Aims: Recently, empirical literature exploring cognitive characteristics of intimate partner violence offenders has received considerable attention with both theory and practice historically focusing on victims of the abuse. Qualitative exploration has proposed implicit theories (ITs), that is distinct sets of schemas that offenders hold in relation to themselves, the world and others. In relation to cognition in intimate partner violence offenders, this thesis had two aims: to systematically analyse qualitative literature exploring cognition in intimate partner violence offenders and to implement interpretative phenomenological analysis to explore cognition in intimate partner violence sex offenders. Methods: Aims are addressed separately in two journal articles. A systematic review of qualitative literature exploring cognition in intimate partner violence offenders is presented in journal article 1. Journal article 2 utilises interpretative phenomenological analysis to explore cognition in 11 intimate partner sex offenders. Results: In relation to journal article 1, systematic searches of bibliographic databases in addition to hand-searches of various articles in the domain of intimate partner violence were conducted to identify eight empirical papers qualitatively exploring cognition in intimate partner violence offenders. Synthesis of the papers resulted in 10 themes being extrapolated thought to be representative of cognition in intimate partner violence males: “violence is normal”; “policing partner”; “women are provoking” “need for control”; “grievance/revenge”; “external factors responsible”; “rejection/abandonment”; “minimisation/denial”; “entitlement” and “remorse”. Journal article two utilised interpretative phenomenological analysis of 11 transcripts of IPV offenders. This revealed five superordinate and 14 subthemes which are proposed as implicit theories present in this specific offender group. These are: “violence is acceptable”; “grievance/revenge”; “dangerous world”; “need for control”; “real man”; “entitlement/women are objects”; “male sex drive/policing partner”; “women are provoking”; “rejection/abandonment”; “women are supportive”; “uncontrollability”; “nature of harm”; “the new me” and “I‟m not like them”. Conclusions: Cognitions identified from the systematic review are discussed in addition to limitations of the synthesis and clinical and empirical utility. The implicit theories identified in journal article 2 are discussed in relation to other offending behaviour groups in addition to their clinical implications in the development of effective interventions and risk assessment tools.

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Background: Until recently, qualitative researchers have avoided interviewing participants with brain injuries because of the ethical and practical dilemmas which may arise and because it has been argued that they may not be able to reflect and accurately report upon their experiences. Therefore, little research has been produced which explores the personal experience of living with a brain injury. Recently, however, some researchers have challenged the view that people with brain injuries are unsuitable as interviewees in qualitative research and have, through their own research, highlighted the importance of understanding their views and perspectives in order to provide them with the best care and rehabilitation. Aims: With this in mind, and in line with current calls for more research gaining the brain injured person’s perspective, this study attempted to gain an in depth understanding of what it is like from the brain injured person’s perspective, to live with an acquired brain injury. The study focussed upon the experience of gaining consciousness following a brain injury, the experience of living with permanent memory loss, the experience of gaining awareness of deficits, the experience of losing an identity and adjusting to a new identity, the impact on relationships with friends and family and experiences as an inpatient in a Brain Injury Unit. Sources of strength and coping mechanisms were also explored. Method: Semi-structured interviews were conducted with six individuals who had severe acquired brain injuries and were inpatients in a post-acute neuro-rehabilitation unit. The verbatim transcripts of the semi-structured interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were: ‘Piecing together the past and becoming aware of the present’, ‘The transition from old self to new self’, ‘Sources of strength and survival’ and ‘Experiences in rehabilitation’. A description of these themes is presented with the corresponding subordinate themes. Conclusions: The clinical implications of the research and guidance for future research are discussed. The study produced a valuable insight into the personal experience of living with a severe acquired brain injury that could be used to inform rehabilitation interventions. The results also indicated that people with acquired brain injuries may experience Post Traumatic Growth.

