Background and goals: This thesis explores the experience of rehabilitaion following myocardial infarction (MI) from the perspective of people who did not attend either a cardiac rehabilitation programme (CR) or a CHD 'self-help' group and their ‘significant others’. These resources are intended to support post-MI rehabilitation and readjustment and research identifies various benefits, yet many people do not use them. Given the scale of the population affected by CHD, the issues of why people do not use the resources, their experience and that of their family members, and the kinds of support people need and want, are of public health importance. These issues formed my investigative goals. Methods: The study used a qualitative methodology, informed by ‘grounded theory’. A screening questionnaire identified non-participants from the post-MI population in Lothian, from which a sample of ‘maximum diversity’ was selected. In-depth interviews were conducted with twenty-seven post-MI people and seventeen ‘significant others’. The analysis combined identifying emergent themes and searching the data for key issues relating to study objectives. Findings: Additional to the barrier of non-invitation, a spectrum of factors relating to people’s ‘lifeworld’ circumstances, beliefs, and identity could either encourage or discourage participation. Factors were highly similar for both resources. Reasons for, and the process of non-participation could be grouped into three categories: “No need / no point”, “Not worth it”, or “Not possible”. These were based on the way the factors that influenced individuals related to three key issues. Shifts between categories were also possible. A link between non-participation and a range of rehabilitation difficulties among post-MI people and family members is also demonstrated. Conclusions and implications: The study addresses a gap in understanding post-MI non-participation and its significance, providing insight into the process by which CR and CHD Group nonuse occurs and the impacts for people who have had MI and family members. Recommendations are made, identifying realistic ways rehabilitation support might be improved, barriers and opportunities, and areas for further investigation.

This study sought to investigate whether the popularity of Information Communication Technologies (ICTs) would impact the behavioral intention (BI) to use of these technologies to aid in interpersonal task completion. Out of the ICTs available today, the most popular is textmessaging, especially among a sizable percentage of the college population. Approximately 600 students at a small, private junior college in eastern North Carolina were invited to participate in this study with a target of 248 responses needed to comprise an adequate sample. A total of 259 usable surveys (n = 259) were received and analyzed. Qualitative data collection instruments consisted of an openended questionnaire and other openended responses that were solicited throughout the data collection phase. Quantitative data collection instruments consisted of a 22item Likertscale survey and a forcedchoice ordinal scale instrument that measured computer user selfefficacy (CUSE) and experience using technology (EUT). Situated in the context of academic helpseeking (AHS), vignettes were developed, validated and administered to offer AHS scenarios where a problem was presented and the participants were then asked to reveal which type of ICT he or she would utilize to seek academic help (AH) in that particular situation.

Objectives: Computer-guided CBT could help to increase much needed access to lowintensity psychological interventions. Evidence for effectiveness has led to the inclusion of certain packages in NICE guidelines but application in clinical settings is unclear. Low uptake and high dropout suggest problems with acceptability and barriers to uptake. Studies neglect to report on acceptability to clinicians despite indications that clinicianrelated variables and attitudes could influence their use of CCBT. This study investigates clinicians‟ views of CCBT and factors related to referring to it, following experience of low referrals to a CCBT pilot, with the aim of learning more about barriers to access and how this might be improved. Method: A mixed quantitative and qualitative design was used. An online survey was developed to gather views on CCBT, its implementation and demographic information. This was sent to a sample of clinicians in the clinical psychology department, mental health nurses and general practitioners, some of whom were involved in the CCBT pilot project and some not. Descriptive statistics, non-parametric correlations, chi-squared analyses and framework thematic analysis was carried out on 72 completed surveys. Results: Most clinicians identified both benefits and concerns of CCBT. Most approved of CCBT but likelihood to refer varied and many preferred to offer other interventions. Clinician-related variables associated with likelihood to refer were whether clinicians saw mild to moderate cases, approval of CCBT and perceived patient uptake. Views regarding the effectiveness of CCBT influenced choices to offer it, with negative beliefs about effectiveness including a perceived need for human contact. There was moderate interest in receiving CCBT training. Most thought it should be accessed widely, with some concern raised about access in public settings. Although GPs were not involved in the CCBT pilot, many expressed interest in receiving training and referring. Conclusions: Clinicians‟ views of CCBT are mixed and some believe it is ineffective and unacceptable to patients, which influences their decisions to offer it. This includes perceptions about key aspects of therapy, such as human contact. Therefore some clinicians need more convincing of the CCBT evidence-base before they are likely to refer to it. Nevertheless there is moderate interest in using CCBT and more so in those seeing mild to moderate cases. CCBT may have a position in stepped care services but views of referrers should be considered and training offered. More research is needed on implementing CCBT, barriers to access and its role alongside other interventions.

