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Robins, Jenny. "Counselling psychology in a changing National Health Service." Thesis, City University London, 2014. http://openaccess.city.ac.uk/3701/.
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Aim: Within the field of obesity, evidence shows that weight regain following weight loss is extremely common, demonstrating that weight loss treatments are not effective. Considering that attachment history influences a person’s capacity for emotional regulation and that some people use food to self-soothe, increasing our understanding of the relationship between attachment style and obesity might inform better treatments. This study is comprised of two parts: the first part investigates whether attachment style predicts outcome in a 12-session group treatment for obesity and the second part explores the experience of that treatment. Design: The study utilises a mixed methods design with participants from a group treatment for obesity which comprises: the Attachment Style Questionniare (ASQ), completed by 52 group members, along with their body mass index (BMI) measures at the start and end of the treatment, analysed using a backwards multiple regression to test whether the 5 dimensions of the ASQ can predict participants’ change in BMI; and semi-structured interviews with 7 people from the same treatment analysed according to Interpretative Phenomenological Analysis (IPA) guidelines. Method: Data was collected from 52 people attending group treatment for obesity with an NHS service in South East England, which included the ASQ and BMI measures at Week 1 and Week 12 of treatment. The change in BMI was entered as the dependent variable for the regression in SPSS and the five attachment dimensions were entered as predictors. 7 people who had taken part in Part I of this research participated in interviews about their group experience. Transcripts were subjected to IPA. Results: Quantitative findings produced a model in which the ASQ dimension Confidence (in relationships) significantly predicted change in BMI in a negative direction (i.e. the participants who scored higher on Confidence lost less weight than those with lower scores). Confidence explained 8% of the variance (R2=0.08, F(1,50)=4.32, p<0.05). Qualitative findings produced four super-ordinate themes which included: the sadness at the course ending; the support and comfort felt from others in the group experience; the positive aspects of the group treatment; and the negative aspects of the group treatment. Other group members appeared to have a substantial impact on participants, whether positive or negative. Some accounts reflected the importance of others in feeling accepted and supported. Other accounts conveyed less of an emphasis on feeling part of the group and more on feeling separate. Conclusions: The quantitative results are inconclusive and possible reasons for this are discussed. The qualitative findings suggest that it is likely that group intervention for obesity could be improved by attention to attachment and by tailoring treatments more specifically to individuals.
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Casey, Kathleen Barbara. "HIV counselling, mental health and psychosocial care in Thailand." School of Psychology - Faculty of Health and Behavioural Sciences, 2007. http://ro.uow.edu.au/theses/73.
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Rationale: International research has demonstrated that in order to retain a skilled and healthy cadre of willing health-workers there is a need to monitor and develop strategies to mitigate adverse impact of this work and improve the quality and effectiveness of client and patient mental health care. Aims: (i) Monitor and evaluate Thailand’s national HIV mental health and psychosocial care program. (ii) Measure the impact of HIV mental and psychological care on health care providers. (iii) Examine the relationship between occupation-related psychological morbidity and the recruitment, training, clinical supervision and work-practices of HIV mental health service providers. (iv) Develop, implement and evaluate a training curriculum that addresses the demands of the HIV client population in Thailand. Method: In Study 1, 826 government hospitals, 1000 government health centres, and 1135 non-government organisations and private providers participated in: semi-structured, key informant interviews; focussed group discussions; and criterion-referenced appraisals of health policy and service delivery. Study 2, a small exploratory, qualitative study, utilised a schema of five key stressors commonly associated with HIV care to analyse responses gained from HIV counsellors and employed semi-structured interviews and focussed discussion groups. Study 3, a cross-sectional study, explored the relationship between training, work practices, Locus of Control of Behaviour and the self-reporting of signs and symptoms of psychological distress. 803 HIV counsellors completed a series of questionnaires including the Thai version of the General Health Questionnaire (GHQ-28), the Locus of Control of Behaviour Questionnaire and the Thai HIV Counsellors Survey (THCS). Study 4 involved the development, delivery and evaluation of a series of short courses designed to train 79 health workers to provide HIV counselling. The training was evaluated by pre and post knowledge examinations and anonymous evaluations. Results: Study 1 found that policy and legislation failed to adequately guide the practitioner in a number of key areas including: testing and counselling of minors; testing without informed consent; confidentiality of medical records and disclosure of HIV status; and “duty of care” in terms of threatened suicide or harm to others. Furthermore, it was found that epidemiological data had not been adequately considered in terms of providing specific psychological support services, and developing counselling curriculum, and that the conduct of Thai based psychological and operations research had been limited. Whilst there was good national coverage of HIV testing counselling services, psychological services to address HIV issues across the disease continuum were limited and frequently provided by individuals without adequate training. There does not appear to be any systematic mechanism for monitoring and evaluating HIV mental health and psychosocial care. This study also revealed that Thailand is limited in its ability to provide adequate HIV field-experienced, trained mental health care personnel who can teach in the necessary languages that would enable sharing of the Thai health sector experience within the region. Study 2: The respondents identified a number of workplace stressors including: fear of contagion; client-professional boundary issues; difficulties with being identified as working in the sphere of a highly stigmatised disease; the experience of multiple losses, in a context of perceived inadequate training; role expansion; and perceived lack of recognition and reward. Participants also identified a number of work and socio-cultural influences which were perceived to mitigate the impact of the work. Study 3: Failure to take up counselling duties after training was primarily associated with counsellors having too many competing non-counselling duties (31.2%; n=108), and being deployed to other workplaces in a non-counselling capacity (22.8%,n=79). Over 81% (n=441) of respondents who indicated that they were continuing to work as counsellors reported signs and symptoms of psychological disturbance on the GHQ-28 screening at a level that warranted further mental health assessment. There was a significant positive correlation between GHQ-28 “caseness” and Locus of Control of Behaviour scores (r =.118; p<.001). Decisions to leave counselling were positively associated with self reported psychological disturbance (r =.324; p<.001) and the perception that their work was not helpful to clients (r =.108; p<.001). Study 4: The results clearly showed that the curriculum, and method of training resulted in both perceived and measured change in knowledge and skills and were reported to have resulted in improvements in the trainees’ perceived self confidence to meet the demands of their clients. Conclusion: The studies identified the many challenges inherent in providing effective HIV counselling, mental health and psychosocial services in Thailand. This research suggests that delivering HIV psychosocial care services in Thailand has potentially an adverse impact on: the health and well being of care providers; the quality of care received by clients and patients; and ultimately on the ability of the health system to retain its skilled personnel.
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Davison, Elizabeth. "The wounded healer : clinical and counselling psychologists with experience of mental health problems." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12535/.
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This study aimed to explore how the experience of previous mental-health problems affects clinical and counselling psychologists’ approach to practice. Semi-structured interviews were conducted with six clinical and four counselling psychologists who had experienced mental-health difficulties. Data was analysed using Interpretative Phenomenological Analysis. Analysis of the interviews highlighted five master themes: Use of the personal-self of psychologist; Ambivalence; Identity as a psychologist; Psychologists as agent of change; and Finding meaning in suffering. The results of this research showed that psychologists with a history of mental-health problems actively draw upon their experience. In managing their dual identity of service-user and professional, they reported a degree of ambivalence which influenced the way that they viewed themselves and their practice. Their personal experiences seemed to be closely tied up with their professional-identity, which either conflicted with their sense of self or complemented it through highlighting how fortunate they were compared to others. The interviews frequently highlighted how psychologists’ experiences can provide an impetus to speak out for patients’ rights to ensure that they are treated with respect and dignity. A number of psychologists with an experience of mental-health difficulties felt that they might not have pursued their career had they not had previous mental-health difficulties. There appeared to be mixed findings concerning whether the participants felt that their mental-health difficulties had helped or hindered their practice.
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Smoczynski, Eva. "Indian Cross-Cultural Counselling : Implications of practicing counselling in urban Karnataka with Western counselling methods." Thesis, Ersta Sköndal högskola, Institutionen för socialvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1784.
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This study presents how Indian counsellors in urban India work with Western counselling methods with Indian clients. The study is categorised as part of the cross-cultural counselling research field where a major assumption is that counselling methods are part universal, part contextual. This study explores how counsellors in Bangalore culturally adapt Western methods. The method used is qualitative semi-structured interviews with seven counsellors at Parivarthan Counselling, Training and Research Centre in Bangalore. The theoretical framework in this study is based on New Institutional Theory, with constructs such as Glocalisation, Translation, and finally Cultural Preparedness to understand the context of the counselling profession in Bangalore. Results show that the Bangalore counsellors meet clients that are culturally prepared for short-term and advice-oriented counselling. The clients are part of a context where family and spirituality are of great importance. The counsellors use Western counselling methods only but adapt their approach and language with indigenous elements and emphasise the individuality of each client. They use a person-centred and an integrative approach, in which they are informed by several Western counselling methods, but do not use them dogmatically. The individuals’ needs and the relationship between counsellor and client is emphasised. Parivarthan Counselling, Training and Research Centre is part of a complex organisational field with influences from India, the East as well as from the West.
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Drevenhorn, Eva. "Counselling patients with hypertension at health centers : a nursing perspective /." Göteborg : Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, 2006. http://hdl.handle.net/2077/713.
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Otoo, Grace. "Understanding primary health care counselling through a multi-method approach." Thesis, Manchester Metropolitan University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368882.
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Corbett, Patrick. "Adolescents' experience of receiving help from a mental health service : a grounded theory approach." Thesis, University of Surrey, 1999. http://epubs.surrey.ac.uk/620/.
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Broglia, Emma L. "Embedded counselling in student mental health : development of a feasibility trial." Thesis, University of Sheffield, 2017. http://etheses.whiterose.ac.uk/20032/.
