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The area of enquiry is a Scottish local authority decision-making process for specialist educational provision for children with additional support needs (ASN). The study had two aims. Firstly, to evaluate the extent to which Cultural Historical Activity Theory (CHAT) and Developmental Work Research (DWR) are useful analytical and intervention tools for local authority organizational change processes (Engestrèom 2007b, 1987) and secondly, to contribute to the change process of local authority policy and practice for children with ASN. Education professionals and authority officers participated in the study which utilized a flexible case study design. The empirical investigation involved three workshops based DWR interventionist methodology, the aim of which was to consider stakeholders' views of the problems associated with the PAG process and to consider the change potential of authority systems. Ethnographic data from two internal authority studies of the PAG process together wit h case study presentations was used as 'mirror' data in the empirical investigation as catalysts for critical discussion. A CHAT analysis of workshop transcripts illuminated hypotheses about systemic contradictions within the process. Contradictions were hypothesized in terms of CHAT concepts of tools, division of labour and rules and the extent to which they mediated the PAG decision-making process. Key themes included ineffective assessment methodology and decision-making criteria, problematic multi-disciplinary working and partnerships with parents, lack of clarity of the role of the educational psychologist, the persistence of traditional categorization of need, and the PAG process as overly complex and non-transparent. Inclusion and special education discourses permeated all of the themes. The authority decision-making process was viewed as a network of activity systems undergoing a cycle of expansive learning and development, artificially provoked via the DWR work intervention, applying Vygotskian notions of dual stimulation and the zone of proximal development (ZPD) as mechanisms to mediate collective learning and change. The cycle of expansive learning reflected a collective journey through the ZPD of the PAG process, mediated by the researcher-practitioner, during which established practice was first challenged via a historical analysis and then developed in consideration of future professional practice. The extent to which expansive learning and knowledge development had occurred in the DWR workshops was assessed against key turning points in discussion, the development of new instrumentalities and participants' evaluation of the workshop sessions. As the object of PAG activity was expanded, key turning points included an initial focus on the decision-making process, then on wider developments to promote inclusive practice and finally on a re-structuring of the authority service delivery model. The expanded object of activity reflected collective le arning in the ZPD of the PAG process, evidenced in a shift in participants' understanding of the PAG process from everyday understandings to a more theoretical, systems-based understanding. Evidence of impact of the DWR intervention on policy and practice was demonstrated via analysis of new policy documentation, professional discourse in strategic working groups and external validation by Inspection processes. The DWR workshops were viewed as a 'marginal microcosm' of the wider authority context with 'centripetal potential' to make inroads into central structures and processes. A key contribution to the authority change process is that the PAG decision-making process has been re-configured as case management review groups (CMRGs), located within the re-structuring of ASL services and in alignment with the new Children's Services Delivery Model (GIRFEC). Allocating specialist provision is no longer a separate process; rather it is part of a coherent, systems-based approach, the principles of which are progressive and proportionate intervention with an emphasis on presumption to mainstream. Findings support the thesis that CHAT and DWR provide a theoretical, conceptual and methodological framework within which to undertake historical analysis of contradictory professional practice to gain a system-based understanding of complex work settings leading to organizational change and observable impact on policy and practice.

Early intervention in schools to tackle alcohol problems is a widespread practice, despite patchy evidence of effectiveness. The 'Social norms' approach emerges from studies showing overestimation of 'others' consumption/approval of alcohol use amongst students. To correct such misperceptions of drinking norms, 'true' norms are fed-back in order to modify perceptions, thus relieving possible social pressure to conform to the misperceived norms. This thesis comprises five studies addressing outstanding concerns with the social norms approach. Study One evaluated a two-year social norms intervention in two Scottish secondary schools and reported little effect of the intervention on pupils' alcohol-related perceptions, but several positive behavioural outcomes relative to controls. The failure to modify perceptions means positive behavioural outcomes could not be attributed to distinctive elements of a social norms intervention. However methodological and design limitations mean this m ay indicate absence of good evidence rather than good evidence of ineffectiveness. Studies Two through Five examined a central tenet of social norms theory - the overestimation of peer norms. Thus, in Study Two, secondary pupils reported more extreme alcohol-related perceptions amongst peers when questioned conjointly on their own and peers' behaviour and attitudes, versus the peer target in isolation. Study Three sought to replicate existing research and found that University of Strathclyde students reported a range of other target groups as drinking more heavily than themselves, paving the way for two further, more focussed, studies. In Study Four, heavier consumption among students recruited in a bar environment was found compared to students in a setting remote from this environment, challenging the usual self-other discrepancy effect. In Study Five, university students' responses were also found to be sensitive to questionnaire structure. These findings demonstrate the implications of the 'where' (environmental context and setting) and the 'how' (questionnaire structure) of data collection within social norms paradigms with each shown to play an important role in the nature of the data obtained. These findings ask important questions of social norms theory and interventions.

