This study aimed to find out about the school experiences of adolescents who have self-harmed and consider how school could support them, taking an exploratory and emancipatory approach. Five young people (four female; one male) aged between 15 and 17 years old were recruited to the study from a Child and Adolescent Mental Health Service (CAMHS) in an outer London borough, all undergoing treatment related to self-harm. They all had above 80% school attendance in the six months prior to joining the study and no Statement of Special Educational Need. A qualitative methodology was used taking a psychosocial approach. Semi-structured interviews were carried out using Free-Association Narrative Interview (FANI) method (Hollway & Jefferson, 2000). Each participant was interviewed on two separate occasions with a gap of between one and three weeks. Interview transcripts were analysed using thematic analysis assisted by the computer software MAX-QDA version 11.01. Researcher fieldnotes were also analysed as a source of data. Initial codes were allocated to data extracts and clustered into themes. Three main themes emerged from the data: Pursuing the Narrative of Identity; Pain and the Mind-Body Dichotomy and Relationship to Help. Implications for school staff as well as educational psychologists and other professionals include the importance of the presence of an attuned and understanding adult. Finally, school systems that respond to disclosures, offer support structures and raise awareness should be developed based on increased understanding of the phenomenon of self-harm in the adolescent group.

This thesis presents the application of Guba & Lincoln's (1989) fourth generation evaluation (FGE) model to a school based clinical intervention aimed at Bangladeshi girls who were self-harming or were potentially at risk of self-harm. This clinical intervention or support project was designed as a preventative early intervention service and involved Bangladeshi girls, their parents and school teachers. It has been reported that women of South Asian background have relatively higher rates of self- harm compared with other ethnic groups. There have been different explanations put forward for this behaviour, one being cultural conflict. The experiences of this sample of Bangladeshi girls who self-harmed or who were at risk of self-harm was explored, illuminating some of the causes of this behaviour. This thesis also highlights the strengths and weaknesses of the FGE model as applied to this intervention. There were a number of factors which contributed to Bangladeshi girls experiencing thoughts of and actual self-harming behaviours, many of which have been found in other studies affecting adolescents across age groups and ethnicities. Although there were cultural components which affected the lives of these girls, the explanation of 'cultural conflict' was seen to be rather simplistic. Findings showing the fluidity with which cultural norms are negotiated allow one to question the idea of 'culture conflict'. This FGE model was useful in eliciting different views of the stakeholders concerning the intervention. Ways of further developing this model as an effective way of evaluating health services are suggested. Greater involvement of parents was recommended as a way to improve the effectiveness of future interventions with this group School based interventions are a useful way of delivering mental health services and have great potential in supporting children and young people with issues to do with self-harm and other emotional and behavioural problems.

Background: Multisystemic Therapy (MST) is a time limited evidence-based intervention for young people with antisocial behaviour and other emotional and behavioural difficulties. Despite it's robust evidence base with over 19 Randomised Control Trials (RCT), long-term follow-up of outcomes and quantitative process-outcome studies little is known about how these positive outcomes are achieved, how they might be sustained and what the effects of the intervention are beyond improvements in offending rates for families after MST finishes. The aims of this study were to explore this. Method: A qualitative approach was adopted and ten semi-structured interviews were carried out with twelve caregivers. A Grounded Theory analysis was used. Results: Nine theoretical codes emerged to form a model of the process of sustained change from caregiver perspectives: Shifting the relationship to help; Care-giver-therapist alliance as a helpful model; Supporting a family alliance; Privileging a positive story of son/daughter; Shifting perspectives: from individual to interpersonal; Sharing responsibility for change; . Increased positive communication in relationships; Increased personal resilience to new challenges; Increased family resilience. Conclusions: The study revised the current model of change in MST based on caregiver perspectives. 1) It draws attention to the therapeutic alliance as a process of change and . sustained change. 2) Reciprocal processes are highlighted between MST's more linear conceptualisation of how outcomes are achieved. 3) Caregivers highlighted more detail on improved family functioning as an outcome and it's importance in sustaining change. These factors are reconceptualised using systemic theory and referred to as 'second order changes.' 4) These second order changes, facilitated in part by the therapist alliance, fed in to the concept of Resilience for both the family and the caregiver, which contributed to sustained change. Clinical implications and future research directions and study limitations are also discussed.

