6,177 research outputs found
UMSL Bulletin 2023-2024
The 2023-2024 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1088/thumbnail.jp
A qualitative study exploring whether emotion work conducted by health visitors has an influence on their assessment and identification of children in need of care and protection?
There is an increased understanding that experiencing adversity in childhood can have a significantly negative impact on the long-term developmental wellbeing of children and young people, as well as their families and communities. Political and societal ambition is that such adverse experiences and their consequences are eradicated through preventative and early intervention measures taken by health, education, and social care practitioners on the identification of a child(ren) who requires support.
Professionals working with children have become increasingly proficient in this type of work however no professional is infallible. As a result, many children and young people living with adverse circumstances can go unnoticed. For some this includes experiencing harm which often only comes to light when they have been significantly or fatally injured.
Every child living in the United Kingdom is aligned with the universal health visiting service following birth to school entry. Health visitors play an essential role in “searching for health needs” through the “surveillance and assessment of the population’s health and wellbeing” (Nursing & Midwifery Council [NMC] 2004, page 11) . Such universal contact based on these core principles mean that health visitors are ideally positioned to identify children living in challenging situations but, like others, they can find this difficult on occasions.
The purpose of this study is to explore whether health visitors view the emotion work they carry out as part of their role has an influence on their ability to assess, identify, and respond to children in need of care and protection.
STUDY – METHOD:
The study has been progressed qualitatively, using a reflexive ethnographic approach to interviews as the main data collection and analytic method with short periods of office-based observation. 16 health visitors who managed caseloads of between 100-450 pre-school children were observed and interviewed to understand their experiences, values, and beliefs. Gee’s (2014) toolkit was used to critically analyse the discourse shared during the interviews.
FINDINGS:
The emergent findings demonstrate that health visitors can be conceptualised as ‘applied clinical anthropologists’ in the way they develop relationships with families to gain access to their home environments. The approach taken is to gather information to the depth required for a social, bioecological assessment (Bronfenbrenner 2005) of a child in the context of their family and community system. Health visitors are welcomed by most families and are often successful in assessing and responding to child need. However, at times, the level of engagement necessary can be overwhelming for both the health visitor and parent/carer. This influences the level of child centred assessment obtained.
The study has demonstrated that the influences on the work of the health visitor can be interpreted through a complex interplay of theoretical concepts. Firstly, Bourdieu’s “theory of practice” (Bourdieu & Wacquant 1992, page 4) provides the basis on which to understand why challenges and barriers arise during the relational work of the health visitor with the child and family. Secondly, Gross’ (2014) Emotion Regulation Framework and Hochschild’s (1983) theory of Emotional Labour, are utilised to consider how health visitors and families respond emotionally to these challenges. The study then goes on to demonstrate what impact these responses can have on the assessment of children.
RECOMMENDATIONS:
Implications for practice are that health visitors require increased rates of supervision. This should include an observational element. Educational programmes for health visitors, require a focus on promoting professional wellbeing with learning sessions on unconscious bias. Research and learning developments are suggested to influence assessment and decision-making practice. Research with other professional groups and children & families is recommended to build on the findings of this study in order to influence future safeguarding policy and practice to protect children
“Have patients with chronic skin diseases needs been met?”:A thesis on psoriasis and eczema patient care in dermatology service