Aim: A wealth of quantitative literature exists exploring the adjustment of children and young people with Type 1 Diabetes Mellitus. However, results are often confusing and contradictory, at least partly due to studies using different definitions and measures. Studies have been criticised for over relying on parental reports and failing to consider young people’s own perceptions. Furthermore, they have often conceptualised adjustment as an outcome, rather than exploring the process involved. Additionally, although peers are considered to play an important role in young people’s lives, their role in young people’s adjustment to living with diabetes has rarely been examined. To address this gap, this study attempted to gain a rich understanding of young people’s experiences of adjusting to life with diabetes and explore how they feel their peers have contributed to this process, with the hope of informing clinical practice and improving support to young people and their families. Method: A qualitative approach was chosen and six young females aged 12 – 15 with a diagnosis of Type 1 diabetes were interviewed using semi-structured interviews. Interpretative Phenomenological Analysis was used to analyse the transcripts. Results: Five main themes emerged from participants’ accounts: Developing a balanced relationship with diabetes; the uncomfortable position of difference; grappling with the fall out of diabetes; making diabetes more bearable; and the role of parents and friends. The findings are discussed in relation to the relevant literature. Clinical implications, methodological limitations and directions for future research are presented. Conclusions: This study provided an insight into the complex and dynamic process of young people’s adjustment to life with Type 1 diabetes. It highlighted the challenges and struggles they faced as a result of their diagnosis and the different strategies they employed to manage these. It also emphasised the valuable role both parents and friends provide in supporting young people with their illness.

Aims: Acquired Brain Injury (ABI) is often researched from a reductionist perspective, focusing on pathology and dysfunction (Olney & Kim, 2001). More recently there has been a call towards taking a person-centred, global approach; questioning old ‘assumptions’ about what is currently known, and incorporating the views of the patient (Hill, 1999). This qualitative research study aimed to make a further contribution to the evidence-base by investigating the experience of adjusting to life after ABI. Method: Six participants, (two female, four male) aged 26-49, who had experienced a severe ABI an average of 31 months previously, were interviewed using a semistructured schedule. Interpretative Phenomenological Analysis (IPA) was employed to analyse the transcripts. Results: Five master themes emerged from the participants’ accounts: Experiencing a loss of control; Observed changes as a threat to identity; Being displaced by the injury: Feeling unchanged in a changed world; Attempts at managing a threatened identity, and Enable me don’t disable me: The role of support in recovery. Implications: Clinical implications were considered within Bronfenbrenner’s (1979, 2004) Ecological Systems Theoretical Framework. Within the Microsystems (the individual’s immediate systems such as their body, home and work) participants described a struggle to make sense of their perceived loss of control of their body and brain. They described the importance of making sense of these changes. Clinically there is a potential role for professionals to facilitate how people make sense of their experiences, perhaps moving away from reductionist explanations, which appeared to prevent participants from having hope to influence change. From a Macrosystemic level (the individual’s social, cultural and political systems) the participants felt they were less valued and as a result, judged by society and by political systems. Participants’ accounts suggested that they wanted to continue to contribute and be valuable in society. An implication therefore is for professionals involved to take more a political stance in influencing how we currently conceptualise people after brain injury, focusing on enablement rather than disablement.

Although psychological research into manic experiences is increasing, it remains an underresearched phenomenon. In particular, there is a dearth of qualitative research exploring these experiences in a clinical sample of people diagnosed with Bipolar Disorder. This study examined six participants’ experiences of mania using Interpretative Phenomenological Analysis. Through semi-structured interviews, the participants provided detailed accounts of how they made sense of and experienced their manic states. Three master themes were described: “A mixed relationship with mania,” “A separate and controlled self”, and “The struggle to be different.” The first master theme explored the participants’ mixed and ambivalent relationship with their manic experiences. These were viewed as both alluring and dangerous, but overall the perceived costs had outweighed the benefits, for all but one of the participants. Most participants described losses in relation to giving up their manic experiences, as well as losses related to the destructive consequences of their episodes. The second master theme examined perceptions of mania as a separate, uncontrollable phenomenon, over which they had little influence. It was hypothesised that these explanations served to relieve these participants from underlying negative emotions, such as guilt, regret, shame and selfstigma. The third master theme described how manic experiences had represented struggles to be different. These included a struggle against society; a struggle to experience a preferred self; and a struggle to access very unique experiences or abilities. A number of issues were discussed in relation to the above themes. These included positive and conflicting appraisals of high moods; loss; entrapment and helplessness; ambivalence; negative moral emotions and a preferred manic identity. A range of therapeutic approaches were suggested as potentially helpful for some of these issues. These included Motivational Interviewing, Narrative, Constructivist and Compassion therapies. Additionally, the findings of the study provided support for existing therapies for Bipolar Disorder; particularly Cognitive-Behavioural Therapy (CBT) and Interpersonal & Social Rhythm Therapy (IPSRT).

