7 research outputs found

    Interpersonal trauma sequelae and treatments: the impact of emotion regulation and social connectedness on suicidal thinking, and effectiveness of group-based treatment

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    Interpersonal trauma is the direct harm to one person by another either through acts of commission (abuse) or omission (neglect). It often occurs in childhood, is usually repetitive in nature, and has significant negative impact on development. These symptoms are now recognised as distinct from Post-Traumatic Stress Disorder (PTSD) and have their own diagnostic category, however, there is insufficient evidence at present for clinical or policy recommendations to be made for the treatment of interpersonal trauma. This thesis aimed to systematically review the literature on group-based treatment interventions for interpersonal trauma and their effectiveness in reducing trauma symptoms, expanding on previous research by broadening inclusion criteria beyond only Randomised Control Trials (RCTs). Furthermore, this thesis aimed to explore a theoretical model of the impact of childhood trauma on suicidal thinking, and how this association may be mediated or moderated by emotion regulation and social connectedness. Thesis research aims were addressed in two studies. Research concerning group interventions for interpersonal trauma was systematically reviewed in Journal Article 1 through a PRISMA systematic search of electronic databases, with included studies rated for quality and their findings presented within a narrative synthesis. Journal Article 2 examined cross-sectional pre-treatment data from patients receiving a group intervention for interpersonal trauma within an outpatient psychological therapies service using bivariate correlation, and mediation and moderation analyses to explore the proposed theoretical model. Twenty-four studies were included within the systematic review, with results highlighting that models of treatment were heterogeneous, but that large effect sizes were found for the reduction of trauma symptoms following group intervention. Journal Article 2 demonstrated that the impact of childhood emotional and physical abuse on suicidal thinking was mediated by emotion regulation skills and different types of group identification. The association between childhood sexual abuse and suicidal thinking was moderated by individuals’ emotion regulation skills and their level of identification with their family. Group-based interventions were found to effectively reduce trauma symptoms in both safety and stabilisation and reprocessing phases of trauma treatment, with further progression in treatment eliciting greater benefits. This type of intervention may be beneficial as a standalone treatment or as an adjunct to individual therapy. However, a clear need for further research with a greater degree of methodological rigour was identified. Findings suggest promoting adaptive emotion regulation and improving social connectedness can help to reduce suicide risk and the negative impact of childhood abuse, though these findings should be considered in the context of a specific trauma sample

    Structured management training in the UK and Ugandan civil services.

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    The aim of the research was to discover strategies for increasing the responsiveness of civil service management training in Uganda in light of the U.K. experience in civil service management training between 1979 and 1991. While the literature has tended to advance theory on management development and training, and to outline characteristics of good management training programmes, there is need to relate the theory much more to the type of organisation.Using Case Study method, the study investigated the development of management training in six U.K. and Ugandan Civil Service organisations, with a view to testing the conjecture that the existence of structured management training in a civil service organisation is evidence that there has been a trigger for change to which top management has responded by instituting a radical change programme, one that involves transformation of policies, structures, processes, products etc.; and an indication that there has been a fundamental change in the way top management perceive the role of management training. Fieldwork findings led to the construction of a new model for understanding the development of structured management training in a civil service organisation. This states that, for structured management training to develop, there must be a trigger for change, perceived as a crisis that requires a significant top management response in the form of a radical transformation of the organisation; the definition of the response to the trigger in management terms by top, rather by senior or middle managers; top management commitment to the implementation of the change; a clear organisational vision, held by the top, shared by key groups, and which incorporates a management development strategy that involves setting up supporting mechanisms and deliberately developing features of structured management training; sufficient autonomy; financial resources and resources of expertise.Recommendations for the U.K. relate to fostering the ongoing development of mechanisms, while those for Uganda focus on the need to implement the radical change programmes that have already been proposed as a result of the recent Public Service Review
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