Overview Female Perpetrated Sexual Abuse (FPSA) remains a largely under-studied and poorly understood phenomenon, despite its growing prevalence. Traditional gender constructions in relation to victimisation and perpetration as ‘gendered’, may be stifling its recognition, and the recognition of those affected. Survivor’s perspectives on disclosure are crucial, given its known under-reporting, and how many people feel silenced. As research on FPSA is in its relative infancy, understanding the process of disclosing is particularly important in influencing professional and social change, and progression. Method Fourteen participants of equal gender distribution, who self identified as having been sexually abused in childhood by a female, were recruited online. The study was advertised via online survivor communities, survivor charities and forums supporting survivors. Participants were directed to a website designed by the Researcher outlining the study in its entirety. Participants then offered their consent to participation and contacted the researcher via the website. Telephone interviews were arranged and conducted with participants meeting eligibility, using a qualitative semi-structured interview protocol. Interviews were transcribed and systematically analysed using a qualitative methodology applying an Inductive Thematic Analysis approach (Braun & Clarke, 2006). Results Four super-ordinate themes relating to participants disclosing sexual abuse by a female were discussed, with one being a central and over-arching theme ‘Perceptions of Gender and Disclosure’, which influenced the three further themes; Perceptions of Gender and Disclosure; consisting of ‘social attitudes’, ‘gender roles’, ‘barrier to recognition’ and ‘barrier to disclosure’ o Decisions to Disclose; consisting of ‘relationship with the perpetrator’, ‘making sense of the experience’, effects of abuse’ and ‘readiness’ o Process of Disclosure; consisting of ‘experiences of services’, ‘contexts of disclosing’ and ‘nature of disclosure’ o Experiences of Disclosure; consisting of ‘perceived professional responses’ and ‘impact of perceived professional responses’. Conclusions Constructions of gender and narrow views of ‘perpetration’ and ‘victimisation’ appear to be stifling personal, professional and social recognition of FPSA. This lack of awareness and perceived cultural denial may be silencing survivors, and restricting their ability to disclose and process their experiences. The impact of gender appears to be two-fold and future research would benefit from exploring disclosure of FPSA for males and females exclusively, as their experiences and needs may greatly differ. The value of involving survivors in educating professionals and in widening awareness is discussed.

Background: An estimated one in ten adolescents living in the community will engage in deliberately self-harming (DSH) during their lifetime. This perplexing behaviour is of growing clinical concern and appears to be increasing in prevalence, yet continues to be without definitive understanding. There are multiple theories on the underlying mechanisms of DSH, however, there is limited empirical evidence to support these theories. The present study aimed to investigate whether Young’s schema theory could provide a comprehensive framework to understand DSH in adolescents from the general community. This study aimed take a unique perspective on DSH by investigating the theorised unconscious cognitive constructs, known as Early Maladaptive Schema’s (EMS’s), which may underlie this behaviour. It also explored the relationship between EMS’s and psychopathology within this sample. Methodology: 252 adolescents recruited from internet forums and social networking sites completed a series of self-report questionnaires online. DSH was measured using the Deliberate Self-Harm Inventory. Early Maladaptive Schema’s were measured using an age downward version of the Young’s Schema Questionnaire-short form. The Brief Symptoms Inventory was used to measure psychopathology, and a demographics questionnaire was designed to gather pertinent additional information. Results: Correlational analyses indicated positive relationships between frequency of DSH behaviours and intensity of 13 of the 15 EMS’s. Despite no association found between the overall EMS score and general psychological distress, when each EMS was considered individually, relationships were found between the intensity of each of the 15 EMS’s and the general measure of psychological distress. Hierarchical multiple regression, controlling for gender and general psychopathology, indicated that the Emotional Deprivation, Vulnerability to Harm, Subjugation and Self-Sacrifice EMS’s accounted for a unique proportion of the variance in DSH behaviour. Conclusions: These finding are unique in that they extend the research into both DSH and EMS’s in adolescents. From the findings one could broadly conclude that, as Schema Theory states, DSH is a coping strategy used to manage unbearable memories, emotions, cognitions, and bodily sensations associated with EMS’s, with positive correlations between the intensity of the EMS’s and the frequency of DSH, and the intensity of the EMS’s and increased psychological distress. Further, during this time the EMS’s Emotional Deprivation, Vulnerability to Harm, Self-Sacrifice and Subjugation are more predictive of DSH than alternative EMS’s. When comparing these findings to the wider literature, one could conclude that EMS’s are unstable in adolescents, as those EMS’s causing distress in an individual’s adolescence may not continue to do so into their adulthood, yet the coping strategy may remain the same. This highlights the role of social, environmental and biological changes in the stability of EMS’s. The pertinence of these findings to adolescents who DSH, the overlap with broader psychological symptomotology, and its relevance to clinical practice is discussed.

