Objective: The aim of this study was to investigate the associations of Traumatic Brain Injury (TBI) in a female prison sample with violent crime and reoffending, psychological and neurobehavioural functioning, and performance on neuropsychological tests. Design: This cross-sectional study was conducted at a female prison in the UK and used a between-participants design to compare a TBI group with a no-TBI group across a range of measures including violent crime, number of times in prison, scores on standardised clinical questionnaires, and scores on performance-based cognitive assessments. In-depth interviews were used to elicit incidence of TBI and forensic history, with forensic information cross-checked against the prison database. Participants: Participants were 56 female inmates admitted to the prison between September 2014 and May 2015. 29 reported TBI and 27 reported no TBI. Results: Those in the TBI group were more likely to be convicted for a violent offence, had committed a greater number and a greater proportion of violent offences, had been to prison a greater number of times, and reported greater psychological and neurobehavioural difficulties. No difference was found between groups in terms of neuropsychological-test performance. Conclusions: The findings suggest that TBI may be a significant risk factor for violent crime and re-offending, and that TBI is associated with a range of psychological and neurobehavioural difficulties in this population. This highlights the need for the routine screening of TBI in prisons alongside interventions that mitigate the attendant psychological and neurobehavioural difficulties.

The ability to form secure attachments shapes the experience of feeling safe in distressing situations. Dementia is often described as a distressing situation which activates the attachment system. Consequently, how people with dementia and caregivers attach to one another informs how safety may be experienced in such circumstances. This thesis has sought to understand how attachment influences the experience of both the person with dementia and their caregiver. Part one presents a literature review on the ‘interactive attachment dyad’ between the person with dementia and caregiver. Findings suggested that interactions within the dyad is a complex phenomenon. Conflicting results across papers highlighted difficulty in understanding how attachment influences the reciprocal interactions that take place between people with dementia and caregivers. Future research could include exploratory observational research of interactions that take place within the dyad, and explore the relevance of attachment theory. Part two presents an empirical paper which qualitatively explored staff caregivers’ understanding of their interactions with, and relationship to, residents in the mid to later stages of dementia in the care home setting. This sought to consider the relevance of attachment within the caregiving relationship. Findings highlighted that a care home setting shares many of the features usually associated with the concept of a secure base in attachment theory. The findings suggest that an attachment-focused model of care may be useful to consider across policies, clinicians and service-levels. Future research is considered.

Prevalence rates of mental health difficulties in UK youth are high and increase with age. The majority of lifetime mental health difficulties emerge by adolescence and young adulthood. Even sub-clinical difficulties occurring in adolescence can have detrimental impact upon future social, health and financial well-being. This age group requires interventions tailored to the specific developmental, social and emotional changes occurring in adolescence. Acceptance and commitment therapy (ACT) offers an intervention, which can be adapted to suit to these requirements. The current systematic review explored all peer-reviewed literature of ACT interventions with adolescents addressing emerging or pre-existing mental health difficulties. Searches produced 21 articles, which covered 20 intervention studies. All studies were assessed for methodological quality, effectiveness and acceptability. The most striking factor was the recentness of the articles, with all but one published after 2011. In line with this emerging field of literature, the majority were described as pilot, feasibility or preliminary research. Methodological weaknesses and small sample sizes resulted in cautionary interpretations of findings, however many studies offered preliminary support for the use of ACT with adolescents. Directions for future research are discussed.

Borderline Personality Disorder (BPD) is a heterogeneous diagnosis which encapsulates a wide range of symptom presentations. There are now a number of effective treatments for BPD but individuals vary in their response to these different treatments. Understanding people’s suitability to treatment would be beneficial in targeting and individualising BPD treatment efforts. This thesis aimed to explore the BPD related predictors of treatment response. Part one of this portfolio presents a narrative review of predictors of BPD treatment outcomes. BPD severity, symptoms and subgroups predictors were included in this review. Findings support previous reports that people with more severe BPD show larger improvements following treatment, although there was a tendency for this to occur in more skills-based treatments compared with reflective treatments. The findings on symptom level predictors were varied and would benefit from replication. Subgroup research is still in its early stages but findings suggest an important role of internal and external coping styles. Part two presents an empirical paper investigating predictors of response to Systems Training for Emotional Predictability and Problem Solving (STEPPS). Severity of BPD was examined as a predictor of outcomes alongside each of the 9 DSM symptom criteria for BPD. Findings are discussed in relation to the different methods of managing missing data. Severity was found to be predictive of response. When severity was broken down into its symptom level sub-parts, identity disturbance and dissociation were the most reliable predictors of response to STEPPS.

