Dissertations / Theses on the topic 'Psychological therapy'
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1
Kershaw, Anna. "Adolescents' attitudes towards psychological therapy." Thesis, University of Leicester, 2011. http://hdl.handle.net/2381/9902.
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The literature review explored adolescents‟ experiences of psychological therapies. Sixteen studies were reviewed and a narrative synthesis found that therapist characteristics, the wider context of mental health and personal feelings were important aspects of the therapeutic encounter for the adolescent population. Synthesis of the evidence was limited by methodological weaknesses. Further research regarding what hinders engagement in therapy and macro-level influences on the therapeutic encounter was suggested. The research study utilised a qualitative, semi-structured interview design to explore adolescents‟ experiences of psychological therapy. The accounts of eight adolescents were analysed using Grounded Theory methodology (Glaser & Strauss, 1967). The findings suggested that adolescents‟ attitudes towards psychological therapy were affected in a complex and dynamic manner by their experiences of the therapeutic process, their experiences of the therapist and their views about what others‟ think. The research also suggested that adolescents represent a high risk group for disengagement from psychological therapy. The findings were discussed in the context of existing research and it was suggested that professionals providing psychological therapy should consider taking an active political role in shaping future service developments to enable services to engage better with this client group. Further research exploring whether these findings are more widely generalisable was suggested. A personal account of the researchers‟ reflections on the research process is provided in the critical appraisal.
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Bennion, Lorna Denise. "Older adults and psychological therapy." Thesis, University of Warwick, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.487648.
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This thesis explores a number of issues related to psychological therapy with people in later life, those over the age of 65 years, over three chapters. Chapter I, the literature review, explores engagement and therapeutic alliance with this population. The review highlights that the literature on this topic is sparse and that it originates in America. The following key themes are discussed: measures, predictors, influencing factors, enhancing or facilitating factors of engagement and/or therapeutic alliance. Implications for clinical practice in terms of awareness, education, training, and further research are discussed. Chapter II, the empirical paper, is a study exploring how people inJater life describe their e{periences of psychological therapy. Eight people over the age of 65 years were interviewed about their recent experiences of psychological therapy. Transcripts were analysed using grounded theory. From the analysis a process model was devised based on 3 core categories: before therapy, in therapy and after therapy. Implications for clinical practice, service development and future research are discussed. Chapter III, the reflective review, reflects on the research process, what has been learnt about the topic area and working with older adults. Reflections are provided with the aim of being useful to the author and others in terms of professional development and future research.
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Völker, Faye Tameryn. "Psychological therapy in prisons : professionals' perceptions." Thesis, University of Wolverhampton, 2016. http://hdl.handle.net/2436/621869.
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Haywood, Catharina S. "Psychological therapy for medically unexplained symptoms." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/415890/.
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The first chapter of this thesis is a systematic review of the literature into factors that influence outcomes for people with medically unexplained symptoms (MUS), treated with cognitive behavioural therapy (CBT). A total of 14 papers were identified that met the inclusion criteria and due to the heterogeneity of results, a narrative synthesis was employed. In terms of participant characteristics, neither age, gender, comorbid depression, comorbid anxiety, or comorbid personality disorder were related to therapeutic outcomes. A greater number and intensity of symptoms were related to better outcomes. Some weak evidence was found for the impact of familial status and social difficulties, however only a limited number of articles examined those variables. In terms of therapeutic factors, individual CBT was identified as having slightly superior outcomes over group CBT and certain cognitive and behavioural factors were also identified as relevant. The findings were less clear about whether clinician profession or the number of sessions offered predict better or worse outcomes. Future research should continue to identify relevant variables involved in CBT’s effectiveness in MUS and, where possible, manipulate variables experimentally. The second chapter of this thesis is an empirical research paper examining the effectiveness of CBT and cognitive analytic therapy (CAT) at improving psychosocial, physical health, and economic outcomes for people with MUS. The paper also sought to consider whether any participant or illness characteristics predicted outcomes after treatment. CBT (N = 31) and CAT (N = 17) were no different across any of the outcomes and they were therefore grouped together as Cognitive Therapy (N = 48). A treatment as usual (TAU, N = 56) group did not receive psychological treatment and were used in analyses of economic outcomes. The Cognitive Therapy group improved significantly across all measures of psychosocial and physical health outcomes at the end of therapy compared to at the start. Neither gender, ethnicity, number of symptoms, or duration of symptoms had any impact on the improvements seen. There was no reduction in inpatient, outpatient or A&E cost at either 6, 12, or 18 months after treatment ended and between those who received cognitive therapy and those who received treatment as usual. Clinical implications and avenues for future research are discussed.
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Holding, Joanne. "Beliefs about psychological therapy for psychosis." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/beliefs-about-psychological-therapy-for-psychosis(954b220f-d471-473b-a75e-8fe4a0fdb30f).html.
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The thesis provides a detailed exploration of the beliefs people with experiences of psychosis have about psychological therapy. It is presented in three papers: (1) a literature review, (2) an empirical study and (3) a critical evaluation and reflection on the research process. The literature review used a narrative synthesis approach to systematically review, explore and consolidate the existing qualitative and quantitative literature available on beliefs about therapies for psychosis. Thirty-five studies were identified for inclusion. Distinct themes and subthemes were developed for two distinct types of beliefs: Expectations and Experience. Within expectations, three themes were described: outcomes, process and barriers. Within experience, four themes were described: satisfaction, outcomes, process and therapist characteristics. Subtheme descriptions were used to highlight the multi-faceted and complex beliefs services users hold about therapy. Levels of satisfaction were high and many positive outcomes were reported. However, the available data is primarily limited to those who have completed therapy, resulting in an unbalanced account available in the literature. Data about expectations has also not been adequately addressed. Key areas for clinical intervention and future research opportunities are highlighted. The empirical study attempted to build on findings from the literature review and employed Q-methodology to explore beliefs about therapy for psychosis with young people in Early Intervention Services (EIS). Four distinct belief factors were identified: (1) Therapy is helpful and gives hope for the future; (2) Therapy is just talking, people need medication; (3) Therapy is useful but stigmatising; (4) Therapy is better than medication. Positive accounts of therapy were most strongly expressed within factor 1, but all factors contained some regard for the therapeutic process. Other important views were present in these accounts as well, including both the importance and dislike of medication, as well as concerns about potential stigmatisation. Q methodology proved to be a useful tool for engaging with young people and developing a rich understanding of a complex topic. The Q study has addressed some of the limitations described in the literature review and highlighted important areas for clinical consideration. Further research is still required to address outstanding issues, such as beliefs of people who are difficult to engage and people from Black and Minority Ethnic (BME) communities. The third paper is a critical evaluation of the research process in totality. This includes reflections on decision-making processes, as well as lessons learned for the future. It provides a final overview of the clinical and research implications highlighted by the previous two papers, concluding that beliefs about therapy are important and warrant further detailed exploration by clinicians and researchers, to improve practice and service user experience.
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McIntosh, Maureen. "Older adults' experience of psychological therapy." Thesis, City University London, 2013. http://openaccess.city.ac.uk/14798/.
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The portfolio examines the older adult experience of psychological therapy. The research study is from the older adult perspective and it provides a rich narrative and strengthens theory and practice links. This research explored older adult service users’ retrospective accounts of Psychological Therapy within a secondary care service. The aim was to enhance the knowledge base and understanding of what is known about older adults’ subjective experiences of the processes involved when receiving Psychological Therapy. A qualitative methodology was chosen to allow the older adult participants to express their thoughts and feelings using unstructured interviews. The Grounded Theory analysis revealed categories and themes which produced a theory that explains the process of therapy. Nine older adult participants volunteered to take part and a grounded theory analysis of the data yielded a core category of ‘moving towards equanimity’. The category can be understood as contributing to the older adult participants regaining emotional stability, mental calm and balance. Within the Professional Practice section the case study features the complexity of the therapeutic work with an older adult who experienced depression and insomnia. The case examines the flexibility in the use of the therapeutic model and the core skills required within a strong therapeutic relationship which helped the older adult hold onto hope. The final part of the portfolio is a critical review about older adults and the therapeutic alliance. The review examines studies that have explored this extensive research area to raise awareness of the factors that influence the development of the alliance with older adults.
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Morris, Eric. "Processes of change in psychological therapy for psychosis." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/processes-of-change-in-psychological-therapy-for-psychosis(c9323073-2a4b-4eb6-b0b8-355f962e177b).html.
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Kainth, Tony. "Managing minority identities : the role of psychological therapy." Thesis, City University London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.551115.
