Background: This thesis contains two elements: the first is a systematic review examining some of the determinants of quality of life for people with intellectual disability. Understanding these determinants can drive improvement at both individual and societal level. Yet there are a number of quality of life measures which might confound findings between studies. This systematic review sought to identify factors that influence quality of life using self-report on one measure developed for use with people with intellectual disability, the ‘Quality of Life Questionnaire’ (Schalock & Keith 1993). The second element is an empirical study that aims to explore the lived experience of aging for older adults with intellectual disability. There are noted differences between people with and without disability as they grow older, for example in terms of health and social opportunity. Previous studies have not consistently sought the experience of the people with intellectual disability themselves, or have used participants not traditionally considered older adults. This study aims to address gaps and further our knowledge in the lived experience of getting older for older adults with intellectual disability. Method: Within the systematic review a systematic search of relevant studies to 20th January 2015 was completed using a specified inclusion criteria, yielding 13 peerreviewed journal articles. These were scored on 11-point purpose-designed quality criteria. For the empirical study semi-structured interviews were completed with ten participants with intellectual disability (age range 60 – 74 years, five female) regarding their understanding of getting older and their experience of ageing. Nine transcribed interviews were analysed using interpretative phenomenological analysis. Results: The systematic review found that living in a semi-independent environment or an urban setting, being employed, being involved in domestic and community activities, receiving social support and possessing social skills and self-determination were factors that improved quality of life for people with intellectual disability. Three major themes emerged from the empirical study data when participants discussed getting older: ‘Not changed by ageing’, ‘Thinking about the ageing process’ and ‘What happens when getting older’. Participants tended to feel that they were still the same due to continuation of the same activities and social support. They demonstrated confusion in the ageing process, considering the process ‘inevitable’ but insignificant, although also recognising some changes associated with the process. They discussed their views about what they considered happens when people get older, which tended to be stereotypical and often negative. However they also reflected on their own experiences and how they had changed. Discussion: The methodological quality of the studies reviewed was found to be generally low due to a range of factors including study design, measurement of intellectual disability and reporting of sample demographics and results and therefore conclusions should be treated with caution. This highlights a need for further research with people with intellectual disability of a higher methodological quality. The empirical study is discussed in reference to previous research and gerontological theories of ageing. The study highlighted that staff or family did not broadly discuss ageing with participants and their views often changed over the course of the interviews from more physical and negative aspects to how ageing impacted them. This research demonstrated older adults with intellectual disability do have opinions on ageing. Further exploration with people with intellectual disability on this topic is to be encouraged in the future to develop a more balanced view.

An expanse of research literature has confirmed that a significant percentage of women are concerned about their body size and appearance. Western cultures have emphasized that women must look good to be worthy. Media attention that alludes to the benefits of a thin, fit body exacerbates women's beliefs that they need to look a certain way to be acceptable and to fit in. How though, can the majority of women fit into a world of contrary ideals? Being strong and healthy does not absolutely mean a woman has to be model thin with conspicuous abdominal muscles and extreme body definition. In the field of art therapy, there has been no specific research to demonstrate the advantages of clay for the exploration of body-image, male or female. The research undertaken focuses on and evaluates the manner and methods in which clay can be employed as an enabling material for body-image issues with women within art therapy practice. With the help of small groups of female participants who were invited to attend sessions in my pottery to make their body-images from clay and join in discussion, I was able to explore within a safe and contained environment the ways in which clay can be utilised within an art therapy setting. None of the women who took part in the research had a diagnosis relating to body-image issues. By pursuing the methods of Participatory Action Research (PAR) for Study One I employed the fundamental features of Cycles of Reflection. The results of Study One assisted me in choosing Interpretative Phenomenological Analysis (IPA) to further the research. In this way, I would be able to identify the most robust of themes within the dialogues of the three women who attended the individual sessions that comprised Study Two. The final results of the research point to a positive and contained means of working with clients and patients in order to provide a significant resource to help women explore and be more accepting of their bodies.

The theory of rejection sensitivity, suggests that early experiences of rejection (e.g. parental rejection, peer rejection) can result in the tendency to anxiously expect, readily perceive, and overreact to rejection by significant others in future relationships. An abundance of quantitative research has suggested that rejection sensitivity has significant implications regarding one’s thoughts and actions within intimate partnerships (e.g. Downey & Feldman, 1996); however, little is known about the lived experience of the women who are sensitive to rejection. The present research sought to move beyond the developmental perspective of the theory of rejection sensitivity (as presented in the first two chapters) by aiming to gain an understanding of how women experience rejection sensitivity within their intimate partnerships and how their thoughts, feelings, and behaviours have impacted their romantic lives. Interpretive Phenomenological Analysis (IPA) was used to explore the lived experience of women who identified with rejection sensitivity. Data generated during two interviews with three participants was transcribed and analyzed using an interpretive phenomenological analysis approach. An over-arching theme of I won’t let it happen again: a journey of self-protection emerged that was representative of the women’s shared experience of protecting themselves from experiencing further rejection in their romantic relationships and was further illustrated throughout three secondary themes: I can control things so I won’t let it happen again, Wait…is it happening anyway?, and A continuous journey. Based on the present findings, considerations for further research and practice are offered. Given lack of research aimed at understanding the experiences of women who identify with rejection sensitivity, the value of the present study is twofold: This research makes a notable contribution to current literature, but also encourages women, and those devoted to helping them, to understand their own unique relationships with rejection sensitivity and navigate their own journeys with a sense of hope for mutually satisfying and beneficial romantic relationships in their futures.