Aims: Quantitative research and clinical observations have long supported a link between the eating disorders and disturbances of self / identity. However, less is known about the process of how this comes about, and little qualitative research has been conducted in the area. The current study therefore aimed to gain an in-depth understanding of the experience of self and eating disorder, using a qualitative approach. The study focused upon the experiences of women, in order to keep the sample homogenous, and sought to explore the following: How women with an eating disorder view and describe themselves; their thoughts and experiences concerning why they view themselves this way; and their thoughts and experiences regarding whether they think there is a link between their view of themselves and their eating disorder. Method: Semi-structured interviews were carried out with four women who had been diagnosed with, and were undergoing treatment for, an eating disorder. Verbatim transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were, "I'm always questioning, who am I?": 'Experiencing a fragile sense of self'; 'The influences of others on self perception'; "Just made me feel better about myself": 'Strategies employed to manage the sense of self'; and "I can't rise above my childhood": 'The enduring influence of early experiences on self'. A description of these master themes and the related subordinate themes is presented. Conclusion: The results of the analysis are considered in light of existing theory and their clinical implications.

Aim: The study aims to explore, in-depth, South Asian bilingual clinical psychologists personal and clinical experiences of conceptualising emotional distress in first and second language. It is hoped that a clearer understanding of these experiences will help emphasise the role of language in the experience of emotional distress, which may be beneficial for working with clients that make sense of emotional distress in multiple languages. An understanding of these processes may also encourage further exploration and critique of the ways in which western psychological models are used to make sense of emotional distress, given many, if not all have been constructed using English language. Method: A qualitative approach was used for this study. Semi-structured interviews were conducted with six South Asian, bilingual clinical psychologists working in NHS services. The resulting data was analysed using interpretative phenomenological analysis (IPA). Results: The analysis highlighted four main themes emerging from participant accounts of conceptualising emotional distress in multiple languages. These were: “Worlds apart in culture and language”, “Oscillating self in language”, Ubiquity of English language and values” and “Challenging and managing difference”. Implications: Whilst much has been written about race and cultural issues in the context of clinical psychology, relatively little attention has been given to the experience and impact of multiple languages on the conceptualisation and experience of emotional distress. A major implication is first language conceptualizations are rarely considered in the development of psychological models of emotional distress, nor are they explicitly considered in the way clinical psychologists are trained and in the majority of current clinical practice guidelines. Participant accounts are dicussed in the wider historical context of psychology, anthropology and sociolinguistics informing further discussions on bilingualism and current psychological practice and theorising.