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This study explores South Asian British gay men's experiences of therapy. Salient literature in the fields of lesbian, gay and bisexual (LGB) identities; ethnic identities; and psychotherapeutic theory and practice highlighted the need for continuing qualitative investigation into experiences of therapy. The paucity of research examining ethnic, sexual and multiple minority populations' experiences of therapy in the United Kingdom, coupled with queer theory's endeavours to deconstruct hegemonic discourses with a view to reconstructing fluid and ambiguous identity categories, deemed the current investigation pertinent. Eight self-identified gay British men of South Asian descent who had experienced psychological therapy were interviewed, using a semi-structured interview schedule. The interview data were then transcribed and were analysed utilising a constructivist grounded theory methodology. Two core categories, seven categories and 21 sub-categories were evident following analysis of the interview data. The core categories were 'Managing Multiple Identities' and 'Experiencing Therapy'. The role of context was also explored in relation to the core category 'Managing Multiple Identities'. The findings were then considered in relation to the existing relevant literature with reflections on the quality of the research and on clinical implications and future directions arising from the findings. Particular focus is given to identity process theory, queer theory and LGB affirmative therapy.
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Copeland, Robert James. "Exercise as a psychological therapy in obese adolescents." Thesis, Sheffield Hallam University, 2007. http://shura.shu.ac.uk/20646/.
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Childhood obesity has reached epidemic proportions globally (Wang & Lobstein, 2006). Obesity has been linked with psychopathology in adolescents seeking treatment (Zametkin, Zoon, Klein & Munson, 2004). To avoid serious health consequences in adulthood, the high incidence of psychopathology in this population needs to be addressed. Exercise has the potential to improve both physical and psychological health simultaneously; however, there is a lack of research investigating the effects of exercise upon psychopathology in obese young people. Therefore, this thesis provides an examination of the effects of a supervised exercise therapy intervention upon psychopathology related outcomes in obese adolescents using a randomised controlled trial (RCT) method. The primary trial hypothesis was that exercise therapy would lead to improvements in participants' physical self-esteem and reductions in psychopathology. Two qualitative studies explored obese adolescents' experiences of participation in an exercise therapy intervention and a further study investigated their ratings of perceived exertion (RPE) during exercise. The population sample consisted of 81 obese (body mass index (BMI) > 2.5 SDS, adult equivalent BMI of > 30) adolescents aged between 11-16 years who had been referred to a children's hospital for evaluation of obesity or responded to a community advert. Participants were randomised to exercise therapy, an equal contact exercise-placebo intervention or usual care control. Intervention participants attended three one-to-one sessions per week, over eight-weeks and then completed a home programme for six-weeks. Participants were interviewed at the end of the eight-week intervention and again after the home programme. Outcomes included self-perceptions (self-esteem), depression, affect, physical activity and BMI. Repeated measures mixed analysis of covariance (controlling for baseline scores) revealed significant differences in physical self-worth, associated measures of self-esteem and physical activity over time in favour of the exercise therapy condition. There were no significant differences in BMI. Findings from the qualitative studies revealed that obese adolescents were happier than when they began the programme, expressed surprise at how much they were capable of achieving in terms of exercise and felt empowered to continue to exercise over the long-term. Some felt that the intervention was not long enough and many of the common barriers to exercise typically reported by other young people, such as time, were cited at interview. Obese adolescents reported RPE during exercise to be significantly greater for the lower limbs compared with aerobic exertion. This study is the first RCT to demonstrate that a brief supervised exercise therapy intervention has the potential to significantly improve psychopathology related outcomes and increase physical activity in obese adolescents, relative to usual care. Findings indicate that obese children can successfully perform short intermittent bouts of structured exercise, given the opportunity, and that physical activity can contribute to the enhancement of their psychological and social well-being. Results also suggest that obese adolescents find prolonged bouts of exercise fatiguing in the lower limbs particularly which underlines the critical need for future interventions aimed at treating obesity to be aware of the importance of assessing ratings of perceived exertion during exercise. It is hoped that this thesis will generate additional research interest and concern about the psychopathology of young people who are obese. In particular, raise awareness of the importance of assessing the efficacy of obesity treatments in relation to psychopathology outcomes in future trials. It is also hoped that the exercise therapy guidelines provided here would inform health practitioners in the delivery of exercise therapy and highlight the potential contribution exercise therapy could make to the treatment of childhood obesity in pragmatic environments such as the NHS.
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Webb-Ferebee, Kelly. "Expressive Arts Therapy with Bereaved Families." Thesis, University of North Texas, 2001. https://digital.library.unt.edu/ark:/67531/metadc2861/.
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Most current grief programs support the children and/or parents of bereaved families rather than the family as a whole. This exploratory study was a quantitative and qualitative investigation of the use of expressive arts therapy with bereaved families during a weekend camp experience and a series of followup sessions. The purpose of the study was to determine the effectiveness of using expressive arts activities in improving the functioning of the bereaved family as a whole as well as individual family members. Participants included eight families who lost a child to a chronic illness between 2 to 36 months months prior to the onset of the study. Children ranged in age from 3 to15, and parents ranged in age from 26 to 66, for a total of 27 participants. The Child Life Department at Children's Medical Center of Dallas, a division of The University of Texas Southwestern Medical Center in Dallas, Texas recruited the families. Participants received flyers and invitational letters and registered through the mail. Families attended a weekend camp where they experienced a wide variety of expressive arts activities in a combination of group formats: multi-family groups, parents' group, developmental age groups for children, total childrens' group, individual family group, mothers' group, and fathers' group. The research design was a pretest/posttest quasi-experimental control group design, but a control group could not be established. Therefore, one-tailed t-tests were used to compare participant functioning between the beginning and end of the study. Instruments used in this study included the Family Environment Scale, the Behavior Assessment System for Children the Beck Anxiety Inventory and the Beck Depression Inventory. In addition, the researcher used qualitative analysis to assess contents of family members' and counseling staff's journals, expressive arts products, and family members' evaluations. Results of this exploratory study indicated some improvements in children's, parents' and total family functioning. Expressive arts therapy shows promise in effecting constructive change in bereaved families and is deserving of further research.
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Vlissides, Nikolaos. "The Psychological Therapy Outcome Scale – Intellectual Disabilities (PTOS-ID) : the development of a psychological therapy outcome measure for adults with intellectual disabilities." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2010980/.
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People with intellectual disabilities are more likely to experience living circumstances and life events associated with an increased risk of mental health problems, compared to the general population (Hulbert-Williams & Hastings, 2008). These include: lack of meaningful relationships, stigmatization, unemployment, and discrimination (Martorell et al., 2009; Thornicroft, 2006). Prevalence of mental health problems are difficult to determine within this population, with estimates ranging from 10% to 39% (Emerson & Hatton, 2007). Pharmacological and behavioural approaches have often been used in the treatment of mental health problems for people with intellectual disabilities (Vereenooghe & Langdon, 2013). Bender (1993) argued that the lack of psychotherapeutic interventions available was due to a perceived “therapeutic disdain” towards this population. Difficulties identifying mental health problems in people with intellectual disabilities, perceived lack of training amongst practitioners, and lack of research evidence have also been cited as reasons for lack of provision of psychotherapy services (Emerson, Moss & Kiernan, 1999; Royal College of Psychiatrists, 2004; Taylor & Knapp, 2013). These views have been challenged by clinicians, and there is a growing evidence base of the effectiveness of psychological therapies with people with intellectual disabilities (Willner, 2005). The research has come from both single case studies (Kellett, Beail, Bush, Dyson & Wilbram, 2009; Salvadori & Jackson, 2009) and controlled clinical trials (Taylor, Novaco, Gillmer, Robertson & Thorne, 2005). Recent systematic reviews and meta-analyses have also highlighted the effectiveness of Cognitive Behavioural Therapy (CBT) and psychodynamic therapy with this population (James & Stacey, 2014; Nicoll, Beail & Saxon, 2013; Vereenooghe & Langdon, 2013). In one of the most comprehensive reviews to date, Prout and Nowak-Drabik (2003) reviewed the outcome and effectiveness of 92 studies and found that there was a moderate benefit of psychotherapy for people with intellectual disabilities. Recent legislation in the United Kingdom has responded by recommending improved access to psychological therapy for people with intellectual disabilities (Department of Health (DoH), 2007; 2009). The emergence of practice-based evidence has also meant that there is a growing expectation that services that provide psychological therapies show some evidence for the effectiveness of what they do (DoH, 2010). Coupled with this is the Payment by Results (PbR) initiative, where commissioners will pay healthcare providers dependent on the number of patients seen and outcomes achieved (DoH, 2013). One of the difficulties for providers of psychological therapies for people with intellectual disabilities is the availability of valid and reliable therapy outcome measures that can be easily used in service settings and accurately assess the effectiveness of interventions (Skelly, 2011; Weston, Elsworth & Stacey, 2011). Thesis This thesis aims to address the difficulties in measuring outcomes of psychological therapy with people with intellectual disabilities. The first paper will systematically review the quality of outcome measures that have been used in psychological therapies with adults with intellectual disabilities. The second paper will assess the psychometric properties of the Psychological Therapy Outcome Scale – Intellectual Disabilities (PTOS-ID), a newly developed therapy outcome measure designed specifically for use with people with intellectual disabilities. Timeline of Work Elements of research reported in this thesis were completed before the commencement of the Doctorate in Clinical Psychology programme. These were the development of the PTOS-ID, which included selection of the dependent variables through the use of focus groups; the selection of the item pool; and the development of the response format (please see the Introduction of the research paper for further details). The assessment of the psychometric properties of the PTOS-ID (i.e. construct validity, concurrent validity and internal consistency) was completed for the research study reported in this thesis in partial fulfilment of the award of Doctor of Clinical Psychology. Data were collected through service audits both prior to, and during, the period of study for this doctorate.