Summaries in Afrikaans and English / The goal of this study is to understand the phenomenon of self mutilation by adolescents, with whom there is no developmental or mental barrier, from an educational-psychological perspective. A literature study was undertaken to investigate the nature, classification, causes and treatment of self mutilation, as well as the Educational Psychological Relations Theory. The self mutilation of adolescents was placed within the Educational Psychological Relations Theory framework. The research results showed that selfmutilation, with adolescents with whom there is no developmental or mental barrier, is a symptom of disharmonic intra- and interpsychic processes, as it is understood within the Educational Psychological Relations Theory. Self mutilation is used as a coping mechanism to regulate unpleasant emotional experiences. The empirical study also showed that an impoverished educational climate contributes to the development of self mutilation by adolescents. / Die doel van hierdie studie is om die verskynsel van selfmutilering by adolessente, by wie daar nie ontwikkelings- of geestesgestremdheid aanwesig is nie, vanuit 'n opvoedkundig-sielkundige perspektief te verstaan. Aan die hand van die literatuurstudie is die aard, klassifisering, oorsake en behandeling van selfmutilering, asook die Opvoedkundig-Sielkundige Relasieteorie verken. Die Opvoedkundig-Sielkundige Relasieteorie is as raamwerk gebruik waarbinne die verskynsel van selfmutilering by adolessente ondersoek is. Die navorsingsresultate het aan die lig gebring dat selfmutilering, by adolessente by wie daar nie geestes- of ontwikkelingsgestremdheid teenwoordig is nie, 'n simptoom is van disharmoniese intra- en interpsigiese gebeure soos dit verstaan word binne die Opvoedkundig-Sielkundige Relasieteorie. Selfmutilering word gebruik as 'n verdedigingsmeganisme waarmee onaangename belewinge gereguleer word. Die empiriese studie het ook getoon dat 'n onbevredigende opvoedingsklimaat 'n groot bydrae lewer tot die ontwikkeling van selfmutilering by adolessente. / Educational Studies / M. Ed. (with specialiation in Guidance and Counseling)

Summaries in Afrikaans and English / The goal of this study is to understand the phenomenon of self mutilation by adolescents, with whom there is no developmental or mental barrier, from an educational-psychological perspective. A literature study was undertaken to investigate the nature, classification, causes and treatment of self mutilation, as well as the Educational Psychological Relations Theory. The self mutilation of adolescents was placed within the Educational Psychological Relations Theory framework. The research results showed that selfmutilation, with adolescents with whom there is no developmental or mental barrier, is a symptom of disharmonic intra- and interpsychic processes, as it is understood within the Educational Psychological Relations Theory. Self mutilation is used as a coping mechanism to regulate unpleasant emotional experiences. The empirical study also showed that an impoverished educational climate contributes to the development of self mutilation by adolescents. / Die doel van hierdie studie is om die verskynsel van selfmutilering by adolessente, by wie daar nie ontwikkelings- of geestesgestremdheid aanwesig is nie, vanuit 'n opvoedkundig-sielkundige perspektief te verstaan. Aan die hand van die literatuurstudie is die aard, klassifisering, oorsake en behandeling van selfmutilering, asook die Opvoedkundig-Sielkundige Relasieteorie verken. Die Opvoedkundig-Sielkundige Relasieteorie is as raamwerk gebruik waarbinne die verskynsel van selfmutilering by adolessente ondersoek is. Die navorsingsresultate het aan die lig gebring dat selfmutilering, by adolessente by wie daar nie geestes- of ontwikkelingsgestremdheid teenwoordig is nie, 'n simptoom is van disharmoniese intra- en interpsigiese gebeure soos dit verstaan word binne die Opvoedkundig-Sielkundige Relasieteorie. Selfmutilering word gebruik as 'n verdedigingsmeganisme waarmee onaangename belewinge gereguleer word. Die empiriese studie het ook getoon dat 'n onbevredigende opvoedingsklimaat 'n groot bydrae lewer tot die ontwikkeling van selfmutilering by adolessente. / Educational Studies / M. Ed. (with specialiation in Guidance and Counseling)

Self-injurious behaviour (SIB) is recognised as a difficult behaviour to work/deal with and Community Support Workers (CSW‟s) who work with this behaviour may not have any formal training in the field of SIB. This study was therefore aimed at assessing the needs of CSW‟s working in the field of self-injurious behaviour amongst adolescents. A qualitative approach was used, the study was of an explorative nature and the researcher made use of purposive non-probability sampling to select respondents who were willing to participate in one-on-one semi-structured interviews with the researcher. This data was then analysed by the researcher making use of Creswell‟s spiral of analysis. The data collected was sorted into themes, sub-themes and categories and interpreted according to literature. The study identified that there are specific needs amongst CSW‟s who work with adolescent SIB in the specific areas of support and education/training. / Social Work / M. Diac. (Play Therapy)

Self-injurious behaviour (SIB) is recognised as a difficult behaviour to work/deal with and Community Support Workers (CSW‟s) who work with this behaviour may not have any formal training in the field of SIB. This study was therefore aimed at assessing the needs of CSW‟s working in the field of self-injurious behaviour amongst adolescents. A qualitative approach was used, the study was of an explorative nature and the researcher made use of purposive non-probability sampling to select respondents who were willing to participate in one-on-one semi-structured interviews with the researcher. This data was then analysed by the researcher making use of Creswell‟s spiral of analysis. The data collected was sorted into themes, sub-themes and categories and interpreted according to literature. The study identified that there are specific needs amongst CSW‟s who work with adolescent SIB in the specific areas of support and education/training. / Social Work / M. Diac. (Play Therapy)