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Ingram, Clair. "Perceptions of health-related quality of life among adults living with sickle cell disease in Cape Town, South Africa." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/27841.
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Sickle cell disease (SCD) is a chronic, heritable blood disorder with affected individuals suffering from debilitating health issues and requiring frequent hospitalisation. SCD is highly prevalent in areas of the world where malaria is endemic and specifically in Sub-Saharan African (SSA) region from where a number of migrants flee to South Africa. This has resulted in increased numbers of SCD patients in the South African healthcare system requiring holistic treatment and care, and ultimately improvement of their health-related quality of life (HRQL). There is limited empirical information on issues related to HRQL in SCD in Africa, with none available on adults living with SCD in South Africa. For this reason, this study was carried out with the aim of qualitatively exploring the perceptions of HRQL in adult SCD patients at Groote Schuur Hospital in Cape Town. Participants were selected from Groote Schuur Hospital, a tertiary referral hospital in Cape Town, South Africa using a purposive sampling method. Participants were asked about how their condition affected physical and psychological functioning, effects of their health on relationships and social issues such as education and employment opportunities as well as discrimination. Perceptions of access to and satisfaction with healthcare, coping strategies and independent living skills were also explored. The data collected for this study were analysed using the framework approach and thematic content analyses methods. Results suggest that participants believed their functioning was affected by the constant and unpredictable nature of SCD clinical events, and this was seen to have social, financial and psychological implications. Environmental factors such as weather, activity and psychological state had significant impact on participants' health, with pain being a common complication of the condition often making coping with the condition difficult. Participants also experienced health-related discrimination and stigma in personal and social relationships and within the workplace often with negative emotional consequences. Both the positive and negative experiences with healthcare were also described. Participants found ways to cope with their condition but it appeared that SCD had more of a negative overall impact on various domains of HRQL for participants. Insights in to the impact of SCD on adult patients is important to allow for healthcare professionals to better understand patient needs and to implement more effective coping and self-management strategies appropriate for their patients. It also allows for genetic counselling services to be better tailored to addressing the concerns and needs of patients to provide better educational and psychosocial support.
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Cheeseman, Mark John. "Is staff counselling an effective intervention in employee distress? : an investigation of two employee counselling services in the National Health Service." Thesis, University of Sheffield, 1996. http://etheses.whiterose.ac.uk/10200/.
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A number of broad questions were addressed (a) Is counselling effective?, (b) Are post-counselling gains maintained at follow-up? (c) Does the sgape of change across counselling sessions adhere to the 'dose-effect' model?, (d) Do measures of distress and interpersonal problems differ in the extent of pre-post change? and (e) Are there any within-group differences in the extent of pre-post change on measures?, (f) A further aim of the study was to collect qualitative accounts of the intervention from clients, to build up a 'picture' of clients experiences of service use: To obtain a consumers point of view. The study took place at two sites, one in London, the second in the Midlands. A prepost-follow-up design was adopted. In addition, measures were completed for each session of counselling. Finally, clients also completed an evaluation questionnaire. Hypotheses were, generally, supported by analyses. There were substantial pre-post reductions on measures of distress and interpersonal problems, which were maintained at follow-up. Significant reductions on measures across sessions of counselling were observed, with change curves adhering to the 'dose-effect' model. Qualitative analyses built-up a picture of the rationale for service use and the costs and benefits that clients perceived from counselling. Discussion focused on a number of issues: The first, the difference between the reported study and the bulk of psychotherapeutic studies, secondly, the methodological and practical issues that arose during the study and, thirdly, the need to approach applied counselling research from a new perspective, that is less dependent on the techniques developed by efficacy studies.
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Ferris, Helen. "Surviving and thriving in work with mental health conditions : refocusing counselling psychology?" Thesis, City University London, 2014. http://openaccess.city.ac.uk/14165/.
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Background and Aim: Mental health costs UK businesses billions of pounds each year through high levels of absence and presenteeism. Despite improved interventions around enabling people with mental health conditions back into and remaining in work through Supported Employment, the figures around retention are discouraging. People with mental health conditions see employment as a sign of recovery and clinicians also support returning to work as an important step in development. Research has largely focused on trying to improve the employment rates of people with mental health conditions who have already accessed mental health services. However, there are many people in employment who are struggling with poor mental health who have chosen not to disclose to their employer about their condition, leading to issues around presenteeism. This study therefore focuses on developing psychological interventions for people struggling in work, who may not access Supported Employment services. Method: Four participants took part in a collaborative action research process over four group sessions. Participants were co-researchers in the process, where the group worked to identify and test out interventions that might improve managing mental health conditions at work. The transcripts were then analysed using constructivist grounded theory to develop an overarching model. Results: The model proposed highlights the role of the individual and the organisation in improving the management of mental health conditions at work, facilitated by the line management relationship. The model suggests that individuals could improve their own mental health by developing their self-awareness, work-life balance, mindfulness practice and aligning job choice with personal values. The organisation could further work on establishing a culture and physical environment centred on well-being to support individuals through line management relationships. Discussion: Counselling Psychologists could play an important role in developing interventions around retention and also champion piloting mental health support groups in work to enable sustained change.
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Lamproukou, Markella. "The experience of chartered counselling psychologists working within the NHS, where the counselling psychology philosophy meets with the medical model : a phenomenological inquiry." Thesis, Regent's University, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.646086.
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Counselling psychology springs from humanistic and existential/phenomenological values arguing for the need to see human beings in a holistic manner. This value system is a move towards well-being rather than pathology and sickness. The philosophical underpinning of counselling psychology gives a unique identity to the profession, raising different questions for counselling psychologists’ working within NHS settings, which is governed by the medical model. At a time that our profession faces enormous challenges and questions about its future, this study explored the experience of seven chartered counselling psychologists working within different NHS settings using the Interpretative Phenomenological Analysis (IPA) method.︣The analysis of the study revealed six major themes: (1)The process of creating a therapeutic identity; (2) Valuing the counselling psychology founding principles in practice; (3) Working within the medical model;(4) Experiencing tensions: the power of the context; (5) Dealing with the tensions; (6) Current changes and the future of counselling psychology in the NHS.︣The results showed in greater detail that the participants held a strong therapeutic identity; practiced in accordance with the counselling psychology values; experienced different tensions while working within the NHS, but have found different ways to deal with these tensions, including holding a pluralistic stance, assimilating the medical model with their own value base system and prioritizing the clients’ needs over the NHS guidelines. Lastly, the analysis indicated that the recent changes have contributed additional feelings of anxiety and uncertainty to the participants regarding the future of the profession.
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Barlow, Robyn Amy. "Exploring the Experiences and Perceptions of Individuals who have Completed the Discovery Health Family History Tool, and how the Personalised Report has Impacted their Lives." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33670.
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Since the completion of the Human Genome Project in 2003, the focus of genomic medicine has expanded to include the more common chronic diseases which are now understood to be multifactorial in origin. These diseases show strong familial clustering, as family members share both genetic and non-genetic risk factors, and therefore a positive family history is considered a risk factor for these diseases. Although a 3-generation pedigree is considered the gold standard for the collection of family health history (FHH) information and the stratification of disease risk, it is underutilised in health care due to various practitioner and patient barriers. Electronic patient-facing tools have been designed to interrogate FHH, with the capability of stratifying disease risks and making management and intervention recommendations, as an effective way of overcoming some of these barriers. Through the identification of at-risk individuals and targeted interventions, the hope is individuals will be more compliant and these programmes will be more effective than standardised health messages. Discovery Health introduced a FHH tool in April 2017, called MyFamilyHistory, to promote disease prevention and future wellness in its members. The tool estimates and reports on an individual's FHH-related lifetime risk for seven chronic diseases and makes recommendations to manage those risks. There is some evidence that FHH tools and personalised risk stratifications do result in screening uptake but only a few studies have looked at the effectiveness of FHH tools at achieving behaviour change and promoting a healthy lifestyle. Additionally, there are limited studies that have looked at the perceptions of the patients who have completed these FHH tools. This study therefore aimed to explore the experiences and perceptions of individuals who have completed Discovery Health's MyFamilyHistory tool, and how the personalised report has impacted their lives. This qualitative study drew on the principles of phenomenology and twelve participants were recruited through purposive sampling. They were recruited from the pool of individuals who had completed the MyFamilyHistory tool in 2019 and were recruited once they had contacted the researcher in response to a participation invitation sent out by Discovery Health. The data was collected through semi-structured, video interviews and thematic analysis was used to analyse the data. Five themes were identified from the data, namely: 1) Patient-Facing Tool, 2) Health Awareness, 3) Trust, 4) Hope for the Future, and 5) Achieving Change. It was found that the MyFamilyHistory tool is user-friendly and relatively easy-to-use and that the risks and recommendations were presented in a way that was easy to understand. The tool provided an improved health awareness and drew attention to risk factors including FHH. Benefits highlighted included it being a tool that promoted both health education and health communication, however the biggest challenge experienced was the lack of post-completion support and follow-up. Behaviour change was linked to the individuals perceived risk, rather than the risk generated by the tool, which is affected by various personal and environmental factors and furthermore was greatly influenced by the individual's health literacy level. Therefore, varying degrees of behaviour change were noted. This study highlights the important role that FHH tools have in health awareness and education as well as the importance of health literacy in achieving a healthier population. It also provides support for the role of health literacy in risk perception and how a less than optimum health literacy not only limits health awareness but also prevents proactive measures from being taken and impedes the health decision-making process. The findings of this study are likely to inform the implementation of personalised, preventative medicine and its role as an alternative and/or a complementary method to achieving health behaviour change. Additionally, the results can be used by Discovery Health, not only to improve their own tool but also to improve the service they offer to their members and the effectiveness thereof.
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Mathoothe, Kesego Duduetsang. "Factors that develop a sense of empowerment : the experiences of community health workers." Diss., University of Pretoria, 2019. http://hdl.handle.net/2263/72420.