Objective: To date there have been few if any qualitative studies of adults who have experienced childhood sexual abuse (CSA) followed by psychotic experiences later in life. This study aimed to explore how a sample of four women make sense of their childhood experiences of sexual abuse and their psychotic experiences later in life. Methodology: Data was gathered through semi-structured interviews with four women. The data were analysed using Interpretative Phenomenological Analysis (IPA) in order to develop a detailed understanding of the women’s search for meaning in their own lives. Results: Four major themes emerged from the analysis of the women’s accounts: ‘Interpersonal difficulties,’ ‘Striving to Get Better’ and ‘A Relationship with Shame’ and ‘Links Between CSA, Mental health & Psychosis’. These are explored in detail. Conclusions: The women’s accounts highlight the ongoing difficulty of living with psychosis and CSA, in particular, the role of psychosis in exacerbating isolation, shame and negative self perceptions. Attention is also drawn to the development of competence for therapists in this area of work. Clinical Implications: Supporting and validating existing healthy coping strategies as well as exploration of the interaction of psychosis and CSA through psychological mechanisms of shame as well as family / society discourses. Therapist/ researcher selfawareness is crucial in supporting clients with such traumatic histories.

This research examined leadership in difficult situations using phenomenological and critical incident analyses of 14 interviews with respected leaders. Leadership in difficult situations was examined as a personal experience consistent with the perspective of counselling psychology. The phenomenological analysis has produced four voices. The first voice captures the participants' description of leadership as a paradox of personal and situational dynamics. The second voice forms an uncommon elucidation of the lived experience of leadership in difficult situations. The participants are seen to be striving in a resilient manner characterized by a sense of acceptance and authenticity. The third and fourth voices describe the means by which the participants are effective in difficult situations. The third voice captures the intra-personal process of resonance, personal and social awareness, personal supports, mastery of the issues, and the capacity to generate remarkable outcomes. The fourth phenomenological voice captures the participant's active engagement in connecting with people, shaping the work context and leading collaboration to develop a successful process. Five categories have been produced by the Critical Incident Technique, which examined what helps and what hinders in the experience of leadership through difficult situations. The five categories are: being experienced, principled and self-aware; having personal supports and influences; being interested and skilled in connecting with people; being both energetic and able to withdraw appropriately; finally, actively cultivating their perspective or vision. These five categories indicate the capacity of the participants for diverse means of participation in difficult situations. Results are discussed in terms of implications for research and practice.

The Birth Centre is a midwife-led, out-of-hospital facility for normal births in Winnipeg, Manitoba. Exploring women’s experiences of choosing the Birth Centre was the primary objective for this thesis. Through a feminist perspective and using interpretative phenomenological analysis (IPA), each participant’s idiographic description of the decision-making experience was analysed. A sample of seventeen women participated in in-depth interviews. Six themes emerged through the qualitative analysis: Exercising personal agency; Making the decision in the context of relationships; An expression of one’s ideology; Really thinking it through; Fitting into the eligibility criteria; and The psychology of the space. The findings suggest that a woman’s sense of safety is related to these themes. The women had a normal birth influence in their lives from personal relationships, past experiences, or personal values and beliefs. The study highlighted the importance of access to midwifery services in order to increase awareness and access to the Birth Centre.

This research examined leadership in difficult situations using phenomenological and critical incident analyses of 14 interviews with respected leaders. Leadership in difficult situations was examined as a personal experience consistent with the perspective of counselling psychology. The phenomenological analysis has produced four voices. The first voice captures the participants' description of leadership as a paradox of personal and situational dynamics. The second voice forms an uncommon elucidation of the lived experience of leadership in difficult situations. The participants are seen to be striving in a resilient manner characterized by a sense of acceptance and authenticity. The third and fourth voices describe the means by which the participants are effective in difficult situations. The third voice captures the intra-personal process of resonance, personal and social awareness, personal supports, mastery of the issues, and the capacity to generate remarkable outcomes. The fourth phenomenological voice captures the participant's active engagement in connecting with people, shaping the work context and leading collaboration to develop a successful process. Five categories have been produced by the Critical Incident Technique, which examined what helps and what hinders in the experience of leadership through difficult situations. The five categories are: being experienced, principled and self-aware; having personal supports and influences; being interested and skilled in connecting with people; being both energetic and able to withdraw appropriately; finally, actively cultivating their perspective or vision. These five categories indicate the capacity of the participants for diverse means of participation in difficult situations. Results are discussed in terms of implications for research and practice.

