Despite being the most common reason for admission to psychiatric inpatient services in the UK (Bowers, 2005), no evidence-based treatment currently exists for self-harm in this setting (Turner, Austin & Chapman, 2014; Winter et al., 2007). Dialectical Behavioural Therapy (DBT) has found promising results in treating self-harm in outpatient settings (Linehan, 1993a). More recently, there have been favourable results from a DBT-informed group in an inpatient setting (Gibson, Booth, Davenport, Keogh & Owens, 2014), however the intervention was longer than the average stay on an inpatient ward (23 days; Health and Social Care Information Centre, 2014). The aim of the current study was to assess the feasibility of a novel DBT-informed group for people who self-harm within the average length of an inpatient stay. The ‘Coping with Crisis’ (CwC) group protocol was compiled using DBT skills (Linehan, 1993a), with particular focus on crisis management strategies. In line with the Consolidated Standards of Reporting Trials (CONSORT) guidelines for feasibility studies (Eldridge et al., 2016), the aim was to collect data on the rates of recruitment, retention, outcome measure completion and participant feedback, in order to inform the design of a main study. Twenty-four participants were recruited from an inpatient ward in a National Health Service (NHS) Trust. Results suggest that the clinicians and participants found the CwC group acceptable and it was found to be feasible to run the group and research study on an inpatient ward. However, the study experienced several challenges in terms of recruiting to target (80% achieved), retaining participants in the treatment groups and completed post-intervention outcome measures (n = 9; 38%). This information, in addition to feedback from the participants can be used to inform adaptions to the study design and make recommendations to improve outcomes for future research.

Individuals who have been in care are often thought of as a homogenous group who, because of past and ongoing contextual adversities, have outcomes reflecting hardship in various do mains. Aggregated outcomes may conceal the presence of individuals within this group who develop life projects and are able to put plans into action. Some manage to succeed educationally and take up places on university course. This research seeks to explore the reflexivity, internal conversations and social networks of young people who had been in care but had managed to become students at university. Five young people were interviewed using Archer’s (2003, 2007) semi-structured internal conversation inter view and then using Hartman’s (1978) ecogram to graphically represent their social network. Data was analysed using Robinson and Smith’s (2010) composite analysis, which incorporates elements of Interpretative Phenomenological Analysis (2015) and the Inter active Model (Miles and Huberman (1995)). The young people’s accounts showed that they were proudly independent, demonstrating considerable personal agency, but were well connected and able to access emotional and practical support in their social networks. They felt different to others and managed their difficult histories in a variety of ways. The results are considered in relationship to Archer’s theory and theories of resilience.

Background: Psychosis was once considered a progressive and untreatable “illness” due to a “diseased brain”. Current thinking suggests childhood adversity along with a combination of psychological, biological and environmental factors influence the development of psychosis experiences, with recovery now considered an achievable aim. Recovery is a multifaceted concept. Research indicates that service-users hold different views about recovery, however research exploring recovery from the viewpoint of those who are currently inpatients is scarce. Aims: The aim of the current study is to explore the views that a group of service-users who are currently inpatients in a psychiatric hospital, hold about what is important to them in recovery. Method: Q-methodology allows the exploration of the distinct viewpoints that are present among a group of people in relation to a subject matter. Thirty-eight participants were recruited across four acute psychiatric wards from a London based psychiatric hospital. Using Q-methodology, participants engaged in a card sort task where they ordered 54 statements relating to recovery from most to least important to them. Results: The analysis revealed four distinct viewpoints held among the group regarding factors that are important to recovery from psychosis. These were: “Stability, independence, and having a roof over your head”, “Hope, optimism, and enhancing wellbeing”, “Emotional change through self-management and social support”, and “Symptom reduction through mental health support”. Conclusions: Service-users who experience psychosis and are currently inpatients, hold different views about what is helpful to them in recovery. Services must be sensitive to the subjective conceptualisations service-users hold of their experiences and be flexible in tailoring support to meet their needs. The findings from this study suggest that changes are required both within services and at a socio-political level, in order to support people with psychosis toward recovery. Clinical implications and areas for future research are discussed.

