Family centres have become a common institution to promote health and wellbeing among young children (0-6 years of age) and their parents in Sweden. The core of the work is usually based on both maternal and child health care, a preschool and social services, all located under the same roof in the local community. The family centre in this study, known as the "Family House", was the first of its type to be built in the city of Kristianstad, Sweden. The overall aim of the thesis was to understand family centre practice through professionals' and parents' perceptions of the Family House and its relationship to modernity. The study employed a qualitative design using phenomenography as method to capture people's perceptions of the practice. The research also drew on the approach of action research, where participants and researchers co-generate knowledge through collaborative communicative processes. Data was generated from semi-structured interviews conducted with nineteen professionals and sixteen individual parents. Dialogue sessions with the professionals of the study have been held in order that they and the researcher could enter into a dialogue based on the findings of the interviews. Data was consequently also generated from these meetings. The way the professionals perceived the practice of the Family House fell into three categories, namely, as a professional service, the provision of an informal meeting place for professionals and families with young children or as a broad community based centre. Parents' perceptions fell into four categories; as a professional reception to obtain expert guidance and support, a study circle and living room to informally share experiences and socialising, and a playground for children where children could interact and learn social skills. One core finding of this thesis is that family centre practice for those involved contained a balancing act between simple modem expertise to control the world and late modem opportunities for self-realisation and reflexivity. The House enhanced both parents' and professionals' mastery of the world, supporting a stable and trusting world view under uncertain late modem conditions. Parents and professionals shared the responsibility for children's well-being and the distinction between private and public was blurred since parents used the House as a social arena for developing personal relations. It was also an arena for integration between Swedes and immigrants based on engagement for both cultural diversity and similarity.

Although parental drug misuse is becoming an increasing concern for child welfare, little is known about the impact it has on children from their unique perspective. In the majority, research fails to listen to the voices of children, as the focus has been on the drug users themselves. Nevertheless, drug misuse undoubtedly has an impact on the whole family, often becoming ‘…the axis around which the family dynamic would revolve’ (Barnard, 2007: 39) and children at the core of these family dynamics are invariably hidden behind closed doors. Although there is a growing commitment to working with children in research, within the arena of parental drug misuse children’s voices are lost. Similarly there is little focus in the British literature on the reflective voice of adults, detailing their childhood experiences of growing up with parents who misuse drugs. This research provides a much-needed insight into the consequences of parental drug misuse, through the voice of an adult reflecting on their childhood years who was willing to open their ‘closed door’, thus contributing a rare perspective to the knowledge base.

The study explores the life experiences of seven adult children of problem drinkers (ACOPDs). Semi-structured interviews were conducted covering four main areas: experiences as a child; experiences as an adult; impact on life; and coping mechanisms. In order to gain an in-depth understanding of the participants’ experiences, Interpretative Phenomenological Analysis (IPA) was used. Five master themes were extracted from the data, namely: parent / child relationships; communication problems; coping mechanisms; the road to recovery; and impact on the self. Each master theme also consisted of a number of interrelated subthemes. Of all the master themes, coping mechanisms was by far the most prevalent with participants using numerous ways of dealing with parental problem drinking (PPD) such as avoidance, and trying to keep their parent’s drinking problem a secret from other people. The findings indicated that whilst many within group difference existed in the sample of participants, such as cultural background and status of parental drinking, many common themes still emerged. Moreover, the severity of PPD did not influence the findings to any great extent. A number of the participants’ problem drinking parents (PDPs) drank to excess on a daily basis whereas for others consumption was far less, a maximum of three to four units per evening. To conclude, participants’ accounts indicated a preference towards informal over professional forms of support. This has important implications for the counselling psychology profession such as a need to improve and increase the services available to both children of problem drinkers (COPDs) and ACOPDs.