Background: Common chronic skin diseases such as eczema and psoriasis usually require long term medical care. They are often associated with psychological and metabolic comorbidities, which can impact on patient quality of life (QOL) and on the self-management of these diseases. Regular assessment of patient needs, comorbidities and feedback is a critical step in the development of decision-analytic models. Currently, no intervention is available to regularly assess such patients’ needs and comorbidities and support their involvement in the decision-making and self-management of their morbidity and comorbidities. The aim of this research is to involve the patients in decision making of their care and to support their self-management by the use of a paper questionnaire (study tool) at each consultation. Objective: To explore the acceptability and potential of a self-developed paper questionnaire that constituted a study tool for addressing the needs, comorbidities, and feedback of patients with psoriasis and eczema and supporting their involvement in decision making and self-management of their chronic conditions. Method: A mixed method study was conducted and included a postal survey on adult male and female patients with psoriasis and eczema, using the study tool, which is a paper questionnaire and contains the Dermatology Life Quality Index (DLQI) and seven supplementary open-ended questions to capture patients’ views, feedback, comorbidities, coping status and needs. The survey was followed by semi-structured face-to-face interviews with a sample of the patients who had participated in the survey. The aims of the interviews were two-fold: 1. to gain a deeper understanding of their experience of living with and managing their skin disease; and 2. to gather patient feedback on the service they received as well as their views on using the new study tool or any alternative intervention to address and support their self-management. The final study was a pilot which involved presenting a proposal of an online version of the study tool to a group of healthcare experts asking them to critically review the extent to which the online model responded to patients expressed needs. Results: Of the 114 patients who participated in the postal survey 108 (94.7%) of them expressed physical, metabolic and psychological comorbidities. Stress was identified as the dominant disease-triggering factor in 72 (63%) participants. Thirty-three (28.9%) of participants reported that they could not cope with their chronic illness. Eighteen (15.7%) participants suffered from anxiety, and 12 (10.5%) had depression and suicidal thoughts. Twenty-nine (25%) participants addressed their needs for support at home, and 16 (14%) of them asked for support at work. In the patient feedback section, 21 (18.4%) and 9 (7.8%) participants rated the service they received from their general practitioner (GP) and dermatologist as poor, respectively. In the interviews, all the participants 22 (100%) welcomed the use of the study tool on a regular basis to address their needs, comorbidities and feedback. Nineteen (86.3%) of them suggested that they would prefer using an online version of the tool or patient portal system as a convenient way of remote and interactive communication with the healthcare provider, particularly during the worsening of their skin condition. In the final pilot study, the healthcare experts agreed that the proposed online version of the study tool could be a convenient platform for such patients to support their self-management. They discussed the potential importance of such a tool if it provided them with access to supportive services such as patient information on skin diseases and self-management, access to local mental health service and other relevant psoriasis and eczema patients’ support groups and charities. Conclusion: This novel mixed method research identified knowledge gaps in managing patients with psoriasis and eczema. It provided a new tool that has the potential to regularly engage and assess patients’ unmet needs, comorbidities and feedback. The tool can involve patients in decision-making and offers them the autonomy to disclose heterogeneous needs that may support their self-management. All the interviewees welcomed regular use of the study tool and the majority of them suggested that they would prefer using an online version of the tool if it was available. Future research is needed to assess the impact of the study tool in filling important gaps in patient self-management and in health service improvement
Influência do viés de interpretação social dos pais no viés de interpretação das crianças em idade pré-escolar: o efeito de variáveis pessoais e parentais
Alguns modelos teóricos cognitivos reconhecem que diferentes tipos de viés cognitivo, como o viés de interpretação, desempenham um papel significativo na origem e manutenção de perturbações psicológicas, nomeadamente das perturbações associadas à ansiedade. Até onde sabemos, a maior parte da literatura que tem explorado as origens e desenvolvimento do viés de interpretação, assim como a sua transmissão intergeracional (pais-filhos), tem-se focado principalmente em crianças em idade escolar. Neste sentido, ao considerarmos a primeira e segunda infância como os períodos onde o desenvolvimento global da criança é mais rápido, pareceu-nos fundamental alongar o estudo da transmissão parental do viés de interpretação à faixa etária da idade pré-escolar. Por outro lado, se a tendência para interpretar negativamente situações ambíguas for adotada pelas crianças através da modelação do comportamento dos seus pais, um estilo de interpretação benigna transmitido pelos pais poderá ser especialmente benéfico em programas de modificação do viés de interpretação (CBM-I). Assim, esperamos que, ao alargar a crianças mais novas (idade pré-escolar) o estudo da transmissão intergeracional do viés de interpretação, possamos contribuir para um maior entendimento acerca da origem desse viés e das possibilidades de interromper o seu ciclo de transmissão.
