Changes in demographic characteristics and modernisation in Malaysia have contributed to relocation of many elderly people to an elderly institution which is rapidly growing in number in Malaysia in spite of traditional cultural values and the personal beliefs towards elderly people. Living in elderly institutions is often associated with deterioration in well-being as a result of negative issues in institutions such as occupational injustice, loss of meaningful relationships, loss of autonomy and individuality which lead to psychological problems such as depression. Subsequently these issues affect several domains in life including future orientation towards ageing (ERA), general self-efficacy (GSE) and quality of life (QoL). Various lifestyle redesign programmes based on occupational therapy have been conducted to prevent such deterioration. However, such programmes are conducted in Western countries and were design for elderly people in the community. To date, there is no substantial work exploring the applicability of such programmes to elderly people in institutions and in different sets of cultures, values and beliefs such as in Malaysia. This provides justification for the need for such a study. The aim of this concurrent embedded experimental mixed methods study was to explore the effect, and identify the ideographic experience, of forty-six elderly people living in a public funded elderly people institution in Malaysia before and after participated in a new lifestyle redesign programme known as the Lively Later Life Programme (3LP) on ERA, GSE and QoL. Another thirty-six elderly people in a control group participated in an ‘in-house’ programme. After six months of taking part in the 3LP, there were statistical significant changes in the scores of the study measures for the participants in the experimental group. In addition, the participants provided ideographic experiences exemplified in various themes relating to the experience of taking part in the 3LP which supported and elaborated the changes in the scores of the study measures. Findings from this study contribute to evidence based practice in occupational therapy, validate and expand previous lifestyle redesign programmes. In addition, the findings demonstrate that a lifestyle redesign programme based on occupational therapy can be successfully transferred to a different setting, transcend cultural barriers and philosophies of life.

This thesis is an exploration of the psychodynamic body and its mythos. I take a phenomenological approach to research that remains connected to lived experience. I begin with image making, painting from the subjective body in response to the ancient Mesopotamian myth of the flood and archaic cultural material on the flood theme. I discover a relationship between this imagery, this mythos, and earlier work on the Dionysian mythology and mysteries. I gather these images together and with work on my own family history I create a painting performance titled Wings from the Deep. The mythos, the poetic structure, of this performance and this thesis, is an exploration of how a people, a person, a body, can journey through traumatic states. The core phenomenon of this thesis is the psychodynamic movement from deadness to aliveness, a movement at the heart of the psychotherapeutic process. I apply knowledge of the psychotherapeutic conversation to the research process by writing to an important other, Etty Hillesum, a young Dutch Jewish woman who wrote a series of diaries during the Holocaust. I then link this conversation with my earlier imagery and the images of the Holocaust to the biblical myth of the flood. This linking of somatic states to mythic material through imagery and text is how I develop the poetic language integral to this thesis. I create a constant dialogue from body to image to word, a process, a language, that mirrors psychotherapy. The psychodynamic body structures the mythos of this thesis. The psychodynamic body structures a mythos of psychotherapy. CD SOUNDTRACK AND DVD PERFORMANCE AVAILABLE AT UWS LIBRARY. / Doctor of Philosophy (PhD)

Art therapy as a way of social assistance, support for social risk group children is poor studied sphere in Lithuania, also in all over the world. It‘s extremely necessary for children, who are suffering form violence of parents and the surrounding, for those, who often run from their home regarding inappropriate lifestyle and reprobation of friends, relatives, they become aggressive, delinquent and commit the crimes; and also for children who experienced emotional and psychological violence. These are the children from social risk group, for who is very important to be needful, to find some friends, develop imagination and to experience positive emotions. This can be reached by using the method of art therapy. Art therapy is a quite new scope in Lithuania, so the purpose of this master thesis is to examine work particularity of Lithuanian art therapists, also to examine the impact of art therapy on social risk group children, attending art therapy classes, how this therapy effects their development and socialization. The purpose also is to explore what kind of difficulties art therapists face and what are the ways of solutions of these problems. In these master theses quantitive research is used. 40 professionals working with children in foster homes, day centers, children and youth house, municipal social support centers and schools were examined and answered questionnaires. The object of research is to examine the peculiarity of work of art therapists and the attitude... [to full text]

This thesis focuses on the relationship between the visual arts and psychotherapy in post Revolutionary Cuba. The material on which it is based was collected over a fourteen month period and three visits to Cuba between April 1999 and August 2001. The study opens with the presentation of two brief histories, that of Cuban Art and Art Education and that of Cuban Mental Health Care. In this context the Revolution is taken as a useful reference point in terms of thinking about change and historical developments in both fields. Naturalistic Inquiry and Grounded Theory respectively were used to collect and analyse the data presented. These approaches allowed the researcher the degree of flexibility necessary to undertake research in a potentially delicate situation full of unknowns and to be able to modify and develop the course of inquiry as new evidence emerged. The main descriptive themes emerging from an analysis of the data pertain to the relationship between artists and mental health care professionals. These are (1) therapeutic work undertaken by artists, (2) artists working collaboratively with mental health professionals and (3) psychologists working with art as a therapy. The story which emerges pertains to a series of largely unrecorded histories spanning a forty year period. It begins with the work of Antonia Eiriz, who emerges as a key figure in the early development of art as a therapy and concludes with the work of the psychologist, Aurora García Morey, who takes centre stage in its continued development. This snapshot of Cuban art therapy is specific and unique and demonstrates the development of a very particular Cuban practice. However an analysis of the analytic themes which emerge from the data suggests that certain concepts such as responsiveness and pragmatism resound within a wider picture. These themes are discussed in chapters 7 and 8 with reference to the wider international context and specifically to the development of the profession in the United Kingdom. In my conclusions I suggest that these themes may be applicable to other areas of research and practice outwith and beyond Cuba and that while the concept of art therapy cannot be narrowly defined when it is applied to understanding practices in other, social, economic and cultural contexts, there are common factors which can be identified.

