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    Supporting whānau through child cancer : an evaluation of the child cancer counselling network : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Manawatū, New Zealand
    (Massey University, 2023) Bell, Esther Joy
    Purpose Child cancer can be considered to be a chronic traumatic event that challenges the functioning of the entire family unit. Whilst families may be well supported by medical teams and support services in hospital, there is often a lack of appropriate psychological support available in the community for those who prefer external support or whose child is not undergoing active treatment. In addition, research investigating the impact of counselling on child cancer parents is scarce. The purpose of this study was to contribute to an evaluation of the innovative Child Cancer Counselling Network (CCCN). In partnership with the Child Cancer Foundation, the CCCN provides free specialised counselling support across Aotearoa New Zealand either in-person or online, available to whānau at any point during their cancer journey. Method To evaluate the CCCN from parents’ perspectives, seven semi-structured interviews were carried out with child cancer mothers who had accessed the counselling. The resulting qualitative data was thematically analysed. Results Five major themes were found. ‘The Educated Outsider’ and ‘A Safe Space’, described qualities of ideal social support for child cancer families and what counselling was able to provide that their social networks and treatment centre could not. ‘Breaking Stigmas’ and ‘Optimising Access’ outlined ways that access to support services could be improved, including what did and didn’t work about the CCCN approach for the participants. Finally, Future Focus Areas identified potential improvements including Māori support, palliative support and investigations into other child conditions that don’t receive the same support as child cancer. Conclusion The qualitative accounts of participants illustrated a range of benefits they experienced from access to the CCCN service. Potential areas for development include enhanced palliative focus and ensuring best practice support for Māori. Provision of a short-term, flexible delivery, specialised counselling support service for child cancer families appears valuable to address gaps in support and shows potential as a translatable model for supporting other child conditions.
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    Understanding the use of Flexible Work Arrangements Among Older New Zealand Caregivers
    (SAGE Publications, 2023-05) Koreshi SY; Alpass F
    Flexibility in the workplace has been suggested to promote prolonged employment among older workers. This study focuses on the question of whether the use of flexible work arrangements (FWAs) differs between caregivers and non-caregivers and how potential differences can be explained. Participants were 296 carers and 1611 non-carers (aged 55–70 years) who completed the 2018 Health, Work and Retirement survey and were in paid employment. Hierarchical regression was used to investigate caregiving as an independent predictor of use of FWAs after controlling for demographic and work-related variables. Results show that caregivers on average used more FWAs than non-caregivers, including flexible work hours, flexible schedules and time off. Differences in FWAs use between caregivers and non-caregivers cannot be explained by differences in socio demographic and work characteristics. The use of FWAs warrants attention in discussions about prolonged employment and reconciliation of care and work among older adults.
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    Is the maternal 'babybrain' adaptive? : examining theory of mind, emotional state, and the association with attachment over pregnancy and the postpartum : a thesis presented in partial fulfilment of the requirements for the degree of Doctorate in Clinical Psychology, Massey University, Wellington, New Zealand
    (Massey University, 2023) Spill, E. Kate
    Pregnancy is a time of great maternal neuroplasticity with associated cognitive and behaviour change. Cognitive decrements are seen in memory, executive functioning, and overall cognitive functioning, and cognitive enhancements in facial and affect processing. It has been proposed that cognitive enhancements may come at the cost of cognitive decrements, due to the brain restructuring in a manner which prioritises adaptive caregiving-related functions. Hoekzema et al. (2016) found significant reductions in the grey matter (GM) volume of first-time pregnant women in the Theory of Mind (ToM) network. On the basis that reduced GM is an indicator of better processing efficiency and specialisation, they proposed that pregnancy may be a sensitive period where ToM may be enhanced to support the maternal-infant attachment relationship. ToM is a multidimensional construct which describes the capacity to understand the mental state of ourselves and others. It has been investigated in maternal-infant attachment as maternal mind-mindedness and parental reflective function. There are very few studies which have investigated individual differences in ToM over the perinatal period and its link to attachment. Objective: The primary aim of this research is to investigate ToM capacity over the perinatal period and its relationship to attachment. Method: Study 1 was a quasi-experimental, between-groups design comparing third trimester primiparous women’s performance on four ToM tasks with that of nulliparous control women. Participants (n=133; 68 pregnant) completed four computer-based ToM tasks: Reading the Mind in the Eyes-Revised (RMET), Hinting, Mind-mindedness, and the Reflective Functioning Questionnaire (RFQ). Prenatal attachment was measured with the Prenatal Attachment Inventory-Revised (PAI-R) and emotional state with the Depression, Anxiety and Stress Scale (DASS-21). It was hypothesised that: ToM would be enhanced in pregnancy; ToM would be associated with pre-natal attachment; emotional state (depression, anxiety, stress) would be negatively associated with both ToM and attachment. Results: Study 1 found no between group differences between pregnant and control participants on ToM performance. In the presence of greater depression and stress (both groups) and anxiety (pregnancy only) there was significantly more uncertainty about the mental states of self and others, an aspect of reflective function ToM. ToM in pregnancy was not consistently associated with prenatal attachment. Method: Study 2 compared ToM measured in pregnancy with caregiving ToM (Parental Reflective Functioning Questionnaire; PRFQ) and maternal-infant attachment (Maternal Postnatal Attachment Scale; MPAS) when mothers and babies were 4-6 months postpartum (n=55). It was hypothesised that ToM in pregnancy would predict parental reflective function and attachment; and that parental reflective function in the postpartum would be concurrently associated with maternal-infant attachment. Emotional state was expected to be negatively associated with both parental reflective function and attachment. Results: ToM in pregnancy had no consistent relationship to postpartum ToM (PRFQ) or attachment (MPAS). In postpartum women, the presence of poor and rigid caregiver ToM (PRFQ-Pre-Mentalising Modes) was associated with poorer quality of attachment and greater hostility in attachment (both MPAS subscales; r > .3). To explore this relationship further two mediation models were computed. These revealed that under conditions of greater depression or stress, mothers were more likely to use poorer, more rigid, and inappropriate ToM when they reflected on the inner experiences of their baby and themselves and, taken together, these factors were linked to significantly greater levels of hostility in the attachment relationship and poorer overall attachment. For each mediation model, stress and depression accounted for over a third of the basic relationship between caregiver ToM and attachment. Conclusions: (1) Contrary to Hoekzema et al. (2016), there is no evidence of general ToM enhancement in late pregnancy nor of a consistent relationship between ToM capacity in pregnancy and postpartum attachment. However, given that pregnant women were also no worse than control women, this might offer preliminary support for a cognitive prioritisation of ToM over general cognition in pregnancy. (2) In postpartum women there was a significant moderate positive relationship between parental reflective function and aspects of maternal-infant attachment. Levels of depression and stress were linked to poorer reflective function and attachment and accounted for over a third of the variance. This research is the first to examine ToM over the perinatal period using multiple measures and to examine the relationship to attachment mediated by mood state.