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The introduction of community health workers has become important to the delivery healthcare services to communities. Thus, their role and impact on the well-being of the communities they serve as well as their own, has been of interest to researchers. Consequently, one of the themes among literature on community health workers, is on the challenges that they face, including disempowerment. Empowerment is a construct common to community psychology. From the available literature on community health workers, it is unclear what makes them feel empowered. To date, scant South African research is available that could shed light on the factors that develop community health workers’ sense of empowerment. To assist in filling this void, this qualitative study was conducted to explore, through their experiences, the factors that develop community health worker’s sense of empowerment. Data was collected through individual semi-structured interviews with four participants selected through purposive sampling. Experiential thematic analysis was used to identify themes in the data. Five main themes reflected the factors the participants regarded as empowering: their individual factors; their opportunity to acquire new skills, knowledge, and information; having effective support systems; the interactions between them and their community; and factors from their organisations. These findings were noteworthy and have implications for organisations employing CHWs, community psychologists, and other professions that work closely with CHWs.Mini Dissertation (MA)--University of Pretoria, 2019.
Psychology
MA
Unrestricted
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Malan, Johanna Elizabeth. "The development, implementation and evaluation of a training intervention for primary health care providers on brief behaviour change counselling, and assessment of the provider’s competency in delivering this counselling intervention." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97977.
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Thesis (PhD)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Unhealthy behaviour is a key modifiable factor that underlies much of the South African (SA) burden of disease and primary care morbidity. Chronic diseases such as heart disease, type 2 diabetes, lung diseases and some cancers are linked to underlying behavioural issues such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy eating. Evidence shows that brief behaviour change counselling by primary care providers can be effective in helping patients to change risky lifestyle behaviours. However, the capacity of South African primary care providers to educate and counsel patients on lifestyle modification is generally poor. The need for primary care provider training in lifestyle counselling, is stated as a critical objective in ‘re-orientating’ the primary health care system to effectively address NCDs in the National Strategic Plan for the Prevention and Control of NCDs and their risk factors in SA. The overall aim of this research was to develop, implement and evaluate the effectiveness of a training intervention for primary care providers in the South African setting, which is based on teaching best practice, behaviour change counselling (BBCC) methods that can be used for patients with risky lifestyle behaviours associated with non-communicable diseases (NCDs). “Effectiveness” relates to the effect of the training on PCPs adoption of a patient centred approach, and skills acquisition after the training, and not the effectiveness in changing, or improving patient outcomes. The sequence of the abstracts of the four articles that were published from this research, gives an overview of the process.
AFRIKAANSE OPSOMMING: Ongesonde lewenstyl kan gekoppel word aan die meeste chroniese siektes wereldwyd, en dra grootliks by tot die las van primere sorg morbiditeit, asook in Suid Afrika. Rook, ongesonde dieet, fisiese onaktiwiteit, en alkohol misbruik word beskou as die onderliggende risiko faktore wat verantwoordelik is vir die ontwikkeling van kardiovaskulere siektes, tipe 2 diabetes, respiratoriese siektes, sowel as sommige kankers. Navorsing het bewys dat primere gesondheidsorg werkers effektief kan wees om pasiente te help om hierdie gewoontes te bekamp. Nieteenstaande hierdie bewyse, is die huidige kapasiteit van primere sorg dokters en verpleegsters in Suid-Afrika nie voldoende om sodanige diens te verskaf nie. In die Nationale Strategiese Plan vir die beheer van chroniese siektes, word opleiding vir primere gesondheidsorg werkers geprioritiseer as n kritiese uitkomste vir die beheer van chroniese siektes, en die onderliggende risiko faktore. Dit is dus duidelik dat daar n behoefte is om sodanige opleidingprogramme te ontwikkel. Die doel van hierdie navorsing was om n bewysgebaseerde opleidingsprogram te ontwikkel, te implementeer, en die effektiwiteit daarvan te evalueer in ons unieke primere gesondheidsorg sisteem in Suid-Afrika. Die opleidingsprogram moes ontwikkel word, vir beide primere sorg dokters en verpleegsters, sodat dit hulle in staat kan stel om pasiente te beraad oor enige van die vier risiko faktore.
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Torekull, Lisa. "Service design to improve the contraceptive counselling at youth centers." Thesis, KTH, Medieteknik och interaktionsdesign, MID, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-231840.
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Sweden has a high rate of unintended pregnancies (UP) despite being a rather open society regarding sexual health education. New technology provides new possibilities to improve access by providing contraceptive consultations online, but will that lower the rate of UP? Very few studies have been done on the people working with the young women to find out what can be done to improve the quality of the contraceptive counseling. That is why this study involved two midwives practicing at a youth center at an early stage of the design process. Cultural Probes was used as method to better understand what needs midwives experience in their daily work. Three key findings stating the needs of the midwives were knowledge, missed appointments and trust. In addition, a service evaluation was done to investigate when and how midwives and young women interact. Making the contraceptive consultations available online with a digital care provider would make it more accessible for the young women and the results of this study do not contradict that hypothesis. However, availability is not the sole influencing factor on contraceptive usage. This study shows that encouragement for young women to seek general knowledge and information about contraceptives prior to the consultation is an important factor in order to improve the quality of contraceptive counselling.Trots Sveriges relativt öppna samhälle gällande sex och sexualundervisning så har vi en väldigt hög frekvens av oönskade graviditeter. Ny teknik möjliggör att hålla preventivmedel konsultationer online vilket leder bättre tillgänglighet, men frågan är om det räcker för att sänka frekvensen oönskade graviditeter? Väldigt få studier har gjort på barnmorskorna som jobbar med de unga kvinnorna för att får reda på vad mer som kan göras för att höja kvaliteten på preventivmedelsrådgivningen. Därför har denna studie, i ett tidigt stadie av designprocessen, involverat två barnmorskor praktiserande på en ungdomsmottagning. Cultural Probes användes som metod för att bättre förstå vilka behov barnmorskor upplever i deras dagliga arbete. Det främsta resultatet summeras i tre teman: kunskap, missade besök och förtroende. Dessutom utfördes en serviceutvärdering av hela kundresan för att ta reda på när och hur barnmorskor och unga kvinnor interagerar. Genom att möjliggöra preventivmedelsrådgivning online genom digital vård så skulle tillgängligheten förbättras för de unga kvinnorna och denna hypotes är inget som denna studie motsätter sig. Men tillgänglighet är inte den enda faktorn som påverkar användandet av preventivmedel. Denna studie visar att uppmuntran till att få unga kvinnor att söka kunskap och information om preventivmedel innan själva besöket är en viktig del som skulle kunna förbättra kvaliteten på preventivmedelsrådgivningen
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Lawrence, Estelle. "School-based HIV counselling and testing: providing a youth friendly service." University of the Western Cape, 2012. http://hdl.handle.net/11394/2159.
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Philosophiae Doctor - PhDHIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. Thereare still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners’ behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and confidentiality addressed; they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place; they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of ‘mass testing’ used by the NGO did not fulfil learners’ expressed need for privacy with regards to HCT. Service providers were friendly and on-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of learners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for proving youth friendly school based HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.
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Hedley, Andrew M. "How do counselling psychology trainees experience working with CBT in their placements?" Thesis, London Metropolitan University, 2018. http://repository.londonmet.ac.uk/3535/.
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Rationale: This study set out to provide an open investigation into how trainee counselling psychologists in the UK experience working with cognitive behavioural therapy (CBT) in their placements. Research and commentary by qualified and trainee counselling psychologists have expressed some concern about how well the profession’s values are upheld when they are working with CBT within the NHS and IAPT settings. However, it is unclear how widely these concerns are shared amongst counselling psychologists the majority of whom work in the NHS. Furthermore, the relevance of these concerns to trainees who may work with CBT in a wide range of other clinical settings within the public, charitable, and private sector was uncertain. Method: Interpretative phenomenological analysis was used to explore six final-year trainee counselling psychologists’ lived experience of working with CBT in their placements. Data was collected through semi-structured interviews via Skype. Findings: It uncovered three interconnected superordinate themes: (i) Pure CBT work vs. integration (ii) CBT conflicts with counselling psychology’s values, and (iii) Deconstructing & assimilating CBT. These findings were interpreted and discussed in relation to the existing literature. The key finding was that the participants’ belief in professional values often led them to feel frustrated with their work in CBT placements and with supervisors that expected them to only work with CBT as a stand-alone-approach. In this regard, the participants’ primary training in person-centred therapy or psychodynamic therapy and their preference for integrative approaches was deemed significant. The dissatisfaction reported by the participants concerning their CBT experiences was largely consistent with previous studies. The methodological limitations of the study are discussed and recommendations are made for further research to investigate the extent of these concerns and what could be done to address them.
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Maillard, Annie. "Beliefs held in counselling psychology regarding secondary mental health care provision : reflections from 1998." Thesis, City University London, 2006. http://openaccess.city.ac.uk/8463/.
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The thesis is an historical record of the beliefs held within the division of counselling psychology at the time of the data collection in November 1998. The broad area of interest is the provision of psychological services by counselling psychologists to individuals who have enduring mental health problems. This research topic was chosen for its personal relevance to the researcher, who at the time was employed as the sole psychologist within a CMHT. The researcher provided psychological therapy to individuals with enduring mental health problems as well as indirect psychological services to other members of the CMHT - supervision, training and liaison with other professionals providing care to service users. The following sections, and the items within them were included because of their relevance to, and association with, the research topic. They also provide the context for understanding the social, political and professional dimensions of the research findings.
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Armstrong, Joseph. "Paraprofessional counselling : the effectiveness and development of a group of volunteer mental health counsellors." Thesis, Abertay University, 2011. https://rke.abertay.ac.uk/en/studentTheses/95f33703-09b3-4504-ac1b-abdf1c1cbbf1.