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Stuart, Joanne. "An exploration of outcomes of psychological therapy for refugees." Thesis, University of East London, 2009. http://roar.uel.ac.uk/3738/.
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Refugees seeking asylum in this country have undergone multiple traumas. Many are fleeing persecution or have lived in war zones where there is a constant fear for one's life or safety. Some have lost loved ones, friends, or members of their community in brutal circumstances. Torture has been a factor for many, where the physical, psychological and social outcomes are far-reaching. All have fled their country of origin seeking refuge in a foreign land, where perhaps the language and culture is unfamiliar to them. The UK government has stated that refugees should be offered therapy in a psychology service once they arrive in the UK and a number of such services exist today. It is difficult to ascertain what psychological help might be useful for refugees and asylum seekers from the current literature due to a number of difficulties with the research. Some have argued that a qualitative methodology is appropriate to use when conducting research with different cultures, as it allows the emergence of unexpected material and can privilege indigenous knowledge, rather than quantitative research, which forces expression within the categories provided by the researcher, thus imposing ideas by dominant cultures. This research set out to explore how refugees and asylum seekers describe their experience of psychological therapy. The aim was to give a voice to those who are generally marginalised, with the hope that the information participants provide can be used to develop future therapeutic services for refugees and asylum seekers. Interpretative Phenomenological Analysis was used to analyse interviews with eight participants who had attended an NHS primary care psychology service. Themes relating to being 'stuck in the past', 'searching for solutions', 'helping me to move on' and 'moving on' were discussed and implications of these themes on service improvements, clinical psychologists, and further research were considered. Conducting this research has led to the conclusion that despite the experience of extreme events people show the strength, determination and resilience to find solutions to their problems thereby enabling them to 'move on' and to find lives that are meaningful to them.
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Kapasi, Zahera Danielle. "Exploring the role of language switching in psychological therapy." Thesis, University of Leicester, 2013. http://hdl.handle.net/2381/28336.
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Literature Review: A systematic review was conducted exploring the use of language switching in therapy and its role in therapeutic engagement for bilingual therapists and their bilingual minority ethnic clients. The review identified three main themes of research focusing on the training needs and professional development of bilingual therapists; the emotional aspects of language use; and the use of language switching and its perceived effects on the therapeutic process. Findings highlighted that language switching can be a powerful and useful tool to enhance therapeutic engagement and client self-disclosure though gaps in the training needs of bilingual therapists was evident. Implications for future research and practice are discussed for enhancing our understanding of a tool which may prove valuable for bilingual therapists when accessing and engaging with diverse populations in the therapeutic domain. Research Report: A two-part investigation was conducted to explore the current practices on language switching amongst bilingual clinical psychologists in the United Kingdom. A survey indicated the prevalence of language switching across a diverse range of language skills and backgrounds whilst semi-structured interviews explored, in depth, experiences of South Asian clinical psychologists and the complexities associated with language switching. Findings highlighted the value of language switching and the tensions which arise relating to psychologists‟ identity, professional boundaries and supervision needs. Clinical implications are discussed and recommendations for future research are provided for an area of practice which is valuable in engaging bilingual minority ethnic populations. Critical Appraisal: A reflective diary provided an account of the research process considering the research strengths, limitations and learning outcomes. Those issues pertinent to the researcher have been discussed in this section.
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Melo, Sara Sigmaringa. "A study of the fundamental psychological needs of young people in receipt of psychological therapy." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/1624/.
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Volume I includes the research work carried out by the author during training, and Volume II refers to the clinical work submitted throughout that training. A literature review is first presented in Volume I, exploring the peer-reviewed papers published in the English language over the past two decades on the application of Self-Determination Theory (SDT) to the psychological treatment of individuals with mental health difficulties. It was written up for submission to Counselling Psychologist. After this, an empirical paper is presented. This is a qualitative study of the experience of psychological therapy by young people with severe mental health problems. The study employs Interpretative Phenomenological Analysis to explore the lived experiences of seven young people, and to identify common themes in relation to how therapy influenced their understanding of themselves and of their future lives. Some implications for future service development are offered in the discussion with a view to highlight what the participants report as both helpful and essential aspects of their psychological treatment. This paper was prepared for submission to Clinical Psychology and Psychotherapy. A Public Domain briefing paper of both papers is presented prior to the appendices. Volume II of the thesis includes five Clinical Practice Reports produced by the author during training.
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Naidoo, Pevashnee. "Barking up the wrong tree : pet therapy in South Africa." Master's thesis, University of Cape Town, 2003. http://hdl.handle.net/11427/7989.
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Bibliography: leaves 183-238.There exists but one local detailed, documented study by Bergensen (1989) that focused on the effects of pet facilitated therapy on the self-esteem and socialisation of primary school children. In addition, a handful of articles have been published in South African journals. It is rather perturbing to note that a proven, highly effective adjunct to conventional therapeutic intervention is lacking in the South African therapeutic milieu. The marked ignorance and defence behind practitioners scorn for this form of therapy is rather perplexing, especially in light of its official existence for over thirty years. This dissertation probes the concept of pet-facilitated therapy by referring to extensive studies, focusing on various sub-populations, and concludes with a study investigating local opposition to pet therapy.
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Hartley, Judith F. "An examination of therapists' experience of impasse in psychological therapy." Thesis, University of Leeds, 2004. http://etheses.whiterose.ac.uk/4188/.
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Whilst therapy impasse has been analysed by a number of clinicians based on their interpretations from case studies, there has been a lack of research studies investigating this phenomenon. The clinical literature points to different aspects of the therapy frame and contract, individual client and therapist factors, the alliance and therapeutic interaction which combine in an idiosyncratic way in each case of impasse. The aims of this research was to examine the accounts of a small number of therapists currently experiencing therapy impasse in order to understand the role that these or other factors play in individual cases of impasse as well as to investigate the meaning and effects of an impasse experience for the therapist. A qualitative methodology was chosen in order to undertake a more in-depth analysis, and four participating therapists were interviewed on two separate occasions. The principles of Interpretative Phenomenological Analysis informed both the design of the study and its analysis. The analysis identified that the early development of problematic transferential patterns of relating was associated with impasse. In these cases of impasse therapists appeared to have a powerful personal engagement with their clients and they experienced strong affect in relation to the therapy process. The role of the therapists' ideal self which comes under threat during impasse was highlighted and the management of impasse was associated with therapists' regaining their therapeutic stance and attending to the therapy process. The implications of the study, in terms o f how clinicians may recognise and respond to cases of impasse at an early stage, are addressed, along with a theoretical discussion of how we might define and understand therapy impasse. A critical analysis of the study is included and suggestions for further research are offered.
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Sharp, Donald MacFie. "The psychological and pharmacological treatment of panic disorder and agoraphobia in primary care." Thesis, University of Stirling, 1997. http://hdl.handle.net/1893/21521.