Paper 1: Evidence suggests that Nurture Groups (NGs) are effective in helping children with social, emotional and behavioural difficulties. NGs recognise the importance of parental involvement and research reveals positive social and emotional outcomes for children when NGs collaborate with parents as respected partners. An implicit power imbalance between NG staff and parents can challenge parental collaboration. This aim of this paper is to explore processes when consistent nurturing principles are being developed between a NG, schools and home. This qualitative study was conducted in a NG in the south west of England and included 3 NG staff, 4 parents, 4 children and a school teacher. An action-research model enabled consultation meetings and VIG to be introduced as an intervention to develop consistent practices. Semi-structured interviews, consultation meetings and a research diary collected data and an interpretative approach was adopted to explore processes, experiences and perceptions shared by participants. Interpretative Phenomenological Analysis was used to analyse and interpret the data and produce a set of themes. The importance of effective communication, building of relationships and sharing of practice/ collaboration were identified as significant themes when developing partnership working between settings. VIG enhanced parents’ and the teacher’s communication skills and concurred with a partnership model based on empowerment, solutions and respect. Recommendations for practice include the development of personalised, informal and formal communication systems between settings. VIG can also be used effectively within NGs to develop consistent nurturing practices between settings. In addition, consideration is given to how VIG can be applied to practice more globally and how local authorities can support this process. Abstract: Paper 2 Evidence suggests that Nurture Groups (NGs) are effective in helping children with social, emotional and behavioural difficulties. The importance of parental involvement is recognised within NGs and research reveals positive social and emotional outcomes for children when NGs collaborate with parents as respected partners. An implicit power imbalance between NG staff and parents can challenge parental collaboration. This aim of this paper is to evaluate outcomes when nurturing principles are consistent between a NG, schools and home. A mixed methodology design with interpretative and scientific approaches was employed in an area NG in the south west of England. An action-research model enabled consultation meetings and Video Interactive Guidance (VIG) to be introduced as an intervention to develop consistent practices for the experimental group. Quantitative outcomes from Boxall Profiles and Strengths and Difficulties Questionnaires (SDQs) are compared pre- and post-intervention for an experimental group (4 children and 4 parents) and a control group (4 children). Three NG staff also volunteered as participants. Qualitative measures (observation records, semi-structured interviews (SSIs), consultation meetings and VIG clips) measured outcomes for the experimental group. Data from the Boxall Profiles, SDQs, VIG clips and observations was analysed descriptively. Interpretative Phenomenological Analysis was used to analyse emergent themes from the SSIs and consultation meetings. The results revealed the experimental group made greater gains post-intervention as measured by the SDQ and the control group made greater gains post-intervention as measured by the Boxall Profile. The majority of results for individual experimental group children revealed positive social and emotional outcomes post-intervention. It is difficult to draw conclusions when outcomes between the experimental and control group were compared. The majority of measures identified positive social, emotional and behavioural outcomes for experimental group children when parents and schools work collaboratively with NGs. VIG and sharing of practices helped to modify how parents and teachers understood, managed, communicated and related to children. Recommendations for practice discuss the development of personalised, informal and formal communication systems between settings while ensuring minimal anxiety for children. VIG can be used effectively within NGs to develop consistent nurturing practices between settings. Consideration is given to how VIG can be applied more broadly and how local authorities can support this process.

Neuroscience is increasingly part of the national dialogue regarding mental health. The field of interpersonal neurobiology may offer a framework for helping mental health professionals identify and apply the most relevant neuroscience principles to counseling. This study explored mental health professionals’ experiences learning IPNB. I conducted semi-structured interviews with participants (n = 6), all of whom were licensed mental health professionals and had completed a year-long study in the application of IPNB through Nurturing the Heart with the Brain in Mind. I analyzed the data, along with a research partner, according to interpretative phenomenological analysis (IPA) protocol. Four super-ordinate themes emerged from the analysis: (1) learning process as dynamic and engaging, (2) deepening knowledge and understanding of self and others, (3) personal and professional growth, and (4) impact on therapeutic practice. A number of sub-ordinate themes also emerged through the analysis , including experiential learning; learning through group process; influence of the past on the present; increased understanding of the change process; increased compassion, empathy, and acceptance for self and for others; increased confidence; using IPNB to educate clients; using IPNB to conceptualize clients; and using IPNB to select interventions. Finally, I identified three higher-order constructs that appeared embedded within and across themes: learning as ongoing, person of the participant, and person of the instructor. The findings in this study suggest that participants’ learning of IPNB had a significant impact on their personal and professional development, specifically in areas related to characteristics of effective counselors. The findings also suggest that these meaningful changes occurred in a learning environment characterized by emotional engagement, experiential activities, and group process. Limitations to this research, as well as further discussion of the results are included. Implications for future research, clinical practice, and counselor education are also offered.