There is a dearth of literature examining mothers’ experiences of mothering in the context of domestic violence (DV), and their perception both of the difficulties they face with regard to parenting their children, and how their own relational history influences their parenting. This research utilised Interpretative Phenomenological Analysis to understand the experiences of seven women living in refuge, and their perceptions of how their relationships with their children had been impacted by the domestic violence. Four super ordinate themes emerged: the perceived influences of their own childhood experiences; transition; relationship to the individual child or children, and emotional regulation and trauma in the mother-child relationship. The findings have clinical implications for therapists and agencies working with mothers transitioning out of DV relationships, and highlight the importance of providing resources as well as respecting and reinforcing women’s personal agency. These findings add to the emergent literature on the attachment relationship within the DV context.

Investigating the experience of life after a suicide attempt, and understanding how people find meaning and go on living, is important for developing appropriate responses. This study explored the unique lived experience of life after surviving a suicide attempt. Seven adults were interviewed using a semi-structured interview schedule. Interviews were transcribed and subjected to an interpretative phenomenological analysis (IPA). Four themes emerged, each with subthemes: relationship to suicide (the ongoing-ness of suicide, in-between-ness), relationship to healing (proceeding differently, freedom to heal, being regarded), relationship to self (encountering oneself, authentic being), and relationship to life (living with meaning, connectedness and belonging, curiosity and uncertainty). An overall theme of transformation emerged from the analysis. The opportunity for transformation can be experienced as ongoing crisis and can lead to deeper personal meaning if facilitated appropriately. Having meaning and purpose in life were experienced as essential to living. It is recommended clinical psychologists, and others, be prepared for the unpredictability of transformation and adapt existing practices where needed.

Understanding how change occurs in psychotherapy is imperative in informing clinical practice. Increasing attention has been given to the role that qualitative research could play in enhancing our understanding of therapeutic change. Although quantitative research suggests that parent-child psychotherapy is effective in facilitating change, no research to date has focused on how parents make sense of their change experience. Interpretative Phenomenological Analysis was used to analyse semi-structured interviews of eight parents who had completed parent-child psychotherapy about their understanding of change. Five master themes emerged which encapsulated participant’s understanding of change. These included constructing a survivor narrative, the experience of being understood enabling further understanding, adjusting expectations and practicing acceptance and feeling empowered to relinquish control. The final theme summarised how despite psychotherapy being conceptualised as a ‘precious’ resource, there was a sense that its limitations could negatively impact participant’s wellbeing. The study concluded that meaningful elements of change were identified from the parents’ experience. Findings were discussed in relation to previous research. Limitations and implications for future research and practice were examined.

There is an emerging interest in the literature base around the use of group singing in dementia care. Although studies indicate positive outcomes, limited research has been carried out from a relational perspective. Additionally, theoretical underpinnings of the reported benefits have yet to be explored. This study aims to investigate the key theoretical mechanisms underlying the experience of group singing. Interview data from seventeen couples who sing together in a group is analysed using grounded theory method. Several key aspects of group singing are presented, namely that the positive experience of the act of singing combined with effective group facilitation enables equal participation and a powerful group effect. A further benefit of new learning and creativity is explored. Implications for clinical practice and possible directions for future research are outlined.

This study explored the application of Weiner’s attribution models of helping behaviour to care staff working with overweight people with learning disabilities. Staff were asked to have a client in mind who was significantly overweight and to complete self-reports of their attributions, affect, optimism and willingness to help the person with their weight. The study found that staff rated their clients’ weight as being attributed slightly more to internal factors than external factors, being low in controllability and high in stability. Staff reported low levels of positive and negative emotion but high levels of sympathy, optimism and willingness to help. No associations were found between attributions or affect and willingness to help. Only optimism was associated with willingness to help. The findings did not support the applicability of Weiner’s attribution models to staff supporting overweight people with learning disabilities. These findings contribute to the inconsistent literature on the applicability of Weiner’s model to staff helping in LD services. Future research should clarify whether willingness to help relates to effective health helping strategies and to explore this further in service contexts. The clinical implications for staff training include enhancing staff’s optimism in health change and providing skills in constructively engaging client’s in healthier behaviours.

Physical activity (PA) during pregnancy is safe for both mother and fetus in the majority of cases, including for women who have undergone in vitro fertilisation (IVF) treatment; however, this population is likely to face unique barriers to PA. Currently, there is a paucity of research exploring the qualitative experiences and decision-making processes surrounding PA for women who have undergone IVF treatment. Eight women, who had undergone successful IVF treatment and given birth within the last two years, participated in semi-structured interviews about their experiences of PA during pregnancy. Interview transcripts were analysed using interpretative phenomenological analysis. Three super-ordinate themes emerged from the data: ‘experiences of loss and opportunities for hope’, ‘navigating risks and obstacles’, and ‘PA can be a valuable part of pregnancy’. Women’s experiences of PA during pregnancy varied. For some, it was a way to keep hold of their active pre-pregnancy selves, for others PA was experienced as a risk to pregnancy, thus influencing the decision-making process. Limitations of the study are considered, as well as implications for clinical practice and directions for future.

