The Faculty offers an extensive portfolio of undergraduate and postgraduate programmes, taught predominantly at the Chester Campus, but with provision in Public Relations and Policing taught at Warrington. A key feature of work in all four specialist subject areas below is the inter-relationship between social science and issues of everyday concern that have relevance for policy making.

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  • Working with risk within the counselling professions

    Reeves, Andrew; University of Chester (British Association for Counselling and Psychotherapy, 2021-09-20)
    This practitioner factsheet looks at the factors that counsellors and psychotherapists need to keep in mind when working with clients who present at risk. Good practice indicators are outlined, as well as evidence-informed interventions.
  • Permission to be kind to myself’. The experiences of informal carers of those with a life-limiting or terminal illness of a brief self-compassion-based self-care intervention

    Diggory, Kate; Reeves, Andrew; University of Chester (Taylor & Francis, 2021-09-19)
    Background: Informal carers of someone with a life-limiting or terminal illness often experience marked levels of depression, anxiety and stress. Carers have limited free time to devote to lengthy, well-being interventions. Carers also struggle to prioitorize their self-care, a factor which may help buffer some of the negative impacts of being a carer. The aim of this study was to gain insight into carers’ views and perceptions of a brief, four session face to face self-compassion intervention for carers (iCare) which was created to improve well- being, increase self-compassion and develop self-care among carers. In so doing, this qualitative research addresses gaps in the literature relating to self-compassion interventions for carers and targeted self-care initiatives for carers. Method: Semi-structured interviews with nine participants of iCare were conducted and data subjected to a reflexive thematic analysis within a critical realist framework. Findings: A number of themes and sub-themes were identified. Carers discovered a kinder, less judgemental way of seeing themselves allowing themselves to recognize that they had their own individual needs. In turn this led to an intentional practise of self-care activities. Benefits from conscious self-care and self-kindness included experiencing a greater sense of calm or relaxation and the development of a more positive outlook. Conclusion: The findings highlight that a brief self-compassion intervention can have a positive impact on carers reported well-being through developing a kindlier internal orientation and locating a permission to allow themselves to practise an intentional self-care.
  • An interview with Judith Weir

    Egeli, Cemil; University of Chester (Egalitarian Publishing, 2021-09-01)
    Cemil Egeli previously worked as a researcher on the flagship arts TV programme 'The South Bank Show' (then broadcast on ITV), where in 2001 Judith Weir received the prestigious music award for her choral and orchestral work, We Are Shadows. Some 20 years later, Judith Weir has very kindly agreed to him posing some interview questions.
  • Editorial: Towards a psychomusicology

    Egeli, Cemil; University of Chester (Egalitarian Publishing, 2021-09-01)
    Editorial for the 'psychomusicology' special issue
  • Unmasking the phantom

    Lewis, Megan; University of Chester (Egalitarian Publishing, 2021-09-01)
    This article explores an experience of bereavement in adolescence and the use of musical theatre in the grieving process.
  • The views of the few or the voices of many: Methods of exploring leadership roles through alternative approaches within Higher Education.

    Lafferty, Moira E.; University of Chester
    In the following chapter I begin by discussing the changing landscape in higher education and argue why “leadership” is an important part of every academic’s journey. I discuss why we need to challenge traditional views of leadership and critically how we need to explore individuals’ views and reflections on their own leadership journeys. Furthermore, I will critically reflect on how we need to adopt different research methods to allow leadership journeys to emerge with a focus on the use of Q-methodology and why such approaches allow not only the emergence of understanding but can serve a dual purpose and contribute not only to a global understanding but also an individual’s personal development.
  • A Game Changer? The Use of Positive Action to Address Racial Disadvantage within Professional Football Coaching