This study sought to explore how men experienced their transfer from prison in the criminal justice system, to being detained indeterminately in mental health services, under the Mental Health Act, for treatment and rehabilitation. An exploratory qualitative method using thematic analysis was adopted throughout the research process. Eleven participants were recruited with each participant engaging in one semi-structured interview. The data was collected and analysed employing a six-stage process, following the guidelines by Braun and Clarke (2006). Four main themes were constructed, with some themes consisting of smaller subthemes: Shifting Identities, Understanding and Negotiating, Engaging with Therapy, and Making Sense of Time. The core of the thematic analysis constructed suggests that individuals found that the process of transfer had a direct impact on their perception of self, causing shifts in identity. The main features which supported their view of self was that of ‘being a patient’ in a system; a system which held power to make important evaluations about them as individuals. This linked directly to a second theme where participants described a process of familiarisation and adaptation to their environment. This was constructed as a strategy which supported participants to set up assumptions and expectations about being detained for treatment in a high secure hospital. The process of transfer and adjustment was underpinned by existing hierarchies of power. This research offers a unique contribution to the current literature by illustrating that the process of transfer has a significant effect on individuals, highlighting the need to support individuals to make sense of this process and their new environment. Given the limitations of the study future research incorporating a wider constituency of participants, including those who may have moved on from high secure services would add useful insights into this experience. The clinical implications suggested by the study include the need for psychological therapy in this setting to focus more upon the impact of transition, with wider consideration by clinicians of the impact of social identity on the process of treatment and rehabilitation for this population.

<p> Despite past discussion of uncertainty as a part of therapeutic theory and practice, few researchers have studied how uncertainty is understood by currently practicing clinical psychologists. Through semistructured interviews, 4 clinical psychologists provided their lived experiences of how they define, become aware of, experience, and make sense of uncertainty in their work. Their accounts were analyzed using interpretative phenomenological analysis, resulting in 16 superordinate themes. These included: (a) defining uncertainty as beyond knowledge, inevitable, future-bound, and from complex sources; (b) becoming aware of uncertainty in interrelating with others and in fulfilling professional roles; (c) experiencing uncertainty as distressing and/or threatening; and (d) reacting through reducing/controlling/rejecting, distancing, questioning themselves, seeking out other perspectives, embracing uncertainty, applying uncertainty, using hope and faith, and experiencing uncertainty as professionally taboo. Findings are discussed individually and integrated according to several dissonances/paradoxes emerging from the analysis. Recommendations are provided for clinicians, researchers, training programs, and students regarding experiencing uncertainty and new opportunities for incorporating the impact of uncertainty into clinical research, practice, and education.</p>