Num primeiro estudo (Capítulo I), tendo em conta que os instrumentos de avaliação do viés de interpretação em crianças em idade pré-escolar são insuficientes, desenvolvemos uma versão portuguesa do Children's Interpretation Bias Measure – Ambiguous Story-Stems (CIBM; Ooi, Dodd, & Walsh, 2015) e avaliámos as suas propriedades psicométricas. Comparativamente à versão original, introduzimos ilustrações para cada uma das oito histórias com o objetivo de auxiliar as crianças a visualizar os aspetos principais da narrativa. A análise de conteúdo das respostas às histórias do CIBM permite captar a tendência de as crianças em idade pré-escolar produzirem interpretações benignas ou malignas a partir de situações quotidianas ambíguas. A rejeição de um modelo estrutural unidimensional para estas respostas indica, no entanto, que a predisposição para produzir interpretações enviesadas não é necessariamente consistente nos diferentes domínios avaliados pelo CIBM. Desta forma, a pontuação total proporcionada por este instrumento (número de respostas que expressam interpretações negativas) deve ser encarada como um indicador cumulativo que agrega tendências para adoptar uma interpretação enviesada em diferentes domínios e não como uma medida de um traço psicológico latente unificado. As correlações positivas entre as pontuações do CIBM, uma medida alternativa de viés de interpretação e uma medida convergente de ansiedade para crianças pré-escolares (PAS) constituem um indicador satisfatório de validade do instrumento. Ao apontar para uma associação positiva entre o viés de interpretação e os sintomas de ansiedade, confirmam-se conclusões obtidas em estudos anteriores com participantes com idades desde o pré-escolar (Dodd et al., 2012) até à adolescência (Blote et al., 2014). Em suma, a abordagem metodológica utilizada – interpretação expressa ao completar histórias que retratam situações quotidianas ambíguas – parece ser das poucas possíveis que permitem investigar o viés de interpretação em crianças de idade pré-escolar. Apesar dos resultados sugerirem que este tipo de abordagem proporciona uma potencial medida do viés de interpretação nesta faixa etária, o CIBM apresenta problemas ao nível da fiabilidade (nomeadamente, consistência interna) que requerem estudo mais aprofundados sobre o modelo métrico que lhe está subjacente. Assim, os nossos resultados devem ser considerados apenas como um primeiro passo para melhorar a qualidade do CIBM devido às limitações do próprio instrumento, sendo necessário trabalho adicional para continuar a desenvolver um instrumento psicometricamente confiável para a interpretação do viés em crianças em idade pré-escolar.
No segundo estudo (Capítulo II), tendo em conta a reduzida investigação conduzida com crianças mais novas, propusemo-nos a explorar de que forma a relação entre pais e filhos contribui para o desenvolvimento do viés de interpretação, e procuramos esclarecer o papel de algumas características da criança (temperamento) e dos pais (nomeadamente, estilos parentais) numa possível transmissão intergeracional deste viés. Assim, pretendemos (1) avaliar se existe associação entre a tendência dos pais interpretarem negativamente situações ambíguas e a tendência para a interpretação negativa apresentada pelos filhos em idade pré-escolar; (2) verificar se a associação entre este viés de interpretação manifestado por pais e filhos é mediada por comportamentos verbais dos progenitores que transmitam esse estilo de interpretação; (3) explorar o efeito de potenciais moderadores – nomeadamente, características da criança (temperamento, género e idade) e características dos pais (estilos parentais) – na associação entre o viés de interpretação dos pais e da criança. Relativamente ao primeiro objetivo, não encontrámos associação significativa entre o nível de viés expresso pelos progenitores (PIBM) e o nível de viés expresso pelos seus filhos (CIBM). Relativamente ao segundo objetivo, observou-se que, embora os progenitores – e sobretudo as mães – expressem parcialmente o seu viés de interpretação na situação empírica por nós utilizada para avaliar comportamentos de transmissão (concluir histórias ambíguas tal como as contariam aos seus filhos em contexto real), esse comportamento não parece traduzir-se de forma significativa no nível de viés de interpretação manifestado pelos filhos. Assim, podemos concluir que a transmissão intergeracional não se manifestou nesta amostra de crianças em idade pré-escolar. No entanto, o grau de associação entre o viés dos progenitores e dos filhos parece ser moderado pela idade da criança (crianças mais velhas partilham mais viés de interpretação com os pais) e pelo nível educacional dos pais (maior escolaridade atenua a associação entre o viés de interpretação do pai e da criança). Além disso, as características da mãe (sobretudo, o seu estilo parental) parecem também moderar a associação entre o viés de interpretação do pai e do filho, indicando que todas estas variáveis interagem de forma complexa dentro da família. Assim, apesar de grande parte dos moderadores considerados ter efeito nulo (sobretudo na associação entre viés da mãe e viés da criança), o grau transmissão intergeracional do viés (sobretudo de pais para filhos) parece ser condicionado pelas caraterísticas da criança e do seu ambiente familiar.