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Background: Existing research findings provide evidence for the general effectiveness of paraprofessional counsellors. However, research into the effectiveness of paraprofessional counsellors with specific client opulations is lacking, and we currently know little about the processes of development in this group of practitioners. To address these issues, two empirical studies were carried out. Aim of Study 1: To evaluate the effectiveness of a group of 12 minimally trained/experienced volunteer mental health counsellors. Method: Data were collected over a one year period on 118 clients referred to a voluntary sector counselling agency. The CORE-OM was used to measure clients' levels of distress on a sessionby-session basis. Clients and counsellors also completed a range of additional selfreport measures before and after counselling. A benchmarking strategy was used to evaluate the outcomes achieved by participants in this study against three benchmark studies selected from published literature. Results: Paraprofessionals in this study achieved an effect size of .70 compared to effect sizes of 1.36, 1.39 and 1.42 in the selected benchmark studies. Conclusions: Minimally trained/experienced paraprofessional counsellors working in mental health settings may benefit from more targeted training before engaging in practice. Findings should be interpreted cautiously as the selected benchmarks may not reflect the organisational factors operating within all voluntary sector counselling agencies. Aims of Study 2: To explore the meaning and experience of becoming a paraprofessional counsellor. Participants: The sample included two men and six women. Method: Each participant was interviewed for approximately one hour at the end of their first year of practice. Data analysis: Data were analysed using a grounded theory approach. Results: Four main categories and a core category were identified. The core category of ‘finding a voice’ represented participant attempts to achieve and sustain an identity as a counsellor. This process involved four related experiences: 1) resonating with counselling and the role of counsellor, the agency ethos and values and the theoretical model employed within the agency; 2) learning the language of counselling; 3) putting the language of counselling into action; and 4) experiencing and resolving dissonant experiences. Conclusions: Findings contribute new understanding to existing models of counsellor development regarding the developmental processes that occur in counsellors prior to the period of professional training. Data from Study 1 and Study 2 were also examined to determine if individual differences existed among participants in terms of their effectiveness, personal philosophies, and counselling practice. Findings showed that counsellors varied in their effectiveness with effect sizes ranging from .96 for the more effective counsellor to .21 for the least effective counsellor. Differences in levels of effectiveness were most apparent at the extremes of the three more effective and the three less effective counsellors. Preliminary findings suggested that the more effective counsellors could be distinguished from the less effective counsellors by the emphasis they placed on the relational aspects of counselling, flexibility, working collaboratively with clients, and by the degree of ‘fit’ that existed between their personal philosophy and the model of counselling preferred with the MHSS agency. Implications of these findings are discussed in section 7.4 of Chapter 7.
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Glasheen, Kevin John. "Can synchronous online counselling increase uptake of counselling services in secondary schools and what can promote or inhibit implementation?" Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/79629/1/Kevin_Glasheen_Thesis.pdf.
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This research showed that online counselling has the potential to increase the help-seeking of secondary school students - especially those who suffer from high levels of psychological distress. An investigation of why school counsellors are currently reluctant to provide an online counselling service identified a number of barriers to implementing such a potentially vital service. Response to focus groups and surveys completed by students and school counsellors indicated that more distressed students prefer to use online counselling and they would use it for sensitive topics. School counsellors remain concerned about effectiveness, ethical, legal and privacy issues as well as potential misuse of the service. Recommendations for implementation are made.
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Van, Wyk Sherine. "Locating a counselling internship within a community setting." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/49732.
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Thesis (MA) -- University of Stellenbosch, 2002.ENGLISH ABSTRACT: no abstract available
AFRIKAANSE OPSOMMING: Hierdie navorsing ondersoek die behoefte van Sielkunde as professie om meer sosiaal relevante en gepaste dienste vir al die mense van Suid-Afrika te lewer. Dit bespreek die kritiek teen tradisionele sielkunde en die dringende behoefte vir 'n meer kontekstuele benadering om the negatiewe sielkundige verskynsels in the samelewing te begryp en verklaar. Die waarde van Gemeenskapsielkunde om voorkomende, kuratiewe en bevorderende geestesgesondheidsdienste aan gemeenskappe te lewer, word ook ondersoek. Verskeie modelle van gemeenskapsielkunde en die voorgestelde integrasie van geestesgesondheidsdienste by Primere Gesondheid word bespreek. Die plasing van 'n voorligtingsielkunde internskap binne 'n gemeenskapsomgewing, naamlik, die Don en Pat Bilton Kliniek, Jamestown, word beskryf en qeevalueer.
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Seabrook, Marianne. "Exploring 'medically unexplained symptoms' with GPs and counselling psychologists : a Foucauldian discourse analysis." Thesis, London Metropolitan University, 2017. http://repository.londonmet.ac.uk/1216/.
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"Medically unexplained symptoms" or "MUS" has been constructed as a term to describe persistent physical symptoms for which no medical aetiology can be found. "MUS" account for at least 20 per cent of UK medical consultations, yet fit uneasily within a biomedical discourse where illness is legitimised by medical diagnosis. "MUS" supposedly operates as a neutral category, yet critical review of the literature problematises this so-called neutrality: it fails to be neutral whilst avoiding depicting the situation as it is. There is widespread conflict about terminology and aetiology, which results in the subjective creation of legitimacy criteria; disavowal of a psychological dimension; and patients receiving costly and ineffective treatment. This research, motivated by the need within this conflict to better understand the implications of how we talk about “MUS”, explores how practitioners are constructing “MUS”. Four semi-structured interviews with GPs and counselling psychologists were undertaken and analysed using Foucauldian Discourse Analysis. Alongside underlying biomedical discourses, discourses of separation, mindbody dualism, psychology and holism were identified. These contributed to various constructions of "MUS", including "MUS-as-choice", "MUS-as-challenge", "MUS-as-unreal", "MUS-as-placeless" and "MUS-as-untold-story". This research problematises the separation of illness into categories, the psychologisation of "MUS" and the lack of availability of an acceptable holistic discourse with which to construct illness. It emphasises the performative nature of our talk about "MUS" and the importance of discourse awareness for deepening our understanding of social and cultural influences on how we see the world and act within it. Exclusive biomedical and psychological constructions of illness displace "MUS" as legitimate illness and limit opportunities for constructive dialogue. As practitioners, we need to resist getting caught up in these frameworks. Suggestions are made for how practical disturbances of current working practices might be achieved.
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Hemmings, Adrian. "Counselling in primary care : is it as effective as routine treatment from GPs?" Thesis, University of Sussex, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.388974.
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Raphela, Ramadimetja Elsie. "Training of health care workers in adherence counselling for comprehensive care, management and treatment clinics." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6858.
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Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011.ENGLISH ABSTRACT: “Treatment failure, defaulter rate, patients lost to follow up”. These are the words usually spoken by health care workers at the CCMT clinics in the country. These are words that they try at all times to come with solutions to, without much success. Much as both the health care workers and patients know the importance of taking medication, often medication is not taken as required. Adherence is defined as the degree to which a patient follows a treatment regimen which has been designed in the context of a consultative partnership between the client and the health care worker. This obligation is comprehensive as it tends to examine all factors that can affect adherence. It includes characteristics such as the treatment regimen, the provider behaviour, social and environmental factors that may hinder adherence on the patient. There are several factors that lead to non-adherence to treatment. The factors may be classified as Biomedical, Psychological and Social factors. The major tool that can be used to address such issues is adequate training of all staff members working at the CCMT clinics. The researcher explored training needs and gaps at a CCMT site that will assist to combat problems of non-adherence to treatment. Health care works at an identified site where questioned on the level of training they have received and on what they need to improve their management of patients and adherence. It was realised that some categories of staff at the clinic do not receive training as expected and that others do not receive adequate training that will assist them in adherence counselling. Recommendations made by staff members were that training should be readily available to all staff members and that it should also be rolled out to other departments and sections within the hospital so there is continuum of care of HIV positive patients. Non adherence to antiretroviral treatment is a challenge faced by health care providers as well as patients themselves. It results in treatment failure, a decrease in the quality of life of the patient and an increase in morbidity and mobility. Non-adherence means any reason where the patient is not taking recommended doses, not sticking to the recommended time or not taking it in the recommended way.
AFRIKAANSE OPSOMMING: Navolging word gedefinieer as die mate waarop die pasiënt die behandeling wat voorgeskryf is in samewerking tussen die pasiënt en die gesondheidsorgwerker, nakom. Hierdie vepligting is omvattend omdat dit geneig is om alle faktore wat die nakoming kan beinvloed, ondersoek. Dit sluit eienskappe in soos die behandeling regimen, die verskaffersgedrag, sosiale en omgewingsfaktore wat ‘n struikelblok kan wees vir die nakoming van die pasiënt. Daar is verskeie faktore wat kan lei tot nie-nakoming van behandeling. Die faktore kan geklassifiseer word as bio-mediese, sielkundige en sosiale faktore. Die belangrike instrument wat gebruik word om sulke sake aan te spreek, is voldoende opleiding van alle personeellede wat by CCMT klinieke werk. Die navorser ondersoek opvoedkundige behoeftes en leemtes by ‘n CCMT perseel, wat sal help om probleme van nie-nakoming van behandeling sal bestry. Gesondheidsorgwerkers by ‘n geïdentifiseerde perseel, was ondervra oor die vlak van opleiding wat hulle ontvang het en wat hulle nodig het vir beter bestuur van pasiënte en nakoming van behandeling deur pasiënte. Daar is gevind dat sommige kategorieë van personeel by die klinkiek nie die opleiding ontvang het wat nodig is nie en dat ander personeellede nie voldoende opleiding ontvang het wat hulle sal help met nakoming van berading nie. Personeellede het aanbeveel dat opleiding geredelik beskikbaar gemaak moet word aan alle personneel en dat dit na ander departemente en afdelings binne die hospitaal uitgebrei moet word om die voortsetting van sorg vir MIV/VIGS-positiewe pasiënte te verseker. Nie-nakoming van antiretrovirale behandeling is ‘n uitdaging vir beide gesondheidsorgwerkers en pasiënte. Dit lei tot die mislukking van behandeling, ‘n afname in die kwaliteit van die pasiënt se lewe en ‘n verhoging in morbiditeit en mobiliteit.