<p> Acceptance and Commitment Therapy (ACT) has been shown to be an effective alternative therapeutic approach for adults of various presenting problems as well as those with whom traditional forms of cognitive-behavioral therapy have been futile (Asmundson &amp; Hadjstavropolous, 2006; Bach &amp; Hayes, 2002; Clarke, Kingston, James, Bolderston &amp; Remington, 2014; Dimidjian, Hollon, Dobson, Schmaling, Kohlenberg et al., 2006; Martell, Addis, &amp; Dimidjian, 2004). Recently, researchers and theorists have posited about the application of ACT with youth, however, little research has been conducted utilizing quantitative measures of change in psychological flexibility. This article presents a single-subject multiple probe experimental design of ACT adapted for application to adolescents. This study compared outcomes of two therapeutic approaches, ACT modified for adolescents and Treatment as Usual, by assessing changes in values (PVQ II; Blackledge, Ciarrochi, &amp; Bailey, 2005), acceptance (CAMM; Greco &amp; Baer, 2006), defusion (AFQ-Y; Greco, Murrell, &amp; Coyne, 2005), committed action (diary card and direct behavioral observation), and quality of life (YQOL-R; Edwards, Hueber, Connell, &amp; Patrick, 2002). Behavioral changes as observed by parent and teacher report (BASC-2; Reynolds &amp; Kamphaus, 2004) were assessed at both pre- and post-intervention to provide an objective measure. By the end of treatment, the ACT participant showed a significant decrease in internalizing problems compared to the TAU participant, indicating improvements in psychological flexibility. Change in isolated ACT processes was non-significant between participants. Findings provide evidence supporting previous research suggesting that ACT can be successfully adapted to and may improve the psychological flexibility of adolescents. </p>

<p> A qualitative inquiry was conducted on the experiences of nine participants who attended an emotion-focused, experiential program, <i>Tri-Life Leadership Training (TLT).</i> The purpose of the TLT program is the development of self-leadership via improved emotional functioning, defined as <i> affective well-being.</i> The program structure is an 8-day workshop in two segments composed of psychoeducation, experiential group exercises, and individually tailored, emotion-focused work. Participants were referred adults who met program selection/exclusion criteria. Participants were individually interviewed one week after the program about their <i> experiences</i> (process) and if any <i>changes</i> (outcome) resulted. Outcome was assessed based on participants&rsquo; experience of emotional resolutions, diminution of negative core beliefs, positive behavioral changes, and improved relationships. Self-report questionnaires (Outcome Questionnaire-45.2, Rosenberg Self-Esteem Inventory, General Self-Efficacy Scale, and PANAS-X), used in a descriptive manner, were administered pre- and post-program. Interviews were coded using Thematic Analysis to determine <i>patterns</i> across the data set. Themes were derived theoretically based on Emotion-focused Therapy (EFT), and results discussed in light of program interventions and outcomes to elucidate EFT theory and process. The value of the TLT program and the EFT model appeared to be supported by the data. The findings suggested that the TLT program had a positive impact on perceived affective well-being. The participants attributed process and outcome changes to both relationship and task factors. The findings showed that an empathic therapeutic and working relationship along with experiential tasks designed to arouse and process emotional material may explain the high level of experienced change. Results confirmed the value of an emotion-focused perspective, and further that experiential work can be successfully conducted in a group format.</p>

<p> Despite the availability of various substance abuse treatments, substance misuse and the negative consequences associated with it remain a serious problem in our society. Various types of meditation have been evaluated for treatment of substance use disorders, but the research has not drawn any specific conclusions. This may be due to lack of both an equivalent control group and spiritual emphasis. Therefore, the current study included a spiritual emphasis (12-steps) and inner eye concentrative meditation (n=15), a progressive relaxation group (n=10), and a treatment-as-usual control (TAU) group (n=21). Subjects at an intensive outpatient treatment center for substance use disorder were offered either progressive muscle relaxation, raja yoga meditation, or TAU, depending on which branch of the treatment center they were receiving treatment. The meditation technique was a simple meditation technique where the attention of focus remains on the point between the eyebrows. The current study examined changes in substance use, general psychological distress and dysfunction, craving, and 12-step involvement between the three conditions over a 6-week period. Compared to the average of all groups meditation was significant in predicting abstinence from substances, ?2 (2) = 6.39, p = .0115. This finding gives some credence to spirituality being a protective factor against substance use, and suggests the benefits of using non-secular meditations in drug treatment facilities.</p>