What are the mechanisms behind the advance of financial actors, instruments, and models into the field of social policy design and delivery? Over the past couple of decades, the state’s function as provider of welfare and safety nets against various forms of socio-economic risk has been transformed not just by privatisation or downsizing, but also by the advent of alternative forms of social policy delivery. One example of the latter is social impact investment, a form of investing in social programmes with the intent of pursuing social (and environmental) impact alongside financial return, and yielding innovative financial instruments such as social impact bonds, social stocks, or community bonds. The emergence of this field is generally seen as an outcome of the broader process of financialisation. From this perspective, both financial return and social policy objectives can be achieved via the straightforward implementation of existing financial instruments and methodologies. However, the very process of implicating existing financial technologies in the sphere of the pursuit of social outcomes generates its own set of dynamics. This study focuses on these dynamics from the perspective of the valuation processes underpinning the emergence of social impact investment. It argues that as finance engulfs this field, it engages in a valuation process of fashioning and delineating a hybridised form of value – blended value – supporting its advance, which is distinctly separate, though not independent, from financial value creation. The result of this process is the concomitant proliferation of non-financial spaces of valuation, which come not to replace, but to accompany and support financialisation. In order to make this argument, it looks at the case of the valuation processes undergirding the launch of the world’s first social impact bond in 2010 in the UK. Besides providing an empirical account of the latter, it also makes a theoretical contribution to the literature on financialisation by deepening the understanding of the manner in which financial actors, instruments, and markets advance in non-financial realms.

Statistics have shown that 30% of women in the UK experience childbirth as traumatising, and some may as a consequence go on to experience symptoms of anxiety, depression or post-traumatic stress disorder (PTSD). However, some women do not go on to develop PTSD. As this is a relatively common occurrence, an important question is: How do women who experience a difficult birth develop resilience? Research has mainly focused on the development of PTSD in such women and researchers have therefore recently tried to shift the focus to positive outcomes following a traumatic birth. The focus of positive outcomes has mainly been around post-traumatic growth and researchers have called for more investigations into the area of resilience. At present, research is still sparse in the area of traumatic birth and resilience. Objectives: The aim of this study was to understand the process of fostering resilience after a traumatic birth. Method: Semi-structured interviews were conducted with eight female participants aged 30 to 50 years who experienced a traumatic childbirth. A constructivist grounded theory was used to analyse interviews. Results: A new model of the process of resilience following a traumatic birth was devised, which emerged from the data. The core category of ‘The Journey towards Resilience following a Traumatic Birth’ was described and connected to the five following categories: Category 1: Traumatic birth: To be cared for ‒ who’s accountable?; Category 2: Moving towards faith and spirituality; Category 3: Motherhood becomes you; Category 4: Supportive relationships; Category 5: Self-care ‒ as a way of owning my journey. Discussion: The model suggests that the journey towards resilience is a process whereby women move towards internal or external resources or both at different points on their journey. This study brings new findings to the area of traumatic birth and resilience which will help guide counselling psychologists and health professionals on how to promote resilience in birthing mothers.

Aims: The aim of the current study is to investigate the usefulness of an internet based positive body image intervention for women which incorporates feminist ideas and media literacy. This novel study will be an initial trial with a non-clinical population of women looking to learn about body image in order to evaluate if it is feasible as an intervention to improve body image in this format. Methods: The present study employed a sequential mixed methods prepost within groups online intervention outcomes study design, whereby quantitative and qualitative data collection and analysis were sequentially undertaken. Phase 1: collected baseline questionnaire data online to screen for eligible participants (N=95), and then measure their level of body dissatisfaction, body appreciation and body anxiety. After 24 hours, Phase 2 commenced: participants received a link to an online psycho-educational intervention (an educational programme of 60-minutes duration), after which they immediately completed (N=80, drop out rate 15.79%) post-intervention questionnaire measures. In Phase 3: semi structured follow-up interviews were conducted with a subsample of the intervention participants (N=4) to gather their feedback on the strengths and limitations of the online intervention. Results: Paired t-test results comparing pre and post scores on the three main measures showed a significant decrease in scores on a body dissatisfaction measure, PFRS (t(79)=9.554, p < .001); a significant increase on a body appreciation measure, BAS (t(79)=-11.464, p < .001); and a significant decrease on a body anxiety measure, SPAS (t(79)= 8.833, p < .001). The thematic analysis of the semi-structured interviews showed four 13 emergent themes: focus on girls and teenagers, media influence and literacy, positive impacts of the intervention, and recommendations. Overall feedback was positive and participants found the intervention insightful and empowering. Conclusions: Collectively, the quantitative and qualitative findings supported each other regarding the development of a novel intervention. The ‘Our Bodies’ Programme appeared to have a positive impact on women’s body image and it was acceptable in the format in which it was presented. However, the study did not include a control group or a follow-up, thus care needs to be taken when drawing conclusions from the results. Nevertheless, this research has the potential to contribute to the understanding of which population may be best suited for this programme, delivery format and dissemination strategies using the existing literature on media literacy, positive body image and feminist theories in order to ensure maximum impact. Future directions and implications for Counselling Psychology practice are discussed.

