Doctorate in Clinical Psychology: Main Research Portfolio

: 1) How do Solution-Focused Systemic Therapists Gather Evidence? An Evaluative Review of Research Methodologies used in Solution-Focused forms of Social Constructionist Systemic Therapy ; 2) : Integrating Formulation into Assessment in a Community Mental Health Recovery Team to Improve Recommendations for Patient Care; 3) Does Paediatric Maladaptive Perfectionism Mediate the Association between Parenting Factors and Paediatric Anxiety in Adolescents?.

Abstract

Main Research Project Abstract Objective: To assess if adolescent perfectionism mediates the association between negative parental factors (anxiety, maladaptive perfectionism, critical and authoritarian parenting) and paediatric anxiety. Method: A cross sectional questionnaire design was used. Sixty-six 12-17-year-old adolescents and their primary caregiver were recruited from a local community school and child and adolescent mental health services. Self- and parent-report questionnaires measured anxiety, perfectionism and parenting style. Results: There was a significant association between adolescent perfectionism and anxiety and between parental perfectionism and anxiety. However, there was no evidence that parental perfectionism was associated with child perfectionism or anxiety. Conclusions: The fact that parental factors were not associated with adolescent maladaptive perfectionism implies that the processes associated with the development of maladaptive perfectionism and anxiety in childhood may be different in adolescents. Implications for treatment and future research are discussed. Service Improvement Project Abstract Background: The 5Ps model is a formulation tool which includes the mental health problem as well as predisposing, precipitating, perpetuating and protective factors. The 5Ps model was integrated into the assessment service in the community mental health recovery team by the first author (trainee clinical psychologist) with support from the service manager and clinical psychologist. Objectives: This research aimed to measure whether assessment staff in the community mental health recovery team were using the 5Ps model in assessment meetings and assessment letters to formulate service user’s mental health problems. This research also aimed to assess whether recommendations for mental health care addressed the 5Ps factors which were noted in the assessment letter and assessment meeting notes. Finally, the research aimed to recommend strategies to improve the use of the 5Ps model by assessment staff. Design: Assessment staff (n=6) were interviewed using semi-structured interviews. Assessment letters and meeting notes (n=36) were analysed using case note analysis. Methods: Percentage use of 5Ps in assessment letters and meeting notes and percentage of recommendations linked to 5Ps in assessment letters were calculated. The amount of 5Ps training staff received was also compared to staff members’ use of the 5Ps in assessment letters. Thematic analysis of staff questionnaire data was completed. Results: Assessment staff are using the 5Ps in their assessment work and some recommendations were linked to the 5Ps stated in assessment letters. Recommendations to improve the use of the 5Ps by assessment staff were based on staff feedback and case note analysis and included; updating the letter and assessment formats/processes to ensure that all of the 5Ps are linked to the mental health problem and recommendations made for treatment, completing the formulation section on the electronic notes system and further training for assessment staff in how to identify the 5Ps/how recommendations can address the 5Ps. Conclusion: Results suggest that the 5Ps formulation was operational to assessment staff as it was utilised to formulate service users mental health problem at assessment. However, results suggest that the recommendations need to be implemented to improve assessment staff’s acceptability and use of the 5Ps. The service agreed to adhere to the recommendations suggested to improve the use of the 5Ps and agreed that if recommendations are adhered to these results support the plan to integrate the 5Ps into other adult mental health teams across Bristol.Literature Review AbstractObjective: All studies of solution-focused therapy which included adults with a mental health problem are reviewed and research methodologies are summarised and rated according to the quality of the research methodology used. Method: Sixteen studies were found and data extracted on setting, mental health problem, modality, target and duration of intervention, research methodology, measures, sample size, method of analysis, comparison treatment and quality score. Results: 14 studies utilised quantitative research methodologies. Eight of the studies used a quasi-experimental design including control groups (n=6) and random assignment (n=3). One study used a post-intervention questionnaire follow-up design and one study calculated recovery rates. One study calculated whether or not the patient presented with self-harm within 1 year post intervention and pre-post intervention change on a solution-focused measure. Two studies were randomised controlled trials and another two studies were single case experimental designs. Two studies utilised qualitative research methodologies including transcribing a therapy session/post-intervention interview. Quantitative outcomes were measured using multiple questionnaire measures and multiple analysis methods. Conversation analysis and thematic analysis were used for qualitative studies. The quality scores of the studies varied from 4 (single case experimental design) to 14 (randomised controlled trial) and 15 (controlled quasi-experimental). Conclusion: This review shows that solution-focused therapy is being evaluated using many valid and reliable research methodologies and questionnaires. It is hoped that solution-focused therapists and researchers can use this review to complete and publish further research which measures the effectiveness of solution-focused therapy using research methodologies which produce valid and reliable results.

Date of Award	6 Sept 2016
Original language	English
Awarding Institution	University of Bath
Supervisor	Rachel Hiller (Supervisor), Claire Lomax (Supervisor), Catherine Butler (Supervisor), Cathy Randle-Phillips (Supervisor), Jo Daniels (Supervisor) & Lorna Hogg (Supervisor)