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Following a review of treatment outcome study methodology, a comparative study of psychological versus pharmacological treatments was conducted; subsidiary studies investigated aspects of treatment outcome in more detail. 193 patients with DSM III-R panic disorder with or without agoraphobia were randomly allocated to; fluvoxamine, placebo, fluvoxamine + CBT (cognitive behaviour therapy), placebo + CBT, or CBT alone. Patients received no concurrent treatments and were treated to the same schedule, with therapist contact balanced across groups. Treatments were conducted in the primary care setting. Outcome at treatment end-point and 6 month follow-up, assessed in terms of both statistical and clinical significance, showed patients receiving active treatments improved significantly, with improvement better preserved over follow-up in the groups receiving CBT. The CBT alone and fluvoxamine + CBT groups showed the most consistent gains, the latter group showing gains earliest in treatment. Outcome was also investigated using brief global ratings of symptom severity, change in symptoms following treatment, general wellbeing and social disruption, completed by psychologist, referring GPs, and patients. Using these measures all active treatments showed statistical advantage over placebo with the groups employing CBT showing the most robust and consistent response. Overall there were no significant differences in drop-out rates between groups although the drop-out rate for patients receiving CBT alone was higher than that for placebo + CBT. Agreement with main outcome measures was demonstrated for psychologist and patient ratings, but not for GP ratings. An investigation of panic attack variables as treatment outcome measures indicated that these did not function as discriminative treatment outcome measures with all treatment groups showing significant reductions in panic attack variables over treatment with few significant differences between treatment groups on any variable throughout treatment. An investigation of prognostic indicators of treatment outcome indicated good prediction of post treatment response using pre-treatment measures of anxiety level, frequency of panic attacks, extroversion and treatment group. Predictions of outcome at 6 month follow-up were less robust. Results are discussed in terms of their relevance to wider clinical practice.
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Kidney, Gillian. "Acceptance and commitment therapy training and psychological flexibility for helping professionals." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/33107.
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This thesis is an exploration of two interconnected areas: Acceptance and Commitment Therapy (ACT) training for helping professionals (HPs) and psychological flexibility in helping professionals. The ACT model holds that HPs need to be psychologically flexible (or, herein, flexible) in order to be effective ACT practitioners, and thus a primary goal of ACT training is to enhance participant flexibility. The first chapter is a systematic review of studies that have evaluated the effectiveness of ACT training. It focused on ACT training practices and outcomes related to knowledge, skills, and psychological flexibility in HPs. The results of this review suggested that ACT training can be effective in providing HPs from a range of occupational background with the necessary knowledge and competency to deliver ACT interventions. Furthermore, ACT training can increase HP flexibility. However, confidence in these findings is limited due to methodological weaknesses, particularly variability in ACT training practices, inconsistent use of available measures, a lack of psychometrically robust measures to assess ACT knowledge, and the absence of a flexibility measure designed for use with HP populations. Recommendations were made regarding future research needs in this area, including the development of a HP-specific measure of flexibility. The second chapter reports on the development and initial validation of a measure designed to assess flexibility in the specific context of professional helping, called the Mindful Healthcare Scale (MHS). The results of two studies employing two separates samples of HPs provided good preliminary evidence of the MHS's factor structure and internal validity. The MHS was also found to converge in theoretically-consistent ways with other measures of flexibility and constructs related to the occupational functioning of HPs including burnout syndrome, self-compassion, and empathy. These findings suggest that the MHS may have considerable utility in relation to ACT training for HPs and may also advance our understanding of flexibility's role in HP occupational well-being and functioning.
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Coles, Sr Gregory E. "The Psychological Impact of Testosterone Replacement Therapy in Middle-Aged Men." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7220.
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Decreased testosterone levels (hypogonadism) in middle-aged men (aged 45-64) has been associated with increased levels of depression. Studies have suggested that increases in anxiety and/or attention problems may also be associated with hypogonadism but have not provided empirical evidence to support these suggestions. The purpose of this quantitative study was to examine depression, anxiety, and attention problems in middle-aged men using a psychological self-report inventory. The theoretical model used in this study was the biomedical model, which combined pharmacological treatment with psychological self-report inventories to determine if there was an association or relationship between the testosterone levels in men and the psychological distress experienced by men who have become hypogonadal. A total of 179 males were recruited through local physicians. There was a statistically significant difference and a small size effect in the level of depression, anxiety, and/or attention issues experienced by those who were receiving TRT versus those who were not. This study may provide some guidance to medical clinicians, such as psychiatrists, primary-care physicians, and endocrinologists, as well as clinical psychologists who see middle-aged men in their practice settings.
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Cormack, M. A. "Psychological alternatives to long-term benzodiazepine use in general practice." Thesis, University of Liverpool, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.234848.
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Harrison, Phillippa. "Expected engagement with psychological therapy : the development of a measure and implementation as a predictor of therapy outcome." Thesis, University of Sheffield, 2018. http://etheses.whiterose.ac.uk/21659/.
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Psychotherapy services face several challenges, one of which is to improve clients’ outcomes following therapy. This thesis aimed to better understand which pre-therapy client factors predict outcomes with particular psychotherapies. A systematic review of client factors that predict therapy outcome was conducted, which identified client expectations of therapy as a promising predictor of therapy outcome. This thesis therefore aimed to develop a programme of studies investigating client expectations of therapy. In order to build on the existing expectations literature, a previously unexplored aspect of expectations- expected engagement- was the research focus. The first aim of this thesis was to develop a valid and reliable measure of expected engagement. The Sheffield Expected Engagement with Therapy Scale (ShEETS) was devised and tested with three independent samples, from which acceptable validity and reliability were established. The next aim was to examine the use of the ShEETS as an outcome prediction tool for depressed clients. Results showed that those who rated cognitive therapy as more expected to engage them, but less credible, had more symptomatic improvement in Cognitive Behavioural Therapy (CBT). There was no significant effect of expected engagement on symptomatic improvement for those who received a person-centred therapy, known as Counselling for Depression (CfD), and no effect on therapy completion for either group. In the final study, levels of engagement during CBT and CfD were rated to understand whether observed engagement mediated the relationship between expected engagement and symptomatic improvement. However, the study did not find evidence to support this hypothesis. The findings of this research indicate that there may be potential for the predictive effect of expected engagement on symptomatic improvement in CBT. The implications of these findings are discussed in relation to the existing literature on expectations and prediction of therapy outcomes.
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Walton, Deborah L. "A Randomised controlled trial of Metacognitive Therapy and exposure Therapy for post-traumatic Stress Disorder: psychological Mechanisms Involved." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.492889.
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Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder effecting an individual's occupational and social functioning. Psychological theories have attempted to explore the underlying mechanisms that are thought to be involved in the development and maintenance of PTSD. From these theories several treatment approacherhavrbeen developed with the majority relying on exposure. To date the effectiveness of exposure treatment has not been surpassed but outcomes vary, with room for improvement. Few studies have examined predictors of change. The study reported here compared a new treatment metacognitive therapy (MCT) with exposure therapy (EXP) and waitlist control condition (WL) and assessed psychological predictors' of treatment outcome.
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Douglas, Blanche Daw. "Understanding the image in art therapy: a phenomenological-hermeneutic investigation." Thesis, Rhodes University, 1999. http://hdl.handle.net/10962/d1002475.
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Part One of the research seeks to establish a context wherein certain assumptions pertaining to the interpretative dimensions of understanding the image in art therapy can be considered and reviewed. Notions about the image, meaning and reality are discussed both in terms of how they relate to current art therapy practice, and how they may be alternatively thought about, both from the perspective of ancient Hellenic Greek thought, and more contemporary thought, particularly that of phenomenological and philosophical-hermeneutics. Part Two of the research investigates the phenomenon of understanding the image in an art therapy situation, with a view to reconsidering certain of the assumptions raised in the first part of the thesis (phrased in the form of research questions). It did this utilizing a qualitative method, by exposing four respondents (patients), and two therapists to an art therapy situation in which images were created out of clay. The respondents (patients) and therapists articulated their understanding of the image production procedure, and the meaning of the images created. The way understanding occurred in the empirical part of the research was explained and illustrated by means of the hermeneutic circle, which was operational on a number of different levels. The results of the research suggest that the meaning of the image in art therapy is a creative synthesis, which emerges from within a dialectics of exchange. This exchange involves a number of meaning-generating contexts, of which the patient’s experience, and the therapist’s knowledge, form only a part. The outcome of this exchange is the derived meaning of the image, which represents a ‘fictional’ world that gives the patient and therapist a way of understanding the patient’s situation. The process of the research, which investigates the way understanding of the image in art therapy occurs, is at the same time, an application of the principles of understanding
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Gilkinson, Laura. "An interpretative phenomenological analysis of refugees' experiences of psychological therapy for trauma." Thesis, University of Hertfordshire, 2010. http://hdl.handle.net/2299/4470.
