This study represents a unique collaboration between the National Health Service and the London Borough of Sutton’s social services. The focus and direction of this study was to examine and explore parental stress levels from a quantitative and qualitative perspective for those parents using residential respite care for their developmentally disabled child. The study sought to gain a better understanding of the influence that short breaks has on parents more specifically to gauge whether a reduction in parental stress is linked to the use of short breaks. Combinations of quantitative and qualitative techniques were used to provide a deeper and broader understanding of the research question. Semi-structured interviews were conducted by the researcher and information was analysed using interpretative phenomenological analysis (IPA). The Parenting Stress Index (short form questionnaire) provided psychometric estimates of parenting stress divided into subscales of parenting distress, parent child dysfunction, difficult child and total stress. Overall parents reported a significant reduction in parental stress when using residential short breaks which were validated by the psychometric measures. The limitations of the study are discussed and suggestions proposed for future research are highlighted.

The research study was carried out, using Foucauldian Discourse Analysis, (FDA) and involved the analysis of three statutory reports into institutional child abuse in Ireland: The Cussen Report (1936), The Kennedy Report (1970) and the Commission to Inquire into Child Abuse (2009). In addition to this, an analysis was carried out on interviews with civilians with regard to their responses to institutional child abuse. My study highlights the difficulty in demarcating institutional from institutionalised abuse and demonstrates how visual technology constructs the response to institutional child abuse. The research has brought to light significant discourses, such as a behaviourist discourse in which the subjectivity of the industrial school child was found to be constructed through the body. The key finding in this study relates to the manner in which the response to institutional abuse in Ireland appears to be bound up with processes of splitting of self and object. Subjectivity was identified as split and constructed as blind/seeing, able/disabled, male/female and so on and I have called this a fractured subjectivity. Moreover, the construction of splits in selves was shown to extend to splits between various out groups and in groups, resulting in agency and responsibility being delegated to others. Subjectivity was identified as thoroughly gendered and it was concluded that separation of gender from sex may allow for ways of rethinking essentialist accounts of personhood. The industrial school was identified as a disciplining and subjugating structure of those inside the institution and those outside the institution. The objective of this study is to inquire into how response to institutional child abuse in Ireland is constructed through discourse, thus shedding light on how the response is constrained or liberated by specific discourses and on how individuals are positioned by these discourses. The method I have chosen to meet this objective is discourse analysis inspired by the work of Michel Foucault, and is sometimes referred to as Foucauldian Discourse Analysis (FDA). The rationale for adopting this method is discussed in the following chapter. Before introducing the socio-historical context of my research and its relation to previous research, the next section will begin with a clarification of the object of my study.

Veterans seeking psychological input for mental health issues, following service with the UK Armed Forces, report difficulties in relating to mental health practitioners, often causing them to disengage with therapy. A wealth of quantitative research including epidemiology studies and outcome reports is available for this client group as well as best practice of treating mental health issues including combat-related post-traumatic stress disorder. More qualitative studies are being produced, both for this client group and their associated mental health issues. However, there appears to be a paucity of qualitative literature regarding the language of veterans and it is this, especially in terms of improving the psychologists’ understanding of this client group, which has inspired this research. Nine veterans were interviewed using a semi-structured schedule and the data was transcribed and analysed using discourse analysis. Nineteen repertoires are described within five groups: Professional/Objective; Personal/Subjective; Exclusive: Mind-Body Connection: and Refutation. In addition, one discourse superstructure – Defence – is identified. Synthesis of the repertoires and superstructure takes place in relation to: military culture; masculinity; Ehlers and Clarks 2000 cognitive model of PTSD and DSM IV symptom criteria; and, neuro-psychology of memory and Brewin, Dalgleish and Joseph’s 1996 Dual Representation Theory of PTSD. In addition, applications of the repertoires for counselling are suggested.

It is well documented that people with Asperger Syndrome show a propensity to mental health problems (e.g. Tantam, 1988); one contributor possibly being difficulties with social interaction (Frith, 2004). People with Asperger Syndrome and mental health problems may therefore require support, one form being psychotherapy (e.g. Schopler & Mesibov, 1983). However, despite the possible need of this population and the recent drives towards improving access to psychological therapies to the wider population (Department of Health, 2010) there is relatively little literature on psychotherapeutic interventions for people with Asperger Syndrome (Weiss & Lunsky, 2010), which might possibly impact on the client and therapist. Furthermore, the author postulated that when people with Asperger Syndrome do access psychological therapy, the difficulties that contributed to them seeking therapy such as interpersonal difficulties may also impact on basic therapeutic assumptions and therapist preferences as outlined in the literature. Thus the overall premise of this current study derives from the way Asperger Syndrome is defined (however, provisionally) as a disorder of interpersonal functioning, this would lead to an expectation that doing therapy (an intrinsically interpersonally process) with those with Asperger Syndrome might negatively impact on basic therapeutic assumptions and therapist attitudes in some way. In this study, therapists’ attitudes to working psychotherapeutically with clients with Asperger Syndrome were explored. Following preliminary discussions with colleagues, interviews with five trainee psychologists and 129 completed questionnaires from therapists, a number of areas were revealed as potentially important to psychotherapists working with people with Asperger Syndrome. These areas were the quality of supervision, therapist satisfaction, the quality of the working alliance, therapist knowledge and experience, the model(s) used and co-morbid psychopathology and other co-morbid concerns. Despite people with Asperger Syndrome being viewed from the dominate discourse as not necessarily contributing to the fulfilment of a number of therapist preferences and therapeutic assumptions as described within the literature, interviews and questionnaire, overall the sample in this study viewed clients with Asperger Syndrome as satisfying to work with and the therapists viewed the working alliance as good, supervision effective and satisfaction was not contingent on the use of the dominant cognitive behavioural therapy model.