    Healey, Ruth; Cowell, Sophie L. (University of Chester, 2021-09)
    This research considers the use of positive action to address the underrepresentation of Black, Asian and Minority Ethnic (BAME) managers and coaches within English professional football. It focuses on the English Football League’s (EFL) Recruitment Code as an example of such a measure and explores whether the Recruitment Code can be considered an effective or flawed form of positive action to redress the racial inequalities faced by BAME managers and coaches. Twenty-five percent of professional footballers within the English professional leagues are BAME, significantly higher than the general BAME population within the United Kingdom of 14% (Sports People’s Think Tank ‘SPTT’, 2015). Despite this, the number of BAME managers and coaches employed within senior positions in professional football remains disproportionately low at 4.6% (SPTT, 2017). At the beginning of the 2016/17 season, the EFL introduced a positive action measure requiring clubs to interview at least one candidate from a BAME background for coaching and management positions (EFL, 2017). Whilst there exists a body of research into the experiences of BAME managers and coaches and barriers to their career progression, the issue is still largely unexplored from an anti-discrimination law perspective (Veuthey, 2013). Further, research on the EFL’s Recruitment Code is limited. This research aims to fill this gap, by utilising a mixed-methods approach to explore stakeholder perceptions of positive action and the EFL’s Recruitment Code as a form of positive action. It considers the extent to which the Recruitment Code may fit within the legal framework and whether it may demonstrate the legislative approach of reflexive regulation working effectively. This research identified several barriers to BAME manager and coach career progression, including higher standards, extra pressure, lack of role models, the recruitment practices used, and the specificity of football. It found that whilst most participants within this research supported the use of positive action, they perceived significant confusion between positive action and positive discrimination amongst the general public. On the EFL’s Recruitment Code, participants pointed to a lack of transparency and a general lack of understanding, believing the Code would not succeed in isolation and should form part of a package of measures. When considered in light of reflexive regulation, participants also pointed to factors including a perceived lack of consultation, monitoring and enforcement that suggest that features of successful reflexive regulation, as outlined by Hepple (2011), are missing. However, some participants commended the EFL for implementing the measure in light of this perceived lack of understanding of, and support for, positive action. This thesis provides Pointers for Action at Micro (Club), Meso (Sector) and Macro (National Policy) Levels, including the need for greater education and awareness, transparent monitoring and senior buy-in, as well as a need to rephrase the concept of positive action. The thesis outlines how the EFL’s Recruitment Code has the potential to be successful if introduced as part of a holistic life cycle approach to addressing underrepresentation, but in its current format can be considered a flawed form of positive action that is unlikely to redress the racial disadvantage that BAME managers and coaches face. It concludes by detailing the impact that a successful positive action measure within such a high-profile arena could have on both football and the use of positive action generally, if the EFL’s Recruitment Code is adapted in line with the suggested implications and pointers for action.
  • Gut thinking and eye tracking: Evidence for a central preference heuristic

    Thoma, Volker; Rodway, Paul; Tamlyn, Guy; University of East London; University of Chester (Taylor and Francis, 2021-09-01)
    People prefer the central item in an array of items. This could be due to applying a decision heuristic or greater visual attention to the central item. We manipulated task instructions as participants chose one from three consumer items. The instructions were to “think carefully” in one block and to “use gut feeling” in another. A centrality preference appeared only in the “gut” condition, which was also negatively correlated with self-reported reflective thinking disposition (Need-for-Cognition). Eye-movement patterns, however, were equivalent across both instruction conditions with more frequent and longer fixations on the middle items. The findings demonstrate an effect of instructions on the centrality preference for non-identical consumer items, and provide evidence for a heuristic cause of the centrality preference rather than the allocation of visual attention. The results also show that the centrality preference is more likely to be present when people choose quickly and intuitively.
  • A Systematic Review Exploring the Reflective Accounts of Applied Sport Psychology Practitioners

    Wadsworth, Nick; McEwan, Hayley; Lafferty, Moira; Tod, David; Eubank, Martin; University of Bolton; University of the West of Scotland; University of Chester; Liverpool John Moores
    This systematic review explores the reflective accounts of applied sport psychology practitioners. The aim of this review was to synthesize the reflective accounts of applied sport psychology practitioners and highlight common themes that provide focus to their reflective practice. The insight into current progress on reflective content in applied sport psychology provides a foundation to build on as we continue to understand this topic. Following a systematic search of the literature, a total of 73 studies were included within the review, which were analyzed using thematic content analysis. Analysis of the reflective accounts resulted in the creation of nine higher-order themes: Process and Purpose of Reflective Practice; Ethical Practice; Supporting Person and Performer; Practitioner Individuation; Relationships with Clients; Cultural Awareness; Competence-Related Angst; Support of Practitioner Development; and Evaluating Practitioner Effectiveness. The review includes recommendations for future research, such as the use of narrative analysis to provide further insight into applied practitioners’ experiences. We also provide practical implications, which are tailored to match the specific demands of practitioners at different stages of development and include increased engagement in critical reflection for trainee practitioners and engaging with ‘critical friends’ to facilitate the process of meta-reflection for newly qualified practitioners.
  • Between-task consistency, temporal stability and the role of posture in simple reach and fishing hand preference in chimpanzees (Pan troglodytes)