The current position of the World Health Organisation (WHO, 2014) is that there is a threat of a global “obesity epidemic” (Boero, 2007, p.1); and existing studies in the UK report that a 5th of pregnant women are overweight. This has created increased scrutiny of fatness and weight, especially in pregnant women. The concern about obesity and pregnancy outcomes also contributes to the National Institute for Health Care Excellence (NICE, 2010), recommending that the antenatal care delivered to overweight pregnant women should be within the guidelines of a high-risk pathway of antenatal care. This has increased the medicalisation of the care for overweight pregnant women. The aim of this study is to explore the experiences of overweight pregnant women in relation to their heightened medicalised antenatal care. Using a social constructionist approach and a Foucauldian interpretive lens, semi-structured face-to-face interviews were used to collect data from 12 women who were between 16 and 30 weeks pregnant, 6 midwives who provide antenatal care for them, and 3 obstetricians to whom women are referred. The data were analysed using thematic analysis. The findings show that pregnant women do not identify with being ‘obese’ and perceive themselves as being overweight but healthy. Key themes that emerged from the data describing women’s perception of heightened antenatal care are: their understanding of risk and risk perception, the power of science and how it constructs their maternal health and the power of obstetricians justifying medical interventions in pregnancy and childbirth. This study creates and contributes to the awareness of how overweight pregnant women who are healthy experience antenatal care. It explores the need of overweight pregnant women, and identifies changes that need to be made to positively enhance how these women experience pregnancy and childbirth. These findings need to be considered by policy makers, individuals in practice and those with a role in educating health care practitioners so that overweight pregnant women are provided the appropriate antenatal care.

The focus of this study is to gain a deeper insight into the subjective and salient belief systems that are held by those individuals who have previously been detained or arrested under the counter terrorism legislation in the UK. Embedded in the theoretical work of Personal Construct Theory, 8 participants completed an extensive life narrative interview alongside a reparatory grid highlighting core constructs and belief systems. A thematic analysis of the corresponding data was undertaken from which a number of themes were identified. The most prominent emerging theme centred around the concept of empathy and empathic anger. i.e. the participants expressed a strong empathy connection towards those in conflict situations who were seen as victims and equally presented with a strong disapproval or empathic anger towards those who were viewed as aggressors and penultimately responsible for the atrocities. Although further research is required the implications of this emerging theme are significant in developing a holistic understanding of the factors which affect motivational drive of individuals who are 'radicalised'. This study builds upon the theoretical work of Hutson, Long & Page, (2009), Taylor & Horgan, (2006) and Moghaddam, (2005) who respectively identify a series of social and psychological processes which potentially exert an influence on the motivational drive. This study therefore suggests that the modulating factor or the spark which maintains an individual on the path of radicalisation is centred around this notion of empathic anger. This study suggests that individuals who are regarded as a radicalised threat go through a series of subjective experiences and processes are catapulted by this empathic response from merely feeling a grievance to actually rationalising a potential action. A number of additional themes centring around relationships (particularly the father), racisms and the impact of life changing events or trauma were also identified but would benefit from further investigation. The study also attempts to provide a critical look at the discourses around terrorism and radicalisation particularly the subjective and emotive uses of the terminology and the inevitable effects of political biases. A potential area for further study is suggested in the form of a theoretical model which suggests that depending upon the individual’s personal attributes the individual may gravitate towards one of 5 roles i.e. an idealist, soldier, Intellectual-Recruiter, Opportunist-Financier or Patsy. The limitations of the study centre around the relative small sample and the lack of diversity within the sample.