Para além da questão da transmissão do viés de pais para filhos, neste estudo também explorámos o efeito das características da criança e dos pais nos níveis de viés. Apesar da escassez de resultados significativos, alguns deles parecem ser merecedores de atenção futura. Em primeiro lugar, identificámos efeitos da idade no nível de viés de interpretação, que sugerem ser as crianças mais velhas mais suscetíveis a este tipo de enviesamento. Este resultado, quando combinado com evidências reportadas na literatura, torna-se relevante para perceber a tendência de desenvolvimento desse viés desde a infância. Em segundo lugar, surpreendentemente, algumas das dimensões do temperamento da criança teoricamente mais relevantes para este tema (tais como a timidez, o medo, a aproximação/antecipação positiva, ou o controlo inibitório) parecem não afetar o nível de viés de interpretação expresso pelas crianças pré-escolares: embora sejam consideradas facetas do temperamento associadas à ansiedade, a inibição comportamental e a timidez poderão não estar especificamente relacionadas às bases cognitivas da ansiedade (ou seja, vieses de processamento de informação) até que as crianças sejam mais velhas e cognitivamente mais maduras. É também possível que, em crianças mais novas, tais facetas do temperamento estejam associadas a outros processos cognitivos envolvidos na ansiedade (por exemplo, atenção) e não ao viés de interpretação.
No entanto, o temperamento das crianças parece influenciar a forma como pais e mães terminam as histórias ambíguas, o que reforça a possibilidade de os progenitores ajustarem aos filhos o seu comportamento verbal face à ambiguidade, talvez como estratégia preventiva de proteção de vivências negativas em situações ambíguas. Em terceiro lugar, embora não tivesse sido registado um efeito significativo, os estilos parentais permissivos e autoritários parecem influenciar o modo como os pais transmitem verbalmente aos seus filhos a forma de lidar com situações ambíguas.
Por último, no terceiro estudo (Capítulo III), realizámos a primeira tentativa de adaptação do programa de intervenção Cognitive Bias Modification Training Intervention (CBMT-I; Lau, Pettit, & Creswell, 2013) a crianças em idade pré-escolar. O CBMT-I tem como objetivo reduzir o viés de interpretação em crianças através da manipulação da natureza da interação pais-filhos em situações sociais ambíguas. Emparelhámos dois grupos de vinte crianças pré-escolares com elevado viés de interpretação, sendo o seu viés de interpretação avaliado em dois momentos, antes e após a aplicação do programa de intervenção (CBMT-I). Não encontrámos diferenças entre os grupos relativamente ao nível de viés de interpretação das crianças no primeiro momento de avaliação. Enquanto um dos grupos seguiu o programa de intervenção estipulado (os progenitores treinavam com os filhos a interpretação benigna de 24 histórias ambíguas que eram lidas ao longo de quatro noites), o outro grupo era apenas exposto às mesmas histórias, sem que houvesse esforço numa interpretação benigna. Quando avaliados no segundo momento, após a intervenção do CBMT-I, observámos uma clara redução do viés de interpretação no grupo de intervenção, por comparação com o grupo de controlo, tanto na escala total do CIBM como nas duas subescalas (ameaça física e, em menor grau, ansiedade de separação). Este resultado é a extensão para uma faixa etária mais jovem dos resultados reportados em estudos anteriores com crianças em idade escolar (Beard & Amir, 2008; Cristea et al., 2015; Krebs et al., 2018; Lau et al., 2013; Vassilopoulos et al., 2009). O CBMT-I aplicado pelos pais parece assim ser um programa de intervenção eficaz na redução do viés de interpretação em crianças pré-escolares. Importa sublinhar que este resultado também apoia a hipótese da existência de uma modelação de pais para filhos do viés de interpretação. De resto, mais do que garantir um "tratamento", o CBMT-I fortalece o conceito de que é possível mudar a perspetiva do outro (negativa ou positivamente) através da transmissão do comportamento verbal e não verbal. Neste sentido, como o viés de interpretação está significativamente associado à ansiedade em crianças e adolescentes, parece-nos que crianças em idade pré-escolar que beneficiem da redução do viés de interpretação através desta intervenção poderão beneficiar em idades posteriores de uma diminuição dos sintomas de ansiedade.
