Objective: The concept of recovery has become an integral part of modern mental health care. Understanding the outcomes and underlying mechanisms of key recovery interventions, such as Wellness Recovery Action Planning (WRAP), is essential in order to expand the theoretical understanding of recovery and inform how to target recovery in treatment. Therefore a systematic review of the literature was conducted to evaluate the mental health outcomes of WRAP for adults. The empirical study then explored three constructs in relation to WRAP and recovery. These were social problem solving, cognitive defusion and social identification. Method: The systematic review of the mental health outcomes of WRAP was conducted by searching four databases, contacting the authors of WRAP research and seeking evaluative information from organisations that deliver WRAP. Fourteen relevant studies met the inclusion criteria. Whereas, the empirical study recruited participants on a trans-diagnostic basis from across Scotland. Using a quantitative cross sectional design, 109 participant's completed 5 self-report questionnaires. These were the Knowledge, Attitudes and Beliefs about WRAP Questionnaire (WRAP beliefs), the Recovery Assessment Scale - Short (RAS-S), the Social Problem Solving Inventory - Revised - Short (SPSI-R-S), the Four Item Measure of Social Identification (FISI) and the Cognitive Fusion Questionnaire (CFQ). Correlation, regression and mediation analysis were used to explore relationships, and in particular, the predictors and mediators of recovery. Results: The systematic review provided strong evidence that WRAP has a significant positive impact on hope and also reduces the symptoms of mental illness. However, whether WRAP improves personal levels of recovery was unclear and a possible risk of disempowerment was found. Promising preliminary mental health outcomes in the areas of confidence in managing mental health, quality of life, service use, self-advocacy and knowledge attitudes and beliefs about recovery were highlighted. Only studies that did not use peer facilitators failed to find significant increases in hope compared to treatment as usual control groups. In the empirical study, the results indicated that all the constructs examined were correlated to recovery. In the regression analysis, WRAP beliefs, social problem solving and cognitive defusion also demonstrated a predictive relationship with recovery. Mediation analysis indicated that, social problem solving mediated two distinct relationships. One between WRAP beliefs and recovery, and another between cognitive defusion and recovery. The social problem solving subscales also showed how the two predictors relate to recovery through social problem solving in different ways. Social identification with the WRAP group did not significantly predict or mediate recovery. Conclusions: The systematic review indicated having peer facilitators delivering WRAP is key to helping participants foster hope and that a further randomised control trial could help clarify if improved personal recovery is an outcome of WRAP. It additionally suggested how the relationship between WRAP beliefs and recovery could be explored, as per the design of the empirical study. Findings from the empirical study implied that improving participants' social problem solving and cognitive defusion should be specifically targeted in WRAP delivery. The studies combined indicate that to achieve the best recovery results interventions, like WRAP, should target inspiring hope through peer support, improving knowledge, attitudes and beliefs about recovery and cognitive defusion from unhelpful thoughts.

Peer tutoring has become well-established in higher education and, with growing interest in peer learning, has started to gain popularity at school level with evident success in a range of settings and subject areas. Specific implementations such as PALS have become commercial successes based on offering attainment gains and social outcomes while reducing teacher workload. However, the impact on children with special educational needs is variable and there remains a lack of consensus on how PALS can affect performance for such students. Similarly, while there are some studies in the Middle East, the supporting literature for peer-tutoring and PALS is highly Western-centric and relies on adoption of constructivist principles in the wider classroom. Such values are uncommon in the Middle East, with the dominance of traditional values presenting a significant barrier to pedagogical innovation in Saudi Arabia. This study is therefore a timely exploration of how peer-tutoring can integrate with a group’s existing traditional pedagogical beliefs, engaging them in more active learning. The study used a mixed methods design to look at three main aspects of the PALS provision: the effectiveness of teacher training as preparation for leading peer tutoring, how fully was the Maths PALS programme implemented, and the impact on students with special educational needs in terms of a range of mathematics attainment and social outcomes. A 3-month intervention model is used to generate comparisons between an intervention and control pupils, helping to locate this study in the context of other quantitative research from Western countries. This is supported by qualitative data looking at the experiences of staff and students to better understand the specific experience of trying such a novel approach in a Saudi Arabian context. It is argued that attainment progress was satisfactory when considered alongside the substantial social progress, suggesting that peer tutoring has the potential to be a long-term learning strategy and, perhaps more importantly, can open the door to Saudi Arabia developing more purposeful and collaborative learning environments. The age grouping common in Saudi Arabia, spanning a much greater age range than is common in other countries, also offers insight into what makes cross-age peer tutoring effective and suggests that measuring progress in such situations requires more advanced statistical techniques. It is also shown that trainee teachers can be efficiently trained in using PALS and highly rate its impact, indicating that teacher training could be a valuable launchpad for pedagogical innovation in Saudi Arabia.

The purpose of this study was to explore and describe the experiences of teachers fulfilling the role of facilitators of the STAR intervention with fellow teachers at two neighbouring schools. The study constituted part of a broader research project that commenced in 2003, at a primary school in the Eastern Cape. At the time of the current study, seven of the ten teachers who participated in the initial study were replicating the initial study’s strategy in two neighbouring schools in an attempt to assist the teachers in providing psychosocial support. In an attempt to explore the experiences of the teacher-facilitators I observed a STAR intervention session (November, 2008), that involved four participants facilitating a STAR intervention session at the neighbouring school. Following my observation of the intervention session, I co-facilitated a focus group, exploring the teacher-facilitators’ experiences in fulfilling the role of peer-facilitators. Two days after the first focus group, I co-facilitated a follow-up focus group for the purpose of member-checking. In addition, I relied on field notes and visual data as data sources. Based on the data analysis that followed, three main themes emerged. Firstly, the teachers seemed to ascribe meaning on a personal level in terms of their experiences as facilitators of STAR. They experienced joy in sharing knowledge and enabling others, feelings of self-worth and self-confidence, personal development and growth, as well as confirmed commitment and motivation. Secondly, they experienced a shared voice in the community, in response to the peer-facilitation of STAR, referring to appreciation and trust that inspired enthusiasm for participation in various school-community systems and a sense of community as outcome of facilitation. Thirdly, participants identified aspects related to being a peer-facilitator, in terms of overcoming feelings of uncertainty and concern, working as a team, relying on creative problem solving when dealing with potential challenges, and extending the scope of facilitation. Based on the findings of the study I concluded that the participating teachers experienced the facilitation of STAR in a positive manner on both a personal and professional level. As a result of their positive experiences, they seemed to become even more committed and motivated than initially, to support their community through the facilitation of STAR. Their positive experiences seemingly influenced their perceived development in terms of self-efficacy beliefs and actualisation, which in turn enhanced their personal and professional growth, thereby forming a cycle of improved positive experiences on various levels. / Dissertation (MEd)--University of Pretoria, 2010. / Educational Psychology / unrestricted