Section A reviews the literature related to compulsory admissions under the Mental Health Act (MHA) 1983/2007 of adults presenting with psychosis. It outlines the legal framework and examines empirical data relating to admissions under the MHA 1983/2007. A brief overview of psychosis, its aetiology and key psychosocial models are provided. Consideration of mental health within the legislative framework is offered and the experience of being compulsorily admitted is explored. Finally, further qualitative research is recommended. Section B: The study’s primary objective was to explore the experience and impact of compulsory admissions (under the MHA 1983/2007) on the psychological functioning of adults with psychosis. The study also aimed to develop a preliminary theoretical model. Design: The qualitative ‘Grounded Theory’ method (Glaser & Strauss, 1967) was chosen since it worked inductively from the data and enabled the development of a model. Method: Seventeen participants (eight service-users with psychosis, nine psychiatrists) involved in compulsory admissions were interviewed. Analysis and interviews were undertaken concurrently so initial findings could influence subsequent data collection. Results: Five higher-order categories and 47 categories were identified. These contributed to the development of the ‘A disturbing journey: To and from detention’ model of compulsory admissions. Conclusion: This small-scale qualitative study achieved its objectives, providing a preliminary model and understanding of the compulsory admission experience for adults with psychosis. Key service and clinical implications are discussed. Despite its limitations, the findings indicated scope for further investigation. Section C: addresses four key questions about the study. The first relates to skills the researcher learnt through conducting the study. The second relates to improvements that could be made if conducting the study again. The third relates to clinical implications, and the fourth to further research.

Section A reviews and synthesizes the extant literature on adherence to clinical guidelines, with specific reference to the use of CBT self-help interventions as a mainstay within the IAPT programme. The review also evaluates the utility of one psychological framework, namely the theory of planned behaviour (TPB), in assessing the cognitive factors that may be most associated with compliance in this context. The review ends by suggesting an avenue for future research. Section B In spite of evidence for their efficacy and effectiveness as well as the recommendations of NICE, CBT self-help materials are not used routinely or used as an intervention in their own right in mental health services. Aims: This cross-sectional study set out to assess whether the main constructs of the TPB, namely, attitudes, subjective norms (SN) and perceived behavioural control (PBC), as well as past use, self-help training and demographic characteristics, could predict IAPT psychological well-being practitioners’ (PWPs) intention to use CBT self-help materials in their clinical practice. Method: A convenience sample of PWPs (n=94) completed a web-based, mixed closed and open-response questionnaire, which was developed from an earlier elicitation study with a sub-sample of their colleagues. The data generated were analyzed by linear, multiple regression, mediation, and qualitative analyses. Results: The TPB’s main constructs predicted PWPs’ intention to use self-help materials in their clinical work, with attitude being most significant. Past use of self-help materials emerged as both a direct predictor of intention, as well as indirectly related to intention, independent of the mediating effects of the main constructs. The overall extended TPB model explained a respectable 70% of the variance in intention. However, neither self-help training nor demographic factors were associated with PWPs’ intention. Conclusion: It is recommended that future research could extend the methodology to prospective, longitudinal investigations of PWPs’ actual use of self-help materials. It is hoped that this would further elucidate the cognitive factors that are involved in PWPs’ decision-making when they are actually using the materials. Section C sets out and answers four specific questions that guide a reflective critical appraisal of the processes involved in the execution of this research project.

Section A consists of a critical review examining the research evidence relating to the effectiveness of reflective practice groups for staff in psychiatric inpatient settings, and the role of psychologically trained practitioners in providing facilitation using psychological formulations. Section B. The role of applied psychologists working in inpatient services is developing with a greater emphasis on providing support and consultation to staff teams. The research suggests that psychologically trained practitioners who facilitate reflective practice groups using psychological formulations can assist staff in developing a deeper understanding of patients’ difficulties, with the potential for improved treatment outcomes. This study aimed to address some of the gaps in the research by exploring the experiences of acute psychiatric inpatient ward staff attending reflective practice groups facilitated by psychologically trained practitioners. Using semi-structured interviews, nine multidisciplinary staff from four acute wards participated in the study. Grounded theory methodology was applied to investigate how staff experienced, processed, and operationalised psychological knowledge in their clinical practice. The results suggested staff increased their psychological understanding through a process of guided reflection, development of theory-practice links, and validation. This enhanced a capacity for mentalization, which generated a more compassionate and empathic stance. The clinical, theoretical and research implications are presented. Section C presents a critical appraisal of the research process.

