Social inclusion for young people with and without psychosis: the importance of internal and external factors

Berry, Clio (2014) Social inclusion for young people with and without psychosis: the importance of internal and external factors. Doctoral thesis (PhD), University of Sussex.

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Psychosis most commonly first occurs during adolescence or early adulthood,
disrupting the social and occupational transitions characterising this time. Studies on
social and occupational outcomes in psychosis have tended to focus on observer-rated,
dysfunction-based outcomes. However, mental health services are increasingly
adopting a personal recovery model; focusing on facilitating hopeful and individually
meaningful lives. Social inclusion is paramount to personal recovery but there is a need
for greater awareness of the processes by which mental health services facilitate social
inclusion for young people with psychosis. Cognitive models and research with longterm
psychosis service users suggests that negative self-beliefs contribute to poorer
social outcomes in psychosis, whereas personal recovery models emphasise the role
of hopefulness and therapeutic relationships with optimistic mental health professionals.
This thesis first investigates a structural model of social inclusion and its association
with hope and negative self-beliefs for healthy young people (n= 387). Then the
processes by which young service users’ self-beliefs, therapeutic relationships and
professionals’ beliefs influence social inclusion are explored using directed path models
(n= 51). Directed path models then test how professional characteristics, focusing on
attachment styles and job attitudes, facilitate therapeutic relationships (n= 61). Finally,
the contributions of self-beliefs, therapeutic relationships, professional beliefs and
social inclusion in predicting vocational outcomes are explored (n= 51).

Current findings support the relative importance of hopefulness over negative selfbeliefs
in social inclusion for young people with and without psychosis. Hope appears
particularly important for adolescents compared to young adults. Positive relationships
with optimistic professionals predict service users’ hopefulness, social inclusion and
vocational activity. Findings suggest that professionals’ own attachment style and job
attitudes may aid in positive therapeutic relationship formation. These findings
encourage a greater focus on therapeutic relationships and service users’ hopefulness
in youth psychosis service provision. Professional training should encourage greater
awareness of professionals’ own attachment style and job attitudes, and how these
factors impact on positive therapeutic relationship development

Item Type: Thesis (Doctoral)
Schools and Departments: School of Psychology > Psychology
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology > HV0040 Social service. Social work. Charity organization and practice Including social case work, private and public relief, institutional care, rural social work, work relief
R Medicine > RC Internal medicine > RC0321 Neurosciences. Biological psychiatry. Neuropsychiatry > RC0438 Psychiatry, including Psychopathology > RC0513 Psychoses
Depositing User: Library Cataloguing
Date Deposited: 18 Jun 2014 14:29
Last Modified: 21 Sep 2015 14:49

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