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Background: Guidelines for the treatment of Post-Traumatic Stress Disorder recommend 8-12 session of trauma-focused CBT or EMDR, however there is an extensive body of literature criticising the PTSD paradigm and usefulness of recommended therapies in treating PTSD in the 'real world', particularly with the complex presentations of refugees . Alternative models for 'complex' PTSD have been proposed, as have transtheoretical phased stages for treatment. To date there has been no research into refugees' experience of trauma-therapy. Leaving a significant gap in understanding of how trauma therapy works. Aims: With this gap in the research in mind, and in line with the current focus on service user involvement in research, this study aims to investigate refugees' experiences of trauma-therapy. Methodology: Semi-structured interviews were conducted with six refugees who were coming towards the end of trauma-therapy with a specialist trauma service. The transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: Six master themes emerged from analysis: 'Therapy as a light in a dark place', 'Rebuilding a shattered sense of self', 'A changing relationship with the world and others', 'Escaping the past to pursue a future', 'A journey from sceptic to convert' and 'From an unknown mystery to a known mystery'. These master themes along with the subordinate themes are expanded into a narrative account of participants' experiences. Implications & Conclusion: Amongst numerous implications for clinical practice the need for support to engage in therapy, thorough explanation of therapy and pre-empting of possible conflicts and difficulties arising were identified. Allowing time to build a therapeutic relationship, the usefulness of the PTSD construct for individuals and the importance of the 'non-specific' factors of therapy in addition to the teaching of techniques to manage symptoms were also found to be of importance. This study has made an important contribution to knowledge about refugees' experiences of therapy for trauma.
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Herbert, Kate. "Overcoming traumatic experiences : psychological therapy, recovery and reflections on the research process." Thesis, University of Warwick, 2008. http://wrap.warwick.ac.uk/2347/.
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This research examined therapeutic approaches to trauma and post traumatic growth and recovery as a result of brief psychological intervention. Chapter one is a critical review of current therapeutic approaches used in the treatment of trauma and post traumatic stress disorder, PTSD. The PTSD treatment literature indicates that the therapy most rigorously assessed and currently recommended by the National Institute for Clinical Excellence (NICE) is trauma-focused Cognitive Behavioural Therapy and Eye Movement Desensitization and Reprocessing. Despite this, the literature review indicated that other forms of therapy have been effective in reducing the symptoms of PTSD. The research indicated that clinicians are successfully using psychodynamic, integrative and person centred approaches in both an individual and group therapy format. Regardless of therapeutic approach used, issues of client motivation, timing of therapy and therapeutic alliance were important determinants in outcome. Chapter two is an empirical study, which focuses on the effect of brief psychological intervention on recovery from trauma. A mixed methodological design was used and five participants took part in the research. The results indicated that those participants whose trauma symptoms reduced had experienced recovery from their trauma. Participants cited underlying beliefs towards adversity, personal and contextual factors as important in facilitating recovery. Recommendations for further research and clinical implications were discussed. Chapter three provides the authors reflections upon the research process and methodological and ethical issues that arise when carrying out qualitative research with a trauma population.
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Ramful, Neena. "The experiences of psychological therapy : perspectives from male Iranian survivors of torture." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/6189/.
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This thesis submitted for the Doctorate of Clinical Psychology comprises of both two volumes. Volume I consists of the research component, including of the literature review, empirical paper and public domain paper. The literature review examined the cultural adaptions of cognitive behavioural therapy and the effectiveness of the culturally adapted cognitive behavioural therapy. The empirical paper used Interpretative Phenomenological Analysis to explore the experiences of psychological therapy from the perspectives of male Iranian survivors of torture. The Public Domain Paper encapsulates the empirical study using language accessible to the general public. Volume II consists of the clinical component, which comprises of five Clinical Practice Reports (CPRs). The first CPR illustrates the case of 25-year-old Amy presenting with anxiety regarding her health which was formulated from a psychodynamic and cognitive behavioural perspective. The service evaluation for CPR 2 assessed the use of the patient experience questionnaire in an adult mental health service. CPR 3 is a single-case experimental design evaluating a behavioural intervention for 18-year-old Jacob, with autistic spectrum disorder and presenting with anger difficulties. CPR 4 describes the case study of 68 year old Jeremy, presenting with co-morbid anxiety and depression following a stroke. Finally, CPR 5 is an abstract summarising a case study presentation of Cece with mixed anxiety and depression following the birth of her baby. To maintain anonymity, pseudonyms were used for all service-users.
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Small, C. S. "Individual psychological therapy in acute inpatient settings : service user and psychologist perspectives." Thesis, University College London (University of London), 2016. http://discovery.ucl.ac.uk/1520905/.
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AIM: This review aimed to critically evaluate research investigating the therapeutic alliance in the psychological treatment of psychosis. It examined the measurement of the alliance, the relationship between alliance and outcomes, and key predictors of the alliance in the psychological treatment of psychosis. METHOD: Studies were identified through a systematic search of PsycINFO, PubMed and a citation search on Web of Science. The review used a vote counting method (Hedges & Olkin, 1980) to collate and assess the evidence across studies. RESULTS: Twenty-one studies were reviewed: eight examined the relationship between alliance and outcomes, and 18 examined predictors of the alliance. The majority of studies used the WAI or CALPAS rated from both client and therapist perspectives. A broad array of psychological functioning and adherence outcome measures were used; there were no consistent associations between alliance and outcomes across studies. The most frequently studied predictor variables were symptoms, insight, and cognitive and global functioning; the most consistent finding was that greater insight was associated with stronger client-rated alliance. CONCLUSIONS: Most standardised therapeutic alliance measures have been established in outpatient settings and require greater assessment of their psychometric properties in severe and enduring populations and settings. There was little agreement across the studies in the type of outcome and predictor measures used to examine the association with the therapeutic alliance. Studies also varied widely in their methodological quality and rigour. These problems are likely to have contributed to the inconsistent findings. The association between insight and the alliance should be investigated in future research.
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Dilks, Sarah. "Building bridges to observational perspectives : mapping processes in psychological therapy in psychosis." Thesis, Birkbeck (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429372.
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Radcliffe, Kay S. "A qualitative analysis of clients' experience of non-response to psychological therapy." Thesis, University of Leeds, 2014. http://etheses.whiterose.ac.uk/7013/.
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Introduction: There has been an expansion of research into psychotherapy outcomes for both clients who improve and clients who deteriorate as a result of therapy. However, those who fail to respond to therapy have been overlooked. Estimates of non-response to therapy vary from 14% to 60%, yet research with this client group is lacking. Additionally, research suggests therapists are limited in their ability to predict negative outcomes in therapy. If this is equivalent for non-response to therapy, our ability to respond appropriately to these clients may be an issue that needs addressing further. This study aims to begin to understand what sense clients make of therapy which, they feel, has brought about no change. Method: Eight clients who had completed a course of therapy within psychological therapy services (6+ sessions) and subjectively felt that they had not benefitted from this were interviewed about their experience. An interpretative phenomenological analysis was employed to allow an in depth, inductive study of a new area, in order to develop a model of participants’ experiences. Results: Five themes emerged regarding the therapy experience; ‘what I expected’, ‘how I found my therapist’, ‘what was therapy like’, ‘external influences’ and ‘what I am left with’. These were brought together into a model which allowed further meaning to be drawn from the accounts and the experience understood as a process. Discussion: The analysis and model were explored in relation to the available literature. This included consideration of attachment theory in relation to managing therapy expectations, facilitating emotional expression and length of therapy required, in addition to seeking further clarity with regard to what is meant by the term ‘non-response’ in psychological therapy. Novel findings of this research were examined in the context of the strengths and limitations of this particular study. From this, areas of future research and potential clinical impactions were considered.
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Reid, Aileen. "An investigation into the role of patient coping style in psychological therapy." Thesis, University of Edinburgh, 2003. http://hdl.handle.net/1842/27248.
