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Title: Factors associated with staff attributions of challenging behaviour, and trainee clinical psychologists' experiences of self-disclosing mental health difficulties
Author: Turner, Kellie
ISNI:       0000 0004 9354 6677
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2020
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Decision-making is a high-level cognitive process by which one course of action is chosen over other alternative options. In healthcare professions, decision-making is integral to evidence-based practice, and is often a complex and dynamic process reliant heavily on contextual factors, which includes workplace culture. The current project explored decision making in different health care contexts highly relevant to staff well-being and is presented as two papers consisting of 1) a systematic literature review; and 2) an empirical research study. Paper one presents a systematic review in the area of intellectual disabilities and staff responses to challenging behaviour. Challenging behaviour of individuals with intellectual disabilities can have a significant impact on an individual’s quality of life and their caregivers. Staff causal attributions play an important role in how staff respond to challenging behaviour. Therefore, to effectively support staff to work with individuals who engage in challenging behaviour we must first better understand attributions. Thirteen studies investigating factors associated with staff causal attributions were systematically reviewed for quality and to summarise evidence. Some evidence was found for the role of staff, service user and organisational factors associated with staff causal attributions however the evidence is limited. More high-quality research is needed in the area that balances rigour with ecological validity. Paper two presents an empirical study designed and conducted after the original project in the area of intellectual disabilities was deemed no longer feasible. The empirical study presented explored trainee clinical psychologists’ experiences of self-disclosing information of lived experience of mental health difficulties during training. Research shows that trainee clinical psychologists are highly likely to have lived experience of mental health difficulties. This raises the questions of whether and how to disclose this during doctoral training. Twelve trainee clinical psychologists with experience of disclosing information about their lived experience of mental health difficulties during training participated in semi-structured interviews. Grounded theory methodology was used to analyse the data from interviews 6 and to construct a theoretical model of disclosure experiences in training. The model that emerged is broadly consistent with literature of self-disclosure in the workplace and has important implications for trainees, supervisors and training programmes around how selfdisclosure may be best supported and managed during training. Furthermore, the model that emerged suggests self-disclosure of mental health difficulties met with supportive responses can have powerful impacts for trainees and colleagues, including greater integration of personal and professional identities; more meaningful working relationships; and gaining appropriate support. The potential impact of this on competency development is also considered. Knowing that research is always conducted in context, these disparate topics were chosen by the researcher for investigation due to their personal relevance. The researcher has personal experience of working in learning disabilities services and experiencing burnout while working in this area prior to training, which has been disclosed in part at various stages in training. Thus, the researcher chose these topics due to a personal interest and passion about both. Furthermore, these topics were chosen to develop competencies in critically appraising literature in an applied field and developing knowledge and skills in qualitative methods, namely grounded theory methodology. These papers, though contrasting in topic area, are relevant to staff well-being literature and highlight the importance of organisational and relational information in decision-making and subsequent behaviours within the healthcare professions. Furthermore, they suggest a shared responsibility in supporting staff to make informed and effective decisions in the workplace, in relation to their work with both service users and colleagues.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: BF Psychology