This thesis explores the experiences and perceptions of young women living with a history of breast cancer in the UK, diagnosed under age 45. Although much research has examined the experience of breast cancer, the distinctive perspectives and lives of young women have been neglected. The literature review identified the following dimensions to living with a history of breast cancer as a young woman as key areas for exploration: embodiment, biographical disruption, gender, and intersectionality. By analysing the significance of intersectionality, the study aimed to redress the tendency in existing research to treat women with breast cancer as a homogeneous group. Qualitative, semi-structured interviews were undertaken with twenty women aged 22-43 at diagnosis, and a stakeholder panel was held with three further young women. Three women who identified as minority ethnic, and two who identified as lesbians, were purposively recruited to the sample. The methodology was informed by social constructionist grounded theory, feminist, and intersectionality perspectives, and preliminary analysis was carried out concurrently with data collection. Although similarities with older women’s experiences exist, the findings showed that young women felt profoundly at odds with their bodies in a number of ways. These included: embodied risk, related to uncertain treatment outcome; and a dissonance between young women’ expectations of their bodies, and the reality. The effects of diagnosis and treatment resulted in a liminal, or suspended, state, because of uncertainty regarding fertility, pregnancy, and menopausal status. This, and the constraints of the treatment timescale, resulted in a perceived loss of agency over their future. Gendered ideals about young women’s bodies, the association of fertility with femininity, and the performance of emotion work, had a considerable impact. Reflecting the effects of intersecting social divisions, lesbian and minority ethnic respondents identified a series of disadvantages that they experienced in the course of treatment and care. The study contributes a deeper, and more nuanced, account to the limited literature about young women in the UK living beyond breast cancer, identifying the distinctive experiences and perceptions which arise for young women.

This thesis examines the underlying cause of social stigma towards people living with HIV, and the extent to which it discourages HIV testing and treatment. We use a discrete choice model to describe a person’s decision to seek treatment for HIV (antiretroviral therapy or ART), and estimate the social cost of seeking treatment using administrative health records from southern Malawi. We show that seeking ART at a clinic where many other community members are present carries a significant cost, even after taking into account clinic quality and location. We investigate the theoretical effects of policy interventions designed to reduce stigma and other barriers to care, and demonstrate important complementarities between such policies. We next evaluate a cluster-randomized information experiment in Zomba, Malawi designed to correct a common misconception: most do not know that ART drugs have a public benefit, that is, the medication prevents HIV transmission between sexual partners. We microfound HIV stigma as sexual discrimination between sexual partners, and model the decision to seek an HIV test (and then, if required, medical treatment) as a signal of infection. We show, theoretically and empirically, that the randomized information intervention reduces this type of stigma and significantly increases the rate of HIV testing. The results demonstrate that social stigma is an important barrier to HIV testing and treatment, that stigma can be due to rational behavior by a misinformed public, and that providing new information can be an effective way to mitigate its effects.

Since 2003, Children’s Services have sought to promote more consolidated work by professionals of different disciplinary backgrounds who might otherwise follow independent forms of practice. This is believed to enhance efficacy and reduce inequality in providing for vulnerable children (Boddy, Potts, & Statham, 2006; DCSF, 2003). Evidence that this improves child outcomes is mixed, however. Professionals may have difficulties working together effectively, for example Anning, Cottrell, Frost, Green, & Robinson (2006) and Sloper (2004). This research presents a qualitative study into the decision-making processes of a Children’s Services multi-disciplinary team (MDT) of educational, health and social care professionals. The study explores which aspects of the MDT strengthen and undermine collaborative work, and how this influences child assessment outcomes. The study was exploratory, using Constructivist Grounded Theory (CGT) analysis of the recorded discussions of professionals concerning six preschool child cases. All six children were referred with neurodevelopment difficulties. The transcripts revealed a fragmentary MDT with a singular, medical model approach to practice, which in this particular situation, averted collaborative working. The established context for the operation of decision-making was in the professionals’ referral system, whereby a Child Assessment ‘pathway’ functioned. Decision-making comprised System routines, Weighing-up significance, Expediency including Centralisation and Convenience, Continuation of Function, and Avoidance of Difficulty/Unpleasantness. Use of the Autism Diagnostic Observation Schedule (ADOS) cut-off score to diagnose autism spectrum disorders (ASD) was an outcome of the decision-making process. Discussions revealed that once such decisions were made, they remained unchanged. Psychoanalytically informed concepts (Hollway, 2011) were used in analyses. This enabled a framework of understanding for professionals’ work, as well as for promoting organisational development and change.

This PhD by publication consists of two single authored books, five single authored papers in refereed journals, five single authored papers and one joint authored paper in edited books and covers the period 1985-2000. Two central ongoing themes are identified in the work: (1) the analysis of changing policy and practice in relation to child abuse in the UK from the late 1960's onwards; and (2), the changing nature of social work, again mainly in the UK. The themes are overlapping and in relation to both a number of concepts and debates in social theory are drawn upon both to analyse the changes and to make a positive contribution to policy and practice, particularly in the area of child welfare social work.

