Aims: Recently, empirical literature exploring cognitive characteristics of intimate partner violence offenders has received considerable attention with both theory and practice historically focusing on victims of the abuse. Qualitative exploration has proposed implicit theories (ITs), that is distinct sets of schemas that offenders hold in relation to themselves, the world and others. In relation to cognition in intimate partner violence offenders, this thesis had two aims: to systematically analyse qualitative literature exploring cognition in intimate partner violence offenders and to implement interpretative phenomenological analysis to explore cognition in intimate partner violence sex offenders. Methods: Aims are addressed separately in two journal articles. A systematic review of qualitative literature exploring cognition in intimate partner violence offenders is presented in journal article 1. Journal article 2 utilises interpretative phenomenological analysis to explore cognition in 11 intimate partner sex offenders. Results: In relation to journal article 1, systematic searches of bibliographic databases in addition to hand-searches of various articles in the domain of intimate partner violence were conducted to identify eight empirical papers qualitatively exploring cognition in intimate partner violence offenders. Synthesis of the papers resulted in 10 themes being extrapolated thought to be representative of cognition in intimate partner violence males: “violence is normal”; “policing partner”; “women are provoking” “need for control”; “grievance/revenge”; “external factors responsible”; “rejection/abandonment”; “minimisation/denial”; “entitlement” and “remorse”. Journal article two utilised interpretative phenomenological analysis of 11 transcripts of IPV offenders. This revealed five superordinate and 14 subthemes which are proposed as implicit theories present in this specific offender group. These are: “violence is acceptable”; “grievance/revenge”; “dangerous world”; “need for control”; “real man”; “entitlement/women are objects”; “male sex drive/policing partner”; “women are provoking”; “rejection/abandonment”; “women are supportive”; “uncontrollability”; “nature of harm”; “the new me” and “I‟m not like them”. Conclusions: Cognitions identified from the systematic review are discussed in addition to limitations of the synthesis and clinical and empirical utility. The implicit theories identified in journal article 2 are discussed in relation to other offending behaviour groups in addition to their clinical implications in the development of effective interventions and risk assessment tools.

This qualitative study provided insight into the phenomenon of newcomers in social networking, in particular, to understand what role specific Facebook features play in motivating content sharing and contribution among newcomers. Research indicated that the first several months or years of social networking site (SNS) membership are the most crucial in terms of indicating long-term participation and commitment to the SNS. Long-term participation is specifically manifested through interactions with peers who are members of the same website and through interactivity such as content sharing and contribution. A number of quantitative studies have focused on motivations for user contribution in social networking sites, but inconsistent findings demonstrated the need for a qualitative approach to understand the user experience more clearly. The purpose of the study was to understand how users are motivated to engage in Facebook from their perspective as newcomers and to distill the significance of social media interface features as an enabler of community sharing. Insight into this phenomenon further demonstrates how specific actions on Facebook such as tagging, posting on profiles, and chatting help foster a sense of belonging and socialization among the sample group. The phenomenon is studied through interviews with a distinct group of Facebook members - women who are aged 40 and older in the Science, Engineering, and Technology (SET) industry who are also newcomers to Facebook. The lived experiences of these respondents were explored through open-ended questions, related to their own use of the said social networking site. Semi-structured interviews allowed respondents to be candid and comprehensive in their answers. Five themes developed related to the motivations for Facebook use from the lived experiences of the women interviewed. The themes were (a) social connection, (b) visual artifact sharing, (c) shared identity, (d) social investigation and (e) education. These themes were consistent with findings of other studies, but the personal accounts of these women revealed how they perceived use of various Facebook features improved the quality and depth of their interpersonal relationships. The findings of this study have implications for designers, developers, and users of computer-mediated communications and technologies. By understanding the value of various features to users of all ages, communications inhibitors such as distance and culture can be overcome with effective design and innovation.

