Thesis (Ph. D.)--University of Washington, 2005. / Vita. Includes bibliographical references (leaves 150-161).

Acquired Brain Injury (ABI) has been associated with significant family disruption, yet few studies explore the experiences of child-relatives. This cross-sectional study sought to explore the experiences of young people and their families (n = 3) following parental ABI. The major aims were (1) to develop an understanding of the processes by which family members make sense of events, and (2) to explore the implications for adjustment in young people and their families. A Personal Construct Psychology (PCP) methodology was implemented and construal processes were identified through individual interviews facilitated by Perceiver Element Grids (PEG; Procter, 2002). The Family Assessment Device (FAD; Epstein et al., 1983) and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) were used to explore aspects of adjustment. Data analysis comprised of two parts; intra-family and inter-family exploration of similarities and differences in construal. The themes identified suggest that following ABI, family members may be faced with a process of reconstrual, in which they are required to assimilate new information into their construct systems, renegotiate their roles, and come to terms with loss. The research offers an insight into some of the processes that may contribute to patterns of interpersonal relating that may negatively impact on adjustment. Psychological support following parental ABI may therefore be a crucial component of supporting young people and their families through these changes whilst reducing the impact on their own psychosocial wellbeing. This research offers an insight into the experiences of three families at one moment in time. Further exploration is recommended to better inform clinical practice, and ensure that the needs of this population are not overlooked.

The present research investigated paternal filicide in South Africa. It aimed to understand the factors underlying fathers killing their child/children. Study one explored paternal filicidal offenders' processes of construction, construing of events leading to the filicide, and meanings of their lived experience of killing their child/children. Study two examined the filicidal offenders' extended families' construction processes, construing of events before the killing, lived experience and construing of filicide, and construing of the filicidal offenders' construing of the filicide. Four paternal filicidal offenders and nine family members of the offenders who had different backgrounds (i.e., age, racial, ethnicity, cultural, educational, occupational, and the nature of the filicide) were purposively sampled and recruited into the research. Personal construct theory (Kelly, 1955) underpinned this research. A semi-structured individual interview which was structured according to the Experience Cycle Methodology (ECM) interview proforma (Oades & Viney, 2012), Perceive Element Grid (PEG) (Procter, 2002), and the ABC model (Tschudi, 1977), were administered to the filicidal and family participants. Data was analysed using Interpretative Phenomenological Analysis (Smith, Flowers, & Larkin, 2009) and personal construct analytic methods (diagnostic construct analysis, PEG, ECM, and the ABC model). The analysed themes suggest that filicide might co-occur with familicide and attempted suicide by the offender in some instances. While in many filicidal cases intimate/marital problems might be contributing factors, in a few cases filicide might be accidental in which it might not be precipitated by intimate/marital discord. Most filicidal offenders who tend to only construe their partners/wives and intimate/marital relationships in terms of positive construct poles might slot rattle when encountering invalidations of constructions. The encountered problems might trigger threat, anxiety, in which the problems are experienced as unconstruable, and anger which might lead to hostility. The filicidal offenders might lack constructions to deal with the issues which might result in unaddressed problems which might lead to a sense of being overwhelmed and feelings of hopelessness. The filicidal offenders might broaden or delimit their perceptual field or fluctuate between constriction and dilation to construe and cope with the situation. They might exceed their inhibition ability which might result in the avoided issues and inhibited feelings exploding in violence. The extended family members might not intervene in the couples' problems, if intervening might be possible, because of an unawareness of issues as a result of submergence and constriction in which they avoid construing the couples' problems, limit their views to issues, and minimise the seriousness of the construed problems. Psychological support, personal construct family therapy and Employee Assistance Program, might help the filicidal offenders cope with their intimate/marital problems, and therefore might prevent filicide. Considering the implications of the filicide on the offenders' identities, relations, and relationships, and also the relationships of their families, intervention programs such as Restorative Justice and sport might help the offenders re-establish their sense of self, find commonality and sociality while rebuilding the damaged relationships.

