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Paper one: The use of coaching programmes is on the increase, including within the field of education. However critics have raised concerns regarding the limited research base concerning their use and the fact many models do not appear to be underpinned by a theoretical basis. One psychological approach to coaching used within the education sector are Solution Focused Approaches, with psychologists including Educational Psychologists taking on the role of ‘executive’ coaches. This paper explores the experiences of school staff and executive coaches involved in one such Solution Focused coaching programme delivered within schools. The paper focuses on exploring the impact of and relationship between contextual, process and outcome factors. Key findings included the fact school staff were not always clear about the aims and purpose of the coaching, that factors such as relationship building and increasing coachees’ sense of ownership were central processes within sessions and that measuring the outcomes of the coaching presented a range of challenges. Within the paper the findings are explore in relation to psychological perspectives including Self-determination theory. Paper two:Following the increased popularity and use of coaching approaches, including within the education sector there is evidence that training courses are being marketed to school staff wishing to implement peer coaching programmes ‘in-house’. Educational Psychologists (EPs) are one group of professionals involved in the delivery of such training and in supporting school staff in implementing coaching following training. This paper focused on exploring the experiences of school staff involved in a Solution Focused peer coaching programme, following training from EPs. Particular focus was placed on exploring the impact of and relationship between contextual, process and outcome factors. Key findings included evidence of potential challenges related to schools not commissioning follow up sessions after training and a perception that the peer coaching had resulted in improvements in OFSTED ratings. Implications for practice include the importance of EPs drawing on and sharing research literature regarding factors which may promote or inhibit changing practice and EPs supporting staff in developing outcome measures which can sit within a SF framework.

The rising incidence of small, asymptomatic renal tumours discovered usmg abdominal imaging during the investigation of unrelated symptoms has fuelled the desire for new therapies which avoid surgical excision. Extracorporeal High Intensity Focused Ultrasound (HIFU) was proposed as one of these modalities but so far clinical research has been ,~." inconclusive. The present work was designed to improve these clii teal outcomes through the conduct of further clinical trials, laboratory based research and the translation of new technology into existing HIFU devices. A Phase II clinical trial of patients (n=13) with newly diagnosed <4cm renal tumours (clinical stage T1a) was designed, peer reviewed and received ethical approval (Ox REC 09/H0606104). Ten of 13 patients underwent renal HIFU using a clinical HIFU device (Model JCIJC200, HAIFU, China). One patient could not be treated due to poor tumour visualisation after anaesthesia and two patients could not be treated as they became unwell before or during anaesthesia. Histological evidence of HIFU ablation in either tumour or normal renal parenchyma was seen in all ten patients. Evidence of sub-total tumour ablation was seen in 8/10 of patients. Grade 1 «50%), 2 (50-90%) & 3 (90-99%) ablation was achieved in 4/10, 3/1 0 & 3/1 0 patients respectively but complete (100%) tumour ablation was not possible. HIFU treatment caused minimal morbidity - no Grade III- V (Clavien-Dindo) complications related to HIFU treatment occurred. Grade I skin pain and induration was seen in 9/1 0 patients; Grade II skin pain occurred in a single patient. Patient demographics, imaging and tumour characteristics were used to design parameters to improve patient selection for renal HIFU. The tumour location, thickness of peri-nephric fat and renal nephrometry score were useful predictors of successful screening for treatment. Page /ii Dr R. W Ritchie Nutiield Department of Surgical Sciences - TT 2012 Abstract Diligent use of these factors could limit unnecessary treatments and Improve ablation outcomes. , It is well known that ultrasound imaging of small renal masses can be challenging. Ultrasound imaging often deteriorates further during HIFU as the abdominal wall and fat tissues swell and cause increased attenuation. This loss of imaging quality was clearly demonstrated in this clinical trial and resulted in the early termination of treatment, before ,#,J' ... ~ .•.. endpoints were reached, in a number of cases. The current clinical method for monitoring the success of HIFU ablation using hyperecho analysis of B-mode ultrasound images is also questionable. Laboratory based studies using ex-vivo bovine liver subjected to HIFU confirmed that hyperecho monitoring had low sensitivity, predictive values and overall accuracy. A novel method of HIFU monitoring - passive mapping of the emissions received from acoustic cavitation activity and other sources of non-linearity during HIFU treatment - is believed to represent a significant opportunity to improve feedback. This technique uses the passively received signature of cavity activity which, when time-reversed, gives high- resolution images of the precise location of the activity. Laboratory-based ex-vivo work, using a commercially available ultrasound system (z.one, Zonare, USA), demonstrates its superiority over hyperecho monitoring. Indeed, thresholds could be applied to successfully predict HIFU ablation with high sensitivity and specificity. This technique was successfully translated into the clinical setting through the design of a Passive Acoustic Mapping (P AM) device. Custom-built receiving elements were applied without limiting the function of the existing HIFU devices. Both pre-clinical and ethically- Page [iii Dr R. W Ritchie Nuffield Department of Surgical Sciences - TT 2012 Abstract approved clinical studies demonstrated its safe integration without significant impact on the device energy output or treatment accuracy. Using similar passive beamfonning algorithms, acoustic cavitation activity was successfully mapped and corresponded with the location of thermal ablation in both ex-vivo tissue phantoms and during clinical HIFU therapy. ,~-' It is believed that the development of new patient selection paral~~tel's will elimil?ate target those patients who are most suitable for renal HIFU - small tumours, minimal peri-nephric fat & low nephrometry score .. The use of P AM will lead to a significant improvement in the efficacy of treatment. It can be successfully applied to existing devices and predicts the location and extent ofHIFU ablation with greater accuracy that existing techniques.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / INTRODUCTION: Evidence supporting outpatient treatments for anorexia nervosa (AN) is severely lacking, due to low retention rates and poor outcome in treatment studies. One explanation for patient drop-out is weak treatment alliances, which are also associated with poor outcome. This study investigates a novel treatment for AN, Alliance Focused Treatment (AFT), which attends to ruptures in the alliance as well as interpersonal difficulties and emotional avoidance commonly associated with AN. Group analyses are presented along with one detailed case. METHOD: Seven women with AN-spectrum illnesses were randomized to receive both AFT and Behavioral Change Treatment (BCT) using a replicated single case A-B-C-B design. Participants began with a Baseline Phase (A) and then received the experimental treatment (AFT) and the comparison treatment (BCT) in alternating fashion. This design allowed each participant to provide comparison (control) data for each treatment. "Time" (session number) was used as a covariate in analyses. Each treatment phase was four weeks long, with twice-weekly sessions. Participants recorded daily kilocalorie intake and post-session treatment alliance. Generalized Estimating Equations were used to examine differences in kilocalorie intake and treatment alliance between phases and within participants. Graphs of slopes of kilocalorie and alliance change for each participant, in each phase, facilitated observation of treatment effects. RESULTS: Six participants completed treatment. Significant overall increases in kilocalorie intake were observed only in BCT relative to a baseline period when controlling for time, however, both AFT and BCT showed interactions with time indicating kilocalorie intake increased in both conditions. No significant differences between active treatments in kilocalorie intake were observed. Participants rated global working alliance significantly higher in BCT, while they rated the task dimension of alliance significantly higher in AFT. Global patient-rated treatment alliance was significantly associated with kilocalorie intake, and the relationship between global alliance and kilocalorie intake became stronger over time. Participants rated ruptures in 39% of sessions and frequently reported discussion of the rupture as a component of its resolution. DISCUSSION: This study provides preliminary support for the feasibility and effect of AFT and BCT, and highlights the importance of the alliance in treating adults with AN. / 2031-01-02