Concluindo, os resultados do presente trabalho contribuíram para aumentar o conhecimento sobre a transmissão e modificação do viés de interpretação em crianças de idade pré-escolar, evidenciando o papel que a influência dos pais pode ter na redução desse viés através da explicitação de interpretações benignas em situações de ambiguidade. O programa de modificação do viés com aplicação parental (CBMT-I) parece reduzir o enviesamento da interpretação nas crianças em idade pré-escolar, sendo previsivelmente um instrumento válido para prevenir o aparecimento de sintomas de ansiedade em fases posteriores do desenvolvimento. Globalmente, este trabalho vem reforçar a importância de intervenções precoces no viés de interpretação das crianças mais novas (pré-escolares).Various theoretical models recognize that cognitive biases, specifically interpretation biases, play a significant role in the origin and maintenance of some psychological disturbances, especially depression and anxiety disorders. As far as we know, the development of interpretation biases has been mostly explored in school-age children. Expanding the study of interpretation bias to younger children (preschoolers) and exploring the role parents might have in this process may help us understand the origins of such biases and how to attenuate the transmission cycle of cognitive biases between parents and children.
In Chapter I, due to the lack of instruments specifically designed to assess interpretation bias in preschoolers, we developed a Portuguese Version of the Children's Interpretation Bias Measure – Ambiguous Story-Stems (CIBM; Ooi, Dodd, & Walsh, 2015) and assessed for the first time its psychometric properties. Our results indicated that this ambiguous story stems methodology could provide an interpretation bias measure in young children. However, these results should be taken as a first step toward improving CIBM quality due to methodological limitations and the instrument itself. Additional work must be done to develop a consistent psychometrically reliable and viable instrument for interpreting bias in preschool children.
Given the lack of conclusive studies addressing the transmission of interpretation bias between parents and their preschool-aged children, Chapter II explores the extent of this intergenerational transmission. The effects of children's (age, gender, temperament) and parents' characteristics (age, education level, parenting styles bias) on intergenerational transmission of interpretation bias were also explored. Results suggest that although parents' own interpretation bias might be transmitted to their children through verbal expressions (namely in a storytelling context), this behavior does not globally influence preschool children's interpretation bias level. However, some child’s and parents’ attributes seem to moderate how interpretation bias might be transmitted across generations.
In Chapter III, we conducted the first attempt to adapt the Cognitive Bias Modification Training Intervention (CBMT-I; Lau, Pettit, & Creswell, 2013) to reduce interpretation bias in preschool children by manipulating the nature of parent-child interaction in ambiguous situations. Results showed that parent-administrated CBMT-I proved a useful intervention program to reduce interpretation bias in preschoolers. Moreover, CBMT-I seems to support the concept that it is possible to change the other's perspective (negatively or positively) through the transmission of verbal and non-verbal behavior.
The results of the present study contributed to a better understanding of the transmission and modification of interpretation bias in preschool-age children, highlighting the role that parents may play in reducing this bias. Also, the information transmitted from parents to children may have a significant, relevant role here since preschool children apparently showed weak responsiveness to parents’ negative interpretation bias but reacted favorably to an intervention based on parents' deliverance of positive interpretations when facing ambiguity. Overall, this work reinforces the importance of early interventions in younger children (preschoolers) interpretation bias
“Not the story you want, I’m sure”: Mental health recovery and the narratives of people from marginalised communities
Background: The dominant narrative in mental health policy and practice has shifted in the 21st century from one of chronic ill health or incurability to an orientation towards recovery. A recovery-based approach is now the most frequently used in services in the Global North, and its relevance has also been explored in Global South settings. Despite the ubiquity of the recovery approach, people experiencing poverty, homelessness, intersecting oppressions (based for example on race, ethnicity, gender, sexuality or ability), and other forms of social marginalisation remain under-represented within recovery-oriented research. More inclusive research has been called for to ensure that knowledge of recovery processes is not based solely on the experiences of the relatively well-resourced.