Due to the improved availability of highly active antiretroviral therapy (HAART) life expectancy amongst people living with HIV has drastically increased. Older people, aged 50 and over now make up the fastest growing group of individuals living with HIV in the UK. Despite this little is known about their experiences of ageing with HIV. In addition, further still is known about older Black African women living with HIV in the UK, despite the complexity of their social and political context. This was, therefore, the first study to explore the lived experiences of this underrepresented group of women. The thesis adopted a phenomenological approach to examining how the intersections of older black African women's identities shaped their experiences of living with HIV in the UK. In addition, it explored the ways in which they coped with the devastating impact HIV appeared to have on their lives. Using interviews with seven women and interpretative phenomenological analysis, the results revealed three master themes. These were 'Spoilt Identities', 'A present without light and a future without hope' and 'Escaping the labyrinth of distress and uncertainty'. A detailed account of these master themes is provided. The findings are discussed in relation to existing literature, implications for clinical practice, methodological limitations and suggestions for future research.

The self of the therapist is widely recognised as being a crucial component in the therapeutic relationship. However, comparatively little is known about the therapist as a person, or of how life-changing events in therapists’ personal lives may impact on their professional identity and practice. The aim of this phenomenological study was to explore the impact of traumatic bereavement on the personal and professional lives of qualified humanistic therapists in order to shed further light on this under-researched area. Underpinned by a phenomenological-hermeneutic philosophy, Interpretative Phenomenological Analysis was selected as the methodology most appropriate to reveal participants’ lived experience. Purposive sampling was used to recruit a homogenous sample of eight humanistic therapists who had experienced traumatic bereavement while practising. Data comprised interview transcripts, participants’ reflective writing and researcher field notes. IPA’s idiographic approach facilitated the creation of a detailed and nuanced thematic analysis of the phenomenon, grounded in participants’ voices. Five super-ordinate themes were created from the interpretative phenomenological analysis, each of which provides a complementary ‘lens’ through which to view participants’ holistic experience: ‘Significance of context’, ‘Confronting a changed reality’, ‘Re-learning the world’, ‘Facing professional challenges’ and ‘Personal and professional reciprocity’. Findings reveal the unique contextual and multi-faceted nature of traumatic bereavement, and suggest that this experience can profoundly impact on therapists’ personal and social identities and beliefs. The professional challenges faced by grieving therapists are also highlighted. Findings illustrate that through a reciprocal process of personal and professional integration, the experience of facing, and living through grief, can lead to therapists’ increased self-knowledge, understanding, empathy and authenticity that informs and enhances their therapeutic practice. Supportive supervision and continued self-reflection are evidenced as significant mediating factors. The research demonstrates that the process of integrating the experience of traumatic bereavement into the therapist’s personal and professional life is a continuing and oscillating process. It is crucial that therapists carrying this burden have opportunities to reflect on this process in supportive supervisory relationships in order to pre-empt and ameliorate difficulties they may face in client work. A greater understanding of therapist bereavement is needed across the profession.

Background: The last few decades have seen neuroscience rapidly progress as a discipline. Development of research techniques such as neuroimaging have been utilised to increase an understanding of our species. Counselling psychologists are trained to combine the world of humanistic and phenomenological philosophies with an ability to understand and undertake psychological research, leading to interventions which are theoretically and subjectively informed. This work is undertaken through the reflexive and scientist-practitioner models which underpin the identity of the discipline. As such, counselling psychologists would seem ideally placed to integrate neuroscience into their work, utilising their reflective and scientist practitioner identities to both utilise and add to neuroscience research, helping to increase the understanding and efficacy of interventions for our species' mental health. However, it appears to be unknown as to whether this is something that counselling psychologists want, particularly in the UK. Aims and Method: The aim of this research was to explore UK based counselling psychologists' views and experiences of integrating neuroscience into their work. An interpretive phenomenological analysis (IPA) was undertaken. Six participants were recruited into three different groups of interest/understanding in integrating neuroscience into counselling psychology. One hour semi-structured interviews were carried out with each participant to explore their views and experiences relating to the paradigm. Findings and Discussion: Six master themes emerged from the analysis; 'The Dangers of neuroscience', 'Defining neuroscience', 'There are ways that neuroscience can help us', 'Methods of learning and the need for training', 'Integration: The opposition and the need - finding the balance', and 'My practitioner identity'. The themes presented various advantages, dangers and challenges to integration, some of which aligned with existing literature and some of which presented new thoughts and feelings on the paradigm. Conclusion: The six master themes highlighted that participants indicated an overall view that UK counselling psychologists are currently integrating neuroscience into their work, utilising neuroscience theory as a way to develop their understanding of clients, as well as to communicate with clients and multi-disciplinary colleagues. Participants provided a number of experiential advantages of integration and indicated that they want to integrate even more with neuroscience, incorporating neuroscience into doctorate and CPD training, though they acknowledged the importance of balanced integration.