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Riha, Anna. "'Being a professional chameleon' : working with children as a counselling psychologist." Thesis, University of Roehampton, 2011. https://pure.roehampton.ac.uk/portal/en/studentthesis/being-a-professional-chameleon(98045c2a-da75-4225-96b4-5e09951983d9).html.
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Children's well-being is an extremely relevant topic at the moment both culturally and politically. Counselling psychologists complete training that includes a diversity of clinical and research approaches though these focus mainly on adults and neglect children. This study aimed to explore the construction of counselling psychologists' experiences of, and perceived contribution to, working with children. Charmaz's (2006) social constructivist version of the original grounded theory method was employed. Purposive sampling was used to recruit participants from the British Psychological Society's website. Participants also self-selected for the study. Eleven individuals who were chartered counselling psychologists and had experience of working with children therapeutically were interviewed. Intensive interviewing was employed and the interviews were audio-taped with a typed transcript of each produced. Data analysis revealed a central concept which the researcher termed 'Being a Professional Chameleon', which gained expression through the subcategories of 'Adapting to Working with Children', 'Professional Selves' and 'Training and Competency of Working with Children'. The findings are discussed in relation to related literature, counselling psychology training and career paths. Implications for the counselling psychology profession are discussed, including suggestions for future research and clinical practice.
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Campbell, Tomas. "Reasons for HIV testing in a heterosexual sample : the role played by affective factors and constructs from the health belief model." Thesis, University of Surrey, 1997. http://epubs.surrey.ac.uk/618/.
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Kaur, Mandeep. "Religion and spirituality within the Sikh religion : how counselling psychologists can help." Thesis, University of Wolverhampton, 2018. http://hdl.handle.net/2436/621892.
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This study investigated the spiritual and religious experience of members of the Sikh community with a focus on how such an experience affects their sense of wellbeing. Consequently, the central aim of this study is to explore how Sikhs use religion and spirituality with coping. This was examined by exploring how Sikhs deal with stressful events and how these impacted on their wellbeing. The thesis was comprised of two parts. Study one comprised of the thematic analysis of questionnaires. 56 UK based Sikh participants (23 males and 33 females; age range 17-62) took part. The findings from study one speculated that the older age group appeared more accepting of their religion and spirituality suggesting maybe they are less occupied by a quest to explore their life through religion and spirituality than the 20-30 year old age group. Consequently, study two looked more closely at participants aged between 20-30 year olds to further explore their lived experience. In line with the IPA methodology, a small well-defined opportunity sample of six people (4 males and 2 females) in the Sikh faith, who have been practicing their religion for at least 2-3 years and between the ages of 20-30 were invited to participate in the interviews. Four superordinate themes were found which represented an overall story. The themes were namely, religious and spiritual struggles; religion and spirituality assisting with the development of self and identity; spiritual striving and aids to well-being: religious/spiritual coping. It is hoped that findings from this research will help to inform our understanding of how Sikh client's religious and spiritual beliefs influences their wellbeing as well as incorporating this knowledge into the therapy process to make good clinical judgements. This study will enhance research in counselling psychology with regards to religion and spirituality and mental health specifically with regards to young Sikh's.
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Mokalake, Ellen N. "Determinants of HIV voluntary counselling and testing among the youth: The case of Botswana." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/9403.
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Includes bibliographical references.This study was conducted in Gaborone city, Botswana. Botswana is a small country in south central part of Africa with a population of 1.7 million (Botswana population census, 2001) The overall aim of the study was to examine barriers and facilitating factors influencing the readiness for and acceptability of voluntary HIV testing among the youth aged 18-24 years in Gaborone, Botswana. A quantitative methodology was used in this study. A multistage sampling strategy was also used to recruit one hundred and forty four (144) participants. Information on socio-demographic characteristic, knowledge and utilization of VCT sexual behaviour and perception of risk was gathered by use of a self administered structured questionnaire. STATA version 8 was used to analyse the results of this study. Summary statistics, chi-square test and logistic regression were employed in the analysis. Participants comprised of students from senior secondary schools and tertiary education institutions from the sampled schools of Gaborone. The modal level of education was secondary and the more than half of participants (56%) were females. Their age ranged from 18-24 years. The majority of participants (75%) were sexually active and just over a third 36% of all participants considered themselves not at risk of HIV. VCT knowledge was reported by a significant proportion (59%) who also reported knowledge of VCT sites. HIV testing was reported by a minority of participants 42% and the most commonly reported reason for testing was media campaigns encouraging HIV testing whilst the most commonly reported reason for not testing was never been sexually active. Findings from this study revealed that, HIV test acceptance among the youth is still an area that needs greater attention. The facilitation of HIV testing amongst the young people and removal of barriers to testing can be achieved through a focus on use of strategies that seem vii to work such as the media. Also, there is need to ensure utilization of VCT services by youth through making them understand of the role that VCT plays in preventing HIV and AIDS.
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Jonas, Nozimanga Minah. "The impact of trauma counselling debriefing on debriefers in the context of the South African Police Service (SAPS) helping professions, Limpompo Province." Pretoria : [s.n.], 2003. http://upetd.up.ac.za/thesis/available/etd-02162004-144802.
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Percat, Ariella. "“I think we’ve lost it”. Sexuality counselling at the antenatal care." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-27049.
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Bakgrund: Flera studier visar att sjuksköterskor inte tillgodoser patientgruppers behov av att tala om sexualitet och sexuell hälsa. Barnmorskors samtal om sexualitet är ett nästan helt outforskat område. Syfte: Syftet är att undersöka barnmorskors syn på och erfarenhet av samtal om sexualitet på barnmorskemottagningen. Metod: Semistrukturerade intervjuer utfördes med nio barnmorskor på sju olika mottagningar i Skåne. Intervjuerna analyserades med en kvalitativ innehållsanalys genom identifiering av kodord, kategorier och teman. Resultat och analys: Skriptteorin har använts för att analysera och förstå hur barnmorskorna agerar och samtalar i relation till sexualitet. Analysen utmynnade i ett övergripande tema: Sexualitet är betydelsefullt men lätt att tappa bort. Barnmorskorna ser sexualitet som ett angeläget ämne men svårt att adressera i möten. Svårigheter att kommunicera sexualitet beror på tids- och kunskapsbrist samt brist på uppmuntran från ledningen och/eller avsaknad av samtalsverktyg samt ytterligare osäkerhet då patienten avviker från heteronormen eller har en annan kulturell bakgrund. Konklusion: Utbildning i sexologi efterfrågas av barnmorskorna för att kommunicera sexualitet och kunna ge den holistiska vård patienter har rätt till oavsett sexuell orientering eller kulturell bakgrund. Men resultatet antyder att tydliga förväntningar och riktlinjer kring att och hur samtal tas upp är viktigare än fördjupad kunskap. Så länge det finns ett kulturellt och interpersonellt skript på arbetsplatsen i vilket sexualitet inte förväntas adresseras kommer inte utbildning förändra förhållningssättet. Stöd från ledningen och/eller organisationen och möjligheter till handledning/reflektion som rör sexuella frågor kan stötta och uppmuntra barnmorskor att initiera frågor om sexualitet och förändra skripten. Vidare studier behöver göras för att till fullo förstå vilka mekanismer som ligger bakom svårigheten att adressera sexualitet på barnmorskemottagningen.Background: Several studies show that nurses don’t meet the need from groups of patients to talk about sexuality and sexual health. There are almost no studies on midwives’ view on sexuality counselling. Aim: The aim of this study is to explore midwives’ views and experiences on sexuality counselling at the antenatal care. Method: Semi-structured interviews were conducted with nine midwives’ at seven different antenatal care centers in Skåne. The interviews were then analyzed with a qualitative content analysis through identification of codes, categories and themes. Results and analysis: The study utilizes scripting theory to analyze and understand how midwives act and counsel patients in relation to sexuality. One main theme emerged: Sexuality is important but easy to lose. The midwives’ consider sexuality as important but sometimes hard to address. The reasons for this is said to be lack of time, lack of knowledge, lack of encouragement from the managerial level and/or lack of counseling tools, and, added to that, even more uncertainty when the patient deviates from the heterosexual norm or has another cultural background. Conclusion: Midwives’ ask for education to communicate around sexuality and to be able to provide the holistic care that the patients are entitled to. The result, however, suggest that clear expectations and guidelines about when and how to address sexuality is more important than deepened knowledge. As long as there is cultural and interpersonal scripts in the workplace in which sexuality is not expected to be addressed, additional education won’t help to change addressing patients’ sexuality. Organizational and managerial support along with opportunities for reflection concerning dialogue regarding sexual issues might evoke the interest and intent of midwives’ to approach sexuality and change the cultural and interpersonal scripts. Further studies are needed to understand fully what mechanisms underline the barriers that prevent midwives’ from addressing patients’ sexuality.
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Nakao, Jolene H. "Acceptance and access : home-based HIV counselling and testing and barriers to care in rural Western Kenya." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/12137.
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Includes abstract.Includes bibliographical references (leaves 83-94).