Personal narratives of recovery from mental distress have played a central role in the establishment of the recovery approach within mental health policy and practice. Originating in survivor/service-user movements, the use of ‘recovery narratives’ has now become widespread for diverse purposes, including staff training to improve service delivery and increase empathy, public health campaigns to challenge stigma, online interventions to increase access to self-care resources, and as a distinctive feature of peer support. Research suggests that recovery-focused narratives can have benefits and also risks for narrators and recipients. At the same time, the elicitation of such narratives by healthcare researchers, educators and practitioners has been problematised by survivor-researchers and other critical theorists, as a co-option of lived experience for neoliberal purposes.
Following a systematic review of empirical research studies undertaken on characteristics of recovery narratives (presented in Chapter 4), a need for empirical research on the narratives of people from socially marginalised groups was identified. What kinds of stories might we/they be telling, and what are their experiences of telling their stories? What do their experiences tell us about the use of stories within a recovery approach?
Aim: Drawing on a body of critical scholarship, my aim is to conduct an empirical inquiry into (i) characteristics of recovery stories told by people from socially marginalised groups, and (ii) their experiences of telling their stories in formal and everyday settings.
Method: I undertook a critical narrative inquiry based on the stories of 77 people from marginalised groups, collected in the context of a wider study. This comprised narratives from people with lived experience of mental distress who additionally met one or more of the following criteria: (i) had experiences of psychosis; (ii) were from Black, Asian and other minoritised ethnic communities; (iii) are under-served by services (operationalised as lesbian, gay, bi, trans, queer + communities (LGBTQ+) or people identified as having multiple and complex needs); or (iv) had peer support roles. Two-part interviews were conducted (18 conducted by me). Part A consisted of an open-ended question designed to elicit a narrative, and part B was a semi-structured interview inviting participants to reflect on their experiences of telling their recovery stories in different contexts. Following Riessman’s analytical approach, I undertook three forms of analysis: a structural narrative analysis of Part A across the dataset (informed by a preliminary conceptual framework developed in Chapter 4); a thematic analysis of Part B where participants additionally reflected on telling their stories; and an in-depth performative narrative analysis of two accounts (parts A and B) from people with multiple and complex needs.
Findings: In a structural analysis of Part A, the recovery narratives told by people from marginalised groups were found to be diverse and multidimensional. Most (97%) could be characterised by the nine dimensions described in the preliminary conceptual framework (Genre; Positioning; Emotional Tone; Relationship with Recovery; Trajectory; Turning Points; Narrative Sequence; Protagonists; and Use of Metaphors). Each dimension of the framework contained a number of different types. These were expanded as a result of the structural analysis to contain more types: for example, a ‘cyclical’ type of trajectory was added), and a more comprehensive typology of recovery narratives was produced. Two narratives were found to be ‘outliers’, in that their structure, form and content could not adequately be described by the majority of existing dimensions and types. These served as exemplars of the framework’s limitations.
In a thematic analysis of Part B, my overarching finding was that power differentials between narrators and recipients could be seen as the key factor affecting participants’ experiences of telling their recovery stories in formal and everyday settings. Four themes describing the possibilities and problems raised by telling their stories were identified: (i) ‘Challenging the status quo’; (ii) ‘Risky consequences’; (iii) ‘Producing acceptable stories’ and (iv) ‘Untellable stories’.
In a performative analysis of two narratives of people with multiple and complex needs (Parts A and B), I found two contrasting ways of responding to the invitation to tell a recovery story: a ‘narrative of personal lack’ and a ‘narrative of resistance’. I demonstrate how the genre of ‘recovery narrative’, with its focus on transformation at the level of personal identity, may function to occlude social and structural causes of distress, and reinforce ideas of personal responsibility for ongoing distress in the face of unchanging living conditions.