In the established field of leadership studies, Relational Leadership is a relatively new and under explored view of a familiar phenomenon. Scholars conceptualise Relational Leadership differently depending upon their philosophical position, in particular whether they privilege leaders’ traits and characteristics (known as an entity perspective) or foreground the relationships and interactions that enable leadership to be accomplished (a social constructionist relational perspective). To date there have been relatively few empirical studies that research Relational Leadership from a social constructionist perspective. This thesis adds to this underdeveloped body of empirical literature. The study uses data from an in-depth ethnographic single case study comprising the executive team of a large and complex UK local authority. The study took place as members of the executive team grappled with previously unheard of economic and social challenges following the global financial crash of 2007/8. Data is drawn from participant observation of the executive team’s meetings over a one year period, a series of in-depth interviews with executive team members, and a contextual analysis incorporating a review of relevant press coverage during the time. The study’s research question was: How is leadership relationally accomplished? The question was subsequently operationalised through the following additional three questions: Q1: How are relational strategies adopted by the case study team? Q2: How do these relational strategies support the accomplishment of the team’s strategic task? Q3: What contextual factors impact and are impacted by the relational strategies that are commonly adopted within the team? Adopting a Grounded Theory method, a theory of Relational Leadership as Meaningful Co-Action is developed. Meaningful Co-Action epitomises the ways in which the group went-on-together in socially and situationally developed ways through their moment-by-moment interactions. Social processes gave rise to individual process mediated through 6 contextual constraining and enabling forces. It was adherence to relational group norms that allowed the collective accomplishment of their leadership task. The study makes empirical, methodological and practice contributions. These are: Empirical Contribution Building on what is a relatively small body of theory on Relational Leadership, for the first time in a UK local authority Executive Team. Developing a theory of Relational Leadership as Meaningful Co-Action as the way that leadership was accomplished in the case study organization. Methodological Contribution Makes a contribution to Grounded Theory by explicitly utilising reflexivity towards disconfirming data as a mechanism for establishing theoretical sensitivity. Practice Contribution The findings from this study may inform the practice of management, particularly organization consultants working with leaders and teams.

This is a study of strategy development and implementation based upon interviews with senior BBC executives. It explores how and why the BBC became the first major UK broadcaster to pioneer on-demand and to devise a Public Value Test for all new services. It does so through three case studies: a regulatory mechanism, the Public Value Test, and two examples of digital innovation: the iPlayer on-demand service, and the BBC Creative Archive. The research questions are: how and why did the BBC develop and implement an on-demand strategy during its Charter renewal process between 2002 and 2007; what was the process; what factors affected the decision-makers, what issues and dilemmas did they confront; and how effective have they been? This research investigates how the BBC responded to a two-fold crisis that threatened both the relevance and legitimacy of public service broadcasting. It builds upon an institutionalist perspective to examine how changes in the dynamics of UK broadcasting, in particular growing tensions between the institutional logics of public service and marketisation, affected the Corporation’s incumbent position within its organisational field, and undermined its ability to launch innovative digital services such as the iPlayer, because of difficulties in establishing a clear distinction between what was legitimate public service online and what should be left to commercial competitors to provide. The findings illuminate the complex relationship between organisational legitimacy and institutional culture, and ask why the BBC devised the Public Value Test, first applied to its proposals for the iPlayer and on-demand provision, how successful this was in enabling the BBC to redefine its own remit, and what the consequences were. It finds that BBC strategy development combined elements of rational long-range planning with improvisation and opportunism, and suggests a dysfunctional relationship between its proactive approach to long-term planning and its process of digital innovation. This finding of a culture of innovation at the BBC challenges the argument that attributes “disruptive innovation” to private sector insurgents rather than incumbents, especially those in the public sector.