Home-based HIV counselling and testing (HBCT) is a wayt to provide confidential HIV testing in a person's home. As home-based testing has not yet been evaluated on a wide scale in Kenya among adult individuals [over age 15], this project is designed to assess in rural Kenya 1) overall acceptance rates and variables that predict differential acceptance rates of home-based HIV testing, 2) reasons for refusal of home-based testing, and 3) barriers to seeking treatment for people who are HIV positive.
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Mabota, Princess Martinah. "Psychological well-being of volunteer counselling and testing counsellors." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/33375.
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In the South African public health care system, HIV Counselling and Testing (HCT) has
become a function that is routinely entrusted to lay counsellors. These counsellors are expected
to educate clients about HIV and AIDS, encourage them to be tested and convince them to
change risky behavioural practices. They have to convey the clients’ test results and assist those
who test HIV-positive and their families to cope with the psychological challenges associated
with the diagnosis. The counsellors occupy the front line of HIV and AIDS service delivery,
even though they are not formally employed in the health care system. They only have basic
training and are not adequately remunerated. The counsellors are confronted with psychological
and structural stressors in their work. Psychological stressors include the impact of emotionally
challenging work, the lack of appropriate training, debriefing and supervision. Because they are
not formally employed in the health care system, there is a lack of formal supervision or
channels to discuss their frustrations. This research focuses on the stressors which HIV
counsellors experience, how they cope, and the impact it has on their psychological well-being.
As part of the mixed methods approach 50 HCT counsellors working at the City of
Tshwane clinics completed the Bar-On Emotional Quotient Inventory, the Maslach Burnout
Inventory for Human Services Survey (MBI- HSS), the Centre for Epidemiologic Studies
Depression scale (CES-D), and the Brief COPE scale to assess their psychological well-being.
In addition, they participated in focus group discussions. EQ-i scores indicated that counsellors reported below average emotional skills, with the overall
group score of (88.76). Scores that indicated average emotional skills were Self-Regard (101),
Interpersonal Relationships (100.12), and Impulse Control (102.66). Scores that indicated low
emotional skills were Independence (86.66), Self-Actualization (88.28), and Reality Testing (83.94). Although they reported high levels of Emotional Exhaustion (27.66), they also have a
sense of high Personal Accomplishment (38.64) (MBI-HSS). Counsellors reported an overall
CES-D score which was indicative of mild depression (26.08). Counsellors used mostly positive
coping skills that included religion, planning, and direct action in coping with stressors in their
lives. In a regression analysis with depression as the dependent variable, there was a positive
relationship between depression and depersonalization and a negative relationship with positive
or active coping and assertiveness.
It was concluded that counsellors experienced some depression, emotional exhaustion,
and lower than average levels of emotional well-being. Despite that, they reported positive ways
of coping and high levels of personal accomplishment. Counsellors were motivated by their
sense of altruism, compassion towards their clients, the positive changes they see in client’s lives
as well as the reciprocal relationships they have formed with their clients. Counsellors thus have
strengths to cope with the high level of stressors and challenges related to their work. It can be
concluded that their state of mental health is in line with Keyes’ proposal that mental health
forms a continuum. They fluctuate between mental well-being and mental ill-being. However, it
is necessary to assist HCT counsellors to develop their emotional capacities to enable them to
enhance their ability to counsel their clients effectively.Dissertation (MA)--University of Pretoria, 2013.
gm2014
Psychology
unrestricted
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Dent, Ann Leslie. "Support for families whose child dies suddenly from accident or illness." Thesis, University of Bristol, 2000. http://hdl.handle.net/1983/3527a355-4008-4d20-af05-01121630e2e1.
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Almoshawah, Saad A. S. "An examination of the mental health service provision in Saudi Arabia with particular reference to counselling." Thesis, University of Hull, 2005. http://hydra.hull.ac.uk/resources/hull:10431.
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This thesis aimed at elucidating the meaning of mental health services within the context of counselling practice in Saudi Arabia. The delineation of mental health practice within this context may help to overcome the incongruence among counselling theory, research, practice, and the experience of counselling patients in that country. Consequently, mental health treatment systems in Saudi Arabia have a history of incompatible philosophies and conflicts that have been associated with poor treatment outcomes for persons diagnosed, which was linked to a deterrent Poor Law to one which incorporated those suffering from a wide range of mental disturbances, which was largely based on treatment willingly undertaken and freely available, and which was associated with a preventive Ministry of Health. It examines the concepts and intentions which underlay policy, and the impact of policy upon the service and its clients. It describes the ways in which the service was moulded by the changing and sometimes conflicting demands of the needs of the mentally patients' and of society as a whole. There is almost full agreement among all those concerned with Psychiatric health care in Saudi Arabia that current treatment is not beneficial and may be harmful to the patients'. Most psychiatrists agree that the major benefit for the patient occur in the first week of his \her treatment. Mental health provision in the Kingdom of Saudi Arabia hospitals, historical background and the use of the current medical model, is examined in the first part of the study and qualitative and quantitative methodology were used in the second part. From the analysis, the questionnaire, and exploratory interviews the major findings were, revealed statistically significant differences between practitioners in their aims and objectives, roles and responsibilities, awareness, effectiveness' , referral system and procedures, and personal development. Although, practitioners experienced dissatisfaction with the whole service; patients' were raised the same issues criticising the poor standard of services in their hospitals. In addition, practitioners felt the referral system was inflexible and unclear, psychiatrists and counsellors failed to understand their patients' needs. It was concluded that there were considerable the lack of training amongst practitioners. In the light of the findings, the researcher came up with several recommendations, the most important of which were the following. I ) there is a need for a viable model for mental health treatment in Saudi Arabia.;2) Improve the current provision regulation;3) establish a mental health Act in Saudi Arabia.
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Weston, Holly. "How do counselling psychologists make sense of their clients' psychiatric diagnoses : an interpretative phenomenological analysis." Thesis, London Metropolitan University, 2016. http://repository.londonmet.ac.uk/1150/.
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Counselling psychology, with its humanistic value base and adherence to certain aspects of the medical model, is in a positional dilemma on issues such as diagnosis. There seems to be a current need to define counselling psychology’s epistemological position due to doubts about its independence as a profession. How counselling psychologists respond to diagnosis has been tentatively explored in the literature, but responses in terms of thoughts, feelings, perceptions, and their interpretation of these responses is absent. To address this gap, semi-structured interviews were carried out with six counselling psychologists and the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Two themes were identified: ‘diagnosis is something to hang your hat on,’ and ‘the bigger picture.’ Like previous research, these themes highlight the different epistemological positions taken up by counselling psychologists on diagnosis. However, the current findings also describe the lived experience of holding these different positions; for example feelings of tension are expressed and the level of uncertainty that needs to be tolerated is explored. A suggestion is made in terms of defining this changeable position, as one of safe uncertainty (Mason, 1993), in order to facilitate clear communication regarding a position. Specific recommendations are made for research, training and practice, including: the need for tolerance of uncertainty to be made more explicit on counselling psychology training programmes; suggestions for further IPA and Grounded Theory Research; and the development of a special interest group has been suggested, where counselling psychologists and other professionals can share ways of managing the impact of diagnosis on their practice.
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Shawa, Remmy Malama. "Exploring experiences of HIV counsellors towards the HIV counselling and testing policy in Zambia’s public urban health centers." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6027.
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Brown, Georgina. "The working alliance in online counselling for crisis intervention and youth." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, c2012, 2012. http://hdl.handle.net/10133/3297.
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The Internet is becoming a more realistic means of accessing support, especially for those who are unable to or are uncomfortable with accessing supports in person. One population that experiences barriers to accessing face-to-face support is youth, and online counselling is an option available for youth to overcome these barriers (King, Bambling, Lloyd, et al., 2006). Online counselling can occur through e-mail and chat services; however, due to the text-based nature of these services, their effectiveness is criticized for having a lack of verbal and nonverbal communication (Cook & Doyle, 2002). Research, however, has suggested that it is possibly this lack of verbal and nonverbal cues that make online counselling effective. Research has also suggested that the effectiveness of counselling can be measured by the working alliance (Fletcher-Tomenius & Vossler, 2009; Hanley, 2009). This study explored if an effective working alliance can be established in online counselling mediums with youth who are in crisis. A quantitative research approach was taken, in which 91 youth completed an online survey that asked how they felt towards online support services. The results of this study suggest that youth respond positively to the lack of verbal and nonverbal cues; youth appear to enjoy an increase sense of anonymity that is created within online support services, which can contribute to open communication. In addition, the results suggest that an effective working alliance is established in online counselling services, as it was found that youth typical felt happy and satisfied with the services they received.x, 135 leaves ; 29 cm
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Kotze, Sophia Catharina. "Rethinking HIV/AIDS pre-test counselling in South Africa." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-01302006-154411.
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Idowu, Barbara. "Counselling psychologists' experience of their professional identity whilst working in an IAPT service : an interpretative phenomenological analysis." Thesis, London Metropolitan University, 2017. http://repository.londonmet.ac.uk/1255/.
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Whilst counselling psychology has established itself as recognised profession in both the NHS and the independent sector, studies and anecdotal evidence have shown that counselling psychology positions itself in opposition to the prevalent medical discourse and is not as well understood an known as its cousin clinical psychology. At the same time, the Increased Access to Psychological Therapies services translate principles of evidence-based practice and clinical governance into a model of psychological therapies delivery, which creates areas of tension between counselling psychology identity and IAPT’s identity. Research conducted in the US and UK as well as anecdotal evidence suggests that this conflict can lead to unclear professional identities for counselling psychologists practising in this setting, contributing to burn-out, disillusionment and job dissatisfaction. Semi-structures interviews were conducted with six counselling psychologists with experience of working in IAPT services, which were analysed using interpretative phenomenological analysis. Their experience of professional identity whilst working in IAPT highlighted an ambivalent relationship with their professional identity, which was attributed to the tension between organisational and professional identities. The consequences were signs of burn-out, disillusionment, disconnection from the profession as well as a negative selfimage of clinical skills. The mediating factor of stages of professional development is discussed.