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Objectives: The aim of this study was to investigate the role of patient coping style in psychological therapy, in particular whether patient coping style was associated with therapeutic alliance and therapeutic outcome after six sessions of therapy. Method: The study was conducted in a naturalistic setting. All outpatients who opted in see a psychologist in a general adult clinical psychology department over a four month period were invited to participate. Patients who agreed to participate completed a pre-therapy questionnaire to measure their coping style. After three sessions of therapy, participants and their psychologists completed independent measures of a therapeutic alliance scale. Participants repeated the pre-therapy coping questionnaire after their sixth session of therapy and another measure (already administered pre-therapy as part of routine practice) to assess for changes in their levels of psychological distress. Results: Patients with a strong reliance on cognitive approach coping strategies were found to have formed a good therapeutic alliance with their psychologist and to have experienced a reduction in their symptoms after six sessions of therapy. Conversely, patients with a strong reliance on cognitive avoidance coping strategies were found to have formed poorer therapeutic alliances with their psychologist and to have experienced smaller reductions in their symptoms after six sessions of therapy. Further examination of the results suggested that the therapeutic alliance might be a possible mediating factor between patient coping style and therapeutic outcome after six sessions, although a statistical examination of this was not viable. Conclusions: The results suggested that aspects of patient coping style might have an important role in the formation of the therapeutic alliance and therapeutic outcome after six sessions of therapy. The methodological limitations and clinical implications of these findings are discussed.
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Sipion, Baltodano Karen Melissa, Cuellar Yesselli Dalila Gómez, Laurente Lucia Huaynapomas, and Cotrina Yony Delgado. "Therapy kids." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2018. http://hdl.handle.net/10757/626102.
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El proyecto consiste en dar solución viable, rentable y novedosa que no existe actualmente en el mercado. El problema que se ha identificado, es que existen aproximadamente 40 mil niños menores de 14 años que viven en Lima Metropolitana y padecen de algún tipo de discapacidad o limitación física y/o mental. Asimismo, la capacidad de atención del sistema de salud a nivel nacional en el Perú es menor al 50%, con solo una sesión de rehabilitación por paciente al mes.
Para atender esta necesidad, se desarrolla el proyecto Therapy Kids, que ofrece terapias de rehabilitación para el desarrollo de las capacidades de estos niños. Los apoderados podrán solicitar servicios a través de los diversos canales de atención, en los que se les ofrecerá precios, horarios accesibles y promociones, con el valor diferenciado de que el servicio será brindado únicamente a domicilio y con una frecuencia de tres veces por semana.
Las fuentes de ingreso para Therapy Kids serán las terapias a domicilio y las consultas del médico terapista., en el primer año, se espera un ingreso de S/5 682 600 sin IGV y la inversión a realizar en dicho año para lograr los objetivos trazados asciende a S/ 285,202.82, de los cuales el 73% provendrá de los accionistas y se buscará un financiamiento por el 27% restante.
Therapy Kids busca evitar el malestar de hacer largas colas y viajes para conseguir una cita con un especialista. Asimismo, no solo busca apoyar a los padres de familia y generar utilidades para la empresa, si no también contribuir considerablemente en el desarrollo del sector salud del país.Trabajo de investigación
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Ander, Malin. "Cancer during adolescence : Psychological consequences and development of psychological treatment." Doctoral thesis, Uppsala universitet, Klinisk psykologi i hälso- och sjukvård, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-330130.
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The overall aim of the present thesis was to examine long-term psychological distress following cancer during adolescence and to develop a tailored psychological intervention to reduce cancer-related distress experienced by young survivors of adolescent cancer that was feasible and acceptable. Study I adopted a longitudinal design, assessing health-related quality of life (HRQOL) and symptoms of anxiety and depression among adolescents diagnosed with cancer from shortly after diagnosis (n=61) up to 10 years after diagnosis (n=28). Findings suggest that development of HRQOL and anxiety and depression is not linear and whilst the majority adjust well, a subgroup report long-term elevated distress. In Study II, experiences of cancer-related psychological distress were explored using unstructured interviews. Participants described cancer treatment as a mental challenge, felt marked and hindered by the cancer experience, and struggled with feelings of inadequacy and insecurity, existential issues, and difficulties handling emotions. Study III was a preliminary investigation of individualised cognitive behavioural therapy (CBT), alongside the identification and conceptualisation of cancer-related concerns using cognitive-behavioural theory. Significant difficulties with recruitment were encountered. Participants reported cancer-related concerns conceptualised as social avoidance, fear and avoidance of emotions and bodily symptoms, imbalance in activity, and worry and rumination. In Study IV, the acceptability and feasibility of an internet-administered CBT based self-help intervention (ICBT) for young persons diagnosed with cancer during adolescence was examined using an uncontrolled design and embedded process evaluation. The study protocol for Study IV was included in this thesis along with preliminary findings demonstrating significant difficulties with recruitment. Overall, findings suggest that whilst the majority of survivors of adolescent cancer adjust well over time a subgroup report elevated levels of distress and a range of distressing cancer-related experiences. A number of cancer-related difficulties were identified in Study II and III, which may be used to inform the development of future psychological treatments for the population. Preliminary investigation of the psychological interventions examined within this thesis further highlights the need for future development work to enhance the feasibility and acceptability of psychological support for the population.
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Cardoso, Louro André. "Effects of a positive emotion-based adjuvant psychological therapy in colorectal cancer patients." Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/316573.
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The purpose of this study is to examine the effectiveness of a Psychological
Intervention based on the positive psychology and the cognitive behavioral therapy in
relieving “psychological problems” at the time of adjuvant chemotherapy treatment
(Folfox Protocol) in patients with colorectal cancer. This Psychological Intervention is
structured and designed to enhance positive emotions in these patients and will be called
“Enhancing Positive Emotions Procedure” (EPEP). The design of this study was of two
groups with pre-post-test and follow-up comparisons. All participants were recruited
between October of 2012 and February of 2014. 52 subjects diagnosed with colorectal
cancer were recruited at the Portuguese Institute of Oncology, Oporto, Portugal. Results
of this research suggest that some features could be modified by the EPEP procedure,
whereas some others would remain unchanged. Some dimensions of quality of life, as
well as anxiety and positive emotions could be slightly improved by the EPEP Thus,
coping skills and depression would not be affected by the EPEP. Thus, it can be stated,
with caution, that EPEP should be useful to improve well-being in CRC patients
receiving chemotherapy.
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Morgan, Tracy. "Psychological change in group therapy experienced by women survivors of childhood sexual abuse." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0002/NQ42569.pdf.
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van, den Heuvel Ananda. "The utility of group narrative therapy to facilitate psychological adjustment in multiple sclerosis." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10195/.
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Section A reviews and critically evaluates the empirical literature on psychosocial interventions for multiple sclerosis (MS), the determinants of adjustment to MS, and the theoretical frameworks to account for these. Further, a conceptual and empirical review of the literature on narrative therapy is provided and an argument advanced for the utility of narrative therapy in facilitating adjustment to MS. Possible areas for further research are outlined. Section B describes a feasibility study which aimed to begin to test a theoretical argument for the application of group narrative therapy to facilitate psychosocial adjustment to MS, and to ascertain the feasibility of a larger scale randomised controlled trial. Fourteen MS patients received 8 weekly sessions of group narrative therapy delivered at two sites in England. Quality of life, coping processes, and illness representations were assessed at two time points prior to the intervention and immediately after the intervention, and analysed using Wilcoxon Matched-Pairs tests. Additional qualitative measures were taken and analysed using content analysis. The feasibility of a larger scale study was, in part, assessed by means of semi-structured interviews with health professionals involved in the study, and analysed using thematic analysis. Although none of the findings reached statistical significance upon correcting for multiple comparisons, positive trends were revealed for the mental health component of quality of life, confrontive coping, and the consequences component of illness representations. With respect to the feasibility of this study, several issues pertaining to recruitment and data collection emerged from the data that can inform future research. Taken together, the results of this pilot study are promising and warrant further investigation using a sufficiently large sample. Section C provides a reflection on the skills and abilities developed and learning needs identified whilst undertaking the research. It further offers a critical reflection on the study‟s methodology and the potential implications for clinical practice. Further potential lines of enquiry are outlined.
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Baron, Hannah Leigh. "Experiences of ending psychological therapy : perspectives of young people who are looked after." Thesis, University of Hertfordshire, 2012. http://hdl.handle.net/2299/9118.
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Background: According to the existing evidence base, the experience of ending therapy, from the perspectives of adolescents who are looked after, is substantially under researched. Moreover, the ending of therapy is highlighted as an important phase of the therapy process and previous research into ending therapy indicates this as a valuable area of research. The available literature indicates that those with a history of loss may find the ending phase particularly challenging. It was hoped that the research findings may assist Clinical Psychologists and other therapists to make sense of how young people experience ending therapy, and may also highlight ways in which therapists can support looked after young people through this transition. Aims: The study aims to provide an in-depth understanding of the way in which young people who are looked after make sense of ending psychological therapy. Methodology: Semi-structured interviews were conducted with six looked after adolescents who had recently ended psychological therapy. The transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: Four master themes emerged from analysis: inextricable link between therapy and therapy relationship, ambivalence, means of coping and moving on from therapy. Implications and Conclusion: This study highlights the need for careful and on going consideration of the ending phase of therapy with this population. It also gives further support to the significance of the therapeutic relationship and consideration of this at the end of therapy. Areas for future research are highlighted, notably the value of conducting further research with looked after young people, to explore factors such as culture and gender on the experience of ending therapy.