Background: Until recently, qualitative researchers have avoided interviewing participants with brain injuries because of the ethical and practical dilemmas which may arise and because it has been argued that they may not be able to reflect and accurately report upon their experiences. Therefore, little research has been produced which explores the personal experience of living with a brain injury. Recently, however, some researchers have challenged the view that people with brain injuries are unsuitable as interviewees in qualitative research and have, through their own research, highlighted the importance of understanding their views and perspectives in order to provide them with the best care and rehabilitation. Aims: With this in mind, and in line with current calls for more research gaining the brain injured person’s perspective, this study attempted to gain an in depth understanding of what it is like from the brain injured person’s perspective, to live with an acquired brain injury. The study focussed upon the experience of gaining consciousness following a brain injury, the experience of living with permanent memory loss, the experience of gaining awareness of deficits, the experience of losing an identity and adjusting to a new identity, the impact on relationships with friends and family and experiences as an inpatient in a Brain Injury Unit. Sources of strength and coping mechanisms were also explored. Method: Semi-structured interviews were conducted with six individuals who had severe acquired brain injuries and were inpatients in a post-acute neuro-rehabilitation unit. The verbatim transcripts of the semi-structured interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were: ‘Piecing together the past and becoming aware of the present’, ‘The transition from old self to new self’, ‘Sources of strength and survival’ and ‘Experiences in rehabilitation’. A description of these themes is presented with the corresponding subordinate themes. Conclusions: The clinical implications of the research and guidance for future research are discussed. The study produced a valuable insight into the personal experience of living with a severe acquired brain injury that could be used to inform rehabilitation interventions. The results also indicated that people with acquired brain injuries may experience Post Traumatic Growth.

Aim: A wealth of quantitative literature exists exploring the adjustment of children and young people with Type 1 Diabetes Mellitus. However, results are often confusing and contradictory, at least partly due to studies using different definitions and measures. Studies have been criticised for over relying on parental reports and failing to consider young people’s own perceptions. Furthermore, they have often conceptualised adjustment as an outcome, rather than exploring the process involved. Additionally, although peers are considered to play an important role in young people’s lives, their role in young people’s adjustment to living with diabetes has rarely been examined. To address this gap, this study attempted to gain a rich understanding of young people’s experiences of adjusting to life with diabetes and explore how they feel their peers have contributed to this process, with the hope of informing clinical practice and improving support to young people and their families. Method: A qualitative approach was chosen and six young females aged 12 – 15 with a diagnosis of Type 1 diabetes were interviewed using semi-structured interviews. Interpretative Phenomenological Analysis was used to analyse the transcripts. Results: Five main themes emerged from participants’ accounts: Developing a balanced relationship with diabetes; the uncomfortable position of difference; grappling with the fall out of diabetes; making diabetes more bearable; and the role of parents and friends. The findings are discussed in relation to the relevant literature. Clinical implications, methodological limitations and directions for future research are presented. Conclusions: This study provided an insight into the complex and dynamic process of young people’s adjustment to life with Type 1 diabetes. It highlighted the challenges and struggles they faced as a result of their diagnosis and the different strategies they employed to manage these. It also emphasised the valuable role both parents and friends provide in supporting young people with their illness.

Aims: Acquired Brain Injury (ABI) is often researched from a reductionist perspective, focusing on pathology and dysfunction (Olney & Kim, 2001). More recently there has been a call towards taking a person-centred, global approach; questioning old ‘assumptions’ about what is currently known, and incorporating the views of the patient (Hill, 1999). This qualitative research study aimed to make a further contribution to the evidence-base by investigating the experience of adjusting to life after ABI. Method: Six participants, (two female, four male) aged 26-49, who had experienced a severe ABI an average of 31 months previously, were interviewed using a semistructured schedule. Interpretative Phenomenological Analysis (IPA) was employed to analyse the transcripts. Results: Five master themes emerged from the participants’ accounts: Experiencing a loss of control; Observed changes as a threat to identity; Being displaced by the injury: Feeling unchanged in a changed world; Attempts at managing a threatened identity, and Enable me don’t disable me: The role of support in recovery. Implications: Clinical implications were considered within Bronfenbrenner’s (1979, 2004) Ecological Systems Theoretical Framework. Within the Microsystems (the individual’s immediate systems such as their body, home and work) participants described a struggle to make sense of their perceived loss of control of their body and brain. They described the importance of making sense of these changes. Clinically there is a potential role for professionals to facilitate how people make sense of their experiences, perhaps moving away from reductionist explanations, which appeared to prevent participants from having hope to influence change. From a Macrosystemic level (the individual’s social, cultural and political systems) the participants felt they were less valued and as a result, judged by society and by political systems. Participants’ accounts suggested that they wanted to continue to contribute and be valuable in society. An implication therefore is for professionals involved to take more a political stance in influencing how we currently conceptualise people after brain injury, focusing on enablement rather than disablement.