George Kelly's Personal Construct Theory, especially as subsumed within the “conversational science" paradigm developed by Thomas and Harri-Augstein, is fundamentally a framework for a geometry of personal meaning in which all of the dimensions of distinction within a person’s experience are like the dimensions of geometric space. A person's system of constructs is not just a framework for predicting the attributes of future events; it is a coordinate system for navigating the dimensionality of experience. The work of F. M. Alexander is primarily concerned with the "psycho-physical unity of the individual," and thus with the continuity of experience. The present work has two aims. The first, drawing on the work of Merleau-Ponty and John Dewey, and culminating in the concept of "Conductive Reasoning", is to lay a theoretical foundation for a synthesis of the practical work of Kelly and Alexander. The primary premise is that the act of comprehending is an embodied act, and as such is as subject to the conditions of the coordination of the whole person as is any other act. The second, practical, aim has been to develop a conversational methodology for dealing with learning in a more fully embodied way. This method of "conductive conversation," formally derived from the "Learning Conversation," evolved from the author's teaching experience with the Alexander Technique. Appendix 1, "A Conversational Introduction to Conductive Reasoning," is an interactive conversational structure which incorporates a development of these concepts in the context of personal experiments for generating the kinds of experiences from which the reader may draw something of the intended meaning, and some skill in using the conductive conversational tools for exploring embodied dimensions in their own meaning. It is intended as a piece that will stand on its own as a conversational research instrument for personal scientists.

Personal construct psychology, as formulated by George Kelly (1955), contributed substantial knowledge to the study of psychopathology. The small amount of research in the area of depression has focused generally on the content of self-constructs and the cognitive complexity characteristic. The purpose of this study was to examine the construct system of the depressed patient specifically by investigating the endogenicity, exogenicity, and severity of depressive symptoms in relationship to construct content as applied to others, cognitive complexity, and ordination.

Two interviews were conducted with 20 participants from a Mental Health and Mental Retardation (MHMR) crisis house. Subjects were classified as good or poor premorbid level of functioning using a case history form and information from their social history charts. The study employed a self-narrative method to direct self disclosure. In the first interview, participants were asked to describe themselves. In the second interview they were asked to identify what they would change about their histories and to describe how this would make a difference in how their lives turned out. Support was not found for the hypothesis that those with the higher premorbid functioning would be better able to shift perspectives and use more positive self constructs. Methodological, theoretical and future research areas are discussed.

People diagnosed with Borderline Personality Disorder (BPD) have been subjected to stigma and told that their difficulties are untreatable. Although recovery is now understood to be possible for this client group, much controversy exists around whether BPD is, in fact, an illness. The implications of this belief have not yet been explored from the perspective of the client. Furthermore, little research has attempted to deconstruct what constitutes the therapeutic alliance for people diagnosed with BPD and their clinicians from a Personal Construct Psychology (PCP) perspective. The present research study therefore aimed to explore what impacts on the recovery of people diagnosed with BPD. This included investigating the impact of the construct of illness and the therapeutic relationship. The research employed a correlational and non-randomised design, using a cross-sectional approach. The Repertory Grid technique was used among a sample of 20 clients diagnosed with BPD and their clinicians. Relevant questionnaires were also administered to ascertain BPD symptomatology and the perceived quality of the therapeutic relationship. Among findings, a statistically significant correlation is presented for the association between a poor therapeutic relationship and increased BPD symptoms. Evidence (in the form of a borderline significant correlation) is also revealed to suggest that clients diagnosed with BPD construe fewer benefits from psychological therapy when they consider the well-ill construct to be more important (i.e. superordinate). The results provide new information with regard to the treatment of people diagnosed with BPD.