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Harris, Marina. "Dental hygiene and therapy students' experiences of psychological wellbeing in their undergraduate education." Thesis, University of Portsmouth, 2018. https://researchportal.port.ac.uk/portal/en/theses/dental-hygiene-and-therapy-students-experiences-of-psychological-wellbeing-in-their-undergraduate-education(56d1b2c5-f751-41fc-b380-8b2a70695689).html.
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Background: Dental schools are recognised to be highly demanding and stressful learning environments. Studies which have examined stress and psychological wellbeing of students within the dental undergraduate environment have, for the last four decades, focused on negative measures of psychological wellbeing. In addition, these studies have been exclusively targeted at dental students; and therefore, ignored the education of other dental professionals. Aims: The aim of this programme of studies was to explore our understanding of stress and positive psychological wellbeing of dental hygiene and therapy students from both a national and international perspective, and then to utilise this knowledge to implement a possible intervention. Participants and methods: The research involved a mixed-method approach using validated psychological tools, semi-structured interviews, and participation in an intervention workshop. Statistical analyses of quantitative data collected were handled with SPSSTM software. Thematic analyses of students' experiences of stress and wellbeing were undertaken using Braun and Clarke's six stages of thematic analysis. Results: Data showed that dental hygiene and therapy students reported similar sources of stress to that of dental students. However, at the same time, the participants also reported high levels of positive psychological wellbeing. The qualitative study showed that, for dental hygiene and therapy students, the significance of the meaning they attributed to their undergraduate training mitigated much of their stressful experiences. Scores from the intervention study showed that taking a positive approach to the education of stress and wellbeing within the dental hygiene and therapy curricula had a beneficial impact on the way participants understood their experience of stress. Conclusions: The results from this programme of studies has made a valuable contribution to our understanding of stress and wellbeing in dental hygiene and therapy undergraduate education. Within the limitations of these studies, stress was seen in a broader context. This research brought into question whether eliminating stress was necessary, or indeed relevant, and concluded that psychological wellbeing needs to be explored further. It highlighted the important role meaning held, and the relationship between meaning and stress. It is concluded the need to argue for psychological interventions/education to be included within the undergraduate curriculum for all dental professionals.
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Hussain, Shazia. "Men's experiences of engaging in psychological therapy in a forensic mental health setting." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8523/.
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Background: The Multifactor Offender Readiness Model (MORM) acknowledges the importance of gender-sensitive interventions in enhancing engagement in the rehabilitation of offenders. However, to date, little attention has been paid to the role of gender identity in psychological therapy. Even though men in forensic settings are likely to endorse hypermasculine attitudes, such as promoting aggression and restricting emotional expression, which run counter to therapeutic ideals. Methodology: Nine men residing in medium-secure forensic mental health hospitals were interviewed. Interpretative Phenomenological Analysis (IPA) was used to obtain first-person accounts of the men’s lived experiences to gain an insight into the subjective meanings they attached to their experiences of psychological therapy. Results: An analysis of the individual transcripts highlighted the men’s journey over the course of therapy, marked by an internal struggle against the external pressures. Three superordinate themes were identified: ‘shifting self’, ‘relationship with other’ and ‘therapeutic journey’, alongside their subsequent sub-themes. Discussion: A gradual, non-linear process of change was evident in the men’s narratives, who at the various phases of psychological therapy were faced with the challenge of questioning and redefining their identity. This involved lowering their guard, learning to become comfortable with vulnerability and face their past in the presence of a supportive ‘other’, in order to move towards building a new or better future for themselves.
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Cheng, Joanna. "The mechanisms of psychological therapy with people with long-term physical health conditions." Thesis, Lancaster University, 2017. http://eprints.lancs.ac.uk/87391/.
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This thesis comprises a literature review, a research paper and a critical appraisal of the research process. Qualitative literature was systematically reviewed using a meta-ethnography, with the aim of understanding how people with long-term physical health conditions (LTCs) experience psychological therapies. Thirteen articles were identified. Six themes emerged from the synthesis: i) ‘therapists’ expertise and empathic approach led to positive relationships’; ii) ‘therapy was a safe and neutral space’; iii) ‘therapy prompted change in LTC management’; iv) ‘psychological awareness reduced isolation and increased control’; v) how physical ill health interacts with being able to participate in therapy’; and vi) ‘time-limited therapy did not always match service users’ illness trajectory’. The findings were discussed in relation to the values of psychological therapy for people with LTCs and the current way services are delivered to people experiencing co-morbid mental health difficulties. The research paper comprised a qualitative study using a Discursive Action Model approach, which aimed to develop an understanding of how practitioners and service users construct resources and preferred futures within solution-focused therapy sessions. Eight participant dyads were recruited, formed by pairs of practitioners and service users. Data were collected via audio recordings. Four discourses were highlighted: i) ‘practitioners' use of assumptions drew out resources’; ii) ‘explicit commentaries construct change’; iii) ‘de-contextualising for goal construction’; and iv) ‘removing the blame, effort and failure’. The results highlighted the discursive mechanisms which enabled construction of resources and goals. The trans-theoretical applicability of the discourses, clinical implications and recommendations for future research were discussed. The critical appraisal discusses the importance of discourse in clinical psychology practice. The drivers behind conducting this thesis, strengths and weaknesses of the study, and lastly reflections on future practice in clinical psychology were offered.
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Wason, Sonali. "Psychological Reactions Post-athletic Injury| A Trauma-Informed Cognitive Behavioral Group Therapy Approach." Thesis, Azusa Pacific University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10931361.
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This study presents a group therapy program for injured athletes recovering from a traumatic physical injury to address and provide coping skills for the trauma-related symptoms athletes may experience post-athletic injury. Eleven expert reviewers in the field of sport psychology, injury rehabilitation, and athletic development reviewed the program and provided feedback regarding the utility, accuracy, organization, applicability, and additional factors. Although reviewers noted traumatic reactions are experienced by a sub-group of athletes, they also generally agreed the group therapy program could aid in clinical work and reduce trauma-related distress experienced by athletes after an injury and provide social support within a safe environment, allowing discussion and sharing of experiences with one another.
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Henry, Courtney L. "The Psychological and Physiological Effects of Using a Therapy Dog in Mindfulness Training." DigitalCommons@USU, 2013. https://digitalcommons.usu.edu/etd/1957.
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Research from various fields has demonstrated the benefits of human-animal interaction for physical and mental health. Recently, animal-assisted therapy (AAT) has become increasingly popular in a variety of healthcare settings--including inpatient mental health care facilities. However, there is limited research investigating the efficacy of AAT in outpatient sites. In addition, the impact of animals as an adjunct to psychotherapy treatment remains mostly uninvestigated. Therefore, it is necessary to empirically explore what therapy animals may contribute to specific treatment interventions with specific populations. The present study was a randomized control trial examining the psychological and physiological effects of adding AAT to a modified mindfulness-based stress reduction program (MBSR) for clients experiencing psychological distress, including anxious and depressive symptoms. It was hypothesized that AAT would be particularly complementary to mindfulness-based interventions because the therapy dog would provide a focus for attention to the current experience and exemplify acceptance and "being," enabling the understanding and practice of the main aspects of mindfulness. Subjects (N = 21) were randomly assigned to the MBSR or MBSR + AAT group and then completed an intervention consisting of six 50-minute individual therapy sessions. Each session included didactic and experiential components modified for delivery with or without a certified therapy dog. State and trait mindfulness, state and trait anxiety, psychological distress, blood pressure, and heart rate were assessed at each session. Results indicate that all participants experienced fewer anxiety and depressive symptoms, decreased psychological distress, and increased mindfulness skills from pre- to posttreatment. Additionally, state anxiety, blood pressure, and heart rate decreased within sessions. No significant difference was found between the control and experimental groups, indicating that interaction with a therapy dog had no impact on symptom reduction, skill acquisition, or client satisfaction in the current study. Future studies need to increase methodological rigor by including multiple therapist/dog teams and increasing sample size. Moreover, researchers must examine more thoroughly the role the dog might have in altering the social environment, such as reducing stigma surrounding mental health services and enhancing the therapeutic alliance.