    Diaz, Sergio; Murray, Lindsay; Roberts, Sam; Rodway, Paul; Universidad Autónoma de Madrid; University of Chester: Liverpool John Moores University (Elsevier, 2021-07-31)
    Studying hand preferences in chimpanzees can provide insights into the evolutionary origins of human hemispheric specialization. Research on chimpanzee hand preference requires careful examination of important factors such as posture, between-task consistency and temporal stability, although few studies have investigated all of these factors in combination. We investigated hand preference in simple reach and fishing behaviours in a group of 19 chimpanzees at Chester Zoo in the UK. Simple reach was defined as extending a hand to grasp a small object, then flexing the limb in a continuous motion, and was examined in quadrupedal, sitting and climbing postures. Fish in hole was defined as inserting a stick into a hole in the wall with one hand and then extracting it with the same hand. Between-task consistency of hand preference was assessed by comparing simple reach and fish in hole, while temporal stability was assessed by comparing simple reach from two points in time: 2017 and 2019. The data showed no significant influence of posture on the strength of hand preference, which contrasts with previous research. The findings of this study show temporal stability in simple reach, although only partial between-task consistency. Overall, the results indicate that simple reach elicits laterality at the individual level and is consistent across postures and stable over time, which is consistent with the literature. These results suggest that posture stability may be important in affecting hand preference. Further, whilst there was overall stability in hand preference across time periods, some individuals changed their preferred hand, suggesting there may be individual level temporal instability of hand preference for certain tasks.
  • Valence of agents and recipients moderates the side-effect effect: Two within-subjects, multi-item conceptual replications

    Stewart, Suzanne L. K.; Kennedy, Bradley J.; Haigh, Matthew.; University of Chester; Northumbria University (Taylor & Francis, 2021-08-27)
    The side-effect effect (SEE) demonstrates that the valence of an unintended side effect influences intentionality judgements; people assess harmful (helpful) side effects as (un)intentional. Some evidence suggests that the SEE can be moderated by factors relating to the side effect’s causal agent and to its recipient. However, these findings are often derived from between-subjects studies with a single or few items, limiting generalisability. Our two within-subjects experiments utilised multiple items and successfully conceptually replicated these patterns of findings. Cumulative link mixed models showed the valence of both the agent and the recipient moderated intentionality and accountability ratings. This supports the view that people represent and consider multiple factors of a SEE scenario when judging intentionality. Importantly, it also demonstrates the applicability of multi-vignette, within-subjects approaches for generalising the effect to the wider population, within individuals, and to a multitude of potential scenarios. For open materials, data, and code, see https://www.doi.org/10.17605/OSF.IO/5MGKN.
  • Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective

    Soosaipillai, G; Wu, A; Dettorre, GM; Diamantis, J; Chester, J; Moss, C; Aguilar-Company, J; Bower, M; Sng, CCT; Salazar, R; et al. (Sage, 2021-09-02)
    Background: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. Methods: From the OnCovid repository (n=1,318), we analysed cancer patients aged ≥18 diagnosed with COVID-19 between 26th February and 22nd June 2020 who had complete specialist palliative care team (SPCT) data (SPCT+ referred; SPCT- not referred). Results: Of 555 eligible patients, 317 were male (57.1%), with a median age of 70 (IQR 20). At COVID-19 diagnosis, 44.7% were on anti-cancer therapy and 53.3% had >1 co-morbidity. 206 patients received SPCT input for symptom control (80.1%), psychological support (54.4%), and/or advance care planning (51%). SPCT+ patients had more DNACPR orders completed prior to (12.6% vs. 3.7%) and during admission (50% vs 22.1%, P<0.001), with more SPCT+ patients deemed suitable for treatment escalation (50% vs. 22.1%, P<0.001). SPCT involvement was associated with higher discharge rates from hospital for end-of-life care (9.7% vs. 0%, P<0.001). End-of-life anticipatory prescribing was higher in SPCT+ patients, with opioids (96.3% vs. 47.1%) and benzodiazepines (82.9% vs. 41.2%) being used frequently for symptom control. Conclusions: SPCT referral facilitated symptom control, emergency care and discharge planning, as well as high rates of referral for psychological support than previously reported. Our study highlighted the critical need of SPCT for patients with cancer during the pandemic and should inform service planning for this population.
  • Addressing Gaps in Cognitive Dissonance Theory and Relational Frame Theory – Research on Coherence and Ambiguity

