Title:
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Doctorate in Clinical Psychology : main research portfolio
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Mental Imagery (MI) and implementation intentions (II; creating concrete plans for when, where and how a goal is to be achieved) have shown promise in enhancing performance and goal achievement. As depressed mood is often characterized by loss of interest and reduced engagement in previously rewarding activities, the aim of this study was to investigate whether MI and II strategies could be used to enhance rates of goal achievement in participants presenting to services with low mood/depression. An experimental three-group comparison was used, with random allocation to the levels of the independent variable (MI, II, Control). Each participant (N = 44) devised three idiosyncratic goals, with the researcher guiding the participants in the MI/II groups through the relevant cognitive strategy in relation to their first goal. Those in the MI group reported a significant increase in the perceived likelihood of achieving their goals post-strategy. There were no significant differences in the achievement of goals amongst the three groups, although higher rates of goal achievement were apparent in the MI group. The current study suggests that generating specific goals and using MI may represent a valuable technique for improving individuals’ beliefs that their goals are attainable and within their reach. Further research with larger samples is recommended to explore the impact of techniques on actual goal attainment. Service Improvement Project Background: Clinical guidance recommends that multi-family psychoeducation groups) should be offered as part of the stepped-care model of intervention in early intervention for psychosis services. This results from the recognition of the important role that families play in supporting the recovery of service users experiencing a first episode of psychosis. Aims: This study aimed to evaluate and improve a series of multifamily information sessions within the North Somerset Early Intervention for Psychosis Team. Methods: Following the initial running of a multifamily psychoeducation group (Group 1), telephone interviews were conducted with six family members who attended to evaluate and identify recommendations for the improvement of the group. This feedback was used to inform the format and content of a second running of the group (Group 2). Three further participants provided evaluative qualitative feedback on this revised group. Results: Following collection of feedback from Group 1, four key themes were identified including the positive aspects of group attendance (e.g. receiving relevant information, opportunity to meet the team and other families), challenges of groups (e.g. accommodating the needs of different families), impact of caring (e.g. feeling isolated and unknowledgeable) and recommendations for improvement (e.g. additional content for siblings, simplifying information). This information was used to develop Group 2, which was adapted to make the information more family-friendly (e.g. simplifying information), with the inclusion of some further information. Conclusions: The positive feedback received from those who attended the group supports the continued use of family information sessions within the service. The use of feedback and the development of this aspect of the service were perceived positively by the team. Systematic Review of the Literature Background: Cognitive behavioural therapy for low self-esteem (LSE) has shown promise as a trans-diagnostic model for treating mental health difficulties in adults. To ascertain the potential value of this treatment approach in working with young people with internalising disorders, we need to develop our understanding of LSE within these mental health conditions. The aim of this review is to explore 1) the co-occurrence of clinically significant anxiety/depression and LSE in young people, and 2) the association between LSE in childhood and adolescence and mental health difficulties in later adolescence and emerging adulthood. Method: A systematic search of two electronic databases (PsychInfo/Pubmed) was conducted to identify relevant studies. Results: Ten studies examining the association between LSE and clinically significant anxiety/depression in young people met the inclusion criteria, as did eight studies investigating the association between LSE in under 18 year-olds with internalising difficulties in later adolescence/emerging adulthood. Conclusions: Although relatively few studies investigating ‘clinically significant’ anxiety and depression were identified, the located studies consistently supported the co-occurrence of LSE and internalising disorders in young people. This was found to be particularly true for young people with depression and co-morbid mental health difficulties. There appears to be less evidence for the association between reported LSE in childhood and adolescence and anxiety/depression in adolescence/emerging adulthood, potentially due to the complexity of confounding variables. Further research investigating Fennell’s cognitive model as a trans-diagnostic treatment model for young people with LSE is indicated.
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