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Wisniewski, Jack J. "Relaxation therapy, treatment compliance, and psychological variables in the treatment of childhood headaches /." The Ohio State University, 1987. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487335992904848.
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Markland, Frances Elizabeth. "Effectiveness of school based art therapy for children who have experienced psychological trauma." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/effectiveness-of-school-based-art-therapy-for-children-who-have-experienced-psychological-trauma(e797ca93-bcc8-4e88-a3c0-4b13ebcd4759).html.
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Experiencing trauma in childhood can have a pervasive impact on child development. There is evidence to suggest that non verbal creative therapies aid the processing of traumatic memories and therefore present as a child centred treatment option for children who have experienced trauma. Art therapy is known to be an effective intervention for children who have experienced trauma however the outcomes of delivering art therapy interventions in specific contexts are not yet well researched. The present study sought to investigate the efficacy of school based art therapy as an intervention for children who have experienced psychological trauma. The study explores what areas of adjustment are achievable and how school based art therapy contributes to this adjustment. A multiple case study analysis was conducted to explore the experiences of three pupils who had attended art therapy interventions at their schools. Each case study used semi structured interviews, post intervention, to gather the views of the pupil, art therapist, a member of school staff and the pupil‘s parent / guardian. The data was analysed using thematic analysis and the results are presented as thematic network maps. The cross case synthesis revealed that after attending school based art therapy the pupils demonstrated positive adjustment in a range of areas. The thematic analysis suggested that the pupils had a greater understanding of themselves, increased resilience skills and a belief in a positive future. School based art therapy was found to be a wholly child centred therapeutic experience for the pupils, with the data suggesting that this child centred experience was facilitated by the process of the therapy, the non verbal creative art making and the context of delivery. This study provides the initial evidence to suggest that school based art therapy is an effective intervention for children who have experienced developmental trauma and presents avenues for future research.
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O'Driscoll, Miriam. "Investigating the relationship between telephone-delivered therapy, therapeutic alliance and psychological well-being." Thesis, University of Southampton, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.560805.
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This literature review examines the current research on structured telephone therapies. Literature searches were conducted to identify studies of structured telephone-delivered therapies targetting a range of mental health disorders. Twenty studies met the criteria, with depression the most frequently represented. Key data was extracted to contrast and compare study designs and report findings. Findings overall support the use of telephone-delivered therapy to help alleviate symptoms of mental distress. Conclusions from several of the studies are limited by small sample size and design limitations. Research and clinical implications are considered in light of the current research findings and limitations. Empirical paper This study describes the use of an adapted Therapy Rating Scale (TRS) to measure therapeutic alliance and adherence to protocol, in a study of telephone- delivered CBT or supportive listening for adjustment to multiple sclerosis (saMS). Three raters listened to audiotapes of sessions conducted by general nurses trained specifically for the trial. Substantial inter-rater reliability was achieved and the TRS was shown to have good reliability. Two factors were identified by principal component analysis - therapist contribution and patient contribution. Correlational analyses were performed with these factors and GHQ and WSAS outcome measures. Therapeutic alliance as measured by the TRS was not found to moderate treatment outcome in saMS. Limitations of the TRS are discussed, as well as clinical implications and directions for future research.
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Howarth, Claire Lisa. "Understanding how clients recently discharged from psychological therapy manage their mental health problems." Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/15242/.
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Research has proved psychotherapy to be effective (Wampold, 2007) though longer term outcomes are less well investigated and relapse still occurs (Crown, 2002; Eaton et al, 2008). There has been little research into how mental health is managed once discharged from therapy, yet the importance of self-management has been highlighted by both professionals and service users (Barlow et al, 2002; Todd et al, 2012). This study focuses on individuals who found psychological therapy to be of benefit and aimed to explore their experiences of how they manage their mental health on a daily basis after discharge. Eight participants who had completed a minimum of six sessions of therapy within adult psychological therapy services and subjectively felt they had benefitted at the time of discharge were interviewed about their experiences. Using thematic analysis to analyse the data, five core themes were identified; ‘how therapy is helping me now’, ‘life changing’, ‘things that helped therapy to be successful’, ‘things outside therapy that are helping me now’ and ‘how therapy could be improved’. Participants maintained their mental health in similar ways irrespective of the initial presentation of symptoms, type of treatment received and the therapist they saw. Subthemes offer a deeper understanding of what people took from therapy and how the changes made are still being used to maintain mental health. Important factors included the acceptance of mental health difficulties, previous difficult life experiences, and the recognition that continued effort and distress in life are to be expected. Understanding and changing interpersonal relationships was also highlighted along with the importance of valuing yourself and not putting others’ needs before your own. Specific strategies were also commented upon including cognitive techniques as well as relaxation and mindfulness. Findings from the analysis are discussed in relation to the literature, along with the consideration of clinical implications and future research.
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Sivyer, Katy. "Mediators of transdiagnostic psychological treatments for eating disorders." Thesis, University of Oxford, 2017. http://ora.ox.ac.uk/objects/uuid:42b0ec86-7fca-42ee-948b-74b77e5e6db4.
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Cognitive behaviour therapy and interpersonal psychotherapy are the leading treatments for eating disorders. Little is understood regarding their mechanisms of action. The research described in this thesis investigated the purported mechanisms of action of two transdiagnostic versions of these treatments; enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy for eating disorders (IPT-ED). A series of mediation studies were embedded within a randomised controlled trial comparing CBT-E and IPT-ED in a transdiagnostic sample of patients with eating disorders. An analytic strategy using multilevel and structural equation modelling was used to assess for statistical mediation. Three of the key purported mediators of action of CBT-E (regularity of eating, frequency of weighing, and frequency of shape checking) and the key purported mediator of IPT-ED (interpersonal problem severity) were studied. Only regularity of eating demonstrated a strong case for being a mediator of the effect of CBT-E (on frequency of binge eating). The findings were inconclusive regarding other putative mediators of the effect of CBT-E, and for interpersonal problem severity being a mediator of the effect of IPT-ED. Limitations of the research included the non-optimal choice of measures and non-optimal timing of measurements for establishing temporal precedence. Future research should investigate the mediating role of both cognitive (e.g. interpretation of weight) and behavioural processes (e.g. frequency of weighing) in CBT-E, and the role of interpersonal functioning in CBT-E and IPT-ED. Research should use daily, or session by session measurement to better assess the temporal relationship between the purported mediator/s and the outcome/s. Experimental designs comparing dismantled versions of treatment would also help determine the relative effects that different treatment procedures have on treatment outcome/s.
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Engel, Scott G. "Humor in therapy : an empirical examination." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1210538.
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In the psychological literature little has been written about the use of humor in therapy. Especially lacking is empirical data regarding the topic. In the current study I investigated the relationship between a personality characteristic, sense of humor, and the amount of humor used by a therapist in a mock therapy session. A 2 x 3 factorial design was implemented with participant's sense of humor and the amount of humor used by the therapist being the independent variables. I hypothesized that a moderate amount of humor would result in more positive ratings of the therapist than either the low or high humor conditions. I also hypothesized that participants who had a greater sense of humor would rate the therapist more positively. Results revealed a partial confirmation of the hypotheses. The greatest amount of humor used by the therapist resulted in decreased ratings of the therapist for a measure of appropriateness of humor and a measure of warmth and empathy. Also, the therapist who used the most humor was rated significantly less rigid and dull than the therapist who used no humor. Suggestions forfuture research in the area are given.Department of Psychological Science
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Butler, Mary. "Reflections on the theological and psychological aspects of women's experience from a feminist perspective." Theological Research Exchange Network (TREN), 1988. http://www.tren.com.
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Masuda, Akihiko. "Acceptance and commitment training and stigma toward people with psychological disorders : developing a new technology /." abstract and full text PDF (free order & download UNR users only), 2006. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3231683.
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Thesis (Ph.D.)--University of Nevada, Reno, 2006."August, 2006." Includes bibliographical references (leaves 65-83). Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2006]. 1 microfilm reel ; 35 mm. Online version available on the World Wide Web.
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Alexander, Loris. "Visual art dialogue in personal psychological learning a private journey with public relevance /." Australasian Digital Theses Program, 2006. http://adt.lib.swin.edu.au/public/adt-VSWT20061006.153107/index.html.
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Thesis (PhD) - Swinburne University of Technology, 2006.Submitted in completion of the degree of Doctor of Philosophy, Swinburne University of Technology - 2006. Typescript. Includes bibliographical references.