Thesis portfolio

Lynch, Lorraine

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Lynch, Lorraine (2024) Thesis portfolio. Doctoral thesis, London Metropolitan University.

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Abstract

Competence 1: Generic professional skills:
This critical reflection will discuss the journey of how my professional practice has developed over the course of my two-year placement as a Trainee Health Psychologist, working in Nurture Health and in CO-LAB Innovation Hub, Kidderminster Hospital (Worcestershire Acute Hospitals NHS Trust).

Competence 2: Behaviour change intervention:
This case study is a 3000-word report (plus a 500-word reflective commentary and observer’s report) of a psychological intervention that has been implemented through face-to-face work with an individual client, detailing all elements of the process: assessment, formulation, intervention and evaluation.

Competence 3a: Systematic review:
Paediatric Traumatic Brain Injury (TBI) is a significant public health concern, with figures suggesting that 35,000 children in the UK are admitted to hospital each year because of a head injury, with 2,000 of these being considered serious TBI or resulting in death (Trefan et al., 2016). For those who survive, paediatric TBI causes a variety of issues for patients, including mild to severe impairments in physical, psychological, educational and social functioning and development, which can range from short-term issues that can be resolved with rehabilitation to more debilitating and long-term challenges. The impact of TBI can be far-reaching and has significant implications for parents of these children, including economic challenges and difficulty adjusting, which lead to significant parental stress and burden of care. When a paediatric TBI occurs, the lives of all family members are changed and it is the parents who must carry this load, despite struggling with their own personal resources (Youngblut et al., 2000). The objectives of the present systematic review are: 1) to examine the lived experience of paediatric TBI on parental stress and 2) to explore what the burden of care is for parents. To date, there is no systematic review investigating the impact of paediatric TBI on parental lived experiences of stress and burden of care. Four established databases were searched: PubMed, Medline, PsycINFO and APA PsychArts. A total of 4,171 papers were initially identified through primary systematic searches, which were refined down to 7 qualitative papers upon further inspection. A narrative synthesis was conducted on these papers and three overarching categories were identified related to the lived experience of parental stress and burden of care associated with paediatric TBI: Parental Stress Stems From Ongoing Uncertainty, The Burden of Parenting in a New Way and The Burden of Time, Energy and Money. Compared to families of typically developing children, families of children with TBI are more likely to experience stress and burden of care, particularly the families of those with a severe TBI. There are several factors relating to TBI that tend to increase parental stress and burden of care, including unmet parental emotional needs, difficulty adjusting to new parenting approaches, and the significant changes to the parenting role, often without any support, service provision or social understanding. Bearing these findings in mind, future research is recommended to explore effective support interventions for parents of children with TBI, which centre around the provision of peer support, compassionate psychoeducation around children’s needs, and counselling for parents who are struggling with coping.

Competence 3b: Research project:
Dyspraxia/DCD (Developmental Coordination Disorder) effects 5-15% of children (Farmer, Echenne, Drouin & Bentourkia, 2017); however, there has been a dearth of research carried out in terms of volume and scope with a view to investigating the impact of living with this condition, particularly in relation to physical activity (PA). There is evidence to suggest that children with DCD are less healthy than their typically developing contemporaries and this may be due to factors such as decreased participation, enjoyment and interest in PA. However, the focus of research has used quantitative approaches, which fails to investigate the lived experiences of children with DCD. Understanding their world through the perspective of their parents is useful as they observe the struggles and challenges of their children on a day-to-day basis.
This qualitative study used a Thematic Analysis approach to analyse ten (n=10) interview transcripts with parents of children with DCD in order to explore the various ways this condition impacts children’s PA. A biopsychosocial approach was used to investigate children’s overall health through the interconnectedness of their physical, mental and social experiences. Transcripts were independently analysed by a primary and secondary researcher using NVivo10 software, and agreed upon sub-themes were selected. A thematic analysis of the data identified three overarching themes: 1) Issues Related to Physicality, 2) Psychological Impact and 3) Social Factors. The first theme that emerged from the data showed that there was a strong connection between children’s physicality and their experiences of PA. Parents reported that this connection was bi-directional in that having DCD impacts upon children’s ability to engage in PA and that, because they move less and are less coordinated, they are less healthy. In terms of their physical wellness, children with DCD are more likely to be overweight/obese, experience body pain and fatigue, fall a lot, have no interest in ball-games and have poor coordination, but that they are more likely to engage in and enjoy swimming and water-play. The second prominent theme encapsulates the common tendency of children with DCD to experience a range of negative emotions connected to PA. Because DCD does not impact one’s intellect, these children can be just as competent, self-aware and academic as their peers. However, at the same time, DCD is a hidden physical disability in the sense that it is not always obvious to the lay-person that these children have any limitations. Therefore, they experience much misunderstanding and a general lack of support in terms of the quality of PA opportunities available for this cohort. This is important because children with DCD tend to experience more frequent and intense frustration, sadness, low confidence and anxiety. The third theme showed how, socially, children with DCD tend to be directly and significantly impacted by their PA coach’s approach and experience limited friendships due to poorer interpersonal skills. These themes are inextricably linked to one another as psychological, social and physical components of DCD are constantly influencing and being influenced by one another. These findings support the work of researchers, practitioners and policy-makers in optimising diagnostic criteria, informing assessment protocols and helping to guide and develop appropriate interventions for those living with DCD in line with their specific needs. Future research should focus on the development of DCD-specific PA interventions which have been informed by both qualitative and quantitative research literature and, in particular, studies representing the voice of those directly affected.

Competence 4: Consultancy:
For my consultancy competence, I was recruited as an external consultant by --. This case study explores my experience during this process, as well as a reflection on how I completed it. It will explain the journey from meeting my client’s needs, through the establishment, development and maintenance of our working relationships, to final completion and evaluation of the project.

Competence 5: Teaching and training:
The following case study chronicles the planning, composition and delivery of a Bachelor of Arts Health Psychology lecture entitled “Stress Management” for the Faculty of Education and Health Sciences at the University of Limerick. As part of a 20-credit module in Health Psychology, the learning outcomes for this lecture are clearly and concisely summarised in the lecture plan (see Appendix 1, p. 17).

Documents