use is a function of three components: predisposing, enabling and need characteristics. Using hierarchical multiple regression analyses three overarching research goals concerning the model were investigated: (1) To test the efficacy of the Andersen model in the prediction of Māori health care utilisation; (2) to extend the model by considering the role of life events as a predictor of Māori health service utilisation; and (3) to extend the model by considering the role of psychological distress as a predictor of Māori health service utilisation. As a further extension on previous work, the present study also sought to: (4) Extend the model by considering the role of traumatic experience in the prediction of Māori health service utilisation. The Andersen model was found to explain between 8.5% and 26% of variability in the sample's use of six types of health care, finding need characteristics to be the major determinants of health care use. Life events was not a significant contributor to explaining use, and psychological distress was effective only in predicting mental health service use. Findings suggest that using aggregate measures of traumatic experience is not a particularly helpful strategy for predicting subsequent health care use by Māori. On reflection of findings and implications the present study concludes with discussion concerning: (1) A need to advance conceptualisations of what constitutes health services for Māori; (2) suggestions for future examination of trauma and Māori health care use; (3) the role of culture in influencing health beliefs and behaviour; and (4) potential barriers to health care access by Māori.

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Jourdain, Rebekah Leigh. ""Psychological fallout" : the effects of nuclear radiation exposure : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University." 2009. http://hdl.handle.net/10179/1425.

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Appendices were not supplied with the digital version of the thesis but are available in the print version.
The present research includes two studies. Study I was based on the research finding that exposure to nuclear radiation and other toxic chemicals results in those who were exposed not only believing their health to be affected, but experiencing significant and chronic stress. It was hypothesised that ongoing stress for New Zealand’s nuclear test veterans resulting from the inability to adapt to their past nuclear exposure would result in them experiencing greater depressive symptomatology, poorer perceived health, and poorer perceived memory performance than a control group. Psychological profiles of 50 nuclear test veterans and 50 age-matched Control participants were obtained through postal survey and face-to-face interview, using the Geriatric Depression Scale, Medical Outcomes Study Short Form-36, and the Memory Assessment Clinics Self-Rating Scale. As predicted, the nuclear veterans exhibited more depressive symptoms, and perceived their health and memory performance to be poorer than the Control group. A stress theory framework is applied to help conceptualise the experience of the nuclear veterans, and to provide an explanation for their lower scores and consequent poorer functioning. Through the pathway of poor perceived health leading to anxiety, health anxiety was considered a form of chronic stress the nuclear veterans were experiencing. Consequently, Study II aimed to examine whether Acceptance and Commitment Therapy (ACT) could be usefully applied to relieve this anxiety. Most psychotherapeutic approaches have been developed for problems that have an "irrational" or "pathological" foundation. However, these approaches often fit poorly with psychological distress that stems from cognitions that are reality-based and may need to be accepted rather than changed, such as in the case of nuclear exposure-related health anxiety. ACT may be particularly useful in these situations in which cognitive change is not warranted. Study II examined the use of ACT with 5 NZ nuclear test veterans (of either Māori or Pākehā descent) experiencing moderate to high levels of health anxiety. Results of self-report measures administered at baseline, during treatment, post-treatment, and at 6-week follow-up indicated varying results amongst these men. One participant showed clinically significant post-treatment reductions in health anxiety, experiential avoidance, and general psychological distress that were maintained at follow-up. Two participants showed clinically significant post- vi treatment reductions in health anxiety, experiential avoidance, and distress, despite not engaging in therapy as they did not wish to make changes. For the same reason, a fourth participant chose not to engage in therapy, despite high baseline scores on all measures, and showed no improvement during or after therapy. The fifth participant had low baseline scores on all measures, maintaining these throughout therapy, and at follow-up. Results are explained in terms of cohort and gender effects, with suggestions for adapting ACT with NZ older adults, particularly males. Implications for the utility of ACT with toxic exposure populations, older adults, and various cultures are discussed.

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Dissertations / Theses on the topic 'Health, Clinical and Counselling Psychology'

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