I takt med att samhället förändras och antalet unga med psykisk ohälsa ökar utvecklas och förändras även de hjälpformar som finns tillgängliga för ungdomar med psykisk ohälsa. Internets framväxt har bland annat resulterat i att traditionella former av hjälp, där den unge möter den professionella ansikte mot ansikte, har kompletterats med onlinehjälp så som onlinechattar. Med hänsyn till denna utveckling syftar denna studie till att undersöka och jämföra ungdomars attityder till att söka hjälp hos kurator och via onlinechatt vid psykisk ohälsa. Detta har åstadkommits med hjälp av ett kvantitativt tillvägagångssätt där pappersenkäter använts som insamlingsmetod. Sammanlagt besvarades enkäterna av 223 högstadie- och gymnasieungdomar mellan 15-20 år i Stockholmsområdet. Studiens resultat visar att ungdomarna känner större tillit till kuratorer än onlinechattar. De är även mer positiva till att söka hjälp hos kurator än via onlinechatt vid psykisk ohälsa. Ungdomarna uppgav varierande svar på vad som påverkar deras attityder till att söka respektive hjälpform. Lättillgänglighet, tillit och kommunikationsform uppgavs vara de faktorer som främst påverkar deras vilja att söka hjälpa hos kurator medan brist på tillit och stigma främst påverkar deras ovilja att söka denna hjälpform. De respondenter som kunde tänka sig att söka hjälp via onlinechatt uppgav däremot lättillgänglighet och anonymiteten som främsta anledningar. Den majoritet som inte kunde tänka sig att söka hjälp via onlinechatt uppgav brist på tillit och kännedom samt kommunikationsform som främsta orsaker till att inte söka denna hjälpform. Studiens respondenter är inte bara mer positiva till att söka hjälp hos kurator än via onlinechatt vid psykisk ohälsa; de har dessutom mer erfarenhet av att söka denna hjälpform. De faktorer som ungdomarna upplevde som positiva och negativa med sina erfarenheter skiljde sig dock avsevärt från de faktorer som påverkade deras attityder till att söka respektive hjälpform. Ungdomarna uppmärksammade exempelvis den professionellas bemötande och om de fick hjälp med sitt problem som positiva och negativa faktorer som utmärkte deras erfarenheter. Generellt hade dock majoriteten av ungdomarna positiva erfarenheter av att söka hjälp hos både kuratorer och onlinechattar. / In pace with changes in society, and as the number of youth with mental illness increases, the forms of help available to youth with mental health issues also develop and change. The evolution of the internet, among other things, has resulted in traditional forms of help, where the one meets a professional face-to-face, being supplemented with online forms of help, such as online chats. In view of this development, this study aims to examine and compare the attitudes of young individuals towards seeking help for mental illnesses from a counselor and an online chat. This thesis will be accomplished using a quantitative approach where paper questionnaires are used as a data collection method. A total of 223 questionnaires were answered by adolescents aged 15-20 years in the Stockholm area. The study’s results show that respondents feel more secure with and trust towards a counselor’s help and are also more likely to seek this form of help than online chat.  Responses varied in regards to what affected attitudes toward each form of assistance, but ease of access, trust and the medium of communication was reported to be the main factors affecting willingness to seek the help of a counselor, while lack of trust and stigma were the main factors contributing to reluctance. The respondents who were willing to seek help from an online chat stated however that accessibility and anonymity were primary factors. The majority who could not imagine seeking such online assistance stated lack of confidence and awareness as well as medium of communication as the foremost explanations. The study also showed that respondents are not only more willing to seek help for mental illness from a counselor than through online chat; they also have more experience in seeking this type of support. The factors that respondents felt to be positive and/or negative with their experience differed considerably from those factors that influenced the respondents' attitudes toward seeking help from a counselor or an online chat. Respondents drew attention to factors like the professionals' attitude and whether they received help with his or her problem as factors that characterized their experiences. Generally, however, the majority of respondents’ had positive experiences of seeking help from both counselors and online chats.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work