This child-centred case study, which explored the impact of parental imprisonment on children, developed from the European COPING research project (2010 - 2012). Qualitative methods and a thematic analysis were used to review data from interviews with children, their parents/carers and imprisoned parents, in 22 families, mainly from the north of England. My findings confirmed that the quality of children’s relationships with their parent/carer and other relatives is the most important protective factors for them. Children’s resilience is frequently characterised by a two-way empathetic process, children being supported by their parents/carers and supporting them in return. Time is a crucial dimension in how children experience parental imprisonment. The experience of stigma was almost universal for families in this study. Children were cautious about sharing information about parental imprisonment. Paternal and maternal imprisonment impact differentially on children. Children seem more likely to experience emotional turmoil from the imprisonment of their same sex parent. Girls tend to be more resilient and boys more vulnerable. Schools are most often the agencies best placed to help children of prisoners. Parents/carers frequently gained self-confidence from successfully fulfilling their responsibilities. They re-appraised their imprisoned partner’s role and status, and families developed either more open or more closed policies about handling parental imprisonment. Imprisoned parents can partially fulfil their parenting roles. Alongside the harm caused to children by parental imprisonment, a majority of families experienced some benefits. Further research should explore the differential impact of parental imprisonment on girls and boys in more detail.

This thesis sets out to explore the place and agency of non-comital women in twelfth-century Anglo-Norman England. Until now, broad generalisations have been applied to all aristocratic women based on a long established scholarship on royal and comital women. Non-comital women have been overlooked, mainly because of an assumed lack of suitable sources from this time period. The first aim of this thesis is to demonstrate that there is a sufficient corpus of charters for a study of this social group of women. It is based on a database created from 5545 charters, of which 3046 were issued by non-comital women and men, taken from three case study counties, Oxfordshire, Suffolk and Yorkshire, and is also supported by other government records. This thesis demonstrates that non-comital women had significant social and economic agency in their own person. By means of a detailed analysis of charters and their clauses this thesis argues that scholarship on non-comital women must rethink the framework applied to the study of non-comital women to address the lifecycle as one of continuities and as active agents in a wider public society. Non-comital women’s agency and identity was not only based on land or in widowhood, which has been the one period in their life cycles where scholars have recognised some level of autonomy, and women had agency in all stages of their life cycle. Women’s agency and identity were drawn from and part of a wider framework that included their families, their kin, and broader local political, religious, and social networks. Natal families continued to be important sources of agency and identity to women long after they had married. Part A of the thesis applies modern charter diplomatic analysis methods to the corpus of charters to bring out and explore women’s presence therein. Part B contextualises these findings and explores women’s agency in their families, landholding, the gift-economy, and the wider religious and social networks of which they were a part.

People of Black African heritage in the UK have increased susceptibility of being diagnosed with Type 2 Diabetes Mellitus (T2DM) compared to the general White population. Nutrition is central in halting T2DM and the progression of complications such as cardiovascular diseases. However, little is known about the factors influencing the diet of women of Black African heritage with T2DM. In addition, clinical and public health conceptions of the problem tend to be individualistic in orientation. This study is an exploratory and in-depth inquiry into food choice and the implications of dietary change for women of Black African heritage who self-manage T2DM by diet alone. Eight participants were recruited using purposive sampling. Recruitment sites included Black and Minority Ethnic charities in Norfolk and Suffolk. Data was derived from direct observation using the ‘Accompanied Shopping Task’, combined with a ‘Think Aloud Technique’ called a ‘Product Choice Reasoning Task’. In-depth interviews were undertaken and transcribed verbatim. Framework Analysis was used to provide a procedure to manage data analysis, which was informed by the PEN-3 public health cultural model which moves beyond overly individualistic conceptions of the issues. The study showed that six participants prioritised the disease and used what I have called a ‘Disease Focused Approach’ to self-manage T2DM. Two used a ‘Family Focused Approach’, as family played a crucial role in T2DM self-management. All participants undertook T2DM self-care by following a culturally appropriate diet. Their least preferred options for managing T2DM were medical therapy and physical activity. The study showed that although food choice is influenced by many factors, culture was particularly important. Moreover, participants showed greater knowledge than had been anticipated about the role of nutrition to prevent progression of T2DM. Results are explored and presented for three main domains of experience for the participants: first, food shopping and decision-making; second, diet choice and lifestyle; and third, the interface with health services. For each of these the culture was found to be of paramount importance. The implications of the findings are presented in relation to the importance of culturally appropriate advice; culturally sensitive service provision; and the significance of household composition in managing the illness, especially for people with T2DM who have young children living at home.