Section A provides a critical review of the literature pertinent to children’s imaginary companions, including definitional issues, historical background, and prevalence. Empirical research concerning the characteristics of children who create imaginary companions is presented, followed by an overview of theories attempting to explain the development and functions of imaginary companions. Empirical research investigating the functions of imaginary companions in normative populations is then reviewed, followed by research into the imaginary companions of children from clinical populations. The review concludes by reviewing the literature into the use of imaginary companions as part of psychological therapy. Section B Imaginary companions represent a common childhood developmental phenomenon, to date, largely neglected in the clinical literature. The grounded theory study investigates the functions and therapeutic use of imaginary companions in a clinical population, by interviewing clinicians working therapeutically with young people accessing Child and Adolescent Mental Health Services. Participants were 10 UK clinicians, most practising as child clinical psychologists. Clinicians reported that imaginary companions served a number of fundamental functions, including serving as a communication aide, a secure attachment figure, proving mastery over a child’s world, and acting to maintain stability in the environment, and in a child’s self-image. Imaginary companions were utilised by most clinicians as part of engagement, and to gain insight into young people’s difficulties. Depending on their salience, and congruence with young people’s self-image, imaginary companions were used as therapeutic allies, to aid perspective-taking, and as a way to manage the intensity of interactions with clinicians. Imaginary companions were not therapeutically utilised by a sub-section of clinicians, owing to their perceived low salience, and to clinical risk issues. The findings are discussed in relation to existing theory and research, and methodological limitations, implications for clinical practice, and directions for future research are provided. Section C provides a critical appraisal of the research methodology and findings, and elaborates on clinical implications and future research ideas discussed in Section B.

Qualitative research has begun focussing on the experience of change within psychological therapy for individuals with a diagnosis of Emotionally Unstable Personality Disorder (EUPD). However, many individuals do not access therapy but instead utilise other forms of support. This study aimed to develop a holistic theory of change, applicable to but extendable beyond the remit of psychological therapy. Twelve individuals were interviewed using semi-structured format about their experience of change. Five individuals with a diagnosis of EUPD were interviewed alongside seven staff members. A Grounded Theory methodology was used. The key change experience was defined as one of ‘shifting positions’ where the individual began evolving their relationship to themselves, to others and to help. This process was often facilitated by development of safe and trusting relationships and a personal readiness to change. The change process could simultaneously be enhanced and set back by staff and Mental Health Services. This change process mirrors and expands the findings of previous research and offers a change model applicable across settings. Future research should include the perspective of carers and clinical settings should explore how best to support staff to attune to individuals’ needs in order to facilitate change.

As with social anxiety, people with high social appearance anxiety (SAA) might experience increased perceptions of being looked at by others and elevated levels of self-focussed evaluative attention (SFEA). This study tested whether individuals with high SAA perceive more people look at them than do those with low SAA, and whether SFEA increases this perception. A sample of 52 low SAA and 48 high SAA participants completed questionnaires and experimental tasks online. Participants estimated the proportion of people looking at them in numerous matrices of faces. A control task of matrices of clocks was used. SFEA was experimentally manipulated. Those high in SAA estimated more people looking at them, and reported higher trait self-focussed attention. Increasing SFEA increased these individual’s estimates of faces looking at them but did not affect perceptions of non- social stimuli. Implications for clinical interventions and the body image literature are discussed. Future lines of research are recommended.

The aim of this phenomenological study was to explore women’s experiences of an Elective Caesarean Section (ECS) following a previous Traumatic Birth (TB). Thirteen women who had undergone an ECS following a TB were either interviewed or provided written accounts of their experiences. Data from these sources were analysed using Interpretative Phenomenological Analysis (IPA) (Smith, Flowers and Larkin, 2009). Five main themes were identified: ‘cautiously moving forward into the unknown: the drive to reproduce’, ‘attempting to make the unknown known’, ‘the longed for, positive birthing experience’ , ‘a different post-natal experience’ and ‘the interaction of the two experiences’. These findings were considered in relation to previous research; relevant theoretical perspectives were considered including those attached to Post-Traumatic Stress Disorder (PTSD). Post-traumatic stress reactions may increase during subsequent pregnancy impeding on women’s ability to consider facing another ‘unknown’ natural birth and domineering their decision to elect for a CS. An ECS following a TB may provide women with the controlled experience and high levels of care they long for. Such experiences could be redemptive and have positive outcomes for women’s relationships and wellbeing. These results highlight the importance of providing women in this position with information and choice regarding a subsequent birth. They also stress that prevention of women carrying Post Traumatic Stress (PTS) reactions into their subsequent pregnancies is imperative. Future research would benefit from focussing on the development and trialling of effective screening tools for PTS reactions following birth.