Conclusion: The recovery narratives of people from socially marginalised groups are diverse and multidimensional. Told in some contexts, they may hold power to challenge the status quo. However, telling stories of lived experience and recovery is risky, and there may be pressure on narrators to produce ‘acceptable’ stories, or to omit or de-emphasise experiences which challenge dominant cultural narratives. A recovery-based approach to the use of lived experience narratives in research and practice may be contributing towards an over-emphasis on individualist approaches to the reduction of distress. This over-emphasis can be seen to reflect what has been identified as a global trend towards the ‘instrumental’ use of personal narratives for utilitarian purposes based on market values. Attention to power differentials and structural as well as agentic factors is vital to ensure that the use of narratives in research and practice does not contribute towards a decontextualised, reductionist form of recovery which pays insufficient attention to the economic, institutional and political injustices that people experiencing mental distress may systematically endure. A sensitive and socially just use of lived experience narratives will remain alert to a variety of power dimensions present within the contexts in which they are shared and hear
Complexity Science in Human Change
This reprint encompasses fourteen contributions that offer avenues towards a better understanding of complex systems in human behavior. The phenomena studied here are generally pattern formation processes that originate in social interaction and psychotherapy. Several accounts are also given of the coordination in body movements and in physiological, neuronal and linguistic processes. A common denominator of such pattern formation is that complexity and entropy of the respective systems become reduced spontaneously, which is the hallmark of self-organization. The various methodological approaches of how to model such processes are presented in some detail. Results from the various methods are systematically compared and discussed. Among these approaches are algorithms for the quantification of synchrony by cross-correlational statistics, surrogate control procedures, recurrence mapping and network models.This volume offers an informative and sophisticated resource for scholars of human change, and as well for students at advanced levels, from graduate to post-doctoral. The reprint is multidisciplinary in nature, binding together the fields of medicine, psychology, physics, and neuroscience
Relationship of Parent-Child Temperament and Parent Responsivity on Language Outcomes in Autistic Children
The purpose of this quantitative, correlational study was to investigate the relationship between parent and child temperament on language acquisition as well as the relationship between parent responsivity and parent-child temperament in autistic children. Participants were 25 parent-child dyads of autistic children between the ages 2 and 8 years of age (18 boys, 7 girls). Parents provided ratings of their temperament and their child’s temperament. The child’s expressive language, receptive language, and receptive vocabulary were assessed by a licensed speech-language pathologist. Parents’ engagement with their children were rated by undergraduate research assistants blind to the study using a Likert rating scale for parent-responsive behaviors. There were several significant findings in the 2-year-old and 3- to 6-year-old age groups. In the 2-year-old age group, significant correlation coefficients were found for the associations between adult effortful control and the autistic child’s language, child extraversion and their language, parent responsivity and adult extraversion and negative affect, and finally parent responsivity and child effortful control. Then in the 3- to 6-year age group, there was a significant positive correlation between the autistic child’s negative affect and their expressive language. Lastly, in the 7- to 8-year age group, there was a near significant association between adult effortful control and the autistic child’s language. Overall, these findings indicate the importance of identifying the parent's and child's temperament and the impact both have on the autistic child’s language and their parent’s responsive behaviors to enhance the therapy model and improve relationships to maximize the child’s ability to acquire language
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Relationships, Assets and Social Capital: A Case Study Review of Youth Mentoring
Youth mentoring, where young people (mentees) work with adult mentors to achieve change, is a popular government and third sector intervention. Past research, concentrating on quantitative analysis of US programmes, concludes that mentoring achieves significant but modest change. Such research assumes that changes from mentoring can be externally identified and measured, often without hearing the views of those involved.
This study investigates the experiences and expectations of mentoring from the perspective of mentees, mentors, referring agencies and programme coordinators. Using social capital theory (Bourdieu, 1986; Coleman, 1988; Putnam, 2000), the study explores how mentoring relationships are built and their role in bringing about change.