This study explores the subjective experience of eight individuals, 7 female and 1 male who have received a clinical diagnosis of borderline personality disorder (BPD) or its equivalent diagnosis; emotionally unstable personality disorder - borderline type (EUPD) in the UK psychiatry system. Using a semi-structured interview, the author aimed to investigate the narratives told by individuals whom have received this diagnosis, with specific reference to the concept of agency. A narrative analysis (NA) based on the Hiles & Cerrnak (2007) model of analysis, revealed eight idiosyncratic life narratives, which indicate that individuals with the aforementioned diagnoses conceptualise their agency in terms of interpersonal and intrapsychic processes. Narrative content was consistent with the diagnostic criteria of both the DSM-IV and the ICD-10 manuals; however there was a wide divergence of how participants identified with their diagnosis. The study finds support for the notion of early experiences leading to narrative 'life scripts.' The implication for service provision is discussed, and increased training and clinical supervision are considered in light of NICE (2009) guidance.

This portfolio comprises three separate, yet connected pieces of work. The first is a critical literature review, the second an empirical research project and the third an extended case study. Each piece may be viewed as distinct in terms of evidencing different "core competencies" that the Health Professions Council (HPC, 2009) requires counselling psychologists to achieve, which is one of the core reasons for choosing to present these three specific pieces of work. A secondary reason is a particular investigative thread that connects each piece, one with another. The collective work in this portfolio is related to the professional development of counselling psychologists and is relevant to other types of therapeutic practitioners, for example clinical psychologists, psychotherapists or counsellors. The first section of the portfolio is a literature review, which provides the foundation for my empirical research project. The aim of the literature review was to critically evaluate current theories and research concerning the specific role that emotions play in self-control behaviour. The rationale for exploring this topic in detail is the assumption that emotions and self-control are two omnipotent aspects of therapy; each having implications not only for clients, but also for therapeutic practitioners. In my role as a Counselling Psychologist, I have found that it is not unusual for clients to report difficulties in self-control and to engage in self-destructive or maladaptive behaviour as a consequence of intense emotions. I therefore propose that successful therapeutic work requires practitioners to be able to regulate their own emotions and understand the influence of self-control on behaviour. The critical literature review reveals that emotional valence (i.e. whether emotions are positive or negative) has an impact on ability to self-regulate. In general, positive emotions seem to play a beneficial role whilst negative emotions play a detrimental role for self- control. However, this is not a generalisable finding, as there is evidence to suggest that there are particular situations where positive and negative emotions may have the opposite effect. Despite relevance to the field of therapeutic practitioners, the literature review identifies a lack of research and a number of limitations to existing research studies on this topic, specifically within clinical and counselling settings. Hence, it is proposed that this review will be of interest amongst therapeutic practitioners to further investigate the relationship between emotions and self-control more specifically within counselling and clinical settings so as to help improve both treatments for clients' self-destructive behaviour (e.g. binge-drinking, binge-eating, smoking, gambling) and practitioners' professional efficiency. Additionally, I believe that this literature review demonstrates my ability to critically evaluate and report on research (HPC, 2009).

In explorations of the nature and operation of influences on attempts to adopt health behaviours, health psychologists have largely concentrated on developing models incorporating statistically predictive combinations of measures of social cognitions. However, this body of work is flawed by theoretical, methodological and performance based limitations. Three different approaches are reported here to moving beyond the social cognition models in order to address current gaps in knowledge and understanding. In the first approach, behaviour-specific predictors were found to contribute significantly to the explanation of variance in intentions once key social cognitions had been accounted for, but a ceiling appeared to have been reached in studies of this kind and the need to consider cognitive and emotional links between past and future behaviour was identified. The second approach therefore involved an evaluation of the Idealised Process Model of Cognitive-Affective Responses to Repeated Failure (Jerusalem and Schwarzer, 1992). Persistent, negative patterns of change in cognitive stress appraisals were found to result from repeated failure experiences in relation to cognitive tasks but the model did not generalise to health behaviour performance. A longitudinal, multiple case study was conducted in the third approach in order to explore meanings associated with experiences of trying to adopt health behaviours, together with the implications of these for outcomes. The desire to act as a positive role model emerged as a key motivating factor, while both having experienced a small number of past failures and having engaged in advanced, strategic planning were identified as beneficial to the maintenance of health behaviour change. The latter is particularly recommended in order to ensure the receipt of early, positive reinforcement in relation to the key motives for change, foster appropriate anticipatory action against potentially difficult situations and in order to identify a range of practical and psychological strategies likely to foster sustained change, alternative sources of support and relief to the original behaviour and ways in which lapses might be prevented from becoming relapses.