Section A consists of a review of the literature relating the therapeutic use of creative writing. It highlights gaps in the literature and suggesting potential avenues of further research. Section B presents the findings of a phenomenological study which aimed to explore the experience and significance of creative writing at times of personal difficulty through the analysis of written accounts. Method. Twenty one people who had personal experience of creative writing in the context of difficult life experiences submitted written accounts. These were analysed using Interpretative Phenomenological Analysis (IPA) (Smith, Larkin & Flowers, 2009). Results. Four main themes were identified: 1) Struggle with a difficult experience, 2) Turning to creative writing, 3) Dealing with it ‘as a matter of words’ and 4) Rejoining the world. A conceptual model illustrating how these master themes are related is presented. Conclusion. Creative writing was deemed to have played an important and meaningful role in helping participants to integrate and move beyond difficult life experiences. Limitations and clinical implications of the study are discussed and suggestions are made for future research. Section C involves a critical appraisal of the study presented in Section B. Reflections on the process of the study, as well as further implications and clinical applications are discussed.

Section A. This paper opens with a broad overview of theoretical and empirical literature on refugee mental health. It highlights a relative weakness in the understandings of post-migration mental health, particularly in the context of female refugees. The paper then focuses on three areas of refugee women's mental health, critically evaluating theoretical and empirical literature: 1) risk factors and prevalence of mental health difficulties 2) coping strategies, 3) mental health service utilisation. Gaps in the extant literature are highlighted and suggestions are made for future research. Section B. This paper describes a qualitative study which aimed to explore refugee women's experiences of distress and their encounters with mental health services in the UK. Refugee women do not utilise UK mental health services as frequently as might be expected owing to their vulnerability to mental health problems. The study investigated the mental health experiences of refugee women who have encountered mental health services in the UK in order to contribute to understandings about factors affecting service utilisation. A grounded theory qualitative methodology was employed. Ten refugee women were recruited from a local non-governmental organisation and participated in semi-structured interviews about their experiences of distress, coping strategies and encounters with UK mental health services. A two-staged model emerged from the data. The first model depicted women’s experiences of distress predominantly in the context of post-migration experiences and how they coped, drawing notably from spiritual and social resources. The second stage of the model indicated how mental health service encounters were varied and a process of engagement involved evaluation and re-evaluation at particular stages. The study concluded that understanding refugee women’s utilisation of mental health services demands a multi-factorial, dynamic appraisal. Section C. This paper offers a critical appraisal of the study reported in Section B. The paper reflects on the research skills and abilities developed by the principal researcher and considers areas for development in terms of future clinical and research work in this field.

Section A consists of a literature review which explores the concept of recovery and its relevance for women who have been detained in a secure setting and diagnosed with a personality disorder. Section B presents the findings of a study to explore the concept of recovery in women diagnosed with personality disorder in a secure unit. Six semi- structured interviews, conducted with women diagnosed with personality disorder and experience of being detained in secure accommodation, were analysed using Interpretative Phenomenological Analysis. Analysis of the transcripts revealed five master themes: recovering; centrality of relationships; assuming responsibility for own care; evolving an identity; understanding of the mental health experience. The study concludes that, as far as is consistent with a secure setting, women should be given maximum opportunity to participate in decisions about their own care. Staff should be creative in providing opportunities for the women to engage in meaningful activities that promote a positive identity. Education with respect to personal recovery and the presentation and aetiology of personality disorder may support more caring and hopeful relationships between staff and service users, within which recovery can be facilitated. Section C involves a critical appraisal of the study.

