This thesis constitutes a narrative description of the evolution of my therapeutic self during my training as a clinical psychologist. During the telling of this story, I review the ways in which I was perturbed by the mix between the various theories and the various contexts visited during the years of my post-graduate training. I have described and critically compared my responses to the following models: psychoanalytic, psychodynamic, first-order cybernetic, and secondorder cybernetic (covering the first, second and third movements). Throughout, I have attempted to track the development of a congruent, personal therapeutic self while simultaneously assuming that this self is constantly coming-into-being. / Psychology / M.A. (Clinical Psychology)

För att möta ett växande behov av tillgänglig hjälp för studiestressproblematik vid högskolor och universitet kan självhjälp som behandlingsform vara viktig att testa. I denna pilotstudie undersöktes effekten av deltagandet i ett textbaserat självhjälpsprogram utifrån kriterierna: perfektionism, prokrastinering, oro och livskvalitet, följsamhet och nöjdhet. Interventionen bestod av fem moduler för deltagarna att arbeta sig igenom under 5-7 veckor med minimal terapeutassistans. Nitton deltagare från ett universitet tackade ja till att delta i studien varav 11 inkom med såväl för- som eftermätningar.  Beroende t-test visade signifikanta skillnader mellan för- och eftermätning för utfallsmåtten prokrastinering (IPS (d=1.0)) och oro (GAD-7 (d=0.7)). För resterande utfallsmått för perfektionism (FMPS-PS, FMPS-CM) och livskvalitet (BBQ) uppvisades inga signifikanta skillnader. Följsamheten var låg, flertalet deltagare genomförde endast programmet till någon del. Uppfattningen fångades av CSQ-8 och visade att deltagarna till största delen var nöjda. Resultaten i pilotstudien ger argument för fortsatt studerande av självhjälp för studiestress och öppnar upp för en vidareutveckling av programmet i fokus, till exempel i form av en större kontrollerad studie med ökad terapeutassistans. / In order to meet a growing need for accessible support for student-related distress at universities, self-help as a treatment form may be important to test. This pilot study examined the effect of participation in a text-based self-help program based on the criterias: Perfectionism, Procrastination, Worry, Quality of Life, Compliance and Satisfaction. The intervention consisted of five modules for the participants to work through during 5-7 weeks with minimal therapist assistance. Nineteen participants from a university participated in the study, of which 11 handed in both pre- and post-measurement.Dependent T-tests showed significant differences between pre- and post-measurement for outcome measurement progression (IPS (d = 1.0)) and anxiety (GAD-7 (d = 0.7)). There were no significant differences for the remaining outcome measures for perfectionism (FMPS-PS, FMPS-CM) and quality of life (BBQ). The compliance was low, most of the participants only carried out the program to some extent. The level of satisfaction was captured by CSQ-8 and showed that the participants were mostly satisfied. The results of this pilot study provide argument for future study of self-help for student-related distress and opens up for further development of the program in focus, for example in the form of a larger controlled study with increased therapeutic assistance.

Background Considering ~9 million Canadians have one or more chronic health conditions, and >3.3 million report some level of disability, the burden of care is substantive for individuals and health system. With such conditions, self-care is essential but may pose challenges to both individuals and providers of care. As a concept, self-care is poorly understood. Further, evidence for effective self-care support is diffuse and typically studied relative to specific conditions. Objectives To investigate the concept of self-care three objectives were undertaken: 1) explore and describe the construct of self-care as understood by individuals/families, health care professionals, researchers, policy-makers; and industry; 2) produce new knowledge for health care professionals about interventions for self-care across a range of population groups; 3) develop a provisional framework to inform practice and research. Method A multi-phase enquiry was undertaken. Phase 1 Concept clarification including: 1) synthesis of qualitative evidence on the experience of self-care reported by individuals/families; 2) content analysis and definitional study of the meaning of self-care; 3) concept analysis of self-care; 4) creation of a conceptual schema encompassing these perspectives. Phase 2 Self-care Interventions: Integrative study of systematic reviews, synthesizing evidence for self-care interventions from multiple disease/impairment groupings. Results Three modes of self-care were revealed : ‘Care of self’ self-care performed on one’s own behalf; ‘care by other’ acknowledging individuals with disabilities who guide and direct care provided by another person; and ‘care of other’- care of families and others at a community level. Analysis of 30 self-care interventions across 16 conditions demonstrated that educational sessions and self-care management plans are emerging as effective strategies to support and guide self-care. Conclusion Self-care is a complex care concept that is becoming an expected element in today’s health care environment. A full understanding of how it is viewed, including the individual’s perspective, is vital for enactment and beneficial support. This comprehensive understanding of the concept along with evidence for effective interventions drawn from multiple groups will assist health care professionals to improve their assessments and provide them with strategies to support self-care needs –ultimately, contributing to enabling individuals to maintain their highest level of functioning. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2010-09-24 09:33:03.17

This thesis constitutes a narrative description of the evolution of my therapeutic self during my training as a clinical psychologist. During the telling of this story, I review the ways in which I was perturbed by the mix between the various theories and the various contexts visited during the years of my post-graduate training. I have described and critically compared my responses to the following models: psychoanalytic, psychodynamic, first-order cybernetic, and secondorder cybernetic (covering the first, second and third movements). Throughout, I have attempted to track the development of a congruent, personal therapeutic self while simultaneously assuming that this self is constantly coming-into-being. / Psychology / M.A. (Clinical Psychology)