Literature Review: Psychological consultation is a common activity in mental health services, but evidence concerning its theoretical grounding, processes, and outcomes are relatively rare. Fifteen mixed method consultation studies were included in the review. Studies were assessed for methodological quality, and found to range from limited to strong. Cognitive behavioural consultation was the main approach used and consultation was most frequently delivered via formulation meetings. Psychological consultation appears to particularly improve staff understanding about clients and consultants should remain visible and accessible to teams. Practical and methodological developments are suggested to the consultation evidence base. Research Report: This empirical study aimed to measure the effectiveness of cognitive analytic consultancy (CAC) offered within a community team and then to explore the possible mechanisms of change. An A-B with follow-up small N case series (N=5) design was used that utilised a mixed methodology employing outcome measures and semi-structured interviews. There were significant improvements in client fragmentation, staff competence and emotional exhaustion, and alliance from a client perspective. Potential mechanism of change included the therapists approach, using the sequential diagrammatic reformulation, and acknowledging that difficult processes helped recovery. Further head-to-head trials comparing CAC to other consultation frameworks appears warranted.

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The aim of this research was to gain a more comprehensive understanding of 5- to 7-year-old children’s creativity and discover what factors affect it. In particular, the focus of this research was to find out how and in which ways touchscreen device use and peer collaboration affect children’s creativity. Two different creative domains were measured: storytelling and drawing. Storytelling was measured in two cultures: the UK and Turkey. A new way to measure children’s creative storytelling was developed. Linguistic components of children’s stories were evaluated to measure two divergent thinking skills (fluency and elaboration) in a more objective way. Children’s stories were also measured by independent judges using the Consensual Assessment Technique. Touchscreen use did not affect children’s creativity in either of the countries. Collaboration had a positive effect on the fluency of British children’s stories, no effect on their overall creativity, and a negative effect on their elaboration. For Turkish children collaboration had a positive effect on the fluency and overall creativity of their stories, and no effect on the elaboration scores. Children’s creative drawing was measured using the Torrance Tests of Creative Thinking (TTCT)-Figural. The effects of children’s perceived peer acceptance were also measured. Collaboration had a positive effect on children’s fluency, however it did not affect their originality or elaboration. Overall these results provide a holistic evaluation of the effects of collaboration on creativity across different domains and different cultures.

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Mental health professionals (MHPs) do not routinely deliver evidence-based practice (EBP) despite significant efforts aiming to identify the best available evidence and to disseminate research findings. This thesis aimed to contribute to bridge the research-practice gap by conducting a meta-analysis and two empirical studies. The first part of this thesis reports on a meta-analysis, reviewing 11 studies. This meta-analytic study evaluated the relationship between the Theory of Planned Behaviour (TPB), intentions and behaviours towards using EBPs in MHPs. The TPB determinants (i.e., attitudes, subjective norms and perceived behavioural control) had moderate to strong sample-weighted average relationships with MHPs intentions to use EBPs. Participants’ country at recruitment and client age group were found to moderate the relationship between subjective norms and intentions. Important limitations included the lack of behavioural measures, large inconsistency between studies, and studies’ methodological issues. Implications for clinical practice and recommendations for future research are provided. The second part of this thesis reports two studies. The aim of these studies was to develop and evaluate the feasibility of a training programme for MHPs to prompt their patients to use a particular EBP, implementation intentions. Implementation intentions are self-regulatory strategies that have been shown to help mental health service users to achieve their goals, but MHP do not use this technique routinely in their clinical practice. The first study developed a novel training programme on implementation intentions. The second study evaluated the feasibility of delivering the training to trainee Psychological Well-being Practitioners (TPWPs). In Study 1, a non-systematic review of the literature on implementation intentions and consultation with 25 experts revealed the training content met the criteria established a priori and experts’ feedback was integrated into the training content. In Study 2, 69 TPWPs took part in the training workshop. Participants significantly increased their theoretical and practical knowledge on implementation intentions and reported using implementation intentions significantly more frequently six-months after the training. Three-percent of participants reported using implementation intentions in their clinical practice before the training, compared to 44% of participants six-months after the training. Qualitative analyses revealed participants found the training acceptable and helpful. Specific recommendations were made for future training sessions. Limitations of self-reported measures and lack of observable competence are discussed, along with future research recommendations and potential implications for the Improving Access for Psychological Therapies services. The two parts of this doctoral thesis contribute to the understanding of the use of EBP among MHPs. Findings suggest that attitudes, subjective norms, and perceived behavioural control are useful to understand MHPs intentions to use EBP, and that a single workshop in a particular EBP can influence MHPs’ clinical practice.

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Literature review: The present study is a systematic literature review of findings from 16 studies investigating the quality of life of adults with an intellectual disability. It was concluded that those with intellectual disability experience a lower quality of life than other groups. The interrater reliability between self-reports and proxy reports were found to be fair. However, proxies were found to consistently underestimate quality of life for individuals with intellectual disability, and physical wellbeing was identified as a problematic domain for agreement between self-report and proxy reports. Employment and good social or family supports emerged as factors most important to good quality of life. Those with severe or profound intellectual disability were under represented in the literature. Clinical implications and recommendations for future research are discussed. Empirical report: There is limited research into how psychological wellbeing and distress are identified in those with a severe or profound intellectual disability. Therefore, the present study aimed to explore carer’s view on how these inner emotional states are identified in those they care for. A qualitative exploratory design was used and 18 paid carers and family members participated in semi-structured interviews. Analysis of transcripts yielded eight superordinate themes relating to: relationship; physical contact; body; vocalisation, things that affect their emotions; facial expression; unknown and telling their story. Agreement between the dyads was fair. Clinical implications and recommendations for future research are outlined.