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Subject: search.filters.subject.170106 Health, Clinical and Counselling Psychology

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    "I know there's a net there" : experiences of Focused Acceptance and Commitment Therapy (fACT) intervention : a new approach to psychological support in primary care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 2020) Berry, Greer Donata
    Psychological distress occurs at an increasing rate within society, with research into the levels of care showing a disturbing gap, especially in the “missing middle”. There has been a growing trend to increase access to mental health services by developing integrated care models within primary healthcare organisations in New Zealand in an attempt to deal with distress in earlier stages. Through semi-structured interviews, this research gained insight to the experiences of patients who participated in a fACT therapy service offered at a primary healthcare organisation in Palmerston North, New Zealand. Participants responses were transcribed and themes identified. By focusing on patients’ perceptions of value, and how they made sense of accessing psychological support services within primary care, three main themes emerged from the findings: expectations of care, stigma and processes. Findings showed that patients could be split into two different groups. The first, those with mild to moderate psychological distress, reported positive experiences including a reduction of stigma, increased access to services and an alignment with their holistic model of care. The second group, typified by those experiencing severe or chronic distress, were also positive in regards to the concept of the service, but were found to more often report negative experiences due to expectations, and value of care. Overall, patients who engaged in the fACT service were supportive of the ability to access mental health services directly from within their GP clinic. Their experiences led them to form strong opinions about the future of the service and its availability to others who are in distress. Issues around processes, such as consistency of care and time delays, and the effect this had on patients’ experiences, were also discussed in the findings. Recommendations for areas of future research were also discussed.
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    Young people with anxiety disorders attending the Aotearoa/New Zealand Regional Health Schools : barriers and facilitators to reintegration, as reported by Regional Health School teachers : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Manawatu, New Zealand
    (Massey University, 2020) Barber, Hayley
    Anxiety is one of the most common experiences of psychological distress experienced by young people in Aotearoa New Zealand (Ministry of Health, 2018). This thesis explored the barriers and facilitators to reintegrating young people with anxiety disorders into regular school, tertiary education, or other vocational pathways, when they are attending the Aotearoa New Zealand Regional Health Schools (RHS). This research was conducted within a qualitative framework with a realist/essentialist epistemology. Nine RHS teachers from across Aotearoa New Zealand participated in semi-structured interviews, asking about their experiences of working with young people with anxiety disorders, and what they perceived to be the barriers and facilitators to reintegration for young people with anxiety disorders attending RHS. The data was analysed using Thematic Analysis with a focus on semantic content. Several themes were identified based on interpretations of the RHS teachers’ accounts. RHS teachers perceived that the whānau, regular schools, and regular school teachers of young people with anxiety disorders need more assistance to be able to support these young people in their reintegration. RHS teachers also spoke of needing more training specific to anxiety disorders, as well as more support around their professional wellbeing due to the unique nature of their role. This thesis emphasises the importance of providing wider and more systemic support to facilitate successful reintegration into education of young people with anxiety. It would be beneficial to conduct further research exploring the experiences of the whānau, regular school teachers, and young people themselves with anxiety disorders attending RHS; along with the current study, this would provide a holistic view of the needs of the support systems for young (school-aged) people experiencing anxiety in Aotearoa New Zealand.
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    Focused acceptance and commitment therapy in an integrated family health centre : service utilization, outcomes and follow-up : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 2019) Burfield, Alison
    Many New Zealanders experience mental health difficulties each year, however the majority do not receive professional support to cope with their distress. One strategy for reducing this treatment gap is to increase access to mental health supports through the provision of evidence-based ultra-brief psychotherapy in primary care settings. The current study investigated the delivery of Focused Acceptance and Commitment Therapy (FACT; Strosahl, Robinson, & Gustavsson, 2012) in a New Zealand primary care setting. Referral, service use and outcome data from the first twelve months of the service was analysed, along with follow-up data from a small sub-sample of patients. A total of 708 people were referred to the FACT service during the first 12 months. Clients attended an average of 2.00 (SD 1.50) sessions with the majority of sessions lasting 30 minutes or less (M = 37.45, SD 11.94). Analysis of available first and last scores on the Hospital Anxiety and Depression Scale, Outcome Rating Scale, Acceptance and Action Questionnaire II, and client reported severity of target issue indicated statistically significant improvements in target issue, anxiety, depression, global distress and psychological flexibility with medium to large effect sizes. Thirty participants provided follow-up data approximately two months after their last session of FACT. Statistically significant improvements in target issue severity and global distress were maintained at follow-up. No statistically significant change was found between first, last and follow-up scores on the measures of anxiety, depression or psychological flexibility. Overall, the results of this study provide support for the effectiveness of FACT delivered in primary care. Limitations of this study included lack of control conditions, participant sampling issues, and lower than ideal fidelity to the FACT model.
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    One parent’s advice to another : an exploration of self-care for parents of children with high-need disabilities and the development of a psychoeducational resource : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Manawatū, New Zealand
    (Massey University, 2020) Oskam, Jana Aria Dunlop
    Currently over 95,000 children are affected by a disability in New Zealand (NZ), making up 11% of the child population (Statistics New Zealand, 2013). Receiving a childhood disability diagnosis can be a life-changing event for the entire family. As current societal structures require parents to assume unforeseen caregiving roles (that typically last the course of their child’s lifetime), parents as informal caregivers make up a significant sector within NZ. Nevertheless, the dominant approach to research in the field of childhood disability has been based on the assumption that informal caregiving results in adverse outcomes for parents. Consequently, existing research has largely focused on the well-documented negative impact of caregiving for parents and their families. Although evidence suggests that effective self-care may act as a mediator against caregiver stress, few studies have approached informal caregiving from a positive psychology and health-promotion perspective. However, it can be argued that by adopting a positive health promotion perspective, we can improve understanding on how best to promote wellbeing for parents, and consequently, their children and families as well. Through two studies, this thesis explored the experience of self-care and wellbeing for parents of children with high-need disabilities (HND). Study One achieved this by interviewing 11 parents of children with high-need cerebral palsy or autism. Thematic analysis found that participants typically experienced and enacted self-care in four key areas, including parents’ Formal Supports and Resources, Informal Relationships, Values and Goals, and their use of Time. In line with a transformative framework, Study Two developed a psychoeducational resource, aimed at enhancing parents’ self-care and perceived wellbeing, by integrating findings from the first study with existing literature. Preliminary evaluation of the resource booklet was achieved by 14 participants completing a written questionnaire to obtain parents’ feedback. Descriptive statistics and thematic analysis of participants’ responses identified that the booklet appears to capture parents’ experiences of self-care when raising a child with HND. Two key themes included participants’ Positive Remarks and Ideas for Change. Overall, findings suggest that despite caregiving challenges, there are effective self-care strategies which parents use to mitigate these risks and improve wellbeing.