A local authority youth mentoring programme in the UK formed the case study for investigating experiences of mentoring and perceptions of change. To allow nuanced exploration of views, an interpretive, qualitative approach was taken. Data were collected from mentors, mentees, referring agencies and coordinators via semi-structured interviews, survey, diaries, focus groups and programme feedback. Data collection and thematic analysis were informed by social capital theory.
Findings indicated that mentees actively participating in the mentoring process benefitted most. Mentees experienced unusual levels of equality in the purposeful and trusting mentoring relationship. Drawing on the relationship’s social capital, mentees enhanced their assets and enjoyed emotional support, learning and challenge. Collaborating with mentors, mentees achieved previously inaccessible outcomes. Assets developed could be used in other relationships.
The study also concludes that social capital and asset acquisition provide a theoretical basis for understanding the mentoring process. By encouraging asset and social capital exchange, mentoring develops mentees’ self-awareness, agency, and confidence, increasing the likelihood of resilience. This knowledge may be transferable to other programmes and relationships. Supporting young people’s knowledge of their needs and strengths through mentoring may contribute to their wellbeing post 2019 Covid pandemic
Loss of a sense of aliveness, bodily unhomeliness and radical estrangement: A phenomenological inquiry into service users’ experiences of psychiatric medication use in the treatment of early psychosis
Quantitative research drawing on the disease-centred model of psychiatric drug action dominates research on psychiatric medication, while little is known about service users’ subjective, embodied experiences of taking psychiatric medication. This research explored service users’ felt, embodied and relational experiences of psychiatric medication use in the
treatment of early psychosis using a multimodal, longitudinal research design. A more in-depth understanding of what it is like and what it means to take psychiatric medication from
service users’ idiographic perspectives is needed to improve the clinical care and support service users receive and better understand the treatment choices they make. Ten participants between the age of 18 and 30 years were recruited from London-based NHS Early Intervention in Psychosis services and participated in in-depth idiographic interviews. Eight participants took part in a follow-up interview between six and nine months later. Visual methods were used to explore the verbal as well as the pre-reflective, embodied aspects of participants’ medication experiences. The data was analysed using a combination of interpretative phenomenological analysis and framework analysis. While taking psychiatric medication, participants reported the loss of a sense of aliveness, feelings of radical estrangement from themselves, the world and other people and a sense of being suspended in a liminal, time-locked dimension in which they felt unable to transition from past
experiences of psychosis to future recovery. The findings of this study highlight the highly distressing and adverse iatrogenic effects of psychiatric medication use, including medication-induced coporealisation, disembodiment, estrangement and a loss of belonging. More holistic, human rights-based, recovery-oriented and body-centred ways of treating psychosis are needed
The Lived Experience of Residential Home Care:An Interpretative Phenomenological Analysis study of the experiences of young adults who reside in therapeutic residential care in Denmark
Residential care is, in many countries, a living arrangement for young people with behavioural problems who require a level of help which is beyond their own family’s resources. Research on residential care has, in recent years, focused on outcomes, intervention evaluation and economy including comparison with alternative care forms. Relatively little research has been conducted on how young people experience living in care. For example, the systematic review conducted as part of this thesis found from a systematic international search just 12 qualitative papers published between 1990 and 2020 which included residents’ accounts in the findings. This thesis’ empirical study engaged interpretative phenomenological analysis as the methodology to investigate the lived experiences of eight young adults who lived in Danish therapeutic residential care. The participants engaged in two individual semi-structured interviews where their accounts of the experience of living in residential care as young people and young adults formed the study’s data. Four group experiential themes are presented as the study’s findings: (1) “They [carers] go up to the young people and talk to them”: Navigating the challenge of staff-system-resident relationships. (2) “I am just more grown up”: The experience of transitions towards adulthood and life beyond residential care. (3) “… actually, they wanted me back”: The experience of having family and friends while living in care. (4) “I said yes, she told me that was good…”: Making sense of receiving help and developing self-help. As an original contribution to knowledge this study concludes with a discussion which highlights the resulting stress from moving both into care and during care, the importance the participants placed on feeling able to develop and ultimately leave care at a pace independent of legislative time frames, and how family, for five of the participants, was experienced as the most stable factor during their residency
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