M.A. / In accordance with literature indications that have established the need for psychotherapeutic outcome assessment instruments to determine the effects of psychotherapy, an exploratory and comparative study was conducted with anxiety disorder clients in private practice settings. The purpose of the study was to verify the recommendations made in the literature for the use of an idiographic method of outcome assessment (the Dyad Grid), as opposed to typically applied normative methods (the IPAT Anxiety Scale). The nature of the suggestions concerning the application of an idiographic method of outcome assessment, required the development of a theoretical framework which integrated the assessment procedure in an explanatory manner. To this end, the personal construct psychology view of anxiety was discussed in relation to repertory grid technique and prior outcome assessment research conducted with the Dyad Grid. On the basis of the personal construct approach to anxiety, a pre-test post-test research design was used to establish the utility of the Dyad Grid to discriminate between beneficial and nonbeneficial psychotherapy outcomes with anxiety disorder clients. The outcome results of the Dyad Grid assessments were compared with the results obtained from the IPAT Anxiety Scale, in conjunction with qualitative post-therapeutic ratings of benefit, or a lack of benefit, made by the client and therapist. The findings obtained on the basis of 14 case-studies are encouraging. The Dyad Grid displayed a statistically significant level of agreement with the client and therapist ratings of therapeutic outcome (onetailed, p = 0,05), whereas the IPAT Anxiety Scale did not. Though limited to a sample of convenience, and subject to an idiographic methodological bias, the discussion of the results indicated that the study provides support for the use of idiographic procedures as an alternative to nomothetic methods of outcome assessment. It is concluded that the initial success of the Dyad Grid in assessing psychotherapy outcome as beneficial or non-beneficial warrants further investigation with a large sample research design.

Social support is strongly associated with resilience and positive outcomes in children who have experienced risk and adversity, including children and young people in care. However, research suggests that children in care are often disadvantaged in their ability to benefit from social support due to disrupted relationships and multiple placements. Whilst a number of measures have been developed to assess the support networks of children, few are able to adequately assess and describe the complex network of relationships that exist for young people in care.The aim of this exploratory study was to investigate the use of a Dependency Grid to assess social support in young people who are looked after. The Dependency Grid is an interview technique derived from George Kelly’s (1955) Theory of Personal Constructs and was administered to ten individuals aged 11-17 years who were either in foster care or residential care. Qualitative and quantitative methods of data analysis were used to explore its utility to assess social support with each case. The appropriateness and ease of completing the Dependency Grid was evaluated through participant feedback interviews. The views and opinions of the young people’s social workers and a reference group consisting of social care practitioners were also obtained.The Dependency Grid was found to be a useful tool for examining the support networks of young people in care, with many advantages over existing measures. The Dependency Grid revealed similarities and differences in the way participants distributed their dependencies. Most of the participants had dispersed dependency grids and carers and friends were the most significant providers of support. Levels of social support did not vary with the increasing size of the support network (r = 0.198) and the felt ‘closeness’ of relationships, as measured using the Four Field Map, was poorly related to the allocation of dependencies (r = -0.243). Some evidence was found in relation to the validity of the Dependency Grid for individual cases using qualitative methods. The strengths and limitations of the Dependency Grid are discussed and the methodological challenges with the study and opportunities for further research are considered.

This thesis explores the use of adapted Dialectical Behaviour Therapy (DBT) with individuals with Intellectual and Developmental Disabilities (ID/D). DBT is a multi-modal psychological intervention that aims to increase skills in interpersonal effectiveness, distress tolerance, emotional regulation and mindfulness. It was initially developed for individuals who presented with parasuicidal behaviours, and is recommended for the treatment of Borderline Personality Disorder (BPD). This thesis is presented in five papers; a systematic literature review, three empirical papers (a, b &c), and a critical review and reflection of the research process. The systematic literature review provides a narrative review of published research regarding the adaptations and outcomes of DBT for individuals with ID/D. Seven studies were reviewed using the Evaluative Method for Determining Evidence Based Practice (EBP) (Reichow, 2011). The findings detail the adaptations, results and critical appraisal of the research to date. The empirical papers consider the outcomes of adults with ID/D who received adapted DBT in a community psychological therapies service. The papers present different methodologies, and combined produce a consilience of evidence regarding the suitability of DBT for this population. Paper 2a found significant reductions on measures of depression, anxiety and anger, and increased mindfulness skills amongst 18 participants following DBT. Paper 2b uses repertory grid technique to explore the psychological changes that occur following DBT for seven participants, and found overall changes in personal construing and improvements in self-esteem. Paper 2c considers the psychological changes that occur in further depth through the presentation of two case studies. The case studies consider the complexity and idiosyncrasy of the individuals and gives consideration to the use of repertory grids to identify implicative dilemmas as part of clinical assessments. The final paper provides a critical review with personal reflections of the thesis. The author considers the research and clinical implications of the study.