In recent years there has been growing interest in arts therapy work with older people who have dementia. This has happened despite a paucity of UK research and writing on the aims of practice. Furthermore, there is little knowledge about the professional background of practitioners, the client group, care settings, theories and methods underpinning their work. This qualitative mapping study employs a methodology from nursing called interpretive description (Thorne et al. 2004). Interpretive description advocates a pluralistic approach for understanding the complex dialogue between clinical and research knowledge. The research design involved thirty-one semi-structured interviews with arts therapists from art therapy, music therapy, dramatherapy and dance movement therapy, participant observations of thirteen care settings and formal and informal interviews with ten medical/care staff who work with the arts therapists. The descriptive map was analysed using template analysis (King, 1998) and was interpreted using an integrative interpretive analysis (Heidegger, 1927; Smith et al.1999) The findings suggest that many arts therapists are pioneers in terms of being the first from their profession to work in the care setting. Issues around the arts therapists being unheard and staying unheard relate to their newness within these established settings. In terms of therapy work, theory and practice were being adapted in order to accommodate the temporal nature of the work. Despite distinctions in the art form, the study found that there is reciprocity of experience in terms of the arts therapists’ feelings about the work and some in-session practices. These united the disciplines beyond the norms of mainstream practice.

Preterm infants born before 37 weeks of gestation constitute up to 10% of all births, and can display development that, frequently, differs from those of full- term infants. Studies indicate that school children born preterm present with a, generally, higher incidence of performing poorly academically. The present study investigated the perceptions of paediatric OTs regarding the type of difficulties with which children born preterm present, and explored the role of OT. In the first, quantitative part of this study, paediatric OTs completed a postal questionnaire (N=353). The second, qualitative part, used asynchronous, online discussions (N=13), by utilising the virtual environment of WebCT, to further explore the topic. The survey was also designed to capture: • information on the extent of this paediatric population within OT services, and how identifiable and accessible it is • OT practices when working with these children • what informs therapists’ clinical decision making. The discussion groups provided a forum for OTs’ “reflexive comment” on the issues emerging from the questionnaire analysis. Despite sensorimotor and attentional difficulties reaching the highest frequencies, the findings revealed rather a combination of problems in most developmental domains. Writing emerged as the predominant problematic area within the school curriculum. A “persistence” of sensorimotor difficulties throughout the preschool years also emerged. More frequent and/or severity difficulties, more medical issues, a higher co morbidity of SLD with other conditions for the preterm group, were other findings. These insights could lead to a further exploration of the need for differentiating assessment and treatment practices for this group. Occupational therapy was highlighted as particularly “advantageous” for this population due to a number of OTspecific contributions e.g. ability to “detect “subtle” difficulties at a young age. The implications of a “shift” of more OTs into the area of early intervention, are discussed. The findings of the study constitute tacit, professional knowledge, and they are based on subjective clinicians’ views. They could, however, help frame hypotheses to be further explored verified with the use of empirical research. KEYWORDS: Prematurity; Specific Learning Difficulties; Early Intervention; Paediatric Occupational Therapy; School; Clinical Decision Making; Assessment; Intervention; Survey; WebCT; Asynchronous Online Discussions

This thesis presents a classic grounded theory study of Condition Management Programmes, which form part of the UK Government Initiative Pathways to Work. Condition Management Programmes provide short, work focused interventions to help people claiming incapacity benefits to return to employment. Delivered jointly between Jobcentre Plus and the NHS, or by providers within the private and voluntary sectors, health care practitioners working in Condition Management Programmes are often faced with competing priorities. This thesis has identified practitioners’ concern with being person driven in a service driven organisation, and presents the emergent grounded theory of Revisioning Service Ideals and Client Realities which explains conceptually the means through which this concern is continually resolved. Practitioners are conceptualised as ‘revisioning’ or making thoughtful, situational adaptations to their practice which either deviate from or retreat within service boundaries. By cycling iteratively between deconstructing and reinstating service ideals, practitioners are able to create a reverberating equilibrium between the expectations and realities of practice, negotiating a person driven approach without compromising service structures completely. The theory has been developed using the full complement of classic grounded theory procedures and is based on interviews with 35 practitioners and observations of 26 practitioner-client sessions. Additional informal observations, programme documentation, client case notes and extant literature were also included as data. The theory adds to current Condition Management literature by explaining the differences across and within programmes, highlighting some important considerations for future development and evaluation within welfare to work. Furthermore, the theory of Revisioning Service Ideals and Client Realities, on account of its conceptual nature, also demonstrates relevance outwith its substantive area. Most notably, offering contributions to current research on treatment fidelity, theories of organisations and bureaucracy, and professional and clinical reasoning by offering a conceptual explanation of the behaviour of practitioners in daily practice.