Although psychological research into manic experiences is increasing, it remains an underresearched phenomenon. In particular, there is a dearth of qualitative research exploring these experiences in a clinical sample of people diagnosed with Bipolar Disorder. This study examined six participants’ experiences of mania using Interpretative Phenomenological Analysis. Through semi-structured interviews, the participants provided detailed accounts of how they made sense of and experienced their manic states. Three master themes were described: “A mixed relationship with mania,” “A separate and controlled self”, and “The struggle to be different.” The first master theme explored the participants’ mixed and ambivalent relationship with their manic experiences. These were viewed as both alluring and dangerous, but overall the perceived costs had outweighed the benefits, for all but one of the participants. Most participants described losses in relation to giving up their manic experiences, as well as losses related to the destructive consequences of their episodes. The second master theme examined perceptions of mania as a separate, uncontrollable phenomenon, over which they had little influence. It was hypothesised that these explanations served to relieve these participants from underlying negative emotions, such as guilt, regret, shame and selfstigma. The third master theme described how manic experiences had represented struggles to be different. These included a struggle against society; a struggle to experience a preferred self; and a struggle to access very unique experiences or abilities. A number of issues were discussed in relation to the above themes. These included positive and conflicting appraisals of high moods; loss; entrapment and helplessness; ambivalence; negative moral emotions and a preferred manic identity. A range of therapeutic approaches were suggested as potentially helpful for some of these issues. These included Motivational Interviewing, Narrative, Constructivist and Compassion therapies. Additionally, the findings of the study provided support for existing therapies for Bipolar Disorder; particularly Cognitive-Behavioural Therapy (CBT) and Interpersonal & Social Rhythm Therapy (IPSRT).

Aims: Quantitative research and clinical observations have long supported a link between the eating disorders and disturbances of self / identity. However, less is known about the process of how this comes about, and little qualitative research has been conducted in the area. The current study therefore aimed to gain an in-depth understanding of the experience of self and eating disorder, using a qualitative approach. The study focused upon the experiences of women, in order to keep the sample homogenous, and sought to explore the following: How women with an eating disorder view and describe themselves; their thoughts and experiences concerning why they view themselves this way; and their thoughts and experiences regarding whether they think there is a link between their view of themselves and their eating disorder. Method: Semi-structured interviews were carried out with four women who had been diagnosed with, and were undergoing treatment for, an eating disorder. Verbatim transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were, "I'm always questioning, who am I?": 'Experiencing a fragile sense of self'; 'The influences of others on self perception'; "Just made me feel better about myself": 'Strategies employed to manage the sense of self'; and "I can't rise above my childhood": 'The enduring influence of early experiences on self'. A description of these master themes and the related subordinate themes is presented. Conclusion: The results of the analysis are considered in light of existing theory and their clinical implications.