    Hulbert-Williams, Lee; Hulbert-Williams, Nick; Lafferty, Moira; Ashcroft, Samuel P. (University of Chester, 2021-03)
    The aim of this thesis was to build a body of evidence to address several gaps in Cognitive Dissonance Theory (Harmon-Jones, E. & Harmon-Jones, C., 2007) and Relational Frame Theory (Hayes et al., 2001), relating to relational coherence, incoherence, and particularly ambiguity. These gaps included a lack of: theory and research on ambiguity; robust definitions of coherence, incoherence and ambiguity; research on the relative appetitiveness of coherence versus incoherence and ambiguity; multiple-stimulus research in Cognitive Dissonance Theory; technical experimentation in Cognitive Dissonance Theory; and clarity about the stimulus-specific lower boundary conditions of coherence-related phenomena. An overview of theory and research pertaining to coherence, incoherence and ambiguity was given (Chapter 1), including discussion regarding the gaps highlighted. Then, working definitions of coherence, incoherence and ambiguity were offered (Chapter 2). The ambiguity-coherence study by Quinones and Hayes (2014) was conceptually replicated and expanded (Chapter 3), discovering that participants spontaneously generate A-C relationships on ambiguous A-C blocks involving nonsense stimuli. A design issue regarding patterns of reinforcement was identified in Chapter 3, and this was discussed and resolved (Chapter 4), alongside an assessment of the appetitive properties of coherence. Participants displayed no preference towards completing a coherent versus an ambiguous A-C block again. Physiological measures of Heart Rate and Galvanic Skin Response were measured in response to coherence and ambiguity (Chapter 5), further evidencing spontaneous generation of relationships in response to ambiguity. No difference in physiological measures was found between coherent and ambiguous A-C blocks. Incoherence was incorporated into the design (Chapter 6), which provided corroborative evidence of the spontaneous generation effect and also demonstrated the validity of the experimental design by matching predictions from Relational Frame Theory. An updated assessment of the appetitive properties of coherence was completed (Chapter 7), with real words as stimuli and discriminatives. Spontaneous generation of relationships in response to ambiguity also occurred using these alternative stimuli. Differences were broadly not found between coherent and ambiguous A-C block types, indicating that there appears to be a stimulus-specific lower boundary condition for various coherence phenomena such as changes in affect and arousal. However, the spontaneous generation of A-C relationships indicates no stimulus-specific lower boundary condition for coherence-related behavioural responses. Finally, the effect of experimental design on spontaneous generation of relationships was assessed (Chapter 8), identifying that spontaneous generation of relationships is moderated by the complexity of the cognitive task at hand. Findings from this thesis were synthesised with literature on coherence, particularly that of Cognitive Dissonance Theory and Relational Frame Theory (Chapter 9), with limitations, implications and future research directions given. This thesis: evidences the importance of ambiguity in any theory relating to coherence; identifies a possible stimulus-specific lower boundary condition for affective but not behavioural coherence-related responses; shows that the spontaneous generation of relationships effect could potentially be considered a fundamental aspect of human relational behaviour; and demonstrates that such spontaneous generation effects appear moderated by the complexity of the cognitive task at hand.
  • Community Renewable Energy Projects. The future of the sustainable energy transition?