Despite the profession’s putative reflexivity, little theoretical or empirical literature addresses British clinical psychologists’ beliefs about the nature of their profession and its relationship with the wider mental health system. This study examined attitudes towards one new development – the adoption of compulsory powers – in order to discover the implicit beliefs that clinical psychologists draw upon in practice. Written comments from 292 clinical psychologists responding to an earlier questionnaire survey were analysed using Grounded Theory, together with data from a focus group. Two contrasting constellations of belief emerged. Some clinical psychologists appeared to believe in the profession’s ability to transform services from the inside by opportunistically accreting power. Others appeared to believe in a need to defend the profession against assimilation, by maintaining separate spaces for more collaborative relationships. These overarching beliefs were associated with different beliefs about specific issues, namely professional identity, its compatibility or otherwise with coercion, where power is located and what drives organisational change. These findings suggest a need for greater professional self-examination. They are considered with reference to organisational, sociological and psychological literature. Limitations and areas for further research are discussed.

Section A is a review of the literature on the psychological and social implications of cochlear implants (CIs) in deaf children and adolescents. The literature is critically evaluated in relation to health-related quality of life, quality of life, psychological and emotional well-being, social well-being and identity. Relevant theories are outlined and discussed. Methodological limitations and gaps in the literature are discussed, and the review concludes with recommendations for further research. Section B describes a study using Interpretative Phenomenological Analysis to explore adolescent experiences of receiving and living with sequential cochlear implants (SCIs). Semi-structured interviews were conducted with eleven adolescents. The master and sub-themes are presented and the results are discussed with consideration of previous research findings and theoretical, clinical and research implications. Most participants enjoyed improved confidence and social well-being following their SCI, and felt that two CIs were superior to one. The majority identified themselves as hearing and deaf, but not culturally Deaf, as they strived to live in the hearing world. However, this was not without challenges and many young people experienced feelings of difference in the hearing world. These findings have clinical implications in terms of the role of clinical psychologists in CI clinics, and in providing information to families making decisions about CIs. These findings add to the emergent deaf identity development literature in young people with CIs.

Service user involvement (SUI) in healthcare and education is an established element of government policy. Emerging research demonstrates that SUI in education can positively impact on mental health students' learning. However, limited empirical attention has been paid to the impact on practice in this area. Moreover, no research has investigated whether impact on practice is sustained. Section B describes a qualitative study exploring qualified clinical psychologists' (CPs) experiences of a placement-based service user and carer involvement (SUCI) scheme during their training. The study focused on understanding their perception of the scheme's impact on their learning and practice and whether the impact on practice was sustained. Seven CPs were interviewed, predominantly 32-33 months post-scheme. Interpretative Phenomenological Analysis was used to analyse the data. Four super-ordinate themes were identified: “Contextual and relational factors underpinning learning”; “Learning: Personal and professional development”; “The enduring impact on practice”; and “Personal reflections and meaning-making”. The findings are discussed in relation to existing literature and relevant theory, including adult learning theories and social positioning theory. The findings suggest that SUCI in placement-based learning during training can support CPs' personal and professional development and a partnership approach to practice. Two participants' experiences highlight factors raising questions regarding for whom and when SUCI may be beneficial to learning. Methodological limitations, implications for SUCI in clinical psychology training and directions for future research are presented.

Section A is a literature review, exploring the psychological theories behind gardening-based mental health interventions and providing an overview of the current evidence to support their use. It builds on the last comprehensive review conducted in 2003, finding that the evidence-base has developed considerably over the past decade but that there is still a need for higher quality research in this field. Section B considers the value of gardening in promoting wellbeing in a non-clinical sample. A qualitative study is presented in which six suburban allotment-holders completed in-depth interviews about their allotment gardening and its perceived impact on their wellbeing. Transcripts were subjected to Interpretative Phenomenological Analysis (IPA). Seven main themes emerged from the data: fundamental importance of food, protection and safety, feeling connected, esteem, pleasure of being in nature, development and values. Parallels were drawn between these themes and Maslow’s hierarchy of needs. While each participant talked to some extent about all of the themes, a different theme was dominant for each individual, suggesting that allotments are flexible environments that may enable people to meet their individual needs, in order to enhance wellbeing. Implications for clinical and community psychology are discussed.