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Gallagher, Rebecca. "The relationship between client work and personal and professional development in Counselling Psychology training." Thesis, London Metropolitan University, 2014. http://repository.londonmet.ac.uk/708/.
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Personal and professional development activities are a central component of Counselling Psychology training due to regulatory requirements and the high value Counselling Psychology places on the therapist’s "self". Most research on the facilitation of personal and professional development focuses on specific training activities such as personal therapy and personal development groups. However, it is widely acknowledged that personal and professional development are also facilitated by aspects of training and life that are not designed for their facilitation. This research explores the relationship between trainee Counselling Psychologists’ personal and professional development and their client work. Interpretive Phenomenological Analysis (IPA) was used to analyse semi-structured interviews with six final year trainee Counselling Psychologists. Two main findings were identified: firstly, participants were unable to discuss their personal and professional development in relation to client work specifically; personal and professional development were facilitated by the relevance of specific experiences to individuals’ needs and preferences rather than activities having a direct facilitative effect themselves. Secondly, participants did not engage in active personal development work, and this was not explicitly discussed or structured in training. These findings imply that trainees may not develop optimally: as personal and professional development are highly individualised and complex processes, research and training that focuses on specific training activities may fail to interrogate the complexity of why and how personal and professional development are facilitated. Regulatory and ethical implications are discussed alongside existing literature to suggest the beginnings of a personal development curriculum for Counselling Psychology training.
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Neufeld, Jennifer. "The Development and Delivery of a Mental Health Literacy and Counselling Skills Workshop for Educators: A Pilot Study." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37200.
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School settings are increasingly being targeted as ideal entry points for youth mental health initiatives and naturally, educators have been identified as playing a critical role in supporting youth in distress. The current study set out to investigate how to strengthen the ability of educators to support youth experiencing bullying and mental health difficulties. The study was conducted in two phases: an initial phase in which a mental health literacy and communication skills workshop for educators was developed and refined, and a second phase in which the workshop was pilot-tested. The 2-hour workshop was delivered to two groups of students (N = 35) in a Teacher’s Education (B.Ed.) program at a Canadian university. Participants completed a questionnaire following the workshop to assess their satisfaction with the workshop experience and their degree of change in knowledge and awareness of bullying and mental health difficulties, as well as self-efficacy and perceived confidence in communicating with young people in distress. Results showed that participant satisfaction with the workshop was high and that most participants would recommend the workshop for pre-service and in-service teachers. In addition, participant knowledge, awareness, self-efficacy, and self-confidence in communicating with youth in distress increased from pre- to post-workshop. Taken together, the results of the pilot study provide support for further development and delivery of this workshop to pre-service and in-service teachers to help prepare educators for the complex, demanding, and vital role of supporting young people in distress due to bullying and mental health difficulties.
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Mavuso, Jabulile Mary-Jane Jace. "Narrated experiences of the pre-termination of pregnancy counselling healthcare encounter in the Eastern Cape public health sector." Thesis, Rhodes University, 2018. http://hdl.handle.net/10962/62928.
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Research that has been conducted about experiences of pre-abortion counselling tends to investigate either womxn's1 or healthcare providers' experiences separately, with research on womxn's experiences of abortion and abortion counselling dominating this area of research. Although some of the studies on womxn's abortion experiences have explored womxn's experiences of interactions between themselves and healthcare providers, these aspects have been underreported. To my knowledge, research that also explores womxn's interactions among themselves in the waiting room has not been done. Furthermore, research that explores the pre-termination of pregnancy healthcare encounter, where womxn's and healthcare providers' experiences of waiting room interactions and of pre-abortion counselling practices are seen as interrelated, has not been conducted. Research that has been conducted among womxn's experiences show that womxn have varying experiences of pre-abortion counselling, with some finding it useful while other womxn have found it to be lacking in relevance to their specific situation or needs. Research conducted among healthcare providers also points to varying experiences, with some healthcare providers stratifying womxn's reasons for abortion according to the acceptability of the request. This study explores health service providers’ and womxn’s narrated experiences of the pre-termination of pregnancy healthcare encounter (waiting room interactions and pre-abortion counselling) in the Eastern Cape public health sector. An African feminist post-structural approach, which enables analysis of how discursive structures and power relations may underpin African womxn's experiences of oppression and resistance, was used. Fusing this approach with a narrative-discursive analysis, enabled an exploration of the discursive resources drawn upon and the power relations referred to by participants when constructing micro-narratives and accounts of their experiences of waiting room interactions and pre-abortion counselling practices. This fusion enabled an understanding of the micro (individual) and macro (social) and how they interact and come to bear on experiences of the pre-abortion counselling healthcare encounter. Womxn's micro-narratives and healthcare providers' accounts were compared for convergences and divergences in the pre-abortion counselling practices they described. The implications of these convergences and divergences and of the power relations referred to by participants for pre-abortion counselling service provision are discussed. The research referred to in this study were conducted in contexts where abortion is legal, although the conditions under which it may be accessed differ across and within contexts. This present study is contextualised by the Choice on Termination of Pregnancy Act No. 92 of 1996 which legalises abortion and stipulates that abortion counselling should be made available to womxn but should be non-mandatory and non-directive. Data were collected at three abortion facilities located in public hospitals in the Eastern Cape. Open-ended, semi-structured interviews were conducted with 30 womxn after they received pre-abortion counselling, and four healthcare providers involved in abortion service provision. Data were analysed using an extended narrative-discursive approach which entailed exploring patterns in and across participants' talk. These patterns took the form of discursive resources (discourses and the subject positions they made available, and canonical narratives), power relations, and micro-narratives and accounts of their experiences of pre-abortion counselling practices and waiting room interactions. Participants described the following pre-abortion counselling practices: information-giving practices, consent practices, administering of LARCs, a waiting period and third-party involvement. In describing these processes, participants drew on an awfulisation of abortion discourse, moralising discourses, pronatalist discourses, and liberal discourses to construct (micro-)narratives in which liberal, pastoral and authoritarian counselling practices and power relations were constructed and referred to. In their micro-narratives, most womxn described the counselling as informative, beneficial and healing whilst also describing shock, hurt, pain and distress at the various kinds of information they received. Healthcare providers drew on discourses and canonical narratives (such as the hero and personal testimony) to justify liberal, pastoral and authoritarian counselling practices which were underpinned by constructing abortion and unintended pregnancy as problematic. The pre-abortion counselling practices that were described were directive in two ways: the coercion of contraceptive uptake post-abortion, and information provision practices which effectively work to delegitimise and persuade womxn against abortion.
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Taylor, Abigail. "Integrating the mind and the body : examining the role of counselling psychology for individuals with physical health problems." Thesis, City University London, 2009. http://openaccess.city.ac.uk/14900/.
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Finding meaning when facing a diagnosis of advanced cancer can be an important part of an individual’s experience as they face the reality of their death. Spirituality has frequently been cited as an important source of meaning, yet there lacks a consensus over what this term actually means. Previous literature has encountered serious methodological problems, such as confounding religion with spirituality, and there is a lack of qualitative studies in this area. The current study explored the experience of spirituality and meaning-making at the end of life in eight participants with advanced cancer. A hermeneutic phenomenological method was employed since this was considered a creative approach to explore such an elusive concept. The transcripts were turned into poems using poetic condensation (Gee, 1991) in order to preserve the emotional content of the narrative. Analysis revealed two modes of being available to participants at this stage of life: the everyday mode of being and the transcendent mode of being. Participants in the everyday mode of being found meaning from relationships with others and their environment. It is argued that the term “spirituality” is not relevant for this mode of being since participants did not connect with this terminology. Instead the term “belonging-in-the-world” is proposed to capture their experience. For individuals in the transcendent mode of being, meaning was created by thinking about the order of the universe or world and seeking comfort from their inner world. It is proposed that the term spirituality is relevant to their experience. The two modes of being were not mutually exclusive and there was context found that influenced movement between the two. These included treatment history, family and relationships and experience of death throughout life. The appropriateness of existential therapy for participants in the advanced stages of cancer is explored and recommendations are made for future research in this area.
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Hore, Beth. "How do counselling psychologists in the UK construct their responsibilities to the wider world? : a Foucauldian discourse analysis." Thesis, London Metropolitan University, 2014. http://repository.londonmet.ac.uk/681/.
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Counselling psychology’s Professional Practice Guidelines state that "counselling psychologists will consider at all times their responsibilities to the wider world". (Division of Counselling Psychology, 2005, p.7). It is suggested that the way in which counselling psychologists construct their relationship with the wider world could impact on practice, training, research and counselling psychology professional identity. A critique of the extant literature found that this issue has not previously been researched. Five counselling psychologists were asked in semi-structured interviews about their responsibilities to the wider world. Foucauldian Discourse Analysis was applied to the transcript of the interviews. Different constructions of the relationship between counselling psychology and the wider world were identified in the transcript and located in four wider discourses: professionalism, scientific, social activism and guru. Common themes across responsibilities constructed by participants utilising the different discourses included: the wider world being outside of the consulting room; difficulties defining responsibilities; and responsibilities being weighty. Responsibilities to communicate knowledge were constructed using three of the discourses. Both the guru and scientific discourses were mobilised to construct responsibilities to engage with technologies of the self (Foucault, 1988). In contrast the professionalism discourse was used to construct a responsibility to perform to others in order to appear professional. The implications of these constructions for counselling psychology, and the discourses mobilised by participants, are discussed.
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Gilmour, Amy. "An interpretative phenomenological analysis of counselling psychology trainees' experiences of working with adult survivors of childhood sexual abuse." Thesis, London Metropolitan University, 2015. http://repository.londonmet.ac.uk/1135/.