The focus of this research thesis is the therapeutic concept of the ‘alliance’. I conducted a literature review on key documents from within the American Psychological Society that sought to establish an evidence-base for psychotherapy that was methodologically compatible and comparable with pharmacotherapy. The ontological assumptions that defined and informed an alliance construct derived from experimental methodology were considered from the perspective of UK Counselling Psychology. This was followed by my first research study, which used a qualitative method to investigate the alliance construct from the clients’ perspective. This was felt to better reflect the Humanistic assumptions of UK Counselling Psychology and further explore the alliance construct and its relevance to clinical practice. A further research project qualitatively investigated Counselling Psychologists experiences of making clinical choices. It sought to develop the current understanding of Counselling Psychologists’ dialectical engagement within the UK’s healthcare climate of efficacy derived practice evidence.

Embitterment has been described as the emotion generated in the aftermath of an event experienced as unjust and unfair. Although embitterment is most commonly presented in the work context, research on workplace embitterment has remained scarce due to the fact that the concept of embitterment is rather new. This thesis aimed to shed some light on the prevalence of this emotion, its developmental context, outcomes and ways of treating it. Three studies were carried out. In study 1, results from a cross-sectional study (N = 337) showed that procedural injustice and over-controlling supervision were significant predictors of workplace embitterment. Findings also showed that embitterment contributes significantly to the prediction of increased affective rumination and reduction in detachment, which are indicative of insufficient recovery from work. In study 2, results from a six month longitudinal study design (N = 169) showed that distributive injustice and informational injustice as well as over controlling supervision in Time 1 significantly predicted workplace embitterment six months later. Results also suggested that workplace embitterment in Time 1 significantly predicted reduced levels of work engagement and job satisfaction six months later. In study 3, results from a randomized control trial using participants who were embittered in their workplace showed that participants who completed an expressive writing exercise (N = 23) did not show significantly lower levels of embitterment, affective rumination, higher levels of detachment, work engagement, job satisfaction, either improved sleep quality, compared to participants who completed the factual writing (N = 21). In summary, results from this thesis suggests that breaches in organisational justice, can trigger feelings of workplace embitterment which can impact negatively employees’ ability to psychologically unwind from work, as well as their work engagement and job satisfaction levels. The unfolding of further features of workplace embitterment and the development of interventions to improve this feeling seems a worthwhile future endeavor.

Introduction: Research into parenting programmes has typically found that parental wellbeing, parenting practices and child wellbeing are linked, with increased parental wellbeing and supportive parenting practices resulting in better wellbeing and outcomes for children. As such, parenting programmes have focussed on supporting parents in how to best manage their child’s behaviour. However, these programmes have been largely based on professional opinion and ignore parental perspective. Research has suggested that what parents want and need from a programme may be different to what is being offered (Hill et al., 2007). Aims: The research aimed to understand what a group of parents thought about elements within current parenting programmes. Method: A q-sort methodology was used to elucidate parental opinion about the parts of a programme that would have the most impact on their ability to parent effectively. 64 parents were asked to sort a number of statements about current parenting programmes on offer using an online tool. Results: A principal components analysis was undertaken with 60 statements and 64 q-sorts. This yielded three factors that were interpreted to represent three different understandings of parenting programmes. “A parenting toolkit of skills”, “Fix me first” and “Nurture the nurturer”. The factors shared some similarities of what parents report with current programmes on offer (e.g. therapeutic relationship, universal, childcare provision) but also highlighted areas where parents wanted different things. The results are discussed in light of the demographics of the individuals assessed and how this may impact on future parenting programmes. Conclusion: the results indicated that the main theme overlapped with the typical concepts embedded in well-established programmes in services. There are however a small group of parents where these concepts did not meet their needs. Consideration needs to be given to more mature parents, single parents and fathers.