<p> High prenatal stress and the stress hormone cortisol have been shown to lead to adverse birth outcomes. Yet, few studies have examined the efficacy of prenatal stress management programs on improving prenatal stress and cortisol outcomes, specifically what factors (i.e., participant comprehension and content fidelity) in implementing these programs might influence whether pregnant women obtain improved stress outcomes. This study demonstrated that participant comprehension (i.e., how well a participant understands program material) and content fidelity (i.e., how well instructors adhere to core program components) were not associated with stress and cortisol outcomes among low-income pregnant women enrolled in a stress management program. Future research should investigate whether program characteristics (e.g., cultural norms of the population, skill-learning, or therapeutic-oriented processes) mediate these implementation factors. By understanding multivariate models of implementation factors and program characteristics, health care practitioners can effectively provide the CBSM program to pregnant women across at-risk communities.</p>

<p> Engaging, maintaining, and treating patients with anorexia nervosa (AN) remains a significant challenge for clinicians, hypothesized explanations for which are thought to involve specific executive functioning impairments. The neuropsychological treatment paradigm Cognitive Remediation Therapy (CRT) represents the translation of neurocognitive research into practice, and is thought to remediate neuropsychological symptoms and associated maladaptive cognitive processes. Additionally, the etiological model of AN related to executive functioning provides a conceptual framework for this novel approach to treatment. This study identifies and examines such a model, in addition to CRT protocols. Methodology involved a comprehensive synthesis and critical analysis of the literature pertaining to these domains. A variety of promising findings attributed to CRT are discussed, including an increase in participant BMI, improved neuropsychological performance, reduced perseveration, increased capacity for global processing, decreased eating disorder and depressive symptomatology, increased motivation, and confidence in patients&rsquo; ability to change and begin subsequent therapies. Numerous important methodological limitations are also elucidated, as many studies utilized small sample sizes resulting in low statistical power and poor generalizability, neglected to identify or consider demographic and cultural variables, failed to assess general intelligence or reference the normative data used, did not identify or discuss potential cohort or practice effects, provided limited details influencing studies&rsquo; reproducibility, and introduced a variety of biases. Nevertheless, this groundwork illuminated promising results in the treatment of a diagnostically complex and challenging disorder. Accordingly, a number of suggested future directions and clinical applications are elaborated upon.</p>

Part one is a systematic review of the literature relating to perceived stigma and support amongst family caregivers of people with dementia. Numerous studies have suggested stigma is associated with negative outcomes in various mental and physical health difficulties. Older people with dementia and their family care givers could be especially vulnerable to experiencing stigma and this could have a negative impact on their engagement with services. Out of an initial literature search resulting in 101 articles, 15 articles met the inclusion criteria for the present review and their methodological quality was assessed. The 15 articles were critically analysed and four main themes from the articles were extracted. The themes were sociocultural aspects, services use and diagnosis, stigma and aging and managing stigma. A proposed model of perceived stigma that explained the potential origins of stigma, the difficulties it may bring and possible links to service engagement was developed from the results of this review. The clinical implications of this and possible further research areas was discussed. Part two is an empirical paper consisting of two aims. The first aim investigated levels and types of hope experienced by older people with and without dementia. The second aim focused on potential relationships between stigma, hope and quality of life in older . people with dementia. Many studies have indicated that hope is positively associated with quality of life in chronic health conditions and there are two contrasting theories of I " hope, multi-dimensional hope and goal directed hope. Preliminary studies suggested that older people with dementia may predominantly experience multi-dimensional hope and that stigma may be a barrier towards hope. A group of 60 older people without dementia completed two different questionnaires on hope and a group of 40 older people with dementia completed two additional questionnaires on their experiences of stigma and their quality of life. The results supported the hypothesis that older people with dementia experienced higher levels of multi-dimensional hope but stigma was not a statistically significant barrier towards this. Implications for services, including the development of psychosocial interventions and possible further research were discussed. Part three are the appendixes including a reflective statement on the designing, planning and implementation of the research.