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Background: In view of the estimation that around one fifth of individuals abused in childhood will develop psychological difficulties which require professional input there is a high chance that counselling psychology trainees will encounter adult survivors in their practice. Counselling psychology trainees are continuously faced with philosophical and practical challenges when they seek to integrate psychological models into their practice. The critical literature review discusses the contentions regarding the most appropriate therapeutic approach when working with this client group, alongside maintaining the focus of therapeutic relationship. The review also explores the risk to clients of re-traumatisation through poorly conducted therapeutic interventions. In addition, potential risks to trainees have also been discussed such as difficult affective reactions or vicarious traumatisation. Aims: A lack of research was identified with regards to exploration of trainees’ internal experiences of working with this client group leading to the research question: How do counselling psychology trainees experience working with adult survivors of childhood sexual abuse? Methodology: Semi-structured interviews were conducted with six trainee counselling psychologists enrolled on BPS Accredited Counselling Psychology Doctoral courses, who had experience of working with adult survivors of CSA. The transcripts of the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Results: From the analysis the following three key super-ordinate themes were developed: balancing the power dynamic in therapeutic relationship; management of vicarious emotional state of self; questioning competent versus incompetent self as therapist. Findings: The study identified clinical implications to develop further understanding and requirements for trainee counselling psychologists in relation the superordinate themes. Furthermore, an important limitation from the study was identified with regards to the inclusion of only one male participant. This highlighted the issue of gender differences between client and therapist; however, it underlined an important area requiring further study.
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Jones, Gemma. "Exploring the psychological health and wellbeing experiences of female veterans transitioning from military to civilian environments." Thesis, University of Manchester, 2018. https://www.research.manchester.ac.uk/portal/en/theses/exploring-the-psychological-health-and-wellbeing-experiences-of-female-veterans-transitioning-from-military-to-civilian-environments(32c236b6-618b-494a-bd4c-b545d97a1a5c).html.
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Background: The inclusion of women in the armed Forces is becoming increasingly commonplace, with figures currently standing at 10.2% of the regular Forces in the United Kingdom (UK). This is set to rise with the introduction of the new Ground Close Combat (GCC) ruling which came in earlier this year (2017), allowing women to serve on the frontline with their male colleagues. However, alongside these changes, women already face stressors and exposure to combat in the Forces that potentially contribute to difficult transitions back into everyday life when leaving the military environment. The aim of this study was therefore to engage with and explore the experiences of female veterans psychological health and wellbeing as they transition from the Forces into civilian life, understanding the different processes they encounter as they transition. Methodology: Six female veterans who fit the inclusion criteria were recruited for the study. In this qualitative study, semi-structured, one-to-one, in-depth interviews were conducted and analysed in accordance with Charmaz's (2006) Constructivist Grounded Theory (CGT) guidelines. This iterative and inductive analytical process was utilised to construct an understanding of the participant's experiences and understandings of their transition. Findings: Concurrent with the CGT approach, nine theoretical categories developed from the analysis of the interviews, including role reversal, sexism and loss. These contributed to the development of a transition model, representing an interaction between the military environment, no mans land and the civilian environment. Findings indicate that experiences of transitioning faced by female veterans are complex, and involve gender-related issues. The findings also suggest that problems with mental health such as Post-Traumatic Stress Disorder are common, and are heightened by additional stressors specific to women's experience in the military and civilian environments. Discussion and Conclusion: These findings suggest that female veterans health and psychological wellbeing experiences in the military are parallel to those they experience in civilian life. Consistent with previous literature, the female veterans interviewed appear to have experienced their transitions differently to male counterparts, with additional stressors present throughout their transitions. These stressors contribute to the uncertainty of identity, stigma and a loss of military ways when transitioning back into a civilian society. Consequently, more services that are tailored to female military veterans, are proposed, in order to support the increasing number of female veterans that will present in the future. This has implications for therapeutic practice in counselling psychology, whereby a deeper understanding of the difficulties and challenges experienced by female veterans during transition into civilian life can inform therapeutic interventions and signposting to specific services tailored their needs.
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Teng, James Wei Jie. "An interpretative phenomenological analysis of the experiences of HIV-positive lay counsellors working in the voluntary counselling and testing settings." Thesis, Rhodes University, 2011. http://hdl.handle.net/10962/d1002579.
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The purpose of this study was to present and understand the experiences of HIV-positive lay counsellors working in Voluntary Counselling and Testing (VCT) settings. Specifically exploring and understanding the utilisation of personal experiences within counselling encounters, the practice of peer counselling within VCT, and the challenges experienced by HIV-positive lay counsellors within VCT settings. This study, employing a qualitative interpretative phenomenological methodology required a small sample of practicing HIV-positive lay counsellors, who were selected and interviewed on their experiences utilising semi-structured interviewing. Data was analysed for meaning units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Three superordinate themes within the participants’ experiences of providing VCT services were determined, namely: ‘diagnosis and disclosure experiences’, ‘peer counselling’, and ‘challenges’. This research found that the experiences of providing peer counselling depended upon identification with their client’s negative appraisal of their diagnosis experiences. Whether through empathic connections generated through the shared experience of discovering a seropositive status, or through countertransferential reactions induced through their client’s yearning for care and support. This required the counsellor to selfdisclose within counselling encounters in order to provide personal experiences of living with HIV/AIDS. Successful implementation of peer counselling provided recently diagnosed individuals with knowledge surrounding HIV/AIDS, coping skills to manage the daily physiological and psychological challenges, facilitation and adherence to treatment, social assistance, ongoing relationships, inspiring hope, and the creation of positive appraisals. However the informal utilisation of task-shifting within lay healthcare cadres, and the lack of governmental recognition for the emotional labour provided within VCT indicated that HIVpositive lay counsellors require ongoing training, support and remuneration to limit potential occupational stress, resignation, and burnout.
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Eberhardt, Judith. "An electronic coping-enhancement programme for bereaved women addressing psychosocial factors in breast-cancer development." Thesis, Teesside University, 2012. http://hdl.handle.net/10149/239431.
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Conventional breast-cancer prevention strategies tend to focus on the reduction of physical breast-cancer risk factors while neglecting psychosocial factors potentially associated with its development. Yet, there is a wealth of evidence linking psychosocial factors such as the occurrence of and maladaptive coping with bereavement and other stressful life events, certain personality traits, and a lack of social support, to breast-cancer incidence, survival and mortality.This thesis aimed to design, implement and evaluate an electronic Coping-Enhancement Programme for the Bereaved (CEPB), addressing such psychosocial factors. Furthermore, participants’ experiences of the programme were to be explored. An experimental 2x2 independent measures design with triangulation was used, employing qualitative and quantitative methodology. Participants’ experiences were elicited qualitatively through blogs and message boards. The two independent variables were (1) emotional-expression-and-stress-reduction (EESR), and (2) psycho-education. Dependent variables were: (1) maladaptive coping with bereavement, (2) maladaptive coping with stressful life events, (3) social support, and (4) awareness of the connections between psychological and physical health. An additional dependent variable was conformity. A Web site containing message boards and blogs was created. Thirty-one women completed a psychological screening form and were then randomly assigned to one of four conditions (EESR-only, psycho-education-only, EESR-plus-pyscho-education, or the control group who received no intervention). They participated in online exercises designed to aid emotional expression and stress reduction (‘Art and Laughter for Wellbeing’) and/or received psycho-education through the reading of autobiographical accounts of breast-cancer sufferers. Participants were analysed on the dependent variables three times: before the programme to obtain a baseline measurement, after the programme, and at six-week follow-up. Thematic analysis was used to illustrate the process of the CEPB, as well as to confirm or disconfirm quantitative results. Analyses of covariance revealed that after the programme, taking part in ‘Art and Laughter for Wellbeing’ was associated with lower maladaptive coping with bereavement, while reading autobiographical accounts of breast-cancer sufferers was associated with lower maladaptive coping with stressful life events. Participation in both conditions was associated with higher levels of social support, and taking part in either condition was associated with lower levels of conformity. The latter effect persisted at follow-up. Mixed analyses of variance showed changes over time in three dependent variables. The CEPB was generally viewed as useful, helpful and enjoyable by participants. Implications for future research are discussed, and a biopsychosocial model of breast-cancer prevention is proposed.
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Hitchins, Jennifer Marie. "Posttraumatic growth as a discursive resource for managing identity after breast cancer : implications for theory, and counselling psychology practice." Thesis, London Metropolitan University, 2015. http://repository.londonmet.ac.uk/695/.
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Previous research conceptualises posttraumatic growth (PTG) as a phenomenon experienced by some people after breast cancer. In this thesis, I consider an alternative understanding of PTG; as discursive identity performance in the context of breast cancer survivorship. First, a critical review of literature on PTG after cancer is presented, with attention to rigour and methodological diversity and also with regard to the fit between existing research and counselling psychology values. It is concluded that much of the existing research is framed within a realist perspective, and accordingly, accounts of PTG are viewed as stable internal beliefs rather than socially constructed ways of managing identity. The social context in which survivorship occurs has not been adequately explored and there is a paucity of work from within the UK, and especially from amongst counselling psychologists, who, arguably, have a significant contribution to make within the psycho-oncology arena. An area for research is marked out, from the epistemological position of social construction, to explore women's accounts of life after cancer, and how they orient to and make use of PTG in this context. Following consideration of the approach taken (a synthesis of two forms of discourse analysis), I present my research with four women who were interviewed about their experiences of life after breast cancer. The analysis highlights the fine grained features of the women's talk as they manage their post-cancer identities discursively negotiating the social and moral obligation to survive well. A number of discourses, including the ‘PTG discourse’ are drawn upon, making a number of subject positions available. Notably, the PTG discourse closes down talk of troubles. Implications for theory, and for counselling psychology practice within psycho-oncology, are discussed.