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

Purpose: The aim of this study was to examine whether a verb-focused language intervention was effective in increasing children’s verb-vocabulary. In particular, this study investigated whether the treatment resulted in changes to children’s production of target words compared to control words for children who are late talkers. Method: The study utilised a single-subject, multiple baseline across behaviours design. Four children, aged 26-to-39 months who exhibited delayed expressive language development participated in the study. At the beginning of the study, all children had poor expressive language performance indicated by a mean length of utterance two standard deviations below the mean expected for their age and limited vocabulary measured by the New Zealand Communicative Development Inventory: Words and Sentences. New verb-vocabulary items were randomly assigned to intervention and untreated control conditions and probed at regular intervals over a period of eight weeks. Results: All the participants showed increased use of the target verbs compared to the control verbs during the intervention and post-intervention phase. Conclusion: The findings suggest that a verb-focused language intervention was effective in increasing the verb-vocabulary of late talkers. Further research is warranted to determine whether similar results can be found with a larger cohort and whether these gains are sustained over time.

Solution-focused therapy is a postmodern strength-based counselling intervention which focuses on the discovery of client strengths, resources and abilities to empower clients to bring about positive change in their lives. My research employed a pragmatic case study (PCS) method to systematically study the self-efficacy experiences of four New Zealand adolescents throughout the solution-focused process. Each client participated in up to five counselling sessions. Following the PCS method my study began with a presentation of my guiding conception which detailed my theoretical approach and the ways in which solution-focused skills and techniques would be applied throughout the study. Case data included analysis of all client counselling sessions and final interviews which were video-recorded, as well as the consideration of a quantitative measurement in the form of the Outcome Rating Scale (ORS). Through analysis of outcome results and using three inductively derived themes to guide cross-case analysis, it was found that the solution-focused counselling process, assisted adolescents in discovering and developing their knowledge and awareness of their personal strengths and resources; encouraged adolescents to feel empowered to act upon these resources, therefore enhancing self-efficacy; and used the quality of the therapeutic relationship to give adolescents a sense of being a co-participator in the counselling process and as a result gave adolescents a ‘boost’ towards taking action, therefore increasing self-efficacy. Process and thematic results, supported by a brief quantitative measure, showed that all four clients made significant progress towards achieving their goals for counselling. Overall the results suggest that the solution-focused process contributed to positive therapeutic outcome and gains in self-efficacy. All four clients demonstrated the confidence to take action to bring about positive change in relation to their counselling goals, supporting enhanced self-efficacy.

In this doctoral thesis, a culturally-sensitive couple therapy model was developed and empirically investigated. In particular, a Western-based couple therapy, Emotionally-Focused Couple Therapy (EFT), was modified to enhance the cultural relevancy of this model to the Japanese population. An extensive literature review was conducted to examine the status of psychotherapy and couple research in Japan, and cultural differences between Western and Japanese couples, with a particular emphasis on important couple variables, including emotional expression, communication, conflict resolution, and attachment. Study objectives included an empirical investigation into cultural differences on key relationship variables of trust, attachment, communication, and conflict resolution, and the use of these findings to guide adaptations of EFT to enhance cultural relevance, and an exploration of the adapted EFT model with three Japanese couples. This study is significant in that it is the first to empirically evaluate the cross-cultural validity of EFT. This dissertation consists of two studies that have been combined in one article for the purpose of publishing the document in a Japanese journal. Both studies were combined in one article for various reasons. First, study one findings are integral to the development of the culturally-sensitive EFT model that is empirically investigated in the second study. Second, the article included in this dissertation will be translated and prepared for publication in a Japanese journal. Including both studies in one article is important given the lack of familiarity in the Japanese research community about key relationship variables, and particularly their applicability to a couple therapy system (i.e., EFT), and their use to measure change in a couple therapy outcome study.

Thesis (Ph.D.)--York University, 2005. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 326-340). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR19784

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 216-225).