Background: A wealth of quantitative literature exists exploring the impact of parental alcohol misuse on adult and child offspring. It is often proposed that children of alcoholics are at risk of experiencing a host of negative outcomes, many of which are said to persist into adulthood. Confusing and contradictory results have led researchers to identify a subset of offspring deemed to be resilient. Little remains known about the factors that influence who becomes negatively affected and who becomes resilient, or how these factors are experienced by individuals. The recent up rise of qualitative methodologies also suggest this divide is not clear, with offspring of alcoholics demonstrating a range of functioning. Aim: With this in mind, the current study aims to explore the lived experience of adult children of alcoholics to gather a richer understanding of how these individuals develop into the people they are today. Method: Semi-structured interviews were conducted with six individuals who grew up with at least one alcoholic parent. Interpretative Phenomenological Analysis was used to analyse verbatim transcripts. Results: The analysis produced four master themes. These were: ‘Dealing with the loss of connection to parents’, ‘Feeling hopeless and helpless’, Struggling to stay sane’ and ‘I know who I want to be more than I know who I am’. The master themes and corresponding subordinate themes are discussed in relation to the relevant literature. Clinical implications, methodological considerations and directions for future research are also presented. Conclusions: This study provided insight into the lived experience of being an adult child of an alcoholic. It highlighted the challenges and struggles they faced in childhood and the ways in which they battled to overcome the difficulties they experienced to forge a preferred identity in adulthood. It also emphasised the importance of perceived parental rejection as the pathway to causing distress and the desire to be better than their parents as a pathway to resiliency.

Objective—To explore the experience of psychological distress and wellbeing in emergency medicine (EM) consultants. Methods— A qualitative, Interpretative Phenomenological Analysis (IPA) study based on interviews with EM consultants working in emergency departments (EDs) across South West England. 18 EM consultants were interviewed, representing a response rate of 54.55% across 5 EDs. The mean (SD) age of participants was 43.17 (5.8) years. All participants worked full-time as EM consultants, with the average years-in-role being 7.64 (5.76). The personal meanings that participants attached to their experiences were inductively analysed and explored alongside their perceived psychological health. Results— The analysis formed three super-ordinate themes: systemic pressures, physical and mental strain, and managing the challenges. Pressures within the ED and healthcare system contributed to participants feeling undervalued and unsatisfied when working in an increasingly uncontrollable environment. Participants described working intensely to meet systemic demands, which inadvertently contributed to a diminishing sense of achievement and self-worth. Consultants perceived their experience of physical and emotional strain as unsustainable, as it negatively impacted: functioning at work, relationships, personal wellbeing and the EM profession. Sustainability was promoted by the presence of social support and through evolving with the consultant role. Conclusions— EM consultants experience considerable physical and mental strain. This strain is dynamically related to consultants' experiences of diminishing self-worth and satisfaction, alongside current socio-political demands on EM services. Recognising the psychological experience and needs of EM consultants through promoting a sustainable EM consultant role could have wide-reaching benefits for the delivery of emergency care and physician wellbeing.

Although there is a recognized need for counseling Muslims and underutilization of mental health services by this population is assumed, research regarding the attitudes of Muslims towards counseling is scarce. This qualitative study explored Muslim women's attitudes towards counseling and utilization of counseling services. The influence of religiosity and religious coping as well as the Muslim women's perception of the Imam-counselor liaison, and the influence of the liaison on counseling-seeking attitudes have been examined. Participants consisted of 10 purposefully selected Muslim women from each of five distinct socio-racial categories, including White, Black, Hispanic, Asian, and Arab. Data collection consisted of semi-structured interviews and the administration of a demographic questionnaire. Data analysis involved phenomenological exploration and hermeneutical interpretations of the participants' meaning. The findings indicated that attitudes towards counseling do not indicate actual use of the services. Rather, utilization of religious coping, availability of family and friend support, accessibility of Muslim counselors and counseling within the Muslim community, and the Imamcounselor liaison have a significant impact on counseling-seeking attitudes of the Muslim women. Additionally, the findings indicated variation of counseling utilization among socioracial groups. All non-U.S.-born Arab, Asian, Hispanic, and Black participants reported no use of professional counseling, whereas U.S.-born White, Black, and Hispanic participants and one non-U.S.-born White participant reported utilization of the services. However, rather than linking ethnicity alone to use of counseling, other factors need to be considered as well. The Imam-counselor liaison seems to hold promise towards closing the gap in delivery and utilization of counseling services by Muslims. The findings generated a greater awareness of the xi importance for the inclusion of religious beliefs and practices in therapeutic conversation with Muslim female clients. It is my hope that the findings will facilitate reflection on current counselor and counselor educator practices, and lead to changes that will enhance service provision to this population. In sum, it is hoped that the revealed pertinent areas will be considered within both the counseling room and the classroom.