Nigeria has the sixth highest number of students from non-EU countries coming to the UK. Not only are professional mental health services underutilised by black men, but the acculturative stressors that typically accompany international students can heighten the risk of experiencing mental distress. The help-seeking experiences of male Nigerian international students in the UK are a significantly under-researched area. Interviews were conducted with eight male Nigerian international students from a UK university, an Interpretive Phenomenological analysis was used to explore how this population makes sense of their help-seeking experiences. The results identified four themes (1) Coping strategies (2) barriers to accessing support, (3) African identity and (4) Masculinity. Findings suggest a preference for using a combination of independent coping strategies, with most participants considering formal psychological support as inappropriate. Clinical implications and the limitations of the study are discussed.

Peer exclusion is when a group of children exclude another child or reject his or her request to join them (Gazelle & Druhen, 2009). Peer exclusion affects the child's wellbeing and academic achievement. A number of studies have examined how children evaluate peer exclusion based on group membership, for example of the basis of gender and ethnicity, in the US and Europe. However, little work has been done in the Middle East. Moreover, no work has included parents with their children to test the relationship between parents and children. This thesis examined how Saudi children and their mothers evaluate religion-based exclusion. Five studies were carried out to achieve the aim of this thesis. The main aim of these studies was to examine how Saudi children evaluate the exclusion of in-group members (Muslim, Sunni) and out-group members (Shia, non-Muslim) when the perpetrator of the exclusion was their father or their peers. In the first study, Saudi children (N= 92) residing in Saudi Arabia were interviewed. Children were more likely to accept exclusion of out-group members than in-group members. Also, they were more likely to accept exclusion when it was ordered by their father than if it was ordered by a group of peers. In the second study, mothers (N= 60) residing in Saudi Arabia and children were interviewed. There was a significant mother-child relationship only when discussing the exclusion of out-group members. In the third study, Saudi children residing in the UK were interviewed (N= 76) and the findings were similar to the first study; children were more likely to accept the exclusion of out-group members than in-group members and exclusion by their fathers than by peers. In the fourth study, Saudi mothers and children residing in the UK were interviewed. There was no significant mother-child relationship in the evaluation of religion-based exclusion. The final study compared Saudi children and their mothers in Saudi Arabia with Saudi children and their mothers in the UK. Saudis in Saudi Arabia were more accepting of exclusion than Saudis in the UK. Children in Saudi Arabia and in the UK were more likely to accept exclusion than their mothers. Generally, children and their mothers in Saudi Arabia and in the UK were more likely to accept exclusion by the father than by their peers. In summary, the results of this thesis suggest that Saudi fathers play a vital role in affecting children's and mothers' attitudes. Mothers seem to hold more tolerant attitudes than their children. The findings are discussed in relation to Saudi culture and the literature on transmission of attitudes and intergroup contact.

Background: A growing concern within the looked after community is that there is an over-representation of Black, Asian and minority ethnic young people in the care system; the largest group being children from Black and mixed heritage backgrounds. Aim: The purpose of this research is to contribute to our understanding of the processes involved in peer support development for Looked After Children (LAC) from minority communities Method: The study gathered information through face-to-face multi-method, interviews informed by a topic guide. The sample comprised of eight young people, both male and female, with their ages ranged from 11- 16 (mean age = 12.88). Results: The three main themes emerged from the data were: learning about each other, levels of closeness, and a sense of belonging. It also found young people from back and dual heritage background hold fairly realist views of LAC by believing they feel sad, experience stigma, struggle with building trusting relationships but should be treated no differently to others. Discussion: This research has also highlighted the potential process used to inform their inclusive nature towards LAC and how this may be related to prosocial qualities and past experiences that are unique to black and dual heritage young people. Conclusion: This research has extended our knowledge on what the views and perceptions black and dual heritage young people have of LAC and can serve as a preliminary base for future studies.