Older listeners often report difficulties understanding speech in noisy environments. Increasing the level of the speech relative to the background - e.g. by way of a hearing aid - usually leads to an increase in intelligibility. The amount of perceptual benefit that can be gained from a given improvement in signal-to-noise ratio (SNR), however, is not fixed: it instead depends entirely on the slope of the psychometric function. The shallower the slope, the less benefit the listener will receive. The aim of the research presented in this thesis was to better understand the factors which lead to shallow slopes. A systematic survey of published psychometric functions considered the factors which affect slope. Speech maskers, modulated-noise maskers, and target/masker confusability were all found to contribute to shallow slopes. Experiment 1 examined the role of target/masker confusion by manipulating masker intelligibility. Intelligible maskers were found to give shallower slopes than unintelligible ones but subsequent acoustic analysis demonstrated that modulation differences between the maskers were responsible for this effect. This was supported by the fact that the effect was seen at low SNRs. Experiment 2 confirmed that the effects of modulation and target/masker confusion occur at different SNRs. Experiments 3 and 4 demonstrated that directing attention to the target speech could "undo" the effects of target/masker confusion. In Experiments 5 and 6 a new method was developed to study whether slope effects are relevant to "real-world" situations. The results suggested that using continuous speech targets gave shallower slopes than standard speech-in-noise tests. There was little evidence found to suggest that shallow slopes are exacerbated for older or hearing-impaired listeners. It is concluded that in the complex demands of everyday listening environments the perceptual benefit received from a given gain in SNR may be considerably less than would be predicted by standard speech-in-noise paradigms.

Cognitive-behavioural Coping Skills Training (CBST) and Acceptance and Commitment Therapy (ACT) both conceptualise smoking relapse as prototypically motivated by a desire to avoid negative affect and associated cognitions and environments. However, they specify contrasting techniques for increasing smokers' abilities to forgo the powerful negative reinforcement of affect reduction that is available through smoking. Whereas CBST focuses on developing smokers' skills for avoiding and coping with negative affect, ACT aims to reduce smokers' avoidance of cues to negative affect instead foster' their willingness to fully experience these cues. A separate line of research suggests that individual differences in smokers' tendencies to suffer paradoxical effects of experiential avoidance may be an important determinant of CBST's therapeutic impact. This study compared the efficacy of group CBST (n = 37) and ACT (n = 42) for long-term smoking abstinence in motivated-to-quit, nicotine-depende nt smokers, and examined mediation of abstinence outcomes by each models' putative mechanisms of action. Moderation of abstinence outcomes by participants' paradoxical behaviour tendencies, as measured on four computer tasks prior to random assignment to CBST or ACT, was also examined. Efficacy analyses showed that CBST and ACT produced high and statistically equivalent rates of past 30-day abstinence at three month follow-up (37% vs. 52%). However at six month follow-up, ACT participants were 3.47 times more likely to report no smoking in the past 30 days, when controlling for other possible explanatory variables (15% vs. 39%). In support of the ACT model, 30-day abstinence outcomes following ACT were mediated by reductions in avoidance of internal smoking cues. In contrast, CBST outcomes were neither mediated by increased use of coping strategies, nor moderated by paradoxical behaviour tendencies. Overall, results suggest that rationalising and training acceptance-based respoonding to smoking cues may provide efficient alternative to traditional cognitive-behavioural interventions in the treatment of nicotine dependence.

Introduction: Recruitment of participants is an integral but challenging process in walking promotion programmes. A lack of information about what was done during recruitment is a limiting factor in knowing what works best and why certain approaches might be worth replicating. Aim: The aim of this thesis was to conduct formative research on the process of recruitment to walking programmes. The objectives included: systematically reviewing the literature, qualitatively investigating practice and the participants' perspective, evaluating a novel approach to recruitment and to produce a set of best practice guidelines for recruitment. Methods: A mixed methods design shaped the methodology in this thesis and included: a systematic review of the literature; qualitative research including focus groups and interviews; and a process evaluation of a novel approach to recruitment. Results: The systematic review showed our understanding of recruitment is limited by a lack of reported information including the lack of a fir for purpose definition. Qualitative research with practitioners showed that there is a demand for best practice guidelines, while participants reported most often being recruited by word of mouth and being attracted to walking groups with broad health appeals. Process evaluation of a strategic approach to recruitment demonstrated that, despite complex and challenging circumstances, disadvantaged men could be recruited to walking programmes. These findings have been combined and developed into guidelines for recruitment. What this study adds to the literature: These studies have shown that recruitment is an active and complex process, not one single method, and that effective recruitment is dependent on the capacity of the recruitment team. The proposed guidelines provide a basis for future learning about conducting, reporting and identifying effective recruitment processes.

School-Based Humanistic Counselling (SBHC) is prevalent in the UK and directed towards the broad construct of psychological distress. Evidence of its effectiveness is limited, and little is known about the processes of change involved. This study aims to test the effectiveness of SBHC and develop understanding of change processes which may lead to enhanced outcomes. Young people aged 13-16 were recruited to a pilot randomised controlled trial comparing SBHC to a waiting list control for one school term (approximately 12 weeks). Psychometric measures were taken at baseline, midpoint and endpoint; adapted Client Change Interviews were conducted at midpoint and endpoint. The primary outcome was psychological distress as measured by YP-CORE. Case material from one male 14 year old participant was systematically analysed by an inquiry group and independent adjudicator. Transcripts from Client Change Interviews with 14 participants allocated to SBHC were analysed using a grounded theory a pproach. Young people allocated to SBHC showed significantly greater reduction in psychological distress, the primary outcome, with an effect size (g) of 1.14 at 12-week endpoint assessment. A range of positive outcomes were reported, including benefits to education. Five potential change processes for young people in SBHC were identified: relief, increasing self worth, developing insight, enhancing coping strategies and improving relational skills. Two processes potentially impeding change were identified: difficulty talking, and time limit. Case material suggested that SBHC made a major contribution to positive change, in addition to changes in parents' behaviour. SBHC reduces psychological distress in young people. Positive change may occur through a complex social process involving the young person's significant relationships. A range of processes are helpful to clients, and not mutually exclusive. Recommendations for further research include further RCTs including economic analysis, a wider range of systematic case studies and more in-depth qualitative analysis of change processes.

No description available.

No description available.