This portfolio presents my qualitative research, which used Interpretative Phenomenological Analysis (IPA) to explore mothers’ experiences of having an adult daughter in personal therapy through nine semi-structured interviews. Mothers were unanimously supportive of their daughter’s therapy and identified generally beneficial, if limited, outcomes. They reported increases in their daughters’ anger and criticism towards them and improvements in closeness and communication. Theorising and questioning activities about the cause of their daughters’ difficulties and her need for therapy were common sense-making processes, underpinned by feelings of guilt, anxiety and confusion. Forgetting, accepting, focusing on progress, negotiating intimacy with their daughters and regulating information-sharing with others are examples of how mothers managed the process. A dynamic cycle of discussion with their daughters and personal reflection sometimes led to re-evaluation and changes in mothers’ behaviour, attitude and self-awareness. From the findings I highlight the complexity and suggest ways that mothers and daughters can be better supported. Transferability issues that must be taken into consideration when applying the findings and areas for future research are also discussed. As a Trainee Counselling Psychologist, I have resonated with the challenges of self-acceptance, use of self and struggles with authenticity and finding a good enough balance. These themes tie the research together with a publishable paper and client study. The publishable paper is my attempt to synthesise the findings from my research for the audience of the Journal of Family Therapy. I address the ways in which mothers manage the process of having an adult daughter in personal therapy and how these findings could inform individual and systemic practice. The client study presents an integrative and relational therapeutic approach with Nathan, a client diagnosed with Bipolar Disorder, who struggled with feelings of inadequacy. I explore the process issues of avoidance, parallel process and fluctuation in mood, and critically evaluate how I have developed professionally.

This qualitative study uses thematic analysis to explore what eight experienced counselling psychologists believe influences their choice of psychotherapeutic interventions. Individual interviews were conducted with the resulting data analysed using thematic analysis. The process of thematic analysis was followed as outlined by Braun and Clarke, (2006). The themes and sub-themes were identified and a summary is captured in a final thematic map. The eight counselling psychologists all described there being an over-arching theme that contains three sub-themes that are enduring and consistent core influences to their psychotherapeutic practice: the psychotherapeutic theoretical models, the client and the therapeutic relationship. With these as the ever-present cornerstones influencing their practice choices, the participants also identified influences that are captured under the theme of them being interchangeable in their strength of influence. These sub-themes are listed in order of their strength of influence: personal aspects of the therapist, professional aspects of the therapist and external factors. The exploration concludes with a discussion of how this information is of theoretical worth, whilst providing helpful insights that can inform counselling psychology practice. There is a critique of this study and suggested avenues for future research.

Within the field of Counselling Psychology there is very little mention of Bondage and Discipline; Dominance and Submission; and Sadism and Masochism (BDSM). Given the wide range of activities that fall under the umbrella of BDSM (Weinberg, 2006), along with the associated stigma of BDSM (Wright, 2006), the exact prevalence of people engaging in it is unknown. However, the huge popularity of the Fifty Shades of Grey books and film (James, 2012, 2015) suggests that dominance and submission may be a common fantasy for far more people than was previously realised (Deahl, 2012). Previous research has concentrated on qualified therapists’ understandings of BDSM. To further improve training around this area this research explored the way in which trainees talk and think about BDSM. The epistemological orientation of this work is social constructionist, and therefore acknowledges that findings arise from a particular time and place. Three focus groups were conducted with a total of thirteen participants. Transcripts of the data was analysed using the six step process of Thematic Analysis (Braun and Clarke, 2006). The analysis generated seven major analytical themes in relation to the subject of BDSM. These included: ‘BDSM as unknown’, ‘BDSM and the parameters of consent’, ‘BDSM as abuse’, ‘BDSM as a pathology’, ‘Visibility of BDSM’, ‘BDSM occurring on a spectrum’ and ‘BDSM as a cause for concern’. Participants were tentative in their language about how they constructed BDSM, in particular within the theme of ‘BDSM as a pathology’. Participants delineated types of BDSM from ‘light, fluffy, playful’, to the more ‘murky, less sanitised and extreme’. Participants expressed their potential for shock if working with ‘extreme’ BDSM, which gave an insight into their thinking around the subject. These findings are discussed in relation to previous literature and their implications for practice. Further training in BDSM for counselling psychologists is recommended, in particular to enable trainees to engage critically in their own reactions to BDSM. Further research into the critical engagement of the wider field of sexualities is recommended.