    Fernandez, Rosa M.; University of Chester
    The Energy Union and the European Green Deal advocate the participation of citizens and communities in the energy transition, which encourage a bottom-up approach in the implementation of sustainable energy initiatives. Both are in tune with the UN Sustainable Development Goals, which attempt to involve all members of society in the sustainability path. The reality in EU Member States however, is that community energy still lacks the necessary regulatory framework to compete with large utility companies. This can indicate that the governance framework is lagging behind, still not ready to include communities (collective citizens) as full participants in the energy transition.
  • An investigation into the development of ACT-based approaches to increase physical activity

    Lafferty, Moira; Whalley, Anthony P. (University of Chester, 2021-01)
    It is well documented that regular physical exercise supports physical and mental wellbeing. Despite the promotion of physical activity by world health experts and governments, physical inactivity within the population remains a cause for concern and disorders associated with sedentary lifestyles have continued to increase. Evidence suggests that the uncomfortable private-events people experience during physical exertion can become psychological barriers to participation in physical activity and thus result in avoidant behaviours. Acceptance and commitment therapy (ACT) has been used to promote increased physical exercise by enhancing psychological flexibility in relation to private-events that are perceived as unpleasant. However, relationships between the individual ACT processes and the theories which underpin their use in interventions designed to promote physical activity have yet to be fully explored. Understanding the relationship between ACT processes and physical exercise is key for appropriate and robust intervention development. This thesis aimed to explore the theoretical and practical application of ACT processes in relation to exercise and inform further development of effective brief interventions designed to increase activity levels. The programme of work within this thesis had two phases. The first phase included two studies: a systematic review to explore the existing evidence; and a quantitative survey study to determine if associations exist between physical activity levels and the individual core processes of ACT. Results from phase one found that the reviewed literature failed to explore the use of Relational Frame Theory (RFT) critical to ACT, and a survey suggested that ACT processes of defusion, self-as-context and personal values were likely to play a significant part in activity levels. The second phase comprised of three interrelated quantitative intervention studies designed using RFT. Each explored the ACT processes by measuring task duration and the intensity of private-events experienced during exercise. The first intervention study combined defusion and self-as-context with no significant effects on an exercise task. The second combined defusion, self-as-context and value orientated cues to behaviour change. Exercise duration was significantly increased in the ACT intervention, while there was no decrease in the intensity of private-events. The final study tested a values clarification task with cues to behaviour change and reported significantly increased exercise duration. The thesis demonstrates that relational frame theory applied to ACT processes can influence the duration of exercise although the relationship with private-events remains uncertain. The robust, theory focused approach to this work represents a small but valuable contribution to the development of intervention strategies and has implications for future research. Strategies worked best using a combination of both deictic and hierarchical relations for training cognitive defuison and self-as-context, and especially for the clarification of personal values used as cues to behaviour change. Further research is needed to establish both the external validity and longevity of observed effects.
  • Europe's Transition to Sustainability: Actors, Approaches and Policies

    Fernandez, Rosa Maria; Schoenefeld, Jonas.; Hoerber, Thomas; Oberthuer, Sebastian; University of Chester; University of East Anglia; ESSCA School of Management; Vrije Universiteit Brussels; University of Eastern Finland (Routledge, 2021-09-06)
    The European Union has developed an international reputation as an advocate of sustainability and as a leader in environmental policy and in tackling climate change. The European Green Deal is the latest amongst numerous policy initiatives indicating an aspiration to lead. The contributions to this special issue show, however, that the path to sustainability in the EU (and beyond) is far from clear cut, with uneven progress in a number of policy areas. Some Member States are lagging behind, and there are barriers both within and outside the EU. Moving forward, a successful transition still requires substantial policy effort.
  • The Finding My Way UK Clinical Trial: Adaptation report and protocol for a replication randomised controlled efficacy trial of a web-based psychological programme to support cancer survivors

    Hulbert-Williams, Nicholas J; Leslie, Monica; Hulbert-Williams, Lee; Koczwara, Bogda; Watson, Eila K; Hall, Peter S; Ashley, Laura; Coulson, Neil S; Jackson, Richard; Millington, Sue; et al. (JMIR, 2021-07-12)
    Background: Cancer survivors frequently report a range of unmet psychological and supportive care needs; these often continue after treatment has finished, and are predictive of psychological distress and poor health-related quality of life. Online interventions demonstrate good efficacy in addressing these concerns and are more accessible than face to face interventions. Finding My Way is an online, psycho-educational and cognitive behaviour therapy intervention for cancer survivors developed in Australia. Previous trials have demonstrated Finding My Way to be acceptable, highly adhered to, and effective in reducing the impact of distress on quality of life, whilst leading to cost-savings through health-resource use reduction. Objectives: Our study will adapt the Australian Finding My Way website for a UK cancer care context, and then undertake a single-blinded, randomised controlled trial (RCT) of Finding My Way UK against a treatment-as-usual waitlist control. Methods: As much as possible, our trial design replicates the existing Australian RCT of Finding My Way. Following a comprehensive adaptation of the web-resource, we will recruit 294 participants (147 per study arm) from across clinical sites in North West England and North Wales. Participants will: (i) have been diagnosed with cancer of any type in the last six months, (ii) have received anti-cancer treatment with curative intent, (iii) be over 16 years of age, (iv) be proficient in English and (v) have access to the internet and an active email address. Participants will be identified and recruited through the NIHR Clinical Research Network. Measures of distress, quality of life, and health economic outcomes will be collected using a self-report online questionnaire at baseline, mid-treatment, post-treatment and both three- and six-month follow-up. Quantitative data will be analysed using intention-to-treat Mixed-Model Repeated Measures analysis. Embedded semi-structured qualitative interviews will probe engagement with, and experiences of using, Finding My Way UK and suggestions for future improvements. Results: Website adaptation work was completed in January 2021. A panel of cancer survivors and healthcare professionals provided feedback on the test version of Finding My Way UK. Feedback was positive overall, though minor updates were made to website navigation, inclusivity, terminology and the wording of the Improving Communication and Sexuality and Intimacy content. Recruitment for the clinical trial commenced in April 2021. We aim to report on findings from mid 2023. Conclusions: Replication studies are an important aspect of the scientific process, particularly in psychological and clinical trial literatures, and especially in different geographical settings. Prior to replicating the Finding My Way trial in the UK setting, some content updating was required. If Finding My Way UK now replicates Australian findings, we will have identified a novel and cost-effective method of psychosocial care delivery for UK cancer survivors.
  • Ambivalent storage, multi-scalar generosity, and challenges of/for everyday consumption

    Collins, Rebecca; Stanes, Elyse; University of Chester; University of Wollongong (Routledge, 2021-09-05)
    Storage plays an important role in domestic practices as a banal yet essential means of practically accomplishing ‘living together’ and caring for people and material ‘stuff’. However, storage and stored things also occupy a provocative and paradoxical place in debates around the sustainability of household consumption. Driven by renewed popular and scholarly attention to ‘decluttering’ and eschewing anything that does not ‘spark joy’, this paper considers the emotional and practical implications of generosity – as both concept and practice – in articulating the sustainability potential in storage and stored things. In so doing we problematise assumptions about ‘clutter’ as unsustainable. Drawing on vignettes from two projects concerned with material consumption in young adulthood, and drawing on – but going beyond – extant framings of geographies of care, we illustrate how shifting spatial and temporal liminalities of storage mediate opportunities to engage in and with different scales of generosity. We argue that spatialities of storage are often less about deferring acts of divestment than they are a space in which to situate materialisations of significant emotional, care-ful(l) connections. We reflect on the implications of storage for sustainable consumption in the home and suggest how future work drawing on geographies of generosity might usefully enrich our understanding.
  • The Neural Correlates of a Central Coherence Task in Young Women with Anorexia Nervosa

    Leslie, Monica; Halls, Daniel; Leppanen, Jenni; Sedgewick, Felicity; Lang, Katie; Fonville, Leon; Simic, Mima; Mandy, William; Nicholls, Dasha; Williams, Steven; et al. (Wiley, 2021-07-18)
    Objective: Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples. Methods: We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan. Results: There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task. Conclusions: These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN.
  • Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): Results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer.

    Hulbert-Williams, NJ; Norwood, S; Gillanders, D; Finucane, AM; Spiller, J; Strachen, J; Millington, S; Kreft, J; Swash, B; University of Chester; The University of Edinburgh; Marie Curie Hospice Edinburgh (BMC, 2021-06-25)
    Objectives: Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress. Methods